Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TUBE TRACH FENEST SZ 8

Facility

$308.15

Hospital Charge Code	270302420
Hospital Revenue Code	272
Min. Negotiated Rate	$7.43
Max. Negotiated Rate	$154.07
Rate for Payer: Aetna Commercial	$117.10
Rate for Payer: Aetna Medicare Advantage	$92.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.58
Rate for Payer: Cigna Commercial	$154.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.44
Rate for Payer: Oxford Commercial	$61.63
Rate for Payer: Qualcare PPO/HMO/WC	$46.22
Rate for Payer: UnitedHealthcare Commercial	$61.63
Rate for Payer: UnitedHealthcare Community & State	$7.43
Rate for Payer: Wellpoint Medicaid Managed Care	$8.17

TUBE TRACH FENEST SZ 8

Facility

$308.15

Hospital Charge Code	270302420
Hospital Revenue Code	272
Min. Negotiated Rate	$46.22
Max. Negotiated Rate	$46.22
Rate for Payer: Qualcare PPO/HMO/WC	$46.22

TUBE TRACH FOME CUFF 8MM

Facility

$831.00

Service Code	HCPCS A4622
Hospital Charge Code	270600632
Hospital Revenue Code	274
Min. Negotiated Rate	$124.65
Max. Negotiated Rate	$201.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$182.82
Rate for Payer: Qualcare PPO/HMO/WC	$124.65

TUBE TRACH FOME CUFF 8MM

Facility

$831.00

Service Code	HCPCS A4622
Hospital Charge Code	270600632
Hospital Revenue Code	274
Min. Negotiated Rate	$20.03
Max. Negotiated Rate	$415.50
Rate for Payer: Aetna Commercial	$315.78
Rate for Payer: Aetna Medicare Advantage	$249.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.91
Rate for Payer: Cigna Commercial	$415.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$182.82
Rate for Payer: Qualcare PPO/HMO/WC	$124.65
Rate for Payer: UnitedHealthcare Community & State	$20.03
Rate for Payer: Wellpoint Medicaid Managed Care	$22.02

TUBE TRACH INNER CANN 8 8DIC

Facility

$151.25

Hospital Charge Code	270302427
Hospital Revenue Code	272
Min. Negotiated Rate	$22.69
Max. Negotiated Rate	$22.69
Rate for Payer: Qualcare PPO/HMO/WC	$22.69

TUBE TRACH INNER CANN 8 8DIC

Facility

$151.25

Hospital Charge Code	270302427
Hospital Revenue Code	272
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$75.62
Rate for Payer: Aetna Commercial	$57.48
Rate for Payer: Aetna Medicare Advantage	$45.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.57
Rate for Payer: Cigna Commercial	$75.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.38
Rate for Payer: Oxford Commercial	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$22.69
Rate for Payer: UnitedHealthcare Commercial	$30.25
Rate for Payer: UnitedHealthcare Community & State	$3.65
Rate for Payer: Wellpoint Medicaid Managed Care	$4.01

TUBE TRACH INNER CANN 8 8DIC**

Facility

$189.00

Hospital Charge Code	270602427
Hospital Revenue Code	274
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$94.50
Rate for Payer: Aetna Commercial	$71.82
Rate for Payer: Aetna Medicare Advantage	$56.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.20
Rate for Payer: Cigna Commercial	$94.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$41.58
Rate for Payer: Qualcare PPO/HMO/WC	$28.35
Rate for Payer: UnitedHealthcare Community & State	$4.55
Rate for Payer: Wellpoint Medicaid Managed Care	$5.01

TUBE TRACH INNER CANN 8 8DIC**

Facility

$189.00

Hospital Charge Code	270602427
Hospital Revenue Code	274
Min. Negotiated Rate	$28.35
Max. Negotiated Rate	$45.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$41.58
Rate for Payer: Qualcare PPO/HMO/WC	$28.35

TUBE TRACH LOW PRESS SZ 6 6LPC

Facility

$573.65

Hospital Charge Code	270302385
Hospital Revenue Code	272
Min. Negotiated Rate	$86.05
Max. Negotiated Rate	$86.05
Rate for Payer: Qualcare PPO/HMO/WC	$86.05

TUBE TRACH LOW PRESS SZ 6 6LPC

Facility

$573.65

Hospital Charge Code	270302385
Hospital Revenue Code	272
Min. Negotiated Rate	$13.82
Max. Negotiated Rate	$286.82
Rate for Payer: Aetna Commercial	$217.99
Rate for Payer: Aetna Medicare Advantage	$172.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.28
Rate for Payer: Cigna Commercial	$286.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.09
Rate for Payer: Oxford Commercial	$114.73
Rate for Payer: Qualcare PPO/HMO/WC	$86.05
Rate for Payer: UnitedHealthcare Commercial	$114.73
Rate for Payer: UnitedHealthcare Community & State	$13.82
Rate for Payer: Wellpoint Medicaid Managed Care	$15.20

TUBE TRACH LOW PR SZ 8

Facility

$573.65

Hospital Charge Code	270302390
Hospital Revenue Code	270
Min. Negotiated Rate	$86.05
Max. Negotiated Rate	$86.05
Rate for Payer: Qualcare PPO/HMO/WC	$86.05

TUBE TRACH LOW PR SZ 8

Facility

$573.65

Hospital Charge Code	270302390
Hospital Revenue Code	270
Min. Negotiated Rate	$13.82
Max. Negotiated Rate	$286.82
Rate for Payer: Aetna Commercial	$217.99
Rate for Payer: Aetna Medicare Advantage	$172.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.28
Rate for Payer: Cigna Commercial	$286.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.09
Rate for Payer: Oxford Commercial	$114.73
Rate for Payer: Qualcare PPO/HMO/WC	$86.05
Rate for Payer: UnitedHealthcare Commercial	$114.73
Rate for Payer: UnitedHealthcare Community & State	$13.82
Rate for Payer: Wellpoint Medicaid Managed Care	$15.20

TUBE TRACH NAS 6.5 CUF 5-22313

Facility

$31.65

Hospital Charge Code	270614231
Hospital Revenue Code	272
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$15.82
Rate for Payer: Aetna Commercial	$12.03
Rate for Payer: Aetna Medicare Advantage	$9.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.07
Rate for Payer: Cigna Commercial	$15.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.49
Rate for Payer: Oxford Commercial	$6.33
Rate for Payer: Qualcare PPO/HMO/WC	$4.75
Rate for Payer: UnitedHealthcare Commercial	$6.33
Rate for Payer: UnitedHealthcare Community & State	$0.76
Rate for Payer: Wellpoint Medicaid Managed Care	$0.84

TUBE TRACH NAS 6.5 CUF 5-22313

Facility

$31.65

Hospital Charge Code	270614231
Hospital Revenue Code	272
Min. Negotiated Rate	$4.75
Max. Negotiated Rate	$4.75
Rate for Payer: Qualcare PPO/HMO/WC	$4.75

TUBE TRACH NAS CUF 6.0 5-12612

Facility

$134.20

Hospital Charge Code	270634798
Hospital Revenue Code	272
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$67.10
Rate for Payer: Aetna Commercial	$51.00
Rate for Payer: Aetna Medicare Advantage	$40.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.22
Rate for Payer: Cigna Commercial	$67.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.26
Rate for Payer: Oxford Commercial	$26.84
Rate for Payer: Qualcare PPO/HMO/WC	$20.13
Rate for Payer: UnitedHealthcare Commercial	$26.84
Rate for Payer: UnitedHealthcare Community & State	$3.23
Rate for Payer: Wellpoint Medicaid Managed Care	$3.56

TUBE TRACH NAS CUF 6.0 5-12612

Facility

$134.20

Hospital Charge Code	270634798
Hospital Revenue Code	272
Min. Negotiated Rate	$20.13
Max. Negotiated Rate	$20.13
Rate for Payer: Qualcare PPO/HMO/WC	$20.13

TUBE TRACH NAS CUF 6.5 5-12613

Facility

$134.20

Hospital Charge Code	270634799
Hospital Revenue Code	272
Min. Negotiated Rate	$20.13
Max. Negotiated Rate	$20.13
Rate for Payer: Qualcare PPO/HMO/WC	$20.13

TUBE TRACH NAS CUF 6.5 5-12613

Facility

$134.20

Hospital Charge Code	270634799
Hospital Revenue Code	272
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$67.10
Rate for Payer: Aetna Commercial	$51.00
Rate for Payer: Aetna Medicare Advantage	$40.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.22
Rate for Payer: Cigna Commercial	$67.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.26
Rate for Payer: Oxford Commercial	$26.84
Rate for Payer: Qualcare PPO/HMO/WC	$20.13
Rate for Payer: UnitedHealthcare Commercial	$26.84
Rate for Payer: UnitedHealthcare Community & State	$3.23
Rate for Payer: Wellpoint Medicaid Managed Care	$3.56

TUBE TRACH NAS CUF 7.0 5-12614

Facility

$134.20

Hospital Charge Code	270634800
Hospital Revenue Code	272
Min. Negotiated Rate	$20.13
Max. Negotiated Rate	$20.13
Rate for Payer: Qualcare PPO/HMO/WC	$20.13

TUBE TRACH NAS CUF 7.0 5-12614

Facility

$134.20

Hospital Charge Code	270634800
Hospital Revenue Code	272
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$67.10
Rate for Payer: Aetna Commercial	$51.00
Rate for Payer: Aetna Medicare Advantage	$40.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.22
Rate for Payer: Cigna Commercial	$67.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.26
Rate for Payer: Oxford Commercial	$26.84
Rate for Payer: Qualcare PPO/HMO/WC	$20.13
Rate for Payer: UnitedHealthcare Commercial	$26.84
Rate for Payer: UnitedHealthcare Community & State	$3.23
Rate for Payer: Wellpoint Medicaid Managed Care	$3.56

TUBE TRACH NASL CUF 7.5 512615

Facility

$169.25

Hospital Charge Code	270608894
Hospital Revenue Code	272
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$84.62
Rate for Payer: Aetna Commercial	$64.31
Rate for Payer: Aetna Medicare Advantage	$50.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.16
Rate for Payer: Cigna Commercial	$84.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.77
Rate for Payer: Oxford Commercial	$33.85
Rate for Payer: Qualcare PPO/HMO/WC	$25.39
Rate for Payer: UnitedHealthcare Commercial	$33.85
Rate for Payer: UnitedHealthcare Community & State	$4.08
Rate for Payer: Wellpoint Medicaid Managed Care	$4.49

TUBE TRACH NASL CUF 7.5 512615

Facility

$169.25

Hospital Charge Code	270608894
Hospital Revenue Code	272
Min. Negotiated Rate	$25.39
Max. Negotiated Rate	$25.39
Rate for Payer: Qualcare PPO/HMO/WC	$25.39

TUBE TRACH NSL CFF 6MM

Facility

$107.00

Service Code	HCPCS A4622
Hospital Charge Code	270608607
Hospital Revenue Code	274
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$53.50
Rate for Payer: Aetna Commercial	$40.66
Rate for Payer: Aetna Medicare Advantage	$32.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.29
Rate for Payer: Cigna Commercial	$53.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$23.54
Rate for Payer: Qualcare PPO/HMO/WC	$16.05
Rate for Payer: UnitedHealthcare Community & State	$2.58
Rate for Payer: Wellpoint Medicaid Managed Care	$2.84

TUBE TRACH NSL CFF 6MM

Facility

$107.00

Service Code	HCPCS A4622
Hospital Charge Code	270608607
Hospital Revenue Code	274
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$25.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$23.54
Rate for Payer: Qualcare PPO/HMO/WC	$16.05

TUBE TRACH ORAL CUFF 6.5

Facility

$63.25

Hospital Charge Code	270600895
Hospital Revenue Code	272
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$9.49
Rate for Payer: Qualcare PPO/HMO/WC	$9.49

Know your out-of-pocket cost for care.

All Charges