Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TUBE TRACH SHILEY #6 6DFEN

Facility

$292.85

Hospital Charge Code	270614140
Hospital Revenue Code	272
Min. Negotiated Rate	$7.06
Max. Negotiated Rate	$146.43
Rate for Payer: Aetna Commercial	$111.28
Rate for Payer: Aetna Medicare Advantage	$87.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.68
Rate for Payer: Cigna Commercial	$146.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.86
Rate for Payer: Oxford Commercial	$58.57
Rate for Payer: Qualcare PPO/HMO/WC	$43.93
Rate for Payer: UnitedHealthcare Commercial	$58.57
Rate for Payer: UnitedHealthcare Community & State	$7.06
Rate for Payer: Wellpoint Medicaid Managed Care	$7.76

TUBE TRACH SHILEY #6 6DFEN

Facility

$292.85

Hospital Charge Code	270614140
Hospital Revenue Code	272
Min. Negotiated Rate	$43.93
Max. Negotiated Rate	$43.93
Rate for Payer: Qualcare PPO/HMO/WC	$43.93

TUBE TRACH SHILEY FENS 4,6,8**

Facility

$279.00

Hospital Charge Code	8001471
Hospital Revenue Code	274
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$139.50
Rate for Payer: Aetna Commercial	$106.02
Rate for Payer: Aetna Medicare Advantage	$83.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.14
Rate for Payer: Cigna Commercial	$139.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.38
Rate for Payer: Qualcare PPO/HMO/WC	$41.85
Rate for Payer: UnitedHealthcare Community & State	$6.72
Rate for Payer: Wellpoint Medicaid Managed Care	$7.39

TUBE TRACH SHILEY FENS 4,6,8**

Facility

$279.00

Hospital Charge Code	8001471
Hospital Revenue Code	274
Min. Negotiated Rate	$41.85
Max. Negotiated Rate	$67.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.38
Rate for Payer: Qualcare PPO/HMO/WC	$41.85

TUBE TRACH SHILEY NONFNS 4-8**

Facility

$335.00

Hospital Charge Code	8002370
Hospital Revenue Code	274
Min. Negotiated Rate	$50.25
Max. Negotiated Rate	$81.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$73.70
Rate for Payer: Qualcare PPO/HMO/WC	$50.25

TUBE TRACH SHILEY NONFNS 4-8**

Facility

$335.00

Hospital Charge Code	8002370
Hospital Revenue Code	274
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$167.50
Rate for Payer: Aetna Commercial	$127.30
Rate for Payer: Aetna Medicare Advantage	$100.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.42
Rate for Payer: Cigna Commercial	$167.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$73.70
Rate for Payer: Qualcare PPO/HMO/WC	$50.25
Rate for Payer: UnitedHealthcare Community & State	$8.07
Rate for Payer: Wellpoint Medicaid Managed Care	$8.88

TUBE TRACH UNCUFFED SZ 6

Facility

$234.25

Hospital Charge Code	270649994
Hospital Revenue Code	270
Min. Negotiated Rate	$35.14
Max. Negotiated Rate	$35.14
Rate for Payer: Qualcare PPO/HMO/WC	$35.14

TUBE TRACH UNCUFFED SZ 6

Facility

$234.25

Hospital Charge Code	270649994
Hospital Revenue Code	270
Min. Negotiated Rate	$5.65
Max. Negotiated Rate	$117.12
Rate for Payer: Aetna Commercial	$89.02
Rate for Payer: Aetna Medicare Advantage	$70.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.73
Rate for Payer: Cigna Commercial	$117.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.28
Rate for Payer: Oxford Commercial	$46.85
Rate for Payer: Qualcare PPO/HMO/WC	$35.14
Rate for Payer: UnitedHealthcare Commercial	$46.85
Rate for Payer: UnitedHealthcare Community & State	$5.65
Rate for Payer: Wellpoint Medicaid Managed Care	$6.21

TUBE TRACH UNCUFFED SZ 8

Facility

$218.90

Hospital Charge Code	270649995
Hospital Revenue Code	270
Min. Negotiated Rate	$5.28
Max. Negotiated Rate	$109.45
Rate for Payer: Aetna Commercial	$83.18
Rate for Payer: Aetna Medicare Advantage	$65.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.82
Rate for Payer: Cigna Commercial	$109.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.67
Rate for Payer: Oxford Commercial	$43.78
Rate for Payer: Qualcare PPO/HMO/WC	$32.84
Rate for Payer: UnitedHealthcare Commercial	$43.78
Rate for Payer: UnitedHealthcare Community & State	$5.28
Rate for Payer: Wellpoint Medicaid Managed Care	$5.80

TUBE TRACH UNCUFFED SZ 8

Facility

$218.90

Hospital Charge Code	270649995
Hospital Revenue Code	270
Min. Negotiated Rate	$32.84
Max. Negotiated Rate	$32.84
Rate for Payer: Qualcare PPO/HMO/WC	$32.84

TUBE TRACH W/CUFF SZ 6DCT

Facility

$232.05

Hospital Charge Code	270643781
Hospital Revenue Code	272
Min. Negotiated Rate	$34.81
Max. Negotiated Rate	$34.81
Rate for Payer: Qualcare PPO/HMO/WC	$34.81

TUBE TRACH W/CUFF SZ 6DCT

Facility

$232.05

Hospital Charge Code	270643781
Hospital Revenue Code	272
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$116.03
Rate for Payer: Aetna Commercial	$88.18
Rate for Payer: Aetna Medicare Advantage	$69.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.17
Rate for Payer: Cigna Commercial	$116.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.61
Rate for Payer: Oxford Commercial	$46.41
Rate for Payer: Qualcare PPO/HMO/WC	$34.81
Rate for Payer: UnitedHealthcare Commercial	$46.41
Rate for Payer: UnitedHealthcare Community & State	$5.59
Rate for Payer: Wellpoint Medicaid Managed Care	$6.15

TUBE TRACH W/CUFF SZ 8DCT

Facility

$232.05

Hospital Charge Code	270605857
Hospital Revenue Code	272
Min. Negotiated Rate	$34.81
Max. Negotiated Rate	$34.81
Rate for Payer: Qualcare PPO/HMO/WC	$34.81

TUBE TRACH W/CUFF SZ 8DCT

Facility

$232.05

Hospital Charge Code	270605857
Hospital Revenue Code	272
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$116.03
Rate for Payer: Aetna Commercial	$88.18
Rate for Payer: Aetna Medicare Advantage	$69.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.17
Rate for Payer: Cigna Commercial	$116.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.61
Rate for Payer: Oxford Commercial	$46.41
Rate for Payer: Qualcare PPO/HMO/WC	$34.81
Rate for Payer: UnitedHealthcare Commercial	$46.41
Rate for Payer: UnitedHealthcare Community & State	$5.59
Rate for Payer: Wellpoint Medicaid Managed Care	$6.15

TUBE TRANSPRT W/SRW CAP 10ML

Facility

$60.00

Hospital Charge Code	270654237
Hospital Revenue Code	272
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

TUBE TRANSPRT W/SRW CAP 10ML

Facility

$60.00

Hospital Charge Code	270654237
Hospital Revenue Code	272
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.00
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$12.00
Rate for Payer: UnitedHealthcare Community & State	$1.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

TUBE TREACHEAL MURPHY TIP 8.0

Facility

$97.18

Hospital Charge Code	270656320
Hospital Revenue Code	271
Min. Negotiated Rate	$14.58
Max. Negotiated Rate	$14.58
Rate for Payer: Qualcare PPO/HMO/WC	$14.58

TUBE TREACHEAL MURPHY TIP 8.0

Facility

$97.18

Hospital Charge Code	270656320
Hospital Revenue Code	271
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$48.59
Rate for Payer: Aetna Commercial	$36.93
Rate for Payer: Aetna Medicare Advantage	$29.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.78
Rate for Payer: Cigna Commercial	$48.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.15
Rate for Payer: Oxford Commercial	$19.44
Rate for Payer: Qualcare PPO/HMO/WC	$14.58
Rate for Payer: UnitedHealthcare Commercial	$19.44
Rate for Payer: UnitedHealthcare Community & State	$2.34
Rate for Payer: Wellpoint Medicaid Managed Care	$2.58

TUBE TYMPANOST GROMMET BL 1.14

Facility

$70.83

Service Code	HCPCS A4649
Hospital Charge Code	270699382
Hospital Revenue Code	272
Min. Negotiated Rate	$10.62
Max. Negotiated Rate	$10.62
Rate for Payer: Qualcare PPO/HMO/WC	$10.62

TUBE TYMPANOST GROMMET BL 1.14

Facility

$70.83

Service Code	HCPCS A4649
Hospital Charge Code	270699382
Hospital Revenue Code	272
Min. Negotiated Rate	$1.71
Max. Negotiated Rate	$35.41
Rate for Payer: Aetna Commercial	$26.92
Rate for Payer: Aetna Medicare Advantage	$21.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.06
Rate for Payer: Cigna Commercial	$35.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.25
Rate for Payer: Oxford Commercial	$14.17
Rate for Payer: Qualcare PPO/HMO/WC	$10.62
Rate for Payer: UnitedHealthcare Commercial	$14.17
Rate for Payer: UnitedHealthcare Community & State	$1.71
Rate for Payer: Wellpoint Medicaid Managed Care	$1.88

TUBE UNIVENT 7.0 ID CUFD H0056

Facility

$768.85

Hospital Charge Code	270633251
Hospital Revenue Code	272
Min. Negotiated Rate	$115.33
Max. Negotiated Rate	$115.33
Rate for Payer: Qualcare PPO/HMO/WC	$115.33

TUBE UNIVENT 7.0 ID CUFD H0056

Facility

$768.85

Hospital Charge Code	270633251
Hospital Revenue Code	272
Min. Negotiated Rate	$18.53
Max. Negotiated Rate	$384.43
Rate for Payer: Aetna Commercial	$292.16
Rate for Payer: Aetna Medicare Advantage	$230.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.06
Rate for Payer: Cigna Commercial	$384.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.66
Rate for Payer: Oxford Commercial	$153.77
Rate for Payer: Qualcare PPO/HMO/WC	$115.33
Rate for Payer: UnitedHealthcare Commercial	$153.77
Rate for Payer: UnitedHealthcare Community & State	$18.53
Rate for Payer: Wellpoint Medicaid Managed Care	$20.37

TUBE UNIVENT 8.0 ID CUFD H0054

Facility

$768.85

Hospital Charge Code	270633250
Hospital Revenue Code	272
Min. Negotiated Rate	$115.33
Max. Negotiated Rate	$115.33
Rate for Payer: Qualcare PPO/HMO/WC	$115.33

TUBE UNIVENT 8.0 ID CUFD H0054

Facility

$768.85

Hospital Charge Code	270633250
Hospital Revenue Code	272
Min. Negotiated Rate	$18.53
Max. Negotiated Rate	$384.43
Rate for Payer: Aetna Commercial	$292.16
Rate for Payer: Aetna Medicare Advantage	$230.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.06
Rate for Payer: Cigna Commercial	$384.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.66
Rate for Payer: Oxford Commercial	$153.77
Rate for Payer: Qualcare PPO/HMO/WC	$115.33
Rate for Payer: UnitedHealthcare Commercial	$153.77
Rate for Payer: UnitedHealthcare Community & State	$18.53
Rate for Payer: Wellpoint Medicaid Managed Care	$20.37

TUBE UNIVERSAL FEEDING ADAPT**

Facility

$22.00

Hospital Charge Code	2300713
Hospital Revenue Code	279
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$3.30
Rate for Payer: Qualcare PPO/HMO/WC	$3.30

Know your out-of-pocket cost for care.

All Charges