Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TUBE UNIVERSAL FEEDING ADAPT**

Facility

$22.00

Hospital Charge Code	2300713
Hospital Revenue Code	279
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$11.00
Rate for Payer: Aetna Commercial	$8.36
Rate for Payer: Aetna Medicare Advantage	$6.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.61
Rate for Payer: Cigna Commercial	$11.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.60
Rate for Payer: Oxford Commercial	$4.40
Rate for Payer: Qualcare PPO/HMO/WC	$3.30
Rate for Payer: UnitedHealthcare Commercial	$4.40
Rate for Payer: UnitedHealthcare Community & State	$0.53
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

TUBE VENT FLURO PLASTIC R TYPE

Facility

$2,160.00

Hospital Charge Code	270655888
Hospital Revenue Code	272
Min. Negotiated Rate	$324.00
Max. Negotiated Rate	$324.00
Rate for Payer: Qualcare PPO/HMO/WC	$324.00

TUBE VENT FLURO PLASTIC R TYPE

Facility

$2,160.00

Hospital Charge Code	270655888
Hospital Revenue Code	272
Min. Negotiated Rate	$52.06
Max. Negotiated Rate	$1,080.00
Rate for Payer: Aetna Commercial	$820.80
Rate for Payer: Aetna Medicare Advantage	$648.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$550.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$550.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$550.80
Rate for Payer: Cigna Commercial	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.00
Rate for Payer: Oxford Commercial	$432.00
Rate for Payer: Qualcare PPO/HMO/WC	$324.00
Rate for Payer: UnitedHealthcare Commercial	$432.00
Rate for Payer: UnitedHealthcare Community & State	$52.06
Rate for Payer: Wellpoint Medicaid Managed Care	$57.24

TUBE VENT SHPHRD GROMM MYRING

Facility

$53.79

Hospital Charge Code	270601241
Hospital Revenue Code	272
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$26.89
Rate for Payer: Aetna Commercial	$20.44
Rate for Payer: Aetna Medicare Advantage	$16.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.72
Rate for Payer: Cigna Commercial	$26.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.14
Rate for Payer: Oxford Commercial	$10.76
Rate for Payer: Qualcare PPO/HMO/WC	$8.07
Rate for Payer: UnitedHealthcare Commercial	$10.76
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.43

TUBE VENT SHPHRD GROMM MYRING

Facility

$53.79

Hospital Charge Code	270601241
Hospital Revenue Code	272
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.07

TUBE VINYL CONNECTING 40CM LNG

Facility

$63.75

Hospital Charge Code	270656104
Hospital Revenue Code	272
Min. Negotiated Rate	$9.56
Max. Negotiated Rate	$9.56
Rate for Payer: Qualcare PPO/HMO/WC	$9.56

TUBE VINYL CONNECTING 40CM LNG

Facility

$63.75

Hospital Charge Code	270656104
Hospital Revenue Code	272
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$31.88
Rate for Payer: Aetna Commercial	$24.23
Rate for Payer: Aetna Medicare Advantage	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.26
Rate for Payer: Cigna Commercial	$31.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.12
Rate for Payer: Oxford Commercial	$12.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.56
Rate for Payer: UnitedHealthcare Commercial	$12.75
Rate for Payer: UnitedHealthcare Community & State	$1.54
Rate for Payer: Wellpoint Medicaid Managed Care	$1.69

TUBE ViSiGi 3D FOR BYPASS 32FR

Facility

$848.00

Hospital Charge Code	270692086
Hospital Revenue Code	272
Min. Negotiated Rate	$127.20
Max. Negotiated Rate	$127.20
Rate for Payer: Qualcare PPO/HMO/WC	$127.20

TUBE ViSiGi 3D FOR BYPASS 32FR

Facility

$848.00

Hospital Charge Code	270692086
Hospital Revenue Code	272
Min. Negotiated Rate	$20.44
Max. Negotiated Rate	$424.00
Rate for Payer: Aetna Commercial	$322.24
Rate for Payer: Aetna Medicare Advantage	$254.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.24
Rate for Payer: Cigna Commercial	$424.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.40
Rate for Payer: Oxford Commercial	$169.60
Rate for Payer: Qualcare PPO/HMO/WC	$127.20
Rate for Payer: UnitedHealthcare Commercial	$169.60
Rate for Payer: UnitedHealthcare Community & State	$20.44
Rate for Payer: Wellpoint Medicaid Managed Care	$22.47

TUBE ViSiGi 3D FOR BYPASS 36FR

Facility

$848.00

Hospital Charge Code	270692087
Hospital Revenue Code	272
Min. Negotiated Rate	$127.20
Max. Negotiated Rate	$127.20
Rate for Payer: Qualcare PPO/HMO/WC	$127.20

TUBE ViSiGi 3D FOR BYPASS 36FR

Facility

$848.00

Hospital Charge Code	270692087
Hospital Revenue Code	272
Min. Negotiated Rate	$20.44
Max. Negotiated Rate	$424.00
Rate for Payer: Aetna Commercial	$322.24
Rate for Payer: Aetna Medicare Advantage	$254.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.24
Rate for Payer: Cigna Commercial	$424.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.40
Rate for Payer: Oxford Commercial	$169.60
Rate for Payer: Qualcare PPO/HMO/WC	$127.20
Rate for Payer: UnitedHealthcare Commercial	$169.60
Rate for Payer: UnitedHealthcare Community & State	$20.44
Rate for Payer: Wellpoint Medicaid Managed Care	$22.47

TUBE ViSiGi 3D FOR BYPASS 40FR

Facility

$848.00

Hospital Charge Code	270692088
Hospital Revenue Code	272
Min. Negotiated Rate	$127.20
Max. Negotiated Rate	$127.20
Rate for Payer: Qualcare PPO/HMO/WC	$127.20

TUBE ViSiGi 3D FOR BYPASS 40FR

Facility

$848.00

Hospital Charge Code	270692088
Hospital Revenue Code	272
Min. Negotiated Rate	$20.44
Max. Negotiated Rate	$424.00
Rate for Payer: Aetna Commercial	$322.24
Rate for Payer: Aetna Medicare Advantage	$254.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.24
Rate for Payer: Cigna Commercial	$424.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.40
Rate for Payer: Oxford Commercial	$169.60
Rate for Payer: Qualcare PPO/HMO/WC	$127.20
Rate for Payer: UnitedHealthcare Commercial	$169.60
Rate for Payer: UnitedHealthcare Community & State	$20.44
Rate for Payer: Wellpoint Medicaid Managed Care	$22.47

TUBE VISIGI W/BULB 32FR

Facility

$848.00

Hospital Charge Code	270692043
Hospital Revenue Code	272
Min. Negotiated Rate	$127.20
Max. Negotiated Rate	$127.20
Rate for Payer: Qualcare PPO/HMO/WC	$127.20

TUBE VISIGI W/BULB 32FR

Facility

$848.00

Hospital Charge Code	270692043
Hospital Revenue Code	272
Min. Negotiated Rate	$20.44
Max. Negotiated Rate	$424.00
Rate for Payer: Aetna Commercial	$322.24
Rate for Payer: Aetna Medicare Advantage	$254.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.24
Rate for Payer: Cigna Commercial	$424.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.40
Rate for Payer: Oxford Commercial	$169.60
Rate for Payer: Qualcare PPO/HMO/WC	$127.20
Rate for Payer: UnitedHealthcare Commercial	$169.60
Rate for Payer: UnitedHealthcare Community & State	$20.44
Rate for Payer: Wellpoint Medicaid Managed Care	$22.47

TUBE VISIGI W/BULB 36FR

Facility

$848.00

Hospital Charge Code	270692044
Hospital Revenue Code	272
Min. Negotiated Rate	$127.20
Max. Negotiated Rate	$127.20
Rate for Payer: Qualcare PPO/HMO/WC	$127.20

TUBE VISIGI W/BULB 36FR

Facility

$848.00

Hospital Charge Code	270692044
Hospital Revenue Code	272
Min. Negotiated Rate	$20.44
Max. Negotiated Rate	$424.00
Rate for Payer: Aetna Commercial	$322.24
Rate for Payer: Aetna Medicare Advantage	$254.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.24
Rate for Payer: Cigna Commercial	$424.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.40
Rate for Payer: Oxford Commercial	$169.60
Rate for Payer: Qualcare PPO/HMO/WC	$127.20
Rate for Payer: UnitedHealthcare Commercial	$169.60
Rate for Payer: UnitedHealthcare Community & State	$20.44
Rate for Payer: Wellpoint Medicaid Managed Care	$22.47

TUBE VISIGI W/BULB 40FR

Facility

$848.00

Hospital Charge Code	270692045
Hospital Revenue Code	272
Min. Negotiated Rate	$20.44
Max. Negotiated Rate	$424.00
Rate for Payer: Aetna Commercial	$322.24
Rate for Payer: Aetna Medicare Advantage	$254.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.24
Rate for Payer: Cigna Commercial	$424.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.40
Rate for Payer: Oxford Commercial	$169.60
Rate for Payer: Qualcare PPO/HMO/WC	$127.20
Rate for Payer: UnitedHealthcare Commercial	$169.60
Rate for Payer: UnitedHealthcare Community & State	$20.44
Rate for Payer: Wellpoint Medicaid Managed Care	$22.47

TUBE VISIGI W/BULB 40FR

Facility

$848.00

Hospital Charge Code	270692045
Hospital Revenue Code	272
Min. Negotiated Rate	$127.20
Max. Negotiated Rate	$127.20
Rate for Payer: Qualcare PPO/HMO/WC	$127.20

TUBE V VENT ARMSTRONG MYRING

Facility

$128.00

Hospital Charge Code	270600316
Hospital Revenue Code	272
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

TUBE V VENT ARMSTRONG MYRING

Facility

$128.00

Hospital Charge Code	270600316
Hospital Revenue Code	272
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$64.00
Rate for Payer: Aetna Commercial	$48.64
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.40
Rate for Payer: Oxford Commercial	$25.60
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$25.60
Rate for Payer: UnitedHealthcare Community & State	$3.08
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

TUBE WATER

Facility

$310.25

Hospital Charge Code	270676862
Hospital Revenue Code	272
Min. Negotiated Rate	$46.54
Max. Negotiated Rate	$46.54
Rate for Payer: Qualcare PPO/HMO/WC	$46.54

TUBE WATER

Facility

$310.25

Hospital Charge Code	270676862
Hospital Revenue Code	272
Min. Negotiated Rate	$7.48
Max. Negotiated Rate	$155.12
Rate for Payer: Aetna Commercial	$117.89
Rate for Payer: Aetna Medicare Advantage	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.11
Rate for Payer: Cigna Commercial	$155.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.08
Rate for Payer: Oxford Commercial	$62.05
Rate for Payer: Qualcare PPO/HMO/WC	$46.54
Rate for Payer: UnitedHealthcare Commercial	$62.05
Rate for Payer: UnitedHealthcare Community & State	$7.48
Rate for Payer: Wellpoint Medicaid Managed Care	$8.22

TUBE WC FEEDING 20F FLOW20PULL

Facility

$433.65

Hospital Charge Code	270623504
Hospital Revenue Code	272
Min. Negotiated Rate	$65.05
Max. Negotiated Rate	$65.05
Rate for Payer: Qualcare PPO/HMO/WC	$65.05

TUBE WC FEEDING 20F FLOW20PULL

Facility

$433.65

Hospital Charge Code	270623504
Hospital Revenue Code	272
Min. Negotiated Rate	$10.45
Max. Negotiated Rate	$216.82
Rate for Payer: Aetna Commercial	$164.79
Rate for Payer: Aetna Medicare Advantage	$130.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.58
Rate for Payer: Cigna Commercial	$216.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.09
Rate for Payer: Oxford Commercial	$86.73
Rate for Payer: Qualcare PPO/HMO/WC	$65.05
Rate for Payer: UnitedHealthcare Commercial	$86.73
Rate for Payer: UnitedHealthcare Community & State	$10.45
Rate for Payer: Wellpoint Medicaid Managed Care	$11.49

Know your out-of-pocket cost for care.

All Charges