Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TUBING ROENTENOGRAPHY*******

Facility

$18.00

Hospital Charge Code	1600543
Hospital Revenue Code	272
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.40
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

TUBING ROENTGENOGRAPHY

Facility

$32.00

Hospital Charge Code	270061235
Hospital Revenue Code	272
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$12.16
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.60
Rate for Payer: Oxford Commercial	$6.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$6.40
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

TUBING ROENTGENOGRAPHY

Facility

$32.00

Hospital Charge Code	270061235
Hospital Revenue Code	272
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

TUBING SAFELINE BASC IV NF1150

Facility

$11.03

Hospital Charge Code	270040240
Hospital Revenue Code	270
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.51
Rate for Payer: Aetna Commercial	$4.19
Rate for Payer: Aetna Medicare Advantage	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.81
Rate for Payer: Cigna Commercial	$5.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.31
Rate for Payer: Oxford Commercial	$2.21
Rate for Payer: Qualcare PPO/HMO/WC	$1.65
Rate for Payer: UnitedHealthcare Commercial	$2.21
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

TUBING SAFELINE BASC IV NF1150

Facility

$11.03

Hospital Charge Code	270040240
Hospital Revenue Code	270
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.65

TUBING SAFELINE EXT SET NF1370

Facility

$11.08

Hospital Charge Code	270617764
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.54
Rate for Payer: Aetna Commercial	$4.21
Rate for Payer: Aetna Medicare Advantage	$3.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.83
Rate for Payer: Cigna Commercial	$5.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.32
Rate for Payer: Oxford Commercial	$2.22
Rate for Payer: Qualcare PPO/HMO/WC	$1.66
Rate for Payer: UnitedHealthcare Commercial	$2.22
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

TUBING SAFELINE EXT SET NF1370

Facility

$11.08

Hospital Charge Code	270617764
Hospital Revenue Code	272
Min. Negotiated Rate	$1.66
Max. Negotiated Rate	$1.66
Rate for Payer: Qualcare PPO/HMO/WC	$1.66

TUBING SAFELINE HEPLOCK NF9100

Facility

$6.65

Hospital Charge Code	270610736
Hospital Revenue Code	270
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.00

TUBING SAFELINE HEPLOCK NF9100

Facility

$6.65

Hospital Charge Code	270610736
Hospital Revenue Code	270
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$3.33
Rate for Payer: Aetna Commercial	$2.53
Rate for Payer: Aetna Medicare Advantage	$2.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.70
Rate for Payer: Cigna Commercial	$3.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.00
Rate for Payer: Oxford Commercial	$1.33
Rate for Payer: Qualcare PPO/HMO/WC	$1.00
Rate for Payer: UnitedHealthcare Commercial	$1.33
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

TUBING SAFELIN PUMP SET NF3140

Facility

$22.37

Hospital Charge Code	270040266
Hospital Revenue Code	270
Min. Negotiated Rate	$3.36
Max. Negotiated Rate	$3.36
Rate for Payer: Qualcare PPO/HMO/WC	$3.36

TUBING SAFELIN PUMP SET NF3140

Facility

$22.37

Hospital Charge Code	270040266
Hospital Revenue Code	270
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$11.19
Rate for Payer: Aetna Commercial	$8.50
Rate for Payer: Aetna Medicare Advantage	$6.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.70
Rate for Payer: Cigna Commercial	$11.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.71
Rate for Payer: Oxford Commercial	$4.47
Rate for Payer: Qualcare PPO/HMO/WC	$3.36
Rate for Payer: UnitedHealthcare Commercial	$4.47
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.59

TUBING SECONDARY IV 14230-28

Facility

$5.25

Hospital Charge Code	270649233
Hospital Revenue Code	272
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$0.79
Rate for Payer: Qualcare PPO/HMO/WC	$0.79

TUBING SECONDARY IV 14230-28

Facility

$5.25

Hospital Charge Code	270649233
Hospital Revenue Code	272
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.62
Rate for Payer: Aetna Commercial	$2.00
Rate for Payer: Aetna Medicare Advantage	$1.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.34
Rate for Payer: Cigna Commercial	$2.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.57
Rate for Payer: Oxford Commercial	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$0.79
Rate for Payer: UnitedHealthcare Commercial	$1.05
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

TUBING SECONDARY IV PIGGYBACK

Facility

$4.11

Hospital Charge Code	270650121
Hospital Revenue Code	270
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$0.62
Rate for Payer: Qualcare PPO/HMO/WC	$0.62

TUBING SECONDARY IV PIGGYBACK

Facility

$4.11

Hospital Charge Code	270650121
Hospital Revenue Code	270
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.06
Rate for Payer: Aetna Commercial	$1.56
Rate for Payer: Aetna Medicare Advantage	$1.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.05
Rate for Payer: Cigna Commercial	$2.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.23
Rate for Payer: Oxford Commercial	$0.82
Rate for Payer: Qualcare PPO/HMO/WC	$0.62
Rate for Payer: UnitedHealthcare Commercial	$0.82
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

TUBING SECONDARY IV SET NF1430

Facility

$7.25

Hospital Charge Code	270040260
Hospital Revenue Code	270
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

TUBING SECONDARY IV SET NF1430

Facility

$7.25

Hospital Charge Code	270040260
Hospital Revenue Code	270
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.62
Rate for Payer: Aetna Commercial	$2.75
Rate for Payer: Aetna Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.17
Rate for Payer: Oxford Commercial	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$1.45
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

TUBING SECOND IV SET V1903****

Facility

$9.00

Hospital Charge Code	7000656
Hospital Revenue Code	279
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

TUBING SECOND IV SET V1903****

Facility

$9.00

Hospital Charge Code	7000656
Hospital Revenue Code	279
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$3.42
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.70
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

TUBING SET APEX1-CONNEC C7120

Facility

$676.00

Hospital Charge Code	270600247
Hospital Revenue Code	272
Min. Negotiated Rate	$16.29
Max. Negotiated Rate	$338.00
Rate for Payer: Aetna Commercial	$256.88
Rate for Payer: Aetna Medicare Advantage	$202.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.38
Rate for Payer: Cigna Commercial	$338.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.80
Rate for Payer: Oxford Commercial	$135.20
Rate for Payer: Qualcare PPO/HMO/WC	$101.40
Rate for Payer: UnitedHealthcare Commercial	$135.20
Rate for Payer: UnitedHealthcare Community & State	$16.29
Rate for Payer: Wellpoint Medicaid Managed Care	$17.91

TUBING SET APEX1-CONNEC C7120

Facility

$676.00

Hospital Charge Code	270600247
Hospital Revenue Code	272
Min. Negotiated Rate	$101.40
Max. Negotiated Rate	$101.40
Rate for Payer: Qualcare PPO/HMO/WC	$101.40

TUBING SET BLOOD N/VENTED

Facility

$16.41

Hospital Charge Code	270649235
Hospital Revenue Code	272
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$8.21
Rate for Payer: Aetna Commercial	$6.24
Rate for Payer: Aetna Medicare Advantage	$4.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.18
Rate for Payer: Cigna Commercial	$8.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.92
Rate for Payer: Oxford Commercial	$3.28
Rate for Payer: Qualcare PPO/HMO/WC	$2.46
Rate for Payer: UnitedHealthcare Commercial	$3.28
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.43

TUBING SET BLOOD N/VENTED

Facility

$16.41

Hospital Charge Code	270649235
Hospital Revenue Code	272
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$2.46
Rate for Payer: Qualcare PPO/HMO/WC	$2.46

TUBING SET BLOOD RENAL*******

Facility

$13.28

Hospital Charge Code	270606942
Hospital Revenue Code	272
Min. Negotiated Rate	$1.99
Max. Negotiated Rate	$1.99
Rate for Payer: Qualcare PPO/HMO/WC	$1.99

TUBING SET BLOOD RENAL*******

Facility

$13.28

Hospital Charge Code	270606942
Hospital Revenue Code	272
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$6.64
Rate for Payer: Aetna Commercial	$5.05
Rate for Payer: Aetna Medicare Advantage	$3.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.39
Rate for Payer: Cigna Commercial	$6.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.98
Rate for Payer: Oxford Commercial	$2.66
Rate for Payer: Qualcare PPO/HMO/WC	$1.99
Rate for Payer: UnitedHealthcare Commercial	$2.66
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.35

Know your out-of-pocket cost for care.

All Charges