Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ULTRATOME SPHYNCTERO SHT

Facility

$1,482.45

Hospital Charge Code	270600940
Hospital Revenue Code	270
Min. Negotiated Rate	$222.37
Max. Negotiated Rate	$222.37
Rate for Payer: Qualcare PPO/HMO/WC	$222.37

ULTRATOME XL 0

Facility

$1,584.00

Hospital Charge Code	270604763
Hospital Revenue Code	270
Min. Negotiated Rate	$237.60
Max. Negotiated Rate	$237.60
Rate for Payer: Qualcare PPO/HMO/WC	$237.60

ULTRATOME XL 0

Facility

$1,584.00

Hospital Charge Code	270604763
Hospital Revenue Code	270
Min. Negotiated Rate	$38.17
Max. Negotiated Rate	$792.00
Rate for Payer: Aetna Commercial	$601.92
Rate for Payer: Aetna Medicare Advantage	$475.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$403.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$403.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$403.92
Rate for Payer: Cigna Commercial	$792.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$475.20
Rate for Payer: Oxford Commercial	$316.80
Rate for Payer: Qualcare PPO/HMO/WC	$237.60
Rate for Payer: UnitedHealthcare Commercial	$316.80
Rate for Payer: UnitedHealthcare Community & State	$38.17
Rate for Payer: Wellpoint Medicaid Managed Care	$41.98

ULTRATOME XL 1

Facility

$1,584.00

Hospital Charge Code	270604764
Hospital Revenue Code	270
Min. Negotiated Rate	$237.60
Max. Negotiated Rate	$237.60
Rate for Payer: Qualcare PPO/HMO/WC	$237.60

ULTRATOME XL 1

Facility

$1,584.00

Hospital Charge Code	270604764
Hospital Revenue Code	270
Min. Negotiated Rate	$38.17
Max. Negotiated Rate	$792.00
Rate for Payer: Aetna Commercial	$601.92
Rate for Payer: Aetna Medicare Advantage	$475.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$403.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$403.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$403.92
Rate for Payer: Cigna Commercial	$792.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$475.20
Rate for Payer: Oxford Commercial	$316.80
Rate for Payer: Qualcare PPO/HMO/WC	$237.60
Rate for Payer: UnitedHealthcare Commercial	$316.80
Rate for Payer: UnitedHealthcare Community & State	$38.17
Rate for Payer: Wellpoint Medicaid Managed Care	$41.98

ULTRATOME XL 3

Facility

$1,584.00

Hospital Charge Code	270604766
Hospital Revenue Code	270
Min. Negotiated Rate	$237.60
Max. Negotiated Rate	$237.60
Rate for Payer: Qualcare PPO/HMO/WC	$237.60

ULTRATOME XL 3

Facility

$1,584.00

Hospital Charge Code	270604766
Hospital Revenue Code	270
Min. Negotiated Rate	$38.17
Max. Negotiated Rate	$792.00
Rate for Payer: Aetna Commercial	$601.92
Rate for Payer: Aetna Medicare Advantage	$475.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$403.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$403.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$403.92
Rate for Payer: Cigna Commercial	$792.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$475.20
Rate for Payer: Oxford Commercial	$316.80
Rate for Payer: Qualcare PPO/HMO/WC	$237.60
Rate for Payer: UnitedHealthcare Commercial	$316.80
Rate for Payer: UnitedHealthcare Community & State	$38.17
Rate for Payer: Wellpoint Medicaid Managed Care	$41.98

ULTRA VAC SMOKE PENCIL

Facility

$154.50

Hospital Charge Code	270664807
Hospital Revenue Code	270
Min. Negotiated Rate	$3.72
Max. Negotiated Rate	$77.25
Rate for Payer: Aetna Commercial	$58.71
Rate for Payer: Aetna Medicare Advantage	$46.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.40
Rate for Payer: Cigna Commercial	$77.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.35
Rate for Payer: Oxford Commercial	$30.90
Rate for Payer: Qualcare PPO/HMO/WC	$23.18
Rate for Payer: UnitedHealthcare Commercial	$30.90
Rate for Payer: UnitedHealthcare Community & State	$3.72
Rate for Payer: Wellpoint Medicaid Managed Care	$4.09

ULTRA VAC SMOKE PENCIL

Facility

$154.50

Hospital Charge Code	270664807
Hospital Revenue Code	270
Min. Negotiated Rate	$23.18
Max. Negotiated Rate	$23.18
Rate for Payer: Qualcare PPO/HMO/WC	$23.18

UNBOUND IRON BINDING

Facility

$91.25

Service Code	HCPCS 83550
Hospital Charge Code	8200317RS
Hospital Revenue Code	301
Min. Negotiated Rate	$2.42
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$23.77
Rate for Payer: Aetna Medicare Advantage	$28.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.55
Rate for Payer: Cigna Commercial	$45.62
Rate for Payer: Cigna Medicare Advantage	$8.74
Rate for Payer: Clover Medicare Advantage	$8.30
Rate for Payer: EmblemHealth Commercial	$26.22
Rate for Payer: Humana Medicare Advantage	$9.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.69
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.99
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.74
Rate for Payer: Wellcare Medicare Advantage	$8.74
Rate for Payer: Wellpoint Medicaid Managed Care	$2.42

UNBOUND IRON BINDING

Facility

$91.25

Service Code	HCPCS 83550
Hospital Charge Code	8200317RS
Hospital Revenue Code	301
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$13.69

UNCOMPLICATED PEPTIC ULCER WITH MCC

Facility

$46,760.56

Service Code	MSDRG 383
Min. Negotiated Rate	$14,237.99
Max. Negotiated Rate	$46,760.56
Rate for Payer: Aetna Commercial	$32,387.17
Rate for Payer: Aetna Medicare Advantage	$46,760.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32,565.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32,565.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,987.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32,565.40
Rate for Payer: Cigna Commercial	$25,838.42
Rate for Payer: Cigna Medicare Advantage	$14,987.36
Rate for Payer: Clover Medicare Advantage	$14,237.99
Rate for Payer: EmblemHealth Commercial	$44,962.08
Rate for Payer: Humana Medicare Advantage	$15,436.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,987.36
Rate for Payer: Oxford Commercial	$18,570.42
Rate for Payer: UnitedHealthcare Commercial	$32,563.81
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,987.36
Rate for Payer: Wellcare Medicare Advantage	$14,987.36

UNCOMPLICATED PEPTIC ULCER WITHOUT MCC

Facility

$29,762.62

Service Code	MSDRG 384
Min. Negotiated Rate	$9,062.33
Max. Negotiated Rate	$29,762.62
Rate for Payer: Aetna Commercial	$20,707.65
Rate for Payer: Aetna Medicare Advantage	$29,762.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20,469.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20,469.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,539.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20,469.68
Rate for Payer: Cigna Commercial	$15,996.73
Rate for Payer: Cigna Medicare Advantage	$9,539.30
Rate for Payer: Clover Medicare Advantage	$9,062.33
Rate for Payer: EmblemHealth Commercial	$28,617.90
Rate for Payer: Humana Medicare Advantage	$9,825.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,539.30
Rate for Payer: Oxford Commercial	$11,497.06
Rate for Payer: UnitedHealthcare Commercial	$20,160.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,539.30
Rate for Payer: Wellcare Medicare Advantage	$9,539.30

UNDERGAURD FOR PLASMA

Facility

$309.05

Hospital Charge Code	270665038
Hospital Revenue Code	270
Min. Negotiated Rate	$46.36
Max. Negotiated Rate	$46.36
Rate for Payer: Qualcare PPO/HMO/WC	$46.36

UNDERGAURD FOR PLASMA

Facility

$309.05

Hospital Charge Code	270665038
Hospital Revenue Code	270
Min. Negotiated Rate	$7.45
Max. Negotiated Rate	$154.53
Rate for Payer: Aetna Commercial	$117.44
Rate for Payer: Aetna Medicare Advantage	$92.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.81
Rate for Payer: Cigna Commercial	$154.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.72
Rate for Payer: Oxford Commercial	$61.81
Rate for Payer: Qualcare PPO/HMO/WC	$46.36
Rate for Payer: UnitedHealthcare Commercial	$61.81
Rate for Payer: UnitedHealthcare Community & State	$7.45
Rate for Payer: Wellpoint Medicaid Managed Care	$8.19

UNDERPAD 30X36

Facility

$5.65

Hospital Charge Code	270303310
Hospital Revenue Code	270
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$2.15
Rate for Payer: Aetna Medicare Advantage	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.70
Rate for Payer: Oxford Commercial	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$1.13
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

UNDERPAD 30X36

Facility

$5.65

Hospital Charge Code	270303310
Hospital Revenue Code	270
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

UNDERPAD ULTRASORB 31x36

Facility

$9.61

Hospital Charge Code	270644336
Hospital Revenue Code	270
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$1.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.44

UNDERPAD ULTRASORB 31x36

Facility

$9.61

Hospital Charge Code	270644336
Hospital Revenue Code	270
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.80
Rate for Payer: Aetna Commercial	$3.65
Rate for Payer: Aetna Medicare Advantage	$2.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.45
Rate for Payer: Cigna Commercial	$4.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.88
Rate for Payer: Oxford Commercial	$1.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.44
Rate for Payer: UnitedHealthcare Commercial	$1.92
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.25

UNDERPAD ULTRASORB AP 24x36

Facility

$405.20

Hospital Charge Code	270648397
Hospital Revenue Code	272
Min. Negotiated Rate	$9.77
Max. Negotiated Rate	$202.60
Rate for Payer: Aetna Commercial	$153.98
Rate for Payer: Aetna Medicare Advantage	$121.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$103.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$103.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$103.33
Rate for Payer: Cigna Commercial	$202.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.56
Rate for Payer: Oxford Commercial	$81.04
Rate for Payer: Qualcare PPO/HMO/WC	$60.78
Rate for Payer: UnitedHealthcare Commercial	$81.04
Rate for Payer: UnitedHealthcare Community & State	$9.77
Rate for Payer: Wellpoint Medicaid Managed Care	$10.74

UNDERPAD ULTRASORB AP 24x36

Facility

$405.20

Hospital Charge Code	270648397
Hospital Revenue Code	272
Min. Negotiated Rate	$60.78
Max. Negotiated Rate	$60.78
Rate for Payer: Qualcare PPO/HMO/WC	$60.78

UNICORTICAL SCREW 10MM

Facility

$813.05

Hospital Charge Code	270657821
Hospital Revenue Code	278
Min. Negotiated Rate	$19.59
Max. Negotiated Rate	$406.52
Rate for Payer: Aetna Commercial	$308.96
Rate for Payer: Aetna Medicare Advantage	$243.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.33
Rate for Payer: Cigna Commercial	$406.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$178.87
Rate for Payer: Qualcare PPO/HMO/WC	$121.96
Rate for Payer: UnitedHealthcare Community & State	$19.59
Rate for Payer: Wellpoint Medicaid Managed Care	$21.55

UNICORTICAL SCREW 10MM

Facility

$813.05

Hospital Charge Code	270657821
Hospital Revenue Code	278
Min. Negotiated Rate	$121.96
Max. Negotiated Rate	$196.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$178.87
Rate for Payer: Qualcare PPO/HMO/WC	$121.96

UNICORTICAL SCREW 12MM

Facility

$813.05

Hospital Charge Code	270657823
Hospital Revenue Code	278
Min. Negotiated Rate	$121.96
Max. Negotiated Rate	$196.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$178.87
Rate for Payer: Qualcare PPO/HMO/WC	$121.96

UNICORTICAL SCREW 12MM

Facility

$813.05

Hospital Charge Code	270657823
Hospital Revenue Code	278
Min. Negotiated Rate	$19.59
Max. Negotiated Rate	$406.52
Rate for Payer: Aetna Commercial	$308.96
Rate for Payer: Aetna Medicare Advantage	$243.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.33
Rate for Payer: Cigna Commercial	$406.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$178.87
Rate for Payer: Qualcare PPO/HMO/WC	$121.96
Rate for Payer: UnitedHealthcare Community & State	$19.59
Rate for Payer: Wellpoint Medicaid Managed Care	$21.55

Know your out-of-pocket cost for care.

All Charges