Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

WATER TRAP AIRLIFE

Facility

$9.51

Hospital Charge Code	270600664
Hospital Revenue Code	272
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$1.43
Rate for Payer: Qualcare PPO/HMO/WC	$1.43

WATER TRAP AIRLIFE

Facility

$9.51

Hospital Charge Code	270600664
Hospital Revenue Code	272
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.75
Rate for Payer: Aetna Commercial	$3.61
Rate for Payer: Aetna Medicare Advantage	$2.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.43
Rate for Payer: Cigna Commercial	$4.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.85
Rate for Payer: Oxford Commercial	$1.90
Rate for Payer: Qualcare PPO/HMO/WC	$1.43
Rate for Payer: UnitedHealthcare Commercial	$1.90
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.25

WAVEGUIDE INVUITY EIGR

Facility

$1,375.00

Hospital Charge Code	270663932
Hospital Revenue Code	270
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$206.25
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

WAVEGUIDE INVUITY EIGR

Facility

$1,375.00

Hospital Charge Code	270663932
Hospital Revenue Code	270
Min. Negotiated Rate	$33.14
Max. Negotiated Rate	$687.50
Rate for Payer: Aetna Commercial	$522.50
Rate for Payer: Aetna Medicare Advantage	$412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.62
Rate for Payer: Cigna Commercial	$687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$412.50
Rate for Payer: Oxford Commercial	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$206.25
Rate for Payer: UnitedHealthcare Commercial	$275.00
Rate for Payer: UnitedHealthcare Community & State	$33.14
Rate for Payer: Wellpoint Medicaid Managed Care	$36.44

WBC

Facility

$21.28

Service Code	HCPCS 85048
Hospital Charge Code	8200340RS
Hospital Revenue Code	301
Min. Negotiated Rate	$3.19
Max. Negotiated Rate	$3.19
Rate for Payer: Qualcare PPO/HMO/WC	$3.19

WBC

Facility

$21.28

Service Code	HCPCS 85048
Hospital Charge Code	8200340RS
Hospital Revenue Code	301
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$6.91
Rate for Payer: Aetna Medicare Advantage	$8.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.17
Rate for Payer: Cigna Commercial	$10.64
Rate for Payer: Cigna Medicare Advantage	$2.54
Rate for Payer: Clover Medicare Advantage	$2.41
Rate for Payer: EmblemHealth Commercial	$7.62
Rate for Payer: Humana Medicare Advantage	$2.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.19
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.54
Rate for Payer: Wellcare Medicare Advantage	$2.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

WBC COUNT

Facility

$103.00

Service Code	HCPCS 85048
Hospital Charge Code	38473014
Hospital Revenue Code	301
Min. Negotiated Rate	$2.03
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$6.91
Rate for Payer: Aetna Medicare Advantage	$8.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.17
Rate for Payer: Cigna Commercial	$51.50
Rate for Payer: Cigna Medicare Advantage	$2.54
Rate for Payer: Clover Medicare Advantage	$2.41
Rate for Payer: EmblemHealth Commercial	$7.62
Rate for Payer: Humana Medicare Advantage	$2.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.54
Rate for Payer: Wellcare Medicare Advantage	$2.54
Rate for Payer: Wellpoint Medicaid Managed Care	$2.73

WBC COUNT

Facility

$103.00

Service Code	HCPCS 85048
Hospital Charge Code	38473014
Hospital Revenue Code	301
Min. Negotiated Rate	$15.45
Max. Negotiated Rate	$15.45
Rate for Payer: Qualcare PPO/HMO/WC	$15.45

WBC STAIN***

Facility

$14.00

Hospital Charge Code	3010212
Hospital Revenue Code	306
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$2.10

WBC STAIN***

Facility

$14.00

Hospital Charge Code	3010212
Hospital Revenue Code	306
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$5.32
Rate for Payer: Aetna Medicare Advantage	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.57
Rate for Payer: Cigna Commercial	$7.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

WC 3 LAYER COMP BANDAGE

Facility

$38.00

Hospital Charge Code	9808265
Hospital Revenue Code	272
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$19.00
Rate for Payer: Aetna Commercial	$14.44
Rate for Payer: Aetna Medicare Advantage	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.69
Rate for Payer: Cigna Commercial	$19.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.40
Rate for Payer: Oxford Commercial	$7.60
Rate for Payer: Qualcare PPO/HMO/WC	$5.70
Rate for Payer: UnitedHealthcare Commercial	$7.60
Rate for Payer: UnitedHealthcare Community & State	$0.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1.01

WC 3 LAYER COMP BANDAGE

Facility

$38.00

Hospital Charge Code	9808265
Hospital Revenue Code	272
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$5.70

WC ACCUCHECK

Facility

$390.00

Service Code	HCPCS 82948
Hospital Charge Code	9808060
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

WC ACCUCHECK

Facility

$390.00

Service Code	HCPCS 82948
Hospital Charge Code	9808060
Hospital Revenue Code	301
Min. Negotiated Rate	$2.90
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$13.71
Rate for Payer: Aetna Medicare Advantage	$16.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.19
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.04
Rate for Payer: Clover Medicare Advantage	$4.79
Rate for Payer: EmblemHealth Commercial	$15.12
Rate for Payer: Humana Medicare Advantage	$5.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.04
Rate for Payer: Wellcare Medicare Advantage	$5.04
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

WC ACEL DERM RPL HD/FT/DIG<100

Facility

$947.13

Service Code	HCPCS 15175
Hospital Charge Code	98000210
Hospital Revenue Code	510
Min. Negotiated Rate	$22.83
Max. Negotiated Rate	$473.56
Rate for Payer: Aetna Commercial	$359.91
Rate for Payer: Aetna Medicare Advantage	$284.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$241.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$241.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$241.52
Rate for Payer: Cigna Commercial	$473.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.14
Rate for Payer: Qualcare PPO/HMO/WC	$142.07
Rate for Payer: UnitedHealthcare Community & State	$22.83
Rate for Payer: Wellpoint Medicaid Managed Care	$25.10

WC ACEL DERM RPL HD/FT/DIG<100

Facility

$947.13

Service Code	HCPCS 15175
Hospital Charge Code	98000210
Hospital Revenue Code	510
Min. Negotiated Rate	$142.07
Max. Negotiated Rate	$142.07
Rate for Payer: Qualcare PPO/HMO/WC	$142.07

WC ACELLULAR DERMAL TISS MATRI

Facility

$2,653.00

Service Code	HCPCS Q4100
Hospital Charge Code	9808270
Hospital Revenue Code	636
Min. Negotiated Rate	$397.95
Max. Negotiated Rate	$642.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$642.03
Rate for Payer: Qualcare PPO/HMO/WC	$397.95

WC ACELLULAR DERMAL TISS MATRI

Facility

$2,653.00

Service Code	HCPCS Q4100
Hospital Charge Code	9808270
Hospital Revenue Code	636
Min. Negotiated Rate	$63.94
Max. Negotiated Rate	$1,326.50
Rate for Payer: Aetna Commercial	$1,008.14
Rate for Payer: Aetna Medicare Advantage	$795.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$676.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$676.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$676.51
Rate for Payer: Cigna Commercial	$1,326.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$642.03
Rate for Payer: Qualcare PPO/HMO/WC	$397.95
Rate for Payer: UnitedHealthcare Community & State	$63.94
Rate for Payer: Wellpoint Medicaid Managed Care	$70.30

WC ACELLULAR XENOGRAFT 1ST 100

Facility

$1,183.95

Hospital Charge Code	9800250
Hospital Revenue Code	510
Min. Negotiated Rate	$28.53
Max. Negotiated Rate	$591.98
Rate for Payer: Aetna Commercial	$449.90
Rate for Payer: Aetna Medicare Advantage	$355.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$301.91
Rate for Payer: Cigna Commercial	$591.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$355.19
Rate for Payer: Qualcare PPO/HMO/WC	$177.59
Rate for Payer: UnitedHealthcare Community & State	$28.53
Rate for Payer: Wellpoint Medicaid Managed Care	$31.37

WC ACELLULAR XENOGRAFT 1ST 100

Facility

$1,183.95

Hospital Charge Code	9800250
Hospital Revenue Code	510
Min. Negotiated Rate	$177.59
Max. Negotiated Rate	$177.59
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC ACELL XENOGRAFT 1ST 100 ADD

Facility

$1,183.95

Hospital Charge Code	9800255
Hospital Revenue Code	510
Min. Negotiated Rate	$177.59
Max. Negotiated Rate	$177.59
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC ACELL XENOGRAFT 1ST 100 ADD

Facility

$1,183.95

Hospital Charge Code	9800255
Hospital Revenue Code	510
Min. Negotiated Rate	$28.53
Max. Negotiated Rate	$591.98
Rate for Payer: Aetna Commercial	$449.90
Rate for Payer: Aetna Medicare Advantage	$355.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$301.91
Rate for Payer: Cigna Commercial	$591.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$355.19
Rate for Payer: Qualcare PPO/HMO/WC	$177.59
Rate for Payer: UnitedHealthcare Community & State	$28.53
Rate for Payer: Wellpoint Medicaid Managed Care	$31.37

WC ACTICOAT SILVER WOUND DRESS

Facility

$226.00

Service Code	HCPCS A9270
Hospital Charge Code	9808160
Hospital Revenue Code	272
Min. Negotiated Rate	$33.90
Max. Negotiated Rate	$33.90
Rate for Payer: Qualcare PPO/HMO/WC	$33.90

WC ACTICOAT SILVER WOUND DRESS

Facility

$226.00

Service Code	HCPCS A9270
Hospital Charge Code	9808160
Hospital Revenue Code	272
Min. Negotiated Rate	$5.45
Max. Negotiated Rate	$113.00
Rate for Payer: Aetna Commercial	$85.88
Rate for Payer: Aetna Medicare Advantage	$67.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.63
Rate for Payer: Cigna Commercial	$113.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.80
Rate for Payer: Oxford Commercial	$45.20
Rate for Payer: Qualcare PPO/HMO/WC	$33.90
Rate for Payer: UnitedHealthcare Commercial	$45.20
Rate for Payer: UnitedHealthcare Community & State	$5.45
Rate for Payer: Wellpoint Medicaid Managed Care	$5.99

WC ALLEVYN AG ADHESIVE 5 X %

Facility

$33.00

Service Code	HCPCS A6212
Hospital Charge Code	9808145
Hospital Revenue Code	272
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$16.50
Rate for Payer: Aetna Commercial	$12.54
Rate for Payer: Aetna Medicare Advantage	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.41
Rate for Payer: Cigna Commercial	$16.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.90
Rate for Payer: Oxford Commercial	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$6.60
Rate for Payer: UnitedHealthcare Community & State	$0.80
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

Know your out-of-pocket cost for care.

All Charges