Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

WHITE ABSORBENT MAT

Facility

$15.00

Hospital Charge Code	270679631
Hospital Revenue Code	272
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$5.70
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.50
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$3.00
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

WHITE ABSORBENT MAT

Facility

$15.00

Hospital Charge Code	270679631
Hospital Revenue Code	272
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

WHITE BLOOD COUNT (WBC)

Facility

$390.00

Service Code	HCPCS 85048
Hospital Charge Code	3002797
Hospital Revenue Code	301
Min. Negotiated Rate	$2.03
Max. Negotiated Rate	$195.00
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	$195.00
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	$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	$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	$10.34

WHITE BLOOD COUNT (WBC)

Facility

$390.00

Service Code	HCPCS 85048
Hospital Charge Code	3002797
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

WHITE PETROLATUM

Facility

$18.22

Service Code	NDC 168005321
Hospital Charge Code	6063943309
Hospital Revenue Code	250
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$2.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.73

WHITE PETROLATUM

Facility

$18.22

Service Code	NDC 168005321
Hospital Charge Code	6063943309
Hospital Revenue Code	250
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$9.11
Rate for Payer: Aetna Commercial	$6.92
Rate for Payer: Aetna Medicare Advantage	$5.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.65
Rate for Payer: Cigna Commercial	$9.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.47
Rate for Payer: Oxford Commercial	$3.64
Rate for Payer: Qualcare PPO/HMO/WC	$2.73
Rate for Payer: UnitedHealthcare Commercial	$3.64
Rate for Payer: UnitedHealthcare Community & State	$0.44
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

WHITE PETRO MNRL OIL OPH OINUD

Facility

$17.95

Hospital Charge Code	60628096
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$8.97
Rate for Payer: Aetna Commercial	$6.82
Rate for Payer: Aetna Medicare Advantage	$5.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.58
Rate for Payer: Cigna Commercial	$8.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.38
Rate for Payer: Oxford Commercial	$3.59
Rate for Payer: Qualcare PPO/HMO/WC	$2.69
Rate for Payer: UnitedHealthcare Commercial	$3.59
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

WHITE PETRO MNRL OIL OPH OINUD

Facility

$17.95

Hospital Charge Code	60628096
Hospital Revenue Code	250
Min. Negotiated Rate	$2.69
Max. Negotiated Rate	$2.69
Rate for Payer: Qualcare PPO/HMO/WC	$2.69

WHOLE BLOOD

Facility

$1,204.00

Hospital Charge Code	38471028
Hospital Revenue Code	390
Min. Negotiated Rate	$29.02
Max. Negotiated Rate	$1,167.00
Rate for Payer: Aetna Commercial	$457.52
Rate for Payer: Aetna Medicare Advantage	$361.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.02
Rate for Payer: Cigna Commercial	$602.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.20
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.60
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$29.02
Rate for Payer: Wellpoint Medicaid Managed Care	$31.91

WHOLE BLOOD

Facility

$1,204.00

Hospital Charge Code	38471028
Hospital Revenue Code	390
Min. Negotiated Rate	$180.60
Max. Negotiated Rate	$180.60
Rate for Payer: Qualcare PPO/HMO/WC	$180.60

WHOLE BLOOD FOR TRANSFUSION

Facility

$1,584.00

Hospital Charge Code	3101499
Hospital Revenue Code	390
Min. Negotiated Rate	$38.17
Max. Negotiated Rate	$1,167.00
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	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$237.60
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$38.17
Rate for Payer: Wellpoint Medicaid Managed Care	$41.98

WHOLE BLOOD FOR TRANSFUSION

Facility

$1,584.00

Hospital Charge Code	3101499
Hospital Revenue Code	390
Min. Negotiated Rate	$237.60
Max. Negotiated Rate	$237.60
Rate for Payer: Qualcare PPO/HMO/WC	$237.60

WHOLEY 035 145 HI TORQ 1002702

Facility

$600.05

Hospital Charge Code	270661632
Hospital Revenue Code	272
Min. Negotiated Rate	$90.01
Max. Negotiated Rate	$90.01
Rate for Payer: Qualcare PPO/HMO/WC	$90.01

WHOLEY 035 145 HI TORQ 1002702

Facility

$600.05

Hospital Charge Code	270661632
Hospital Revenue Code	272
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.02
Rate for Payer: Aetna Commercial	$228.02
Rate for Payer: Aetna Medicare Advantage	$180.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.01
Rate for Payer: Cigna Commercial	$300.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.01
Rate for Payer: Oxford Commercial	$120.01
Rate for Payer: Qualcare PPO/HMO/WC	$90.01
Rate for Payer: UnitedHealthcare Commercial	$120.01
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

WHOLEY 035 145 HI TORQ 1002702

Facility

$600.05

Hospital Charge Code	270661632S
Hospital Revenue Code	272
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.02
Rate for Payer: Aetna Commercial	$228.02
Rate for Payer: Aetna Medicare Advantage	$180.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.01
Rate for Payer: Cigna Commercial	$300.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.01
Rate for Payer: Oxford Commercial	$120.01
Rate for Payer: Qualcare PPO/HMO/WC	$90.01
Rate for Payer: UnitedHealthcare Commercial	$120.01
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

WHOLEY 035 145 HI TORQ 1002702

Facility

$600.05

Hospital Charge Code	270661632S
Hospital Revenue Code	272
Min. Negotiated Rate	$90.01
Max. Negotiated Rate	$90.01
Rate for Payer: Qualcare PPO/HMO/WC	$90.01

WILSON-COOK WIRE GUIDE

Facility

$313.00

Hospital Charge Code	270332077
Hospital Revenue Code	278
Min. Negotiated Rate	$46.95
Max. Negotiated Rate	$75.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$68.86
Rate for Payer: Qualcare PPO/HMO/WC	$46.95

WILSON-COOK WIRE GUIDE

Facility

$313.00

Hospital Charge Code	270332077
Hospital Revenue Code	278
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$156.50
Rate for Payer: Aetna Commercial	$118.94
Rate for Payer: Aetna Medicare Advantage	$93.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.81
Rate for Payer: Cigna Commercial	$156.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$68.86
Rate for Payer: Qualcare PPO/HMO/WC	$46.95
Rate for Payer: UnitedHealthcare Community & State	$7.54
Rate for Payer: Wellpoint Medicaid Managed Care	$8.29

WILSON FRAME PATIENT KIT

Facility

$133.75

Hospital Charge Code	270339536
Hospital Revenue Code	272
Min. Negotiated Rate	$20.06
Max. Negotiated Rate	$20.06
Rate for Payer: Qualcare PPO/HMO/WC	$20.06

WILSON FRAME PATIENT KIT

Facility

$133.75

Hospital Charge Code	270339536
Hospital Revenue Code	272
Min. Negotiated Rate	$3.22
Max. Negotiated Rate	$66.88
Rate for Payer: Aetna Commercial	$50.83
Rate for Payer: Aetna Medicare Advantage	$40.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.11
Rate for Payer: Cigna Commercial	$66.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.12
Rate for Payer: Oxford Commercial	$26.75
Rate for Payer: Qualcare PPO/HMO/WC	$20.06
Rate for Payer: UnitedHealthcare Commercial	$26.75
Rate for Payer: UnitedHealthcare Community & State	$3.22
Rate for Payer: Wellpoint Medicaid Managed Care	$3.54

WING BMT 360 TIB SM CRUCIATE

Facility

$3,990.00

Service Code	HCPCS C1776
Hospital Charge Code	270687243
Hospital Revenue Code	278
Min. Negotiated Rate	$96.16
Max. Negotiated Rate	$1,995.00
Rate for Payer: Aetna Commercial	$1,516.20
Rate for Payer: Aetna Medicare Advantage	$1,197.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,017.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,017.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$798.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,017.45
Rate for Payer: Cigna Commercial	$1,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$965.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$877.80
Rate for Payer: Qualcare PPO/HMO/WC	$598.50
Rate for Payer: UnitedHealthcare Community & State	$96.16
Rate for Payer: Wellpoint Medicaid Managed Care	$105.73

WING BMT 360 TIB SM CRUCIATE

Facility

$3,990.00

Service Code	HCPCS C1776
Hospital Charge Code	270687243
Hospital Revenue Code	278
Min. Negotiated Rate	$598.50
Max. Negotiated Rate	$965.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$798.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$965.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$877.80
Rate for Payer: Qualcare PPO/HMO/WC	$598.50

WINRHO 5000U 2.5ML

Facility

$1,287.00

Hospital Charge Code	60635361
Hospital Revenue Code	636
Min. Negotiated Rate	$31.02
Max. Negotiated Rate	$643.50
Rate for Payer: Aetna Commercial	$489.06
Rate for Payer: Aetna Medicare Advantage	$386.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.19
Rate for Payer: Cigna Commercial	$643.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.45
Rate for Payer: Qualcare PPO/HMO/WC	$193.05
Rate for Payer: UnitedHealthcare Community & State	$31.02
Rate for Payer: Wellpoint Medicaid Managed Care	$34.11

WINRHO 5000U 2.5ML

Facility

$1,287.00

Hospital Charge Code	60635361
Hospital Revenue Code	636
Min. Negotiated Rate	$193.05
Max. Negotiated Rate	$311.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.45
Rate for Payer: Qualcare PPO/HMO/WC	$193.05

WIPE DISINFECTANT ANTIMICROBIL

Facility

$24.68

Hospital Charge Code	270653103
Hospital Revenue Code	270
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$3.70
Rate for Payer: Qualcare PPO/HMO/WC	$3.70

Know your out-of-pocket cost for care.

All Charges