Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

WOUNDVAC DRSG BLACK LG 5PK

Facility

$262.71

Hospital Charge Code	270100000
Hospital Revenue Code	272
Min. Negotiated Rate	$6.33
Max. Negotiated Rate	$131.35
Rate for Payer: Aetna Commercial	$99.83
Rate for Payer: Aetna Medicare Advantage	$78.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.99
Rate for Payer: Cigna Commercial	$131.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.81
Rate for Payer: Oxford Commercial	$52.54
Rate for Payer: Qualcare PPO/HMO/WC	$39.41
Rate for Payer: UnitedHealthcare Commercial	$52.54
Rate for Payer: UnitedHealthcare Community & State	$6.33
Rate for Payer: Wellpoint Medicaid Managed Care	$6.96

WOUNDVAC DRSG BLACK LG 5PK

Facility

$262.71

Hospital Charge Code	270100000
Hospital Revenue Code	272
Min. Negotiated Rate	$39.41
Max. Negotiated Rate	$39.41
Rate for Payer: Qualcare PPO/HMO/WC	$39.41

WOUNDVAC DRSG BLACK MED 10PK

Facility

$197.38

Hospital Charge Code	270672867
Hospital Revenue Code	272
Min. Negotiated Rate	$29.61
Max. Negotiated Rate	$29.61
Rate for Payer: Qualcare PPO/HMO/WC	$29.61

WOUNDVAC DRSG BLACK MED 10PK

Facility

$197.38

Hospital Charge Code	270672867
Hospital Revenue Code	272
Min. Negotiated Rate	$4.76
Max. Negotiated Rate	$98.69
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$59.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.33
Rate for Payer: Cigna Commercial	$98.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.21
Rate for Payer: Oxford Commercial	$39.48
Rate for Payer: Qualcare PPO/HMO/WC	$29.61
Rate for Payer: UnitedHealthcare Commercial	$39.48
Rate for Payer: UnitedHealthcare Community & State	$4.76
Rate for Payer: Wellpoint Medicaid Managed Care	$5.23

WOUNDVAC DRSG BLACK MED 5PK

Facility

$217.80

Hospital Charge Code	270100005
Hospital Revenue Code	272
Min. Negotiated Rate	$32.67
Max. Negotiated Rate	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$32.67

WOUNDVAC DRSG BLACK MED 5PK

Facility

$217.80

Hospital Charge Code	270100005
Hospital Revenue Code	272
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$108.90
Rate for Payer: Aetna Commercial	$82.76
Rate for Payer: Aetna Medicare Advantage	$65.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.54
Rate for Payer: Cigna Commercial	$108.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: Oxford Commercial	$43.56
Rate for Payer: Qualcare PPO/HMO/WC	$32.67
Rate for Payer: UnitedHealthcare Commercial	$43.56
Rate for Payer: UnitedHealthcare Community & State	$5.25
Rate for Payer: Wellpoint Medicaid Managed Care	$5.77

WOUNDVAC DRSG BLACK SML 10PK

Facility

$156.54

Hospital Charge Code	270672865
Hospital Revenue Code	272
Min. Negotiated Rate	$23.48
Max. Negotiated Rate	$23.48
Rate for Payer: Qualcare PPO/HMO/WC	$23.48

WOUNDVAC DRSG BLACK SML 10PK

Facility

$156.54

Hospital Charge Code	270672865
Hospital Revenue Code	272
Min. Negotiated Rate	$3.77
Max. Negotiated Rate	$78.27
Rate for Payer: Aetna Commercial	$59.49
Rate for Payer: Aetna Medicare Advantage	$46.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.92
Rate for Payer: Cigna Commercial	$78.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.96
Rate for Payer: Oxford Commercial	$31.31
Rate for Payer: Qualcare PPO/HMO/WC	$23.48
Rate for Payer: UnitedHealthcare Commercial	$31.31
Rate for Payer: UnitedHealthcare Community & State	$3.77
Rate for Payer: Wellpoint Medicaid Managed Care	$4.15

WOUNDVAC DRSG BLACK SML 5PK

Facility

$172.89

Hospital Charge Code	270100010
Hospital Revenue Code	272
Min. Negotiated Rate	$25.93
Max. Negotiated Rate	$25.93
Rate for Payer: Qualcare PPO/HMO/WC	$25.93

WOUNDVAC DRSG BLACK SML 5PK

Facility

$172.89

Hospital Charge Code	270100010
Hospital Revenue Code	272
Min. Negotiated Rate	$4.17
Max. Negotiated Rate	$86.44
Rate for Payer: Aetna Commercial	$65.70
Rate for Payer: Aetna Medicare Advantage	$51.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.09
Rate for Payer: Cigna Commercial	$86.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.87
Rate for Payer: Oxford Commercial	$34.58
Rate for Payer: Qualcare PPO/HMO/WC	$25.93
Rate for Payer: UnitedHealthcare Commercial	$34.58
Rate for Payer: UnitedHealthcare Community & State	$4.17
Rate for Payer: Wellpoint Medicaid Managed Care	$4.58

WOUNDVAC DRSG GRANUFOAM MED

Facility

$256.26

Hospital Charge Code	270655349
Hospital Revenue Code	272
Min. Negotiated Rate	$6.18
Max. Negotiated Rate	$128.13
Rate for Payer: Aetna Commercial	$97.38
Rate for Payer: Aetna Medicare Advantage	$76.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.35
Rate for Payer: Cigna Commercial	$128.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.88
Rate for Payer: Oxford Commercial	$51.25
Rate for Payer: Qualcare PPO/HMO/WC	$38.44
Rate for Payer: UnitedHealthcare Commercial	$51.25
Rate for Payer: UnitedHealthcare Community & State	$6.18
Rate for Payer: Wellpoint Medicaid Managed Care	$6.79

WOUNDVAC DRSG GRANUFOAM MED

Facility

$256.26

Hospital Charge Code	270655349
Hospital Revenue Code	272
Min. Negotiated Rate	$38.44
Max. Negotiated Rate	$38.44
Rate for Payer: Qualcare PPO/HMO/WC	$38.44

WOUNDVAC DRSG SILVER MEDIUM

Facility

$308.30

Hospital Charge Code	270100035
Hospital Revenue Code	272
Min. Negotiated Rate	$7.43
Max. Negotiated Rate	$154.15
Rate for Payer: Aetna Commercial	$117.15
Rate for Payer: Aetna Medicare Advantage	$92.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.62
Rate for Payer: Cigna Commercial	$154.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.49
Rate for Payer: Oxford Commercial	$61.66
Rate for Payer: Qualcare PPO/HMO/WC	$46.24
Rate for Payer: UnitedHealthcare Commercial	$61.66
Rate for Payer: UnitedHealthcare Community & State	$7.43
Rate for Payer: Wellpoint Medicaid Managed Care	$8.17

WOUNDVAC DRSG SILVER MEDIUM

Facility

$308.30

Hospital Charge Code	270100035
Hospital Revenue Code	272
Min. Negotiated Rate	$46.24
Max. Negotiated Rate	$46.24
Rate for Payer: Qualcare PPO/HMO/WC	$46.24

WOUNDVAC DRSG SILVER SM

Facility

$258.45

Hospital Charge Code	270677273
Hospital Revenue Code	272
Min. Negotiated Rate	$38.77
Max. Negotiated Rate	$38.77
Rate for Payer: Qualcare PPO/HMO/WC	$38.77

WOUNDVAC DRSG SILVER SM

Facility

$258.45

Hospital Charge Code	270677273
Hospital Revenue Code	272
Min. Negotiated Rate	$6.23
Max. Negotiated Rate	$129.22
Rate for Payer: Aetna Commercial	$98.21
Rate for Payer: Aetna Medicare Advantage	$77.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.90
Rate for Payer: Cigna Commercial	$129.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.53
Rate for Payer: Oxford Commercial	$51.69
Rate for Payer: Qualcare PPO/HMO/WC	$38.77
Rate for Payer: UnitedHealthcare Commercial	$51.69
Rate for Payer: UnitedHealthcare Community & State	$6.23
Rate for Payer: Wellpoint Medicaid Managed Care	$6.85

WOUNDVAC DRSG WHITEFOAM SM

Facility

$51.36

Hospital Charge Code	270636063
Hospital Revenue Code	270
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$7.70
Rate for Payer: Qualcare PPO/HMO/WC	$7.70

WOUNDVAC DRSG WHITEFOAM SM

Facility

$237.31

Hospital Charge Code	270641761
Hospital Revenue Code	272
Min. Negotiated Rate	$5.72
Max. Negotiated Rate	$118.66
Rate for Payer: Aetna Commercial	$90.18
Rate for Payer: Aetna Medicare Advantage	$71.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.51
Rate for Payer: Cigna Commercial	$118.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.19
Rate for Payer: Oxford Commercial	$47.46
Rate for Payer: Qualcare PPO/HMO/WC	$35.60
Rate for Payer: UnitedHealthcare Commercial	$47.46
Rate for Payer: UnitedHealthcare Community & State	$5.72
Rate for Payer: Wellpoint Medicaid Managed Care	$6.29

WOUNDVAC DRSG WHITEFOAM SM

Facility

$237.31

Hospital Charge Code	270641761
Hospital Revenue Code	272
Min. Negotiated Rate	$35.60
Max. Negotiated Rate	$35.60
Rate for Payer: Qualcare PPO/HMO/WC	$35.60

WOUNDVAC DRSG WHITEFOAM SM

Facility

$51.36

Hospital Charge Code	270636063
Hospital Revenue Code	270
Min. Negotiated Rate	$1.24
Max. Negotiated Rate	$25.68
Rate for Payer: Aetna Commercial	$19.52
Rate for Payer: Aetna Medicare Advantage	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.10
Rate for Payer: Cigna Commercial	$25.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.41
Rate for Payer: Oxford Commercial	$10.27
Rate for Payer: Qualcare PPO/HMO/WC	$7.70
Rate for Payer: UnitedHealthcare Commercial	$10.27
Rate for Payer: UnitedHealthcare Community & State	$1.24
Rate for Payer: Wellpoint Medicaid Managed Care	$1.36

WOUNDVAC MACHINE INFOVAC

Facility

$297.25

Hospital Charge Code	270640148
Hospital Revenue Code	270
Min. Negotiated Rate	$44.59
Max. Negotiated Rate	$44.59
Rate for Payer: Qualcare PPO/HMO/WC	$44.59

WOUNDVAC MACHINE INFOVAC

Facility

$297.25

Hospital Charge Code	270640148
Hospital Revenue Code	270
Min. Negotiated Rate	$7.16
Max. Negotiated Rate	$148.62
Rate for Payer: Aetna Commercial	$112.95
Rate for Payer: Aetna Medicare Advantage	$89.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.80
Rate for Payer: Cigna Commercial	$148.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.17
Rate for Payer: Oxford Commercial	$59.45
Rate for Payer: Qualcare PPO/HMO/WC	$44.59
Rate for Payer: UnitedHealthcare Commercial	$59.45
Rate for Payer: UnitedHealthcare Community & State	$7.16
Rate for Payer: Wellpoint Medicaid Managed Care	$7.88

WOUNDVAC PICO NEG PRESS 5.9 X

Facility

$830.38

Service Code	HCPCS A6550
Hospital Charge Code	270689961
Hospital Revenue Code	270
Min. Negotiated Rate	$124.56
Max. Negotiated Rate	$124.56
Rate for Payer: Qualcare PPO/HMO/WC	$124.56

WOUNDVAC PICO NEG PRESS 5.9 X

Facility

$830.38

Service Code	HCPCS A6550
Hospital Charge Code	270689961
Hospital Revenue Code	270
Min. Negotiated Rate	$20.01
Max. Negotiated Rate	$415.19
Rate for Payer: Aetna Commercial	$315.54
Rate for Payer: Aetna Medicare Advantage	$249.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.75
Rate for Payer: Cigna Commercial	$415.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.11
Rate for Payer: Oxford Commercial	$166.08
Rate for Payer: Qualcare PPO/HMO/WC	$124.56
Rate for Payer: UnitedHealthcare Commercial	$166.08
Rate for Payer: UnitedHealthcare Community & State	$20.01
Rate for Payer: Wellpoint Medicaid Managed Care	$22.01

WOUNDVAC TRAC PAD

Facility

$82.62

Hospital Charge Code	270100030
Hospital Revenue Code	272
Min. Negotiated Rate	$12.39
Max. Negotiated Rate	$12.39
Rate for Payer: Qualcare PPO/HMO/WC	$12.39

Know your out-of-pocket cost for care.

All Charges