Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BLOWFLY LARVAE

Facility

$247.70

Hospital Charge Code	6010300
Hospital Revenue Code	251
Min. Negotiated Rate	$37.16
Max. Negotiated Rate	$37.16
Rate for Payer: Qualcare PPO/HMO/WC	$37.16

BLS/ALS MILEAGE

Facility

$22.00

Hospital Charge Code	26000510
Hospital Revenue Code	540
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$3,643.00
Rate for Payer: Aetna Commercial	$8.36
Rate for Payer: Aetna Medicare Advantage	$6.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.61
Rate for Payer: Cigna Commercial	$11.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.60
Rate for Payer: Oxford Commercial	$2,078.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.30
Rate for Payer: UnitedHealthcare Commercial	$3,643.00
Rate for Payer: UnitedHealthcare Community & State	$0.53
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

BLS/ALS MILEAGE

Facility

$22.00

Hospital Charge Code	26000510
Hospital Revenue Code	540
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$3.30
Rate for Payer: Qualcare PPO/HMO/WC	$3.30

BLUEBOOST SUVMUCOSAL 10ML

Facility

$300.00

Hospital Charge Code	270700338
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

BLUEBOOST SUVMUCOSAL 10ML

Facility

$300.00

Hospital Charge Code	270700338
Hospital Revenue Code	272
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.00
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$60.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

BLUE MAX BALLOON DIALTION

Facility

$813.00

Hospital Charge Code	270332340
Hospital Revenue Code	272
Min. Negotiated Rate	$19.59
Max. Negotiated Rate	$406.50
Rate for Payer: Aetna Commercial	$308.94
Rate for Payer: Aetna Medicare Advantage	$243.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.31
Rate for Payer: Cigna Commercial	$406.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.90
Rate for Payer: Oxford Commercial	$162.60
Rate for Payer: Qualcare PPO/HMO/WC	$121.95
Rate for Payer: UnitedHealthcare Commercial	$162.60
Rate for Payer: UnitedHealthcare Community & State	$19.59
Rate for Payer: Wellpoint Medicaid Managed Care	$21.54

BLUE MAX BALLOON DIALTION

Facility

$813.00

Hospital Charge Code	270332340
Hospital Revenue Code	272
Min. Negotiated Rate	$121.95
Max. Negotiated Rate	$121.95
Rate for Payer: Qualcare PPO/HMO/WC	$121.95

BLUE MAXI LOOPS

Facility

$15.00

Hospital Charge Code	270331579
Hospital Revenue Code	272
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

BLUE MAXI LOOPS

Facility

$15.00

Hospital Charge Code	270331579
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

BLUNT 12MM STD THD ANCHOR

Facility

$695.52

Service Code	HCPCS C1713
Hospital Charge Code	270600096
Hospital Revenue Code	278
Min. Negotiated Rate	$16.76
Max. Negotiated Rate	$347.76
Rate for Payer: Aetna Commercial	$264.30
Rate for Payer: Aetna Medicare Advantage	$208.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.36
Rate for Payer: Cigna Commercial	$347.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$153.01
Rate for Payer: Qualcare PPO/HMO/WC	$104.33
Rate for Payer: UnitedHealthcare Community & State	$16.76
Rate for Payer: Wellpoint Medicaid Managed Care	$18.43

BLUNT 12MM STD THD ANCHOR

Facility

$695.52

Service Code	HCPCS C1713
Hospital Charge Code	270600096
Hospital Revenue Code	278
Min. Negotiated Rate	$104.33
Max. Negotiated Rate	$168.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$153.01
Rate for Payer: Qualcare PPO/HMO/WC	$104.33

BLUNT OBTURATOR 5MM

Facility

$2,750.00

Hospital Charge Code	270664003
Hospital Revenue Code	270
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

BLUNT OBTURATOR 5MM

Facility

$2,750.00

Hospital Charge Code	270664003
Hospital Revenue Code	270
Min. Negotiated Rate	$66.28
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.00
Rate for Payer: Oxford Commercial	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Commercial	$550.00
Rate for Payer: UnitedHealthcare Community & State	$66.28
Rate for Payer: Wellpoint Medicaid Managed Care	$72.88

BLUNT OBTURATOR 8MM

Facility

$2,750.00

Hospital Charge Code	27066397
Hospital Revenue Code	270
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

BLUNT OBTURATOR 8MM

Facility

$2,750.00

Hospital Charge Code	27066397
Hospital Revenue Code	270
Min. Negotiated Rate	$66.28
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.00
Rate for Payer: Oxford Commercial	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Commercial	$550.00
Rate for Payer: UnitedHealthcare Community & State	$66.28
Rate for Payer: Wellpoint Medicaid Managed Care	$72.88

BLUNT OBTURATOR, LONG 8MM

Facility

$2,950.00

Hospital Charge Code	270663995
Hospital Revenue Code	272
Min. Negotiated Rate	$442.50
Max. Negotiated Rate	$442.50
Rate for Payer: Qualcare PPO/HMO/WC	$442.50

BLUNT OBTURATOR, LONG 8MM

Facility

$2,950.00

Hospital Charge Code	270663995
Hospital Revenue Code	272
Min. Negotiated Rate	$71.09
Max. Negotiated Rate	$1,475.00
Rate for Payer: Aetna Commercial	$1,121.00
Rate for Payer: Aetna Medicare Advantage	$885.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$752.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$752.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$752.25
Rate for Payer: Cigna Commercial	$1,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$885.00
Rate for Payer: Oxford Commercial	$590.00
Rate for Payer: Qualcare PPO/HMO/WC	$442.50
Rate for Payer: UnitedHealthcare Commercial	$590.00
Rate for Payer: UnitedHealthcare Community & State	$71.09
Rate for Payer: Wellpoint Medicaid Managed Care	$78.17

BLUNT PIN 3.2MM

Facility

$265.00

Hospital Charge Code	270692840
Hospital Revenue Code	272
Min. Negotiated Rate	$39.75
Max. Negotiated Rate	$39.75
Rate for Payer: Qualcare PPO/HMO/WC	$39.75

BLUNT PIN 3.2MM

Facility

$265.00

Hospital Charge Code	270692840
Hospital Revenue Code	272
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$132.50
Rate for Payer: Aetna Commercial	$100.70
Rate for Payer: Aetna Medicare Advantage	$79.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.58
Rate for Payer: Cigna Commercial	$132.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.50
Rate for Payer: Oxford Commercial	$53.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.75
Rate for Payer: UnitedHealthcare Commercial	$53.00
Rate for Payer: UnitedHealthcare Community & State	$6.39
Rate for Payer: Wellpoint Medicaid Managed Care	$7.02

BLUNTPORT

Facility

$611.00

Hospital Charge Code	270335150
Hospital Revenue Code	272
Min. Negotiated Rate	$91.65
Max. Negotiated Rate	$91.65
Rate for Payer: Qualcare PPO/HMO/WC	$91.65

BLUNTPORT

Facility

$611.00

Hospital Charge Code	270335150
Hospital Revenue Code	272
Min. Negotiated Rate	$14.73
Max. Negotiated Rate	$305.50
Rate for Payer: Aetna Commercial	$232.18
Rate for Payer: Aetna Medicare Advantage	$183.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.81
Rate for Payer: Cigna Commercial	$305.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.30
Rate for Payer: Oxford Commercial	$122.20
Rate for Payer: Qualcare PPO/HMO/WC	$91.65
Rate for Payer: UnitedHealthcare Commercial	$122.20
Rate for Payer: UnitedHealthcare Community & State	$14.73
Rate for Payer: Wellpoint Medicaid Managed Care	$16.19

BLUNTPORT 11.5 *******

Facility

$434.00

Hospital Charge Code	1603232
Hospital Revenue Code	272
Min. Negotiated Rate	$65.10
Max. Negotiated Rate	$65.10
Rate for Payer: Qualcare PPO/HMO/WC	$65.10

BLUNTPORT 11.5 *******

Facility

$434.00

Hospital Charge Code	1603232
Hospital Revenue Code	272
Min. Negotiated Rate	$10.46
Max. Negotiated Rate	$217.00
Rate for Payer: Aetna Commercial	$164.92
Rate for Payer: Aetna Medicare Advantage	$130.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.67
Rate for Payer: Cigna Commercial	$217.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.20
Rate for Payer: Oxford Commercial	$86.80
Rate for Payer: Qualcare PPO/HMO/WC	$65.10
Rate for Payer: UnitedHealthcare Commercial	$86.80
Rate for Payer: UnitedHealthcare Community & State	$10.46
Rate for Payer: Wellpoint Medicaid Managed Care	$11.50

BLUNTPORT TROCAR 11.5MM *****

Facility

$459.00

Hospital Charge Code	1605864
Hospital Revenue Code	272
Min. Negotiated Rate	$68.85
Max. Negotiated Rate	$68.85
Rate for Payer: Qualcare PPO/HMO/WC	$68.85

BLUNTPORT TROCAR 11.5MM *****

Facility

$459.00

Hospital Charge Code	1605864
Hospital Revenue Code	272
Min. Negotiated Rate	$11.06
Max. Negotiated Rate	$229.50
Rate for Payer: Aetna Commercial	$174.42
Rate for Payer: Aetna Medicare Advantage	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.05
Rate for Payer: Cigna Commercial	$229.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.70
Rate for Payer: Oxford Commercial	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$68.85
Rate for Payer: UnitedHealthcare Commercial	$91.80
Rate for Payer: UnitedHealthcare Community & State	$11.06
Rate for Payer: Wellpoint Medicaid Managed Care	$12.16

Know your out-of-pocket cost for care.

All Charges