Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BOTTLE HOT WATER PERS DISP

Facility

$29.65

Hospital Charge Code	270300426
Hospital Revenue Code	272
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$14.82
Rate for Payer: Aetna Commercial	$11.27
Rate for Payer: Aetna Medicare Advantage	$8.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.56
Rate for Payer: Cigna Commercial	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.89
Rate for Payer: Oxford Commercial	$5.93
Rate for Payer: Qualcare PPO/HMO/WC	$4.45
Rate for Payer: UnitedHealthcare Commercial	$5.93
Rate for Payer: UnitedHealthcare Community & State	$0.71
Rate for Payer: Wellpoint Medicaid Managed Care	$0.79

BOTTLE HOT WATER PERS DISP

Facility

$29.65

Hospital Charge Code	270300426
Hospital Revenue Code	272
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$4.45
Rate for Payer: Qualcare PPO/HMO/WC	$4.45

BOTTLE HUMIDIFIER DISP

Facility

$6.47

Hospital Charge Code	270651655
Hospital Revenue Code	270
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$3.23
Rate for Payer: Aetna Commercial	$2.46
Rate for Payer: Aetna Medicare Advantage	$1.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.65
Rate for Payer: Cigna Commercial	$3.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.94
Rate for Payer: Oxford Commercial	$1.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.97
Rate for Payer: UnitedHealthcare Commercial	$1.29
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

BOTTLE HUMIDIFIER DISP

Facility

$6.47

Hospital Charge Code	270651655
Hospital Revenue Code	270
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.97

BOTTLE SPRAY FILM BARRIER 28ml

Facility

$37.13

Hospital Charge Code	270641452
Hospital Revenue Code	270
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$18.57
Rate for Payer: Aetna Commercial	$14.11
Rate for Payer: Aetna Medicare Advantage	$11.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.47
Rate for Payer: Cigna Commercial	$18.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.14
Rate for Payer: Oxford Commercial	$7.43
Rate for Payer: Qualcare PPO/HMO/WC	$5.57
Rate for Payer: UnitedHealthcare Commercial	$7.43
Rate for Payer: UnitedHealthcare Community & State	$0.89
Rate for Payer: Wellpoint Medicaid Managed Care	$0.98

BOTTLE SPRAY FILM BARRIER 28ml

Facility

$37.13

Hospital Charge Code	270641452
Hospital Revenue Code	270
Min. Negotiated Rate	$5.57
Max. Negotiated Rate	$5.57
Rate for Payer: Qualcare PPO/HMO/WC	$5.57

BOTTLE SPRY FM 28ML 4509003346

Facility

$37.50

Hospital Charge Code	270641452W
Hospital Revenue Code	272
Min. Negotiated Rate	$5.62
Max. Negotiated Rate	$5.62
Rate for Payer: Qualcare PPO/HMO/WC	$5.62

BOTTLE SPRY FM 28ML 4509003346

Facility

$37.50

Hospital Charge Code	270641452W
Hospital Revenue Code	272
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$18.75
Rate for Payer: Aetna Commercial	$14.25
Rate for Payer: Aetna Medicare Advantage	$11.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.56
Rate for Payer: Cigna Commercial	$18.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.25
Rate for Payer: Oxford Commercial	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$5.62
Rate for Payer: UnitedHealthcare Commercial	$7.50
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

BOTTLE STERILE SALINE POUR

Facility

$18.45

Hospital Charge Code	270612190
Hospital Revenue Code	272
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$9.22
Rate for Payer: Aetna Commercial	$7.01
Rate for Payer: Aetna Medicare Advantage	$5.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.70
Rate for Payer: Cigna Commercial	$9.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.54
Rate for Payer: Oxford Commercial	$3.69
Rate for Payer: Qualcare PPO/HMO/WC	$2.77
Rate for Payer: UnitedHealthcare Commercial	$3.69
Rate for Payer: UnitedHealthcare Community & State	$0.44
Rate for Payer: Wellpoint Medicaid Managed Care	$0.49

BOTTLE STERILE SALINE POUR

Facility

$18.45

Hospital Charge Code	270612190
Hospital Revenue Code	272
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$2.77
Rate for Payer: Qualcare PPO/HMO/WC	$2.77

BOTTLE THOROSEAL REPLAC 713900

Facility

$144.85

Hospital Charge Code	270300906
Hospital Revenue Code	272
Min. Negotiated Rate	$3.49
Max. Negotiated Rate	$72.42
Rate for Payer: Aetna Commercial	$55.04
Rate for Payer: Aetna Medicare Advantage	$43.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.94
Rate for Payer: Cigna Commercial	$72.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.45
Rate for Payer: Oxford Commercial	$28.97
Rate for Payer: Qualcare PPO/HMO/WC	$21.73
Rate for Payer: UnitedHealthcare Commercial	$28.97
Rate for Payer: UnitedHealthcare Community & State	$3.49
Rate for Payer: Wellpoint Medicaid Managed Care	$3.84

BOTTLE THOROSEAL REPLAC 713900

Facility

$144.85

Hospital Charge Code	270300906
Hospital Revenue Code	272
Min. Negotiated Rate	$21.73
Max. Negotiated Rate	$21.73
Rate for Payer: Qualcare PPO/HMO/WC	$21.73

BOTTLE VACUUM 1000 ********

Facility

$69.00

Hospital Charge Code	7000649
Hospital Revenue Code	279
Min. Negotiated Rate	$10.35
Max. Negotiated Rate	$10.35
Rate for Payer: Qualcare PPO/HMO/WC	$10.35

BOTTLE VACUUM 1000 ********

Facility

$69.00

Hospital Charge Code	7000649
Hospital Revenue Code	279
Min. Negotiated Rate	$1.66
Max. Negotiated Rate	$34.50
Rate for Payer: Aetna Commercial	$26.22
Rate for Payer: Aetna Medicare Advantage	$20.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.59
Rate for Payer: Cigna Commercial	$34.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.70
Rate for Payer: Oxford Commercial	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.35
Rate for Payer: UnitedHealthcare Commercial	$13.80
Rate for Payer: UnitedHealthcare Community & State	$1.66
Rate for Payer: Wellpoint Medicaid Managed Care	$1.83

BOTTLE VACUUM 1000ML

Facility

$13.65

Hospital Charge Code	270303225
Hospital Revenue Code	270
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.05

BOTTLE VACUUM 1000ML

Facility

$13.65

Hospital Charge Code	270303225
Hospital Revenue Code	270
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$6.83
Rate for Payer: Aetna Commercial	$5.19
Rate for Payer: Aetna Medicare Advantage	$4.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.48
Rate for Payer: Cigna Commercial	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.09
Rate for Payer: Oxford Commercial	$2.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.05
Rate for Payer: UnitedHealthcare Commercial	$2.73
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

BOTTLE VACUUM 500 *******

Facility

$36.00

Hospital Charge Code	7000631
Hospital Revenue Code	279
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.40

BOTTLE VACUUM 500 *******

Facility

$36.00

Hospital Charge Code	7000631
Hospital Revenue Code	279
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$18.00
Rate for Payer: Aetna Commercial	$13.68
Rate for Payer: Aetna Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.18
Rate for Payer: Cigna Commercial	$18.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.80
Rate for Payer: Oxford Commercial	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$5.40
Rate for Payer: UnitedHealthcare Commercial	$7.20
Rate for Payer: UnitedHealthcare Community & State	$0.87
Rate for Payer: Wellpoint Medicaid Managed Care	$0.95

BOTULINUM ANTITOXIN, EQUINE, ANY ROUTE

Facility

$1,626.00

Service Code	CPT 90287
Hospital Revenue Code	360
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00

BOTULINUM TOXIN TYPE A 100U

Facility

$4,832.04

Service Code	HCPCS J0585
Hospital Charge Code	606390191
Hospital Revenue Code	636
Min. Negotiated Rate	$6.18
Max. Negotiated Rate	$1,169.35
Rate for Payer: Aetna Commercial	$17.71
Rate for Payer: Aetna Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.50
Rate for Payer: Cigna Medicare Advantage	$6.51
Rate for Payer: Clover Medicare Advantage	$6.18
Rate for Payer: EmblemHealth Commercial	$19.53
Rate for Payer: Humana Medicare Advantage	$6.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,169.35
Rate for Payer: Qualcare PPO/HMO/WC	$724.81
Rate for Payer: UnitedHealthcare Community & State	$116.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.51
Rate for Payer: Wellcare Medicare Advantage	$6.51
Rate for Payer: Wellpoint Medicaid Managed Care	$128.05

BOTULINUM TOXIN TYPE A 100U

Facility

$4,832.04

Service Code	HCPCS J0585
Hospital Charge Code	606390191
Hospital Revenue Code	636
Min. Negotiated Rate	$724.81
Max. Negotiated Rate	$1,169.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,169.35
Rate for Payer: Qualcare PPO/HMO/WC	$724.81

BOTULINUM TOXIN TYPE A INJ/1M

Facility

$3,150.00

Hospital Charge Code	60628765
Hospital Revenue Code	636
Min. Negotiated Rate	$472.50
Max. Negotiated Rate	$762.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$762.30
Rate for Payer: Qualcare PPO/HMO/WC	$472.50

BOTULINUM TOXIN TYPE A INJ/1M

Facility

$3,150.00

Hospital Charge Code	60628765
Hospital Revenue Code	636
Min. Negotiated Rate	$75.92
Max. Negotiated Rate	$1,575.00
Rate for Payer: Aetna Commercial	$1,197.00
Rate for Payer: Aetna Medicare Advantage	$945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$803.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$803.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$803.25
Rate for Payer: Cigna Commercial	$1,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$762.30
Rate for Payer: Qualcare PPO/HMO/WC	$472.50
Rate for Payer: UnitedHealthcare Community & State	$75.92
Rate for Payer: Wellpoint Medicaid Managed Care	$83.47

BOUGIE M-FLEX BLUE 52FR

Facility

$1,445.00

Hospital Charge Code	270683619
Hospital Revenue Code	272
Min. Negotiated Rate	$34.82
Max. Negotiated Rate	$722.50
Rate for Payer: Aetna Commercial	$549.10
Rate for Payer: Aetna Medicare Advantage	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$368.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$368.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$368.48
Rate for Payer: Cigna Commercial	$722.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.50
Rate for Payer: Oxford Commercial	$289.00
Rate for Payer: Qualcare PPO/HMO/WC	$216.75
Rate for Payer: UnitedHealthcare Commercial	$289.00
Rate for Payer: UnitedHealthcare Community & State	$34.82
Rate for Payer: Wellpoint Medicaid Managed Care	$38.29

BOUGIE M-FLEX BLUE 52FR

Facility

$1,445.00

Hospital Charge Code	270683619
Hospital Revenue Code	272
Min. Negotiated Rate	$216.75
Max. Negotiated Rate	$216.75
Rate for Payer: Qualcare PPO/HMO/WC	$216.75

Know your out-of-pocket cost for care.

All Charges