Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BOUGIE M-FLEX BLUE 54FR

Facility

$1,445.00

Hospital Charge Code	270683621
Hospital Revenue Code	272
Min. Negotiated Rate	$216.75
Max. Negotiated Rate	$216.75
Rate for Payer: Qualcare PPO/HMO/WC	$216.75

BOUGIE M-FLEX BLUE 54FR

Facility

$1,445.00

Hospital Charge Code	270683620
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 54FR

Facility

$1,445.00

Hospital Charge Code	270683621
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 54FR

Facility

$1,445.00

Hospital Charge Code	270683620
Hospital Revenue Code	272
Min. Negotiated Rate	$216.75
Max. Negotiated Rate	$216.75
Rate for Payer: Qualcare PPO/HMO/WC	$216.75

BOURDEAUXS BUTT PASTE

Facility

$15.08

Service Code	NDC 62103033300
Hospital Charge Code	606380038
Hospital Revenue Code	250
Min. Negotiated Rate	$2.26
Max. Negotiated Rate	$2.26
Rate for Payer: Qualcare PPO/HMO/WC	$2.26

BOURDEAUXS BUTT PASTE

Facility

$15.08

Service Code	NDC 62103033300
Hospital Charge Code	606380038
Hospital Revenue Code	250
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$7.54
Rate for Payer: Aetna Commercial	$5.73
Rate for Payer: Aetna Medicare Advantage	$4.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.85
Rate for Payer: Cigna Commercial	$7.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.52
Rate for Payer: Oxford Commercial	$3.02
Rate for Payer: Qualcare PPO/HMO/WC	$2.26
Rate for Payer: UnitedHealthcare Commercial	$3.02
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

BOWER PEG KIT 20FR

Facility

$744.00

Hospital Charge Code	270332542
Hospital Revenue Code	272
Min. Negotiated Rate	$17.93
Max. Negotiated Rate	$372.00
Rate for Payer: Aetna Commercial	$282.72
Rate for Payer: Aetna Medicare Advantage	$223.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.72
Rate for Payer: Cigna Commercial	$372.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.20
Rate for Payer: Oxford Commercial	$148.80
Rate for Payer: Qualcare PPO/HMO/WC	$111.60
Rate for Payer: UnitedHealthcare Commercial	$148.80
Rate for Payer: UnitedHealthcare Community & State	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$19.72

BOWER PEG KIT 20FR

Facility

$744.00

Hospital Charge Code	270332542
Hospital Revenue Code	272
Min. Negotiated Rate	$111.60
Max. Negotiated Rate	$111.60
Rate for Payer: Qualcare PPO/HMO/WC	$111.60

BOWL MIXING ADVANCED CEMENT

Facility

$419.75

Hospital Charge Code	270651658
Hospital Revenue Code	272
Min. Negotiated Rate	$62.96
Max. Negotiated Rate	$62.96
Rate for Payer: Qualcare PPO/HMO/WC	$62.96

BOWL MIXING ADVANCED CEMENT

Facility

$419.75

Hospital Charge Code	270651658
Hospital Revenue Code	272
Min. Negotiated Rate	$10.12
Max. Negotiated Rate	$209.88
Rate for Payer: Aetna Commercial	$159.50
Rate for Payer: Aetna Medicare Advantage	$125.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.04
Rate for Payer: Cigna Commercial	$209.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.92
Rate for Payer: Oxford Commercial	$83.95
Rate for Payer: Qualcare PPO/HMO/WC	$62.96
Rate for Payer: UnitedHealthcare Commercial	$83.95
Rate for Payer: UnitedHealthcare Community & State	$10.12
Rate for Payer: Wellpoint Medicaid Managed Care	$11.12

BOWL MIXING ORTHO DISP ******

Facility

$26.35

Hospital Charge Code	1601616
Hospital Revenue Code	272
Min. Negotiated Rate	$3.95
Max. Negotiated Rate	$3.95
Rate for Payer: Qualcare PPO/HMO/WC	$3.95

BOWL MIXING ORTHO DISP ******

Facility

$26.35

Hospital Charge Code	1601616
Hospital Revenue Code	272
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$13.18
Rate for Payer: Aetna Commercial	$10.01
Rate for Payer: Aetna Medicare Advantage	$7.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.72
Rate for Payer: Cigna Commercial	$13.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.91
Rate for Payer: Oxford Commercial	$5.27
Rate for Payer: Qualcare PPO/HMO/WC	$3.95
Rate for Payer: UnitedHealthcare Commercial	$5.27
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.70

BOWL MIXING OSTEOBOND 5049-91

Facility

$864.85

Hospital Charge Code	270600357
Hospital Revenue Code	272
Min. Negotiated Rate	$20.84
Max. Negotiated Rate	$432.43
Rate for Payer: Aetna Commercial	$328.64
Rate for Payer: Aetna Medicare Advantage	$259.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$220.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$220.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$220.54
Rate for Payer: Cigna Commercial	$432.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.45
Rate for Payer: Oxford Commercial	$172.97
Rate for Payer: Qualcare PPO/HMO/WC	$129.73
Rate for Payer: UnitedHealthcare Commercial	$172.97
Rate for Payer: UnitedHealthcare Community & State	$20.84
Rate for Payer: Wellpoint Medicaid Managed Care	$22.92

BOWL MIXING OSTEOBOND 5049-91

Facility

$864.85

Hospital Charge Code	270600357
Hospital Revenue Code	272
Min. Negotiated Rate	$129.73
Max. Negotiated Rate	$129.73
Rate for Payer: Qualcare PPO/HMO/WC	$129.73

BOWL PROCES ELECTA 55ML ESOR55

Facility

$332.40

Hospital Charge Code	270635592
Hospital Revenue Code	272
Min. Negotiated Rate	$8.01
Max. Negotiated Rate	$166.20
Rate for Payer: Aetna Commercial	$126.31
Rate for Payer: Aetna Medicare Advantage	$99.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.76
Rate for Payer: Cigna Commercial	$166.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.72
Rate for Payer: Oxford Commercial	$66.48
Rate for Payer: Qualcare PPO/HMO/WC	$49.86
Rate for Payer: UnitedHealthcare Commercial	$66.48
Rate for Payer: UnitedHealthcare Community & State	$8.01
Rate for Payer: Wellpoint Medicaid Managed Care	$8.81

BOWL PROCES ELECTA 55ML ESOR55

Facility

$332.40

Hospital Charge Code	270635592
Hospital Revenue Code	272
Min. Negotiated Rate	$49.86
Max. Negotiated Rate	$49.86
Rate for Payer: Qualcare PPO/HMO/WC	$49.86

BOWL PROCESSING 125ml ESOR125

Facility

$348.75

Hospital Charge Code	270640211
Hospital Revenue Code	270
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$174.38
Rate for Payer: Aetna Commercial	$132.53
Rate for Payer: Aetna Medicare Advantage	$104.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.93
Rate for Payer: Cigna Commercial	$174.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.62
Rate for Payer: Oxford Commercial	$69.75
Rate for Payer: Qualcare PPO/HMO/WC	$52.31
Rate for Payer: UnitedHealthcare Commercial	$69.75
Rate for Payer: UnitedHealthcare Community & State	$8.40
Rate for Payer: Wellpoint Medicaid Managed Care	$9.24

BOWL PROCESSING 125ml ESOR125

Facility

$348.75

Hospital Charge Code	270640211
Hospital Revenue Code	270
Min. Negotiated Rate	$52.31
Max. Negotiated Rate	$52.31
Rate for Payer: Qualcare PPO/HMO/WC	$52.31

BOWL PROCESSING SOR 175 SOR175

Facility

$340.00

Hospital Charge Code	270619103
Hospital Revenue Code	272
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

BOWL PROCESSING SOR 175 SOR175

Facility

$340.00

Hospital Charge Code	270619103
Hospital Revenue Code	272
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$129.20
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.00
Rate for Payer: Oxford Commercial	$68.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00
Rate for Payer: UnitedHealthcare Commercial	$68.00
Rate for Payer: UnitedHealthcare Community & State	$8.19
Rate for Payer: Wellpoint Medicaid Managed Care	$9.01

BOWL PROCESSING SOR 225 SOR225

Facility

$340.00

Hospital Charge Code	270619102
Hospital Revenue Code	272
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$129.20
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.00
Rate for Payer: Oxford Commercial	$68.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00
Rate for Payer: UnitedHealthcare Commercial	$68.00
Rate for Payer: UnitedHealthcare Community & State	$8.19
Rate for Payer: Wellpoint Medicaid Managed Care	$9.01

BOWL PROCESSING SOR 225 SOR225

Facility

$340.00

Hospital Charge Code	270619102
Hospital Revenue Code	272
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

BOWL PROCESSING SORIN 55 SOR55

Facility

$340.00

Hospital Charge Code	270619038
Hospital Revenue Code	272
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

BOWL PROCESSING SORIN 55 SOR55

Facility

$340.00

Hospital Charge Code	270619038
Hospital Revenue Code	272
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$129.20
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.00
Rate for Payer: Oxford Commercial	$68.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00
Rate for Payer: UnitedHealthcare Commercial	$68.00
Rate for Payer: UnitedHealthcare Community & State	$8.19
Rate for Payer: Wellpoint Medicaid Managed Care	$9.01

BOWL ZIM MIX QUIKVAC 50490110

Facility

$337.26

Hospital Charge Code	270616932
Hospital Revenue Code	272
Min. Negotiated Rate	$8.13
Max. Negotiated Rate	$168.63
Rate for Payer: Aetna Commercial	$128.16
Rate for Payer: Aetna Medicare Advantage	$101.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.00
Rate for Payer: Cigna Commercial	$168.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.18
Rate for Payer: Oxford Commercial	$67.45
Rate for Payer: Qualcare PPO/HMO/WC	$50.59
Rate for Payer: UnitedHealthcare Commercial	$67.45
Rate for Payer: UnitedHealthcare Community & State	$8.13
Rate for Payer: Wellpoint Medicaid Managed Care	$8.94

Know your out-of-pocket cost for care.

All Charges