Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BOWL ZIM MIX QUIKVAC 50490110

Facility

$337.26

Hospital Charge Code	270616932
Hospital Revenue Code	272
Min. Negotiated Rate	$50.59
Max. Negotiated Rate	$50.59
Rate for Payer: Qualcare PPO/HMO/WC	$50.59

BPAGE AFF PLUS 4000

Facility

$342.25

Hospital Charge Code	270692363
Hospital Revenue Code	272
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$171.12
Rate for Payer: Aetna Commercial	$130.06
Rate for Payer: Aetna Medicare Advantage	$102.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.27
Rate for Payer: Cigna Commercial	$171.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.67
Rate for Payer: Oxford Commercial	$68.45
Rate for Payer: Qualcare PPO/HMO/WC	$51.34
Rate for Payer: UnitedHealthcare Commercial	$68.45
Rate for Payer: UnitedHealthcare Community & State	$8.25
Rate for Payer: Wellpoint Medicaid Managed Care	$9.07

BPAGE AFF PLUS 4000

Facility

$342.25

Hospital Charge Code	270692363
Hospital Revenue Code	272
Min. Negotiated Rate	$51.34
Max. Negotiated Rate	$51.34
Rate for Payer: Qualcare PPO/HMO/WC	$51.34

B/P BLADDER REPAIR ADULT

Facility

$93.65

Hospital Charge Code	270300111
Hospital Revenue Code	270
Min. Negotiated Rate	$14.05
Max. Negotiated Rate	$14.05
Rate for Payer: Qualcare PPO/HMO/WC	$14.05

B/P BLADDER REPAIR ADULT

Facility

$93.65

Hospital Charge Code	270300111
Hospital Revenue Code	270
Min. Negotiated Rate	$2.26
Max. Negotiated Rate	$46.83
Rate for Payer: Aetna Commercial	$35.59
Rate for Payer: Aetna Medicare Advantage	$28.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.88
Rate for Payer: Cigna Commercial	$46.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.09
Rate for Payer: Oxford Commercial	$18.73
Rate for Payer: Qualcare PPO/HMO/WC	$14.05
Rate for Payer: UnitedHealthcare Commercial	$18.73
Rate for Payer: UnitedHealthcare Community & State	$2.26
Rate for Payer: Wellpoint Medicaid Managed Care	$2.48

BP CUFF ADULT

Facility

$135.05

Hospital Charge Code	270665801
Hospital Revenue Code	270
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$67.53
Rate for Payer: Aetna Commercial	$51.32
Rate for Payer: Aetna Medicare Advantage	$40.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.44
Rate for Payer: Cigna Commercial	$67.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.52
Rate for Payer: Oxford Commercial	$27.01
Rate for Payer: Qualcare PPO/HMO/WC	$20.26
Rate for Payer: UnitedHealthcare Commercial	$27.01
Rate for Payer: UnitedHealthcare Community & State	$3.25
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

BP CUFF ADULT

Facility

$135.05

Hospital Charge Code	270665801
Hospital Revenue Code	270
Min. Negotiated Rate	$20.26
Max. Negotiated Rate	$20.26
Rate for Payer: Qualcare PPO/HMO/WC	$20.26

B/P CUFF ADULT 1-TUBE

Facility

$55.40

Hospital Charge Code	27063317
Hospital Revenue Code	270
Min. Negotiated Rate	$8.31
Max. Negotiated Rate	$8.31
Rate for Payer: Qualcare PPO/HMO/WC	$8.31

B/P CUFF ADULT 1-TUBE

Facility

$55.40

Hospital Charge Code	27063317
Hospital Revenue Code	270
Min. Negotiated Rate	$1.34
Max. Negotiated Rate	$27.70
Rate for Payer: Aetna Commercial	$21.05
Rate for Payer: Aetna Medicare Advantage	$16.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.13
Rate for Payer: Cigna Commercial	$27.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.62
Rate for Payer: Oxford Commercial	$11.08
Rate for Payer: Qualcare PPO/HMO/WC	$8.31
Rate for Payer: UnitedHealthcare Commercial	$11.08
Rate for Payer: UnitedHealthcare Community & State	$1.34
Rate for Payer: Wellpoint Medicaid Managed Care	$1.47

B/P CUFF ADULT LG RESUSEABLE

Facility

$56.60

Hospital Charge Code	270649394
Hospital Revenue Code	270
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$28.30
Rate for Payer: Aetna Commercial	$21.51
Rate for Payer: Aetna Medicare Advantage	$16.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.43
Rate for Payer: Cigna Commercial	$28.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.98
Rate for Payer: Oxford Commercial	$11.32
Rate for Payer: Qualcare PPO/HMO/WC	$8.49
Rate for Payer: UnitedHealthcare Commercial	$11.32
Rate for Payer: UnitedHealthcare Community & State	$1.36
Rate for Payer: Wellpoint Medicaid Managed Care	$1.50

B/P CUFF ADULT LG RESUSEABLE

Facility

$56.60

Hospital Charge Code	270649394
Hospital Revenue Code	270
Min. Negotiated Rate	$8.49
Max. Negotiated Rate	$8.49
Rate for Payer: Qualcare PPO/HMO/WC	$8.49

BP CUFF REUSALBE LG ADULT

Facility

$48.65

Hospital Charge Code	270665395
Hospital Revenue Code	270
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$24.32
Rate for Payer: Aetna Commercial	$18.49
Rate for Payer: Aetna Medicare Advantage	$14.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.41
Rate for Payer: Cigna Commercial	$24.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.60
Rate for Payer: Oxford Commercial	$9.73
Rate for Payer: Qualcare PPO/HMO/WC	$7.30
Rate for Payer: UnitedHealthcare Commercial	$9.73
Rate for Payer: UnitedHealthcare Community & State	$1.17
Rate for Payer: Wellpoint Medicaid Managed Care	$1.29

BP CUFF REUSALBE LG ADULT

Facility

$48.65

Hospital Charge Code	270665395
Hospital Revenue Code	270
Min. Negotiated Rate	$7.30
Max. Negotiated Rate	$7.30
Rate for Payer: Qualcare PPO/HMO/WC	$7.30

BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD

Facility

$4,413.55

Service Code	APR-DRG 1321
Min. Negotiated Rate	$4,327.01
Max. Negotiated Rate	$4,413.55
Rate for Payer: UnitedHealthcare Community & State	$4,327.01
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,413.55
Rate for Payer: Wellpoint Medicaid Managed Care	$4,327.01

BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD

Facility

$5,968.61

Service Code	APR-DRG 1322
Min. Negotiated Rate	$5,851.58
Max. Negotiated Rate	$5,968.61
Rate for Payer: UnitedHealthcare Community & State	$5,851.58
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,968.61
Rate for Payer: Wellpoint Medicaid Managed Care	$5,851.58

BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD

Facility

$16,713.43

Service Code	APR-DRG 1324
Min. Negotiated Rate	$16,385.72
Max. Negotiated Rate	$16,713.43
Rate for Payer: UnitedHealthcare Community & State	$16,385.72
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,713.43
Rate for Payer: Wellpoint Medicaid Managed Care	$16,385.72

BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD

Facility

$11,117.60

Service Code	APR-DRG 1323
Min. Negotiated Rate	$10,899.61
Max. Negotiated Rate	$11,117.60
Rate for Payer: UnitedHealthcare Community & State	$10,899.61
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,117.60
Rate for Payer: Wellpoint Medicaid Managed Care	$10,899.61

BPERTAB I

Facility

$90.65

Service Code	HCPCS 8661591
Hospital Charge Code	39990084A
Hospital Revenue Code	302
Min. Negotiated Rate	$2.18
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$34.45
Rate for Payer: Aetna Medicare Advantage	$27.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.12
Rate for Payer: Cigna Commercial	$45.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.18
Rate for Payer: Wellpoint Medicaid Managed Care	$2.40

BPERTAB I

Facility

$90.65

Service Code	HCPCS 8661591
Hospital Charge Code	39990084A
Hospital Revenue Code	302
Min. Negotiated Rate	$13.60
Max. Negotiated Rate	$13.60
Rate for Payer: Qualcare PPO/HMO/WC	$13.60

BPERTAB II

Facility

$90.65

Service Code	HCPCS 8661591
Hospital Charge Code	39990084B
Hospital Revenue Code	302
Min. Negotiated Rate	$2.18
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$34.45
Rate for Payer: Aetna Medicare Advantage	$27.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.12
Rate for Payer: Cigna Commercial	$45.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.18
Rate for Payer: Wellpoint Medicaid Managed Care	$2.40

BPERTAB II

Facility

$90.65

Service Code	HCPCS 8661591
Hospital Charge Code	39990084B
Hospital Revenue Code	302
Min. Negotiated Rate	$13.60
Max. Negotiated Rate	$13.60
Rate for Payer: Qualcare PPO/HMO/WC	$13.60

BPERTAB III

Facility

$90.65

Service Code	HCPCS 8661591
Hospital Charge Code	39990084C
Hospital Revenue Code	302
Min. Negotiated Rate	$2.18
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$34.45
Rate for Payer: Aetna Medicare Advantage	$27.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.12
Rate for Payer: Cigna Commercial	$45.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.18
Rate for Payer: Wellpoint Medicaid Managed Care	$2.40

BPERTAB III

Facility

$90.65

Service Code	HCPCS 8661591
Hospital Charge Code	39990084C
Hospital Revenue Code	302
Min. Negotiated Rate	$13.60
Max. Negotiated Rate	$13.60
Rate for Payer: Qualcare PPO/HMO/WC	$13.60

BPERTAB IV

Facility

$90.65

Service Code	HCPCS 8661591
Hospital Charge Code	39990084D
Hospital Revenue Code	302
Min. Negotiated Rate	$13.60
Max. Negotiated Rate	$13.60
Rate for Payer: Qualcare PPO/HMO/WC	$13.60

BPERTAB IV

Facility

$90.65

Service Code	HCPCS 8661591
Hospital Charge Code	39990084D
Hospital Revenue Code	302
Min. Negotiated Rate	$2.18
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$34.45
Rate for Payer: Aetna Medicare Advantage	$27.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.12
Rate for Payer: Cigna Commercial	$45.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.18
Rate for Payer: Wellpoint Medicaid Managed Care	$2.40

Know your out-of-pocket cost for care.

All Charges