Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BRUSH CYTOLOGY *****

Facility

$60.00

Hospital Charge Code	2300689
Hospital Revenue Code	279
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.00
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$12.00
Rate for Payer: UnitedHealthcare Community & State	$1.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

BRUSH CYTOLOGY BR 220CM 1604

Facility

$156.85

Hospital Charge Code	270606081
Hospital Revenue Code	272
Min. Negotiated Rate	$23.53
Max. Negotiated Rate	$23.53
Rate for Payer: Qualcare PPO/HMO/WC	$23.53

BRUSH CYTOLOGY BR 220CM 1604

Facility

$156.85

Hospital Charge Code	270606081
Hospital Revenue Code	272
Min. Negotiated Rate	$3.78
Max. Negotiated Rate	$78.42
Rate for Payer: Aetna Commercial	$59.60
Rate for Payer: Aetna Medicare Advantage	$47.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.00
Rate for Payer: Cigna Commercial	$78.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.05
Rate for Payer: Oxford Commercial	$31.37
Rate for Payer: Qualcare PPO/HMO/WC	$23.53
Rate for Payer: UnitedHealthcare Commercial	$31.37
Rate for Payer: UnitedHealthcare Community & State	$3.78
Rate for Payer: Wellpoint Medicaid Managed Care	$4.16

BRUSH CYTOLOGY DISP OLYMPUS***

Facility

$40.00

Hospital Charge Code	1601087
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.00
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$8.00
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

BRUSH CYTOLOGY DISP OLYMPUS***

Facility

$40.00

Hospital Charge Code	1601087
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

BRUSH CYTOLOGY RX WIRE GUID

Facility

$525.00

Hospital Charge Code	270628065
Hospital Revenue Code	272
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$78.75
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

BRUSH CYTOLOGY RX WIRE GUID

Facility

$525.00

Hospital Charge Code	270628065
Hospital Revenue Code	272
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.50
Rate for Payer: Oxford Commercial	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Commercial	$105.00
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

BRUSH DISPOSABLE CYTOLOGY

Facility

$79.54

Hospital Charge Code	270655058
Hospital Revenue Code	272
Min. Negotiated Rate	$11.93
Max. Negotiated Rate	$11.93
Rate for Payer: Qualcare PPO/HMO/WC	$11.93

BRUSH DISPOSABLE CYTOLOGY

Facility

$79.54

Hospital Charge Code	270655058
Hospital Revenue Code	272
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$39.77
Rate for Payer: Aetna Commercial	$30.23
Rate for Payer: Aetna Medicare Advantage	$23.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.28
Rate for Payer: Cigna Commercial	$39.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.86
Rate for Payer: Oxford Commercial	$15.91
Rate for Payer: Qualcare PPO/HMO/WC	$11.93
Rate for Payer: UnitedHealthcare Commercial	$15.91
Rate for Payer: UnitedHealthcare Community & State	$1.92
Rate for Payer: Wellpoint Medicaid Managed Care	$2.11

BRUSH ENDO 5MM CHANNEL 2-4MM

Facility

$12.88

Hospital Charge Code	270677794
Hospital Revenue Code	272
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.44
Rate for Payer: Aetna Commercial	$4.89
Rate for Payer: Aetna Medicare Advantage	$3.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.28
Rate for Payer: Cigna Commercial	$6.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.86
Rate for Payer: Oxford Commercial	$2.58
Rate for Payer: Qualcare PPO/HMO/WC	$1.93
Rate for Payer: UnitedHealthcare Commercial	$2.58
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

BRUSH ENDO 5MM CHANNEL 2-4MM

Facility

$12.88

Hospital Charge Code	270677794
Hospital Revenue Code	272
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$1.93

BRUSH ENDO CLEANING 000639

Facility

$16.85

Hospital Charge Code	270600924
Hospital Revenue Code	270
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

BRUSH ENDO CLEANING 000639

Facility

$16.85

Hospital Charge Code	270600924
Hospital Revenue Code	270
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.43
Rate for Payer: Aetna Commercial	$6.40
Rate for Payer: Aetna Medicare Advantage	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.05
Rate for Payer: Oxford Commercial	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$3.37
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

BRUSHES CLEANING

Facility

$125.25

Hospital Charge Code	270665251
Hospital Revenue Code	270
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$62.62
Rate for Payer: Aetna Commercial	$47.59
Rate for Payer: Aetna Medicare Advantage	$37.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.94
Rate for Payer: Cigna Commercial	$62.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.58
Rate for Payer: Oxford Commercial	$25.05
Rate for Payer: Qualcare PPO/HMO/WC	$18.79
Rate for Payer: UnitedHealthcare Commercial	$25.05
Rate for Payer: UnitedHealthcare Community & State	$3.02
Rate for Payer: Wellpoint Medicaid Managed Care	$3.32

BRUSHES CLEANING

Facility

$29.00

Hospital Charge Code	270665252
Hospital Revenue Code	270
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$14.50
Rate for Payer: Aetna Commercial	$11.02
Rate for Payer: Aetna Medicare Advantage	$8.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.39
Rate for Payer: Cigna Commercial	$14.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.70
Rate for Payer: Oxford Commercial	$5.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.35
Rate for Payer: UnitedHealthcare Commercial	$5.80
Rate for Payer: UnitedHealthcare Community & State	$0.70
Rate for Payer: Wellpoint Medicaid Managed Care	$0.77

BRUSHES CLEANING

Facility

$29.00

Hospital Charge Code	270665252
Hospital Revenue Code	270
Min. Negotiated Rate	$4.35
Max. Negotiated Rate	$4.35
Rate for Payer: Qualcare PPO/HMO/WC	$4.35

BRUSHES CLEANING

Facility

$125.25

Hospital Charge Code	270665251
Hospital Revenue Code	270
Min. Negotiated Rate	$18.79
Max. Negotiated Rate	$18.79
Rate for Payer: Qualcare PPO/HMO/WC	$18.79

BRUSH EUS RADIAL DBL HEAD COMB

Facility

$437.50

Hospital Charge Code	270684737
Hospital Revenue Code	272
Min. Negotiated Rate	$65.62
Max. Negotiated Rate	$65.62
Rate for Payer: Qualcare PPO/HMO/WC	$65.62

BRUSH EUS RADIAL DBL HEAD COMB

Facility

$437.50

Hospital Charge Code	270684737
Hospital Revenue Code	272
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$218.75
Rate for Payer: Aetna Commercial	$166.25
Rate for Payer: Aetna Medicare Advantage	$131.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.56
Rate for Payer: Cigna Commercial	$218.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.25
Rate for Payer: Oxford Commercial	$87.50
Rate for Payer: Qualcare PPO/HMO/WC	$65.62
Rate for Payer: UnitedHealthcare Commercial	$87.50
Rate for Payer: UnitedHealthcare Community & State	$10.54
Rate for Payer: Wellpoint Medicaid Managed Care	$11.59

BRUSH EZ SCRUB ULTRADEX

Facility

$2.81

Hospital Charge Code	270601067C
Hospital Revenue Code	272
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.41
Rate for Payer: Aetna Commercial	$1.07
Rate for Payer: Aetna Medicare Advantage	$0.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.72
Rate for Payer: Cigna Commercial	$1.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.84
Rate for Payer: Oxford Commercial	$0.56
Rate for Payer: Qualcare PPO/HMO/WC	$0.42
Rate for Payer: UnitedHealthcare Commercial	$0.56
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.07

BRUSH EZ SCRUB ULTRADEX

Facility

$2.81

Hospital Charge Code	270601067C
Hospital Revenue Code	272
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$0.42
Rate for Payer: Qualcare PPO/HMO/WC	$0.42

BRUSH FEMORAL BONE *******

Facility

$75.00

Hospital Charge Code	1601640
Hospital Revenue Code	272
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

BRUSH FEMORAL BONE *******

Facility

$75.00

Hospital Charge Code	1601640
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

BRUSH FEMORAL BONE 5059-13

Facility

$121.65

Hospital Charge Code	270600345
Hospital Revenue Code	272
Min. Negotiated Rate	$18.25
Max. Negotiated Rate	$18.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.25

BRUSH FEMORAL BONE 5059-13

Facility

$121.65

Hospital Charge Code	270600345
Hospital Revenue Code	272
Min. Negotiated Rate	$2.93
Max. Negotiated Rate	$60.83
Rate for Payer: Aetna Commercial	$46.23
Rate for Payer: Aetna Medicare Advantage	$36.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.02
Rate for Payer: Cigna Commercial	$60.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.49
Rate for Payer: Oxford Commercial	$24.33
Rate for Payer: Qualcare PPO/HMO/WC	$18.25
Rate for Payer: UnitedHealthcare Commercial	$24.33
Rate for Payer: UnitedHealthcare Community & State	$2.93
Rate for Payer: Wellpoint Medicaid Managed Care	$3.22

Know your out-of-pocket cost for care.

All Charges