Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BUFFERED OPHTH IRRIG 118ML

Facility

$48.00

Hospital Charge Code	6000756
Hospital Revenue Code	251
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

BUFFERIN/TAB

Facility

$1.00

Hospital Charge Code	60634217
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

BUFFERIN/TAB

Facility

$1.00

Hospital Charge Code	60634217
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.50
Rate for Payer: Aetna Commercial	$0.38
Rate for Payer: Aetna Medicare Advantage	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.30
Rate for Payer: Oxford Commercial	$0.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.15
Rate for Payer: UnitedHealthcare Commercial	$0.20
Rate for Payer: UnitedHealthcare Community & State	$0.02
Rate for Payer: Wellpoint Medicaid Managed Care	$0.03

BUFFER PH4 500ML

Facility

$207.25

Hospital Charge Code	270605119
Hospital Revenue Code	272
Min. Negotiated Rate	$31.09
Max. Negotiated Rate	$31.09
Rate for Payer: Qualcare PPO/HMO/WC	$31.09

BUFFER PH4 500ML

Facility

$207.25

Hospital Charge Code	270605119
Hospital Revenue Code	272
Min. Negotiated Rate	$4.99
Max. Negotiated Rate	$103.62
Rate for Payer: Aetna Commercial	$78.75
Rate for Payer: Aetna Medicare Advantage	$62.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.85
Rate for Payer: Cigna Commercial	$103.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.17
Rate for Payer: Oxford Commercial	$41.45
Rate for Payer: Qualcare PPO/HMO/WC	$31.09
Rate for Payer: UnitedHealthcare Commercial	$41.45
Rate for Payer: UnitedHealthcare Community & State	$4.99
Rate for Payer: Wellpoint Medicaid Managed Care	$5.49

BUFFER PH7 500ML

Facility

$207.25

Hospital Charge Code	270605118
Hospital Revenue Code	272
Min. Negotiated Rate	$4.99
Max. Negotiated Rate	$103.62
Rate for Payer: Aetna Commercial	$78.75
Rate for Payer: Aetna Medicare Advantage	$62.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.85
Rate for Payer: Cigna Commercial	$103.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.17
Rate for Payer: Oxford Commercial	$41.45
Rate for Payer: Qualcare PPO/HMO/WC	$31.09
Rate for Payer: UnitedHealthcare Commercial	$41.45
Rate for Payer: UnitedHealthcare Community & State	$4.99
Rate for Payer: Wellpoint Medicaid Managed Care	$5.49

BUFFER PH7 500ML

Facility

$207.25

Hospital Charge Code	270605118
Hospital Revenue Code	272
Min. Negotiated Rate	$31.09
Max. Negotiated Rate	$31.09
Rate for Payer: Qualcare PPO/HMO/WC	$31.09

BUG GUARD LONG

Facility

$1,531.80

Hospital Charge Code	270657064
Hospital Revenue Code	272
Min. Negotiated Rate	$229.77
Max. Negotiated Rate	$229.77
Rate for Payer: Qualcare PPO/HMO/WC	$229.77

BUG GUARD LONG

Facility

$1,531.80

Hospital Charge Code	270657064
Hospital Revenue Code	272
Min. Negotiated Rate	$36.92
Max. Negotiated Rate	$765.90
Rate for Payer: Aetna Commercial	$582.08
Rate for Payer: Aetna Medicare Advantage	$459.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$390.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$390.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$390.61
Rate for Payer: Cigna Commercial	$765.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.54
Rate for Payer: Oxford Commercial	$306.36
Rate for Payer: Qualcare PPO/HMO/WC	$229.77
Rate for Payer: UnitedHealthcare Commercial	$306.36
Rate for Payer: UnitedHealthcare Community & State	$36.92
Rate for Payer: Wellpoint Medicaid Managed Care	$40.59

BULB J PRATT 100CC SUI301305

Facility

$24.85

Hospital Charge Code	270600417
Hospital Revenue Code	270
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.43
Rate for Payer: Aetna Commercial	$9.44
Rate for Payer: Aetna Medicare Advantage	$7.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.34
Rate for Payer: Cigna Commercial	$12.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.46
Rate for Payer: Oxford Commercial	$4.97
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
Rate for Payer: UnitedHealthcare Commercial	$4.97
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

BULB J PRATT 100CC SUI301305

Facility

$24.85

Hospital Charge Code	270600417
Hospital Revenue Code	270
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

BULB SUCTION

Facility

$16.00

Hospital Charge Code	270331434
Hospital Revenue Code	272
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.40

BULB SUCTION

Facility

$16.00

Hospital Charge Code	270331434
Hospital Revenue Code	272
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$8.00
Rate for Payer: Aetna Commercial	$6.08
Rate for Payer: Aetna Medicare Advantage	$4.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.08
Rate for Payer: Cigna Commercial	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.80
Rate for Payer: Oxford Commercial	$3.20
Rate for Payer: Qualcare PPO/HMO/WC	$2.40
Rate for Payer: UnitedHealthcare Commercial	$3.20
Rate for Payer: UnitedHealthcare Community & State	$0.39
Rate for Payer: Wellpoint Medicaid Managed Care	$0.42

BULB SYRINGE IRRIGATION SET

Facility

$6.86

Service Code	HCPCS A4322
Hospital Charge Code	270649781
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.43
Rate for Payer: Aetna Commercial	$2.61
Rate for Payer: Aetna Medicare Advantage	$2.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.75
Rate for Payer: Cigna Commercial	$3.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.06
Rate for Payer: Oxford Commercial	$1.37
Rate for Payer: Qualcare PPO/HMO/WC	$1.03
Rate for Payer: UnitedHealthcare Commercial	$1.37
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

BULB SYRINGE IRRIGATION SET

Facility

$6.86

Service Code	HCPCS A4322
Hospital Charge Code	270649781
Hospital Revenue Code	272
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$1.03
Rate for Payer: Qualcare PPO/HMO/WC	$1.03

BULB VAG SPEC ILLUMNATION 4.6V

Facility

$130.80

Hospital Charge Code	270651674
Hospital Revenue Code	270
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$65.40
Rate for Payer: Aetna Commercial	$49.70
Rate for Payer: Aetna Medicare Advantage	$39.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.35
Rate for Payer: Cigna Commercial	$65.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.24
Rate for Payer: Oxford Commercial	$26.16
Rate for Payer: Qualcare PPO/HMO/WC	$19.62
Rate for Payer: UnitedHealthcare Commercial	$26.16
Rate for Payer: UnitedHealthcare Community & State	$3.15
Rate for Payer: Wellpoint Medicaid Managed Care	$3.47

BULB VAG SPEC ILLUMNATION 4.6V

Facility

$130.80

Hospital Charge Code	270651674
Hospital Revenue Code	270
Min. Negotiated Rate	$19.62
Max. Negotiated Rate	$19.62
Rate for Payer: Qualcare PPO/HMO/WC	$19.62

BULKAMID URET IMP BULKING SYST

Facility

$5,750.00

Service Code	HCPCS L8603
Hospital Charge Code	270697611
Hospital Revenue Code	278
Min. Negotiated Rate	$138.57
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$2,185.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,265.00
Rate for Payer: Qualcare PPO/HMO/WC	$862.50
Rate for Payer: UnitedHealthcare Community & State	$138.57
Rate for Payer: Wellpoint Medicaid Managed Care	$152.38

BULKAMID URET IMP BULKING SYST

Facility

$5,750.00

Service Code	HCPCS L8603
Hospital Charge Code	270697611
Hospital Revenue Code	278
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$1,391.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,265.00
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

BULK TWIST LOCK CABLE 64CM

Facility

$400.00

Hospital Charge Code	270671696
Hospital Revenue Code	272
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

BULK TWIST LOCK CABLE 64CM

Facility

$400.00

Hospital Charge Code	270671696
Hospital Revenue Code	272
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.00
Rate for Payer: Oxford Commercial	$80.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Commercial	$80.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.60

BULLDOG ATRAUMATIC VASCULAR CL

Facility

$4,694.55

Hospital Charge Code	270665288
Hospital Revenue Code	272
Min. Negotiated Rate	$704.18
Max. Negotiated Rate	$704.18
Rate for Payer: Qualcare PPO/HMO/WC	$704.18

BULLDOG ATRAUMATIC VASCULAR CL

Facility

$4,694.55

Hospital Charge Code	270665287
Hospital Revenue Code	272
Min. Negotiated Rate	$113.14
Max. Negotiated Rate	$2,347.28
Rate for Payer: Aetna Commercial	$1,783.93
Rate for Payer: Aetna Medicare Advantage	$1,408.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,197.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,197.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,197.11
Rate for Payer: Cigna Commercial	$2,347.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,408.37
Rate for Payer: Oxford Commercial	$938.91
Rate for Payer: Qualcare PPO/HMO/WC	$704.18
Rate for Payer: UnitedHealthcare Commercial	$938.91
Rate for Payer: UnitedHealthcare Community & State	$113.14
Rate for Payer: Wellpoint Medicaid Managed Care	$124.41

BULLDOG ATRAUMATIC VASCULAR CL

Facility

$4,694.55

Hospital Charge Code	270665288
Hospital Revenue Code	272
Min. Negotiated Rate	$113.14
Max. Negotiated Rate	$2,347.28
Rate for Payer: Aetna Commercial	$1,783.93
Rate for Payer: Aetna Medicare Advantage	$1,408.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,197.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,197.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,197.11
Rate for Payer: Cigna Commercial	$2,347.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,408.37
Rate for Payer: Oxford Commercial	$938.91
Rate for Payer: Qualcare PPO/HMO/WC	$704.18
Rate for Payer: UnitedHealthcare Commercial	$938.91
Rate for Payer: UnitedHealthcare Community & State	$113.14
Rate for Payer: Wellpoint Medicaid Managed Care	$124.41

BULLDOG ATRAUMATIC VASCULAR CL

Facility

$4,694.55

Hospital Charge Code	270665287
Hospital Revenue Code	272
Min. Negotiated Rate	$704.18
Max. Negotiated Rate	$704.18
Rate for Payer: Qualcare PPO/HMO/WC	$704.18

Know your out-of-pocket cost for care.

All Charges