Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CANNULA 7.0 X 72 MM

Facility

$163.80

Hospital Charge Code	270682201
Hospital Revenue Code	272
Min. Negotiated Rate	$24.57
Max. Negotiated Rate	$24.57
Rate for Payer: Qualcare PPO/HMO/WC	$24.57

CANNULA 7 X 75 214116

Facility

$625.00

Hospital Charge Code	270641698
Hospital Revenue Code	272
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$125.00
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

CANNULA 7 X 75 214116

Facility

$625.00

Hospital Charge Code	270641698
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

CANNULA 8 5mm X 75mm 214680

Facility

$145.00

Hospital Charge Code	270637606
Hospital Revenue Code	272
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$21.75
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

CANNULA 8 5mm X 75mm 214680

Facility

$145.00

Hospital Charge Code	270637606
Hospital Revenue Code	272
Min. Negotiated Rate	$3.49
Max. Negotiated Rate	$72.50
Rate for Payer: Aetna Commercial	$55.10
Rate for Payer: Aetna Medicare Advantage	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.98
Rate for Payer: Cigna Commercial	$72.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.50
Rate for Payer: Oxford Commercial	$29.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.75
Rate for Payer: UnitedHealthcare Commercial	$29.00
Rate for Payer: UnitedHealthcare Community & State	$3.49
Rate for Payer: Wellpoint Medicaid Managed Care	$3.84

CANNULA 8MM ENDOSCOPE

Facility

$6,500.00

Hospital Charge Code	270664217
Hospital Revenue Code	270
Min. Negotiated Rate	$156.65
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$2,470.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,950.00
Rate for Payer: Oxford Commercial	$1,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00
Rate for Payer: UnitedHealthcare Commercial	$1,300.00
Rate for Payer: UnitedHealthcare Community & State	$156.65
Rate for Payer: Wellpoint Medicaid Managed Care	$172.25

CANNULA 8MM ENDOSCOPE

Facility

$6,500.00

Hospital Charge Code	270664217
Hospital Revenue Code	270
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$975.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

CANNULA 8MM LENGTH 7,8,9

Facility

$445.25

Hospital Charge Code	270673919
Hospital Revenue Code	272
Min. Negotiated Rate	$66.79
Max. Negotiated Rate	$66.79
Rate for Payer: Qualcare PPO/HMO/WC	$66.79

CANNULA 8MM LENGTH 7,8,9

Facility

$445.25

Hospital Charge Code	270673919
Hospital Revenue Code	272
Min. Negotiated Rate	$10.73
Max. Negotiated Rate	$222.62
Rate for Payer: Aetna Commercial	$169.19
Rate for Payer: Aetna Medicare Advantage	$133.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.54
Rate for Payer: Cigna Commercial	$222.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.57
Rate for Payer: Oxford Commercial	$89.05
Rate for Payer: Qualcare PPO/HMO/WC	$66.79
Rate for Payer: UnitedHealthcare Commercial	$89.05
Rate for Payer: UnitedHealthcare Community & State	$10.73
Rate for Payer: Wellpoint Medicaid Managed Care	$11.80

CANNULA 8 MM PIVOT LENGTH

Facility

$74.21

Hospital Charge Code	270688334
Hospital Revenue Code	272
Min. Negotiated Rate	$11.13
Max. Negotiated Rate	$11.13
Rate for Payer: Qualcare PPO/HMO/WC	$11.13

CANNULA 8 MM PIVOT LENGTH

Facility

$74.21

Hospital Charge Code	270688334
Hospital Revenue Code	272
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$37.10
Rate for Payer: Aetna Commercial	$28.20
Rate for Payer: Aetna Medicare Advantage	$22.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.92
Rate for Payer: Cigna Commercial	$37.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.26
Rate for Payer: Oxford Commercial	$14.84
Rate for Payer: Qualcare PPO/HMO/WC	$11.13
Rate for Payer: UnitedHealthcare Commercial	$14.84
Rate for Payer: UnitedHealthcare Community & State	$1.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1.97

CANNULA ACCUPORT 15GA X 60MM

Facility

$2,575.00

Hospital Charge Code	270688007
Hospital Revenue Code	272
Min. Negotiated Rate	$386.25
Max. Negotiated Rate	$386.25
Rate for Payer: Qualcare PPO/HMO/WC	$386.25

CANNULA ACCUPORT 15GA X 60MM

Facility

$2,575.00

Hospital Charge Code	270688007
Hospital Revenue Code	272
Min. Negotiated Rate	$62.06
Max. Negotiated Rate	$1,287.50
Rate for Payer: Aetna Commercial	$978.50
Rate for Payer: Aetna Medicare Advantage	$772.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$656.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$656.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$656.62
Rate for Payer: Cigna Commercial	$1,287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$772.50
Rate for Payer: Oxford Commercial	$515.00
Rate for Payer: Qualcare PPO/HMO/WC	$386.25
Rate for Payer: UnitedHealthcare Commercial	$515.00
Rate for Payer: UnitedHealthcare Community & State	$62.06
Rate for Payer: Wellpoint Medicaid Managed Care	$68.24

CANNULA ACCUPORT 15 X 60 MM

Facility

$2,575.00

Hospital Charge Code	270688038
Hospital Revenue Code	272
Min. Negotiated Rate	$386.25
Max. Negotiated Rate	$386.25
Rate for Payer: Qualcare PPO/HMO/WC	$386.25

CANNULA ACCUPORT 15 X 60 MM

Facility

$2,575.00

Hospital Charge Code	270688038
Hospital Revenue Code	272
Min. Negotiated Rate	$62.06
Max. Negotiated Rate	$1,287.50
Rate for Payer: Aetna Commercial	$978.50
Rate for Payer: Aetna Medicare Advantage	$772.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$656.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$656.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$656.62
Rate for Payer: Cigna Commercial	$1,287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$772.50
Rate for Payer: Oxford Commercial	$515.00
Rate for Payer: Qualcare PPO/HMO/WC	$386.25
Rate for Payer: UnitedHealthcare Commercial	$515.00
Rate for Payer: UnitedHealthcare Community & State	$62.06
Rate for Payer: Wellpoint Medicaid Managed Care	$68.24

CANNULA ACCUPORT SIDE

Facility

$2,475.00

Hospital Charge Code	270678977
Hospital Revenue Code	272
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$742.50
Rate for Payer: Oxford Commercial	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$495.00
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

CANNULA ACCUPORT SIDE

Facility

$2,475.00

Hospital Charge Code	270678977
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

CANNULA ADULT SALTER DIVIDED

Facility

$11.26

Hospital Charge Code	270618587
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

CANNULA ADULT SALTER DIVIDED

Facility

$11.26

Hospital Charge Code	270618587
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.63
Rate for Payer: Aetna Commercial	$4.28
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.38
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$2.25
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

CANNULA AIR INJECTION 27G

Facility

$115.00

Hospital Charge Code	270655980
Hospital Revenue Code	272
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$17.25
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

CANNULA AIR INJECTION 27G

Facility

$115.00

Hospital Charge Code	270655980
Hospital Revenue Code	272
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$57.50
Rate for Payer: Aetna Commercial	$43.70
Rate for Payer: Aetna Medicare Advantage	$34.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.32
Rate for Payer: Cigna Commercial	$57.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.50
Rate for Payer: Oxford Commercial	$23.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.25
Rate for Payer: UnitedHealthcare Commercial	$23.00
Rate for Payer: UnitedHealthcare Community & State	$2.77
Rate for Payer: Wellpoint Medicaid Managed Care	$3.05

CANNULA AIR INJECTOR 30G

Facility

$99.00

Hospital Charge Code	270332095
Hospital Revenue Code	272
Min. Negotiated Rate	$14.85
Max. Negotiated Rate	$14.85
Rate for Payer: Qualcare PPO/HMO/WC	$14.85

CANNULA AIR INJECTOR 30G

Facility

$99.00

Hospital Charge Code	270332095
Hospital Revenue Code	272
Min. Negotiated Rate	$2.39
Max. Negotiated Rate	$49.50
Rate for Payer: Aetna Commercial	$37.62
Rate for Payer: Aetna Medicare Advantage	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.25
Rate for Payer: Cigna Commercial	$49.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.70
Rate for Payer: Oxford Commercial	$19.80
Rate for Payer: Qualcare PPO/HMO/WC	$14.85
Rate for Payer: UnitedHealthcare Commercial	$19.80
Rate for Payer: UnitedHealthcare Community & State	$2.39
Rate for Payer: Wellpoint Medicaid Managed Care	$2.62

CANNULA ALCON J-SHAPED

Facility

$71.25

Hospital Charge Code	270600209
Hospital Revenue Code	272
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$35.62
Rate for Payer: Aetna Commercial	$27.07
Rate for Payer: Aetna Medicare Advantage	$21.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.17
Rate for Payer: Cigna Commercial	$35.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.38
Rate for Payer: Oxford Commercial	$14.25
Rate for Payer: Qualcare PPO/HMO/WC	$10.69
Rate for Payer: UnitedHealthcare Commercial	$14.25
Rate for Payer: UnitedHealthcare Community & State	$1.72
Rate for Payer: Wellpoint Medicaid Managed Care	$1.89

CANNULA ALCON J-SHAPED

Facility

$71.25

Hospital Charge Code	270600209
Hospital Revenue Code	272
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$10.69
Rate for Payer: Qualcare PPO/HMO/WC	$10.69

Know your out-of-pocket cost for care.

All Charges