Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CANNULA ANTERIOR CHAMBER 25G

Facility

$40.00

Hospital Charge Code	270331006
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

CANNULA ANTERIOR CHAMBER 25G

Facility

$40.00

Hospital Charge Code	270331006
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CANNULA ATX TWST 6.0 7 AR6535

Facility

$211.25

Hospital Charge Code	270623033
Hospital Revenue Code	272
Min. Negotiated Rate	$5.09
Max. Negotiated Rate	$105.62
Rate for Payer: Aetna Commercial	$80.28
Rate for Payer: Aetna Medicare Advantage	$63.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.87
Rate for Payer: Cigna Commercial	$105.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.38
Rate for Payer: Oxford Commercial	$42.25
Rate for Payer: Qualcare PPO/HMO/WC	$31.69
Rate for Payer: UnitedHealthcare Commercial	$42.25
Rate for Payer: UnitedHealthcare Community & State	$5.09
Rate for Payer: Wellpoint Medicaid Managed Care	$5.60

CANNULA ATX TWST 6.0 7 AR6535

Facility

$211.25

Hospital Charge Code	270623033
Hospital Revenue Code	272
Min. Negotiated Rate	$31.69
Max. Negotiated Rate	$31.69
Rate for Payer: Qualcare PPO/HMO/WC	$31.69

CANNULA ATX TWST 8.25 7 AR6530

Facility

$211.25

Hospital Charge Code	270622382
Hospital Revenue Code	272
Min. Negotiated Rate	$31.69
Max. Negotiated Rate	$31.69
Rate for Payer: Qualcare PPO/HMO/WC	$31.69

CANNULA ATX TWST 8.25 7 AR6530

Facility

$211.25

Hospital Charge Code	270622382
Hospital Revenue Code	272
Min. Negotiated Rate	$5.09
Max. Negotiated Rate	$105.62
Rate for Payer: Aetna Commercial	$80.28
Rate for Payer: Aetna Medicare Advantage	$63.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.87
Rate for Payer: Cigna Commercial	$105.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.38
Rate for Payer: Oxford Commercial	$42.25
Rate for Payer: Qualcare PPO/HMO/WC	$31.69
Rate for Payer: UnitedHealthcare Commercial	$42.25
Rate for Payer: UnitedHealthcare Community & State	$5.09
Rate for Payer: Wellpoint Medicaid Managed Care	$5.60

CANNULA ATX TWST 8.25 9 AR6540

Facility

$211.25

Hospital Charge Code	270623032
Hospital Revenue Code	272
Min. Negotiated Rate	$5.09
Max. Negotiated Rate	$105.62
Rate for Payer: Aetna Commercial	$80.28
Rate for Payer: Aetna Medicare Advantage	$63.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.87
Rate for Payer: Cigna Commercial	$105.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.38
Rate for Payer: Oxford Commercial	$42.25
Rate for Payer: Qualcare PPO/HMO/WC	$31.69
Rate for Payer: UnitedHealthcare Commercial	$42.25
Rate for Payer: UnitedHealthcare Community & State	$5.09
Rate for Payer: Wellpoint Medicaid Managed Care	$5.60

CANNULA ATX TWST 8.25 9 AR6540

Facility

$211.25

Hospital Charge Code	270623032
Hospital Revenue Code	272
Min. Negotiated Rate	$31.69
Max. Negotiated Rate	$31.69
Rate for Payer: Qualcare PPO/HMO/WC	$31.69

CANNULA BD BIL SHT TIP 050330

Facility

$332.00

Hospital Charge Code	270601177
Hospital Revenue Code	272
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$166.00
Rate for Payer: Aetna Commercial	$126.16
Rate for Payer: Aetna Medicare Advantage	$99.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.66
Rate for Payer: Cigna Commercial	$166.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.60
Rate for Payer: Oxford Commercial	$66.40
Rate for Payer: Qualcare PPO/HMO/WC	$49.80
Rate for Payer: UnitedHealthcare Commercial	$66.40
Rate for Payer: UnitedHealthcare Community & State	$8.00
Rate for Payer: Wellpoint Medicaid Managed Care	$8.80

CANNULA BD BIL SHT TIP 050330

Facility

$332.00

Hospital Charge Code	270601177
Hospital Revenue Code	272
Min. Negotiated Rate	$49.80
Max. Negotiated Rate	$49.80
Rate for Payer: Qualcare PPO/HMO/WC	$49.80

CANNULA BD RADPQ ERCP 050310

Facility

$332.00

Hospital Charge Code	270600925
Hospital Revenue Code	272
Min. Negotiated Rate	$49.80
Max. Negotiated Rate	$49.80
Rate for Payer: Qualcare PPO/HMO/WC	$49.80

CANNULA BD RADPQ ERCP 050310

Facility

$332.00

Hospital Charge Code	270600925
Hospital Revenue Code	272
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$166.00
Rate for Payer: Aetna Commercial	$126.16
Rate for Payer: Aetna Medicare Advantage	$99.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.66
Rate for Payer: Cigna Commercial	$166.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.60
Rate for Payer: Oxford Commercial	$66.40
Rate for Payer: Qualcare PPO/HMO/WC	$49.80
Rate for Payer: UnitedHealthcare Commercial	$66.40
Rate for Payer: UnitedHealthcare Community & State	$8.00
Rate for Payer: Wellpoint Medicaid Managed Care	$8.80

CANNULA BD RADPQ ERCP 050320

Facility

$412.85

Hospital Charge Code	270600923
Hospital Revenue Code	272
Min. Negotiated Rate	$61.93
Max. Negotiated Rate	$61.93
Rate for Payer: Qualcare PPO/HMO/WC	$61.93

CANNULA BD RADPQ ERCP 050320

Facility

$412.85

Hospital Charge Code	270600923
Hospital Revenue Code	272
Min. Negotiated Rate	$9.95
Max. Negotiated Rate	$206.43
Rate for Payer: Aetna Commercial	$156.88
Rate for Payer: Aetna Medicare Advantage	$123.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.28
Rate for Payer: Cigna Commercial	$206.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.86
Rate for Payer: Oxford Commercial	$82.57
Rate for Payer: Qualcare PPO/HMO/WC	$61.93
Rate for Payer: UnitedHealthcare Commercial	$82.57
Rate for Payer: UnitedHealthcare Community & State	$9.95
Rate for Payer: Wellpoint Medicaid Managed Care	$10.94

CANNULA BERKELEY 11MM

Facility

$321.00

Hospital Charge Code	270657432
Hospital Revenue Code	272
Min. Negotiated Rate	$48.15
Max. Negotiated Rate	$48.15
Rate for Payer: Qualcare PPO/HMO/WC	$48.15

CANNULA BERKELEY 11MM

Facility

$321.00

Hospital Charge Code	270657432
Hospital Revenue Code	272
Min. Negotiated Rate	$7.74
Max. Negotiated Rate	$160.50
Rate for Payer: Aetna Commercial	$121.98
Rate for Payer: Aetna Medicare Advantage	$96.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.86
Rate for Payer: Cigna Commercial	$160.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.30
Rate for Payer: Oxford Commercial	$64.20
Rate for Payer: Qualcare PPO/HMO/WC	$48.15
Rate for Payer: UnitedHealthcare Commercial	$64.20
Rate for Payer: UnitedHealthcare Community & State	$7.74
Rate for Payer: Wellpoint Medicaid Managed Care	$8.51

CANNULA BERKELEY CURVED VCURET

Facility

$478.95

Hospital Charge Code	270651734
Hospital Revenue Code	272
Min. Negotiated Rate	$71.84
Max. Negotiated Rate	$71.84
Rate for Payer: Qualcare PPO/HMO/WC	$71.84

CANNULA BERKELEY CURVED VCURET

Facility

$478.95

Hospital Charge Code	270651734
Hospital Revenue Code	272
Min. Negotiated Rate	$11.54
Max. Negotiated Rate	$239.47
Rate for Payer: Aetna Commercial	$182.00
Rate for Payer: Aetna Medicare Advantage	$143.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.13
Rate for Payer: Cigna Commercial	$239.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.69
Rate for Payer: Oxford Commercial	$95.79
Rate for Payer: Qualcare PPO/HMO/WC	$71.84
Rate for Payer: UnitedHealthcare Commercial	$95.79
Rate for Payer: UnitedHealthcare Community & State	$11.54
Rate for Payer: Wellpoint Medicaid Managed Care	$12.69

CANNULA BIO DELIVERY

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270701780
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

CANNULA BIO DELIVERY

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270701780
Hospital Revenue Code	278
Min. Negotiated Rate	$75.31
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$75.31
Rate for Payer: Wellpoint Medicaid Managed Care	$82.81

CANNULA BIO-MEDICUS 15FR EA

Facility

$1,594.00

Hospital Charge Code	2703110I
Hospital Revenue Code	272
Min. Negotiated Rate	$38.42
Max. Negotiated Rate	$797.00
Rate for Payer: Aetna Commercial	$605.72
Rate for Payer: Aetna Medicare Advantage	$478.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$406.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$406.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$406.47
Rate for Payer: Cigna Commercial	$797.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$478.20
Rate for Payer: Oxford Commercial	$318.80
Rate for Payer: Qualcare PPO/HMO/WC	$239.10
Rate for Payer: UnitedHealthcare Commercial	$318.80
Rate for Payer: UnitedHealthcare Community & State	$38.42
Rate for Payer: Wellpoint Medicaid Managed Care	$42.24

CANNULA BIO-MEDICUS 15FR EA

Facility

$1,594.00

Hospital Charge Code	2703110I
Hospital Revenue Code	272
Min. Negotiated Rate	$239.10
Max. Negotiated Rate	$239.10
Rate for Payer: Qualcare PPO/HMO/WC	$239.10

CANNULA BIO-MEDICUS 17FR EA

Facility

$1,594.00

Hospital Charge Code	2703110J
Hospital Revenue Code	272
Min. Negotiated Rate	$38.42
Max. Negotiated Rate	$797.00
Rate for Payer: Aetna Commercial	$605.72
Rate for Payer: Aetna Medicare Advantage	$478.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$406.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$406.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$406.47
Rate for Payer: Cigna Commercial	$797.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$478.20
Rate for Payer: Oxford Commercial	$318.80
Rate for Payer: Qualcare PPO/HMO/WC	$239.10
Rate for Payer: UnitedHealthcare Commercial	$318.80
Rate for Payer: UnitedHealthcare Community & State	$38.42
Rate for Payer: Wellpoint Medicaid Managed Care	$42.24

CANNULA BIO-MEDICUS 17FR EA

Facility

$1,594.00

Hospital Charge Code	2703110J
Hospital Revenue Code	272
Min. Negotiated Rate	$239.10
Max. Negotiated Rate	$239.10
Rate for Payer: Qualcare PPO/HMO/WC	$239.10

CANNULABIO-MEDICUS 17FR EA

Facility

$1,894.00

Hospital Charge Code	2703110D
Hospital Revenue Code	272
Min. Negotiated Rate	$284.10
Max. Negotiated Rate	$284.10
Rate for Payer: Qualcare PPO/HMO/WC	$284.10

Know your out-of-pocket cost for care.

All Charges