Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CANNULA CUT FLEX

Facility

$325.00

Hospital Charge Code	270677468
Hospital Revenue Code	272
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

CANNULA CUT FLEX

Facility

$325.00

Hospital Charge Code	270677468
Hospital Revenue Code	272
Min. Negotiated Rate	$7.83
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$123.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Oxford Commercial	$65.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Commercial	$65.00
Rate for Payer: UnitedHealthcare Community & State	$7.83
Rate for Payer: Wellpoint Medicaid Managed Care	$8.61

CANNULA DRI-LOK 8.0m3910075800

Facility

$127.75

Hospital Charge Code	270641989
Hospital Revenue Code	272
Min. Negotiated Rate	$19.16
Max. Negotiated Rate	$19.16
Rate for Payer: Qualcare PPO/HMO/WC	$19.16

CANNULA DRI-LOK 8.0m3910075800

Facility

$127.75

Hospital Charge Code	270641989
Hospital Revenue Code	272
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$63.88
Rate for Payer: Aetna Commercial	$48.55
Rate for Payer: Aetna Medicare Advantage	$38.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.58
Rate for Payer: Cigna Commercial	$63.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.33
Rate for Payer: Oxford Commercial	$25.55
Rate for Payer: Qualcare PPO/HMO/WC	$19.16
Rate for Payer: UnitedHealthcare Commercial	$25.55
Rate for Payer: UnitedHealthcare Community & State	$3.08
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

CANNULA DRI-LOK 8mm3910075501

Facility

$127.75

Hospital Charge Code	270641988
Hospital Revenue Code	272
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$63.88
Rate for Payer: Aetna Commercial	$48.55
Rate for Payer: Aetna Medicare Advantage	$38.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.58
Rate for Payer: Cigna Commercial	$63.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.33
Rate for Payer: Oxford Commercial	$25.55
Rate for Payer: Qualcare PPO/HMO/WC	$19.16
Rate for Payer: UnitedHealthcare Commercial	$25.55
Rate for Payer: UnitedHealthcare Community & State	$3.08
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

CANNULA DRI-LOK 8mm3910075501

Facility

$127.75

Hospital Charge Code	270641988
Hospital Revenue Code	272
Min. Negotiated Rate	$19.16
Max. Negotiated Rate	$19.16
Rate for Payer: Qualcare PPO/HMO/WC	$19.16

CANNULA ENDOPATH XCEL 11x100MM

Facility

$90.00

Hospital Charge Code	270671543
Hospital Revenue Code	272
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.00
Rate for Payer: Oxford Commercial	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$18.00
Rate for Payer: UnitedHealthcare Community & State	$2.17
Rate for Payer: Wellpoint Medicaid Managed Care	$2.38

CANNULA ENDOPATH XCEL 11x100MM

Facility

$90.00

Hospital Charge Code	270671543
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

CANNULA END TARGET 11GA 120MML

Facility

$2,575.00

Hospital Charge Code	270680419
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 END TARGET 11GA 120MML

Facility

$2,575.00

Hospital Charge Code	270680419
Hospital Revenue Code	272
Min. Negotiated Rate	$386.25
Max. Negotiated Rate	$386.25
Rate for Payer: Qualcare PPO/HMO/WC	$386.25

CANNULA ERCP CONTOUR

Facility

$230.00

Hospital Charge Code	270604751
Hospital Revenue Code	272
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$115.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.00
Rate for Payer: Oxford Commercial	$46.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Commercial	$46.00
Rate for Payer: UnitedHealthcare Community & State	$5.54
Rate for Payer: Wellpoint Medicaid Managed Care	$6.09

CANNULA ERCP CONTOUR

Facility

$230.00

Hospital Charge Code	270604751
Hospital Revenue Code	272
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

CANNULA ERCP FLUOR TIP 3096-10

Facility

$338.45

Hospital Charge Code	270611765
Hospital Revenue Code	272
Min. Negotiated Rate	$50.77
Max. Negotiated Rate	$50.77
Rate for Payer: Qualcare PPO/HMO/WC	$50.77

CANNULA ERCP FLUOR TIP 3096-10

Facility

$338.45

Hospital Charge Code	270611765
Hospital Revenue Code	272
Min. Negotiated Rate	$8.16
Max. Negotiated Rate	$169.22
Rate for Payer: Aetna Commercial	$128.61
Rate for Payer: Aetna Medicare Advantage	$101.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.30
Rate for Payer: Cigna Commercial	$169.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.53
Rate for Payer: Oxford Commercial	$67.69
Rate for Payer: Qualcare PPO/HMO/WC	$50.77
Rate for Payer: UnitedHealthcare Commercial	$67.69
Rate for Payer: UnitedHealthcare Community & State	$8.16
Rate for Payer: Wellpoint Medicaid Managed Care	$8.97

CANNULA ERCP RX TAPERED TIP

Facility

$360.00

Hospital Charge Code	270627936
Hospital Revenue Code	272
Min. Negotiated Rate	$8.68
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$136.80
Rate for Payer: Aetna Medicare Advantage	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.80
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.00
Rate for Payer: Oxford Commercial	$72.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Commercial	$72.00
Rate for Payer: UnitedHealthcare Community & State	$8.68
Rate for Payer: Wellpoint Medicaid Managed Care	$9.54

CANNULA ERCP RX TAPERED TIP

Facility

$360.00

Hospital Charge Code	270627936
Hospital Revenue Code	272
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

CANNULA ERCP TANDEM XL

Facility

$328.50

Hospital Charge Code	270604753
Hospital Revenue Code	272
Min. Negotiated Rate	$49.27
Max. Negotiated Rate	$49.27
Rate for Payer: Qualcare PPO/HMO/WC	$49.27

CANNULA ERCP TANDEM XL

Facility

$328.50

Hospital Charge Code	270604753
Hospital Revenue Code	272
Min. Negotiated Rate	$7.92
Max. Negotiated Rate	$164.25
Rate for Payer: Aetna Commercial	$124.83
Rate for Payer: Aetna Medicare Advantage	$98.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.77
Rate for Payer: Cigna Commercial	$164.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.55
Rate for Payer: Oxford Commercial	$65.70
Rate for Payer: Qualcare PPO/HMO/WC	$49.27
Rate for Payer: UnitedHealthcare Commercial	$65.70
Rate for Payer: UnitedHealthcare Community & State	$7.92
Rate for Payer: Wellpoint Medicaid Managed Care	$8.71

CANNULA ERCP TAPRD CONTOUR 5FR

Facility

$227.45

Hospital Charge Code	270600946
Hospital Revenue Code	272
Min. Negotiated Rate	$34.12
Max. Negotiated Rate	$34.12
Rate for Payer: Qualcare PPO/HMO/WC	$34.12

CANNULA ERCP TAPRD CONTOUR 5FR

Facility

$227.45

Hospital Charge Code	270600946
Hospital Revenue Code	272
Min. Negotiated Rate	$5.48
Max. Negotiated Rate	$113.72
Rate for Payer: Aetna Commercial	$86.43
Rate for Payer: Aetna Medicare Advantage	$68.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.00
Rate for Payer: Cigna Commercial	$113.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.23
Rate for Payer: Oxford Commercial	$45.49
Rate for Payer: Qualcare PPO/HMO/WC	$34.12
Rate for Payer: UnitedHealthcare Commercial	$45.49
Rate for Payer: UnitedHealthcare Community & State	$5.48
Rate for Payer: Wellpoint Medicaid Managed Care	$6.03

CANNULA ET02 GAS SAMPLING LINE

Facility

$11.85

Hospital Charge Code	270667014
Hospital Revenue Code	270
Min. Negotiated Rate	$1.78
Max. Negotiated Rate	$1.78
Rate for Payer: Qualcare PPO/HMO/WC	$1.78

CANNULA ET02 GAS SAMPLING LINE

Facility

$11.85

Hospital Charge Code	270667014
Hospital Revenue Code	270
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$5.92
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$3.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.02
Rate for Payer: Cigna Commercial	$5.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.56
Rate for Payer: Oxford Commercial	$2.37
Rate for Payer: Qualcare PPO/HMO/WC	$1.78
Rate for Payer: UnitedHealthcare Commercial	$2.37
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.31

CANNULA ETCO2 W/7 GAS SAMPL

Facility

$12.80

Hospital Charge Code	270666779
Hospital Revenue Code	272
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$1.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.92

CANNULA ETCO2 W/7 GAS SAMPL

Facility

$12.80

Hospital Charge Code	270666779
Hospital Revenue Code	272
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.40
Rate for Payer: Aetna Commercial	$4.86
Rate for Payer: Aetna Medicare Advantage	$3.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.26
Rate for Payer: Cigna Commercial	$6.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.84
Rate for Payer: Oxford Commercial	$2.56
Rate for Payer: Qualcare PPO/HMO/WC	$1.92
Rate for Payer: UnitedHealthcare Commercial	$2.56
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

CANNULA ETCO2 W/7 GAS SAMPL

Facility

$12.80

Hospital Charge Code	270666779S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.40
Rate for Payer: Aetna Commercial	$4.86
Rate for Payer: Aetna Medicare Advantage	$3.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.26
Rate for Payer: Cigna Commercial	$6.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.84
Rate for Payer: Oxford Commercial	$2.56
Rate for Payer: Qualcare PPO/HMO/WC	$1.92
Rate for Payer: UnitedHealthcare Commercial	$2.56
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

Know your out-of-pocket cost for care.

All Charges