Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CANNULA ETCO2 W/7 GAS SAMPL

Facility

$12.80

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

CANNULA FLESIBLE 6.5mmx73mm

Facility

$50.00

Hospital Charge Code	270639290
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

CANNULA FLESIBLE 6.5mmx73mm

Facility

$50.00

Hospital Charge Code	270639290
Hospital Revenue Code	272
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$25.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$10.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

CANNULA FLOWPORT II

Facility

$1,954.05

Hospital Charge Code	270679419
Hospital Revenue Code	272
Min. Negotiated Rate	$47.09
Max. Negotiated Rate	$977.02
Rate for Payer: Aetna Commercial	$742.54
Rate for Payer: Aetna Medicare Advantage	$586.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$498.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$498.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$498.28
Rate for Payer: Cigna Commercial	$977.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$586.22
Rate for Payer: Oxford Commercial	$390.81
Rate for Payer: Qualcare PPO/HMO/WC	$293.11
Rate for Payer: UnitedHealthcare Commercial	$390.81
Rate for Payer: UnitedHealthcare Community & State	$47.09
Rate for Payer: Wellpoint Medicaid Managed Care	$51.78

CANNULA FLOWPORT II

Facility

$1,954.05

Hospital Charge Code	270679419
Hospital Revenue Code	272
Min. Negotiated Rate	$293.11
Max. Negotiated Rate	$293.11
Rate for Payer: Qualcare PPO/HMO/WC	$293.11

CANNULA FLUORO TIP ERCP***

Facility

$236.00

Hospital Charge Code	2300804
Hospital Revenue Code	279
Min. Negotiated Rate	$35.40
Max. Negotiated Rate	$35.40
Rate for Payer: Qualcare PPO/HMO/WC	$35.40

CANNULA FLUORO TIP ERCP***

Facility

$236.00

Hospital Charge Code	2300804
Hospital Revenue Code	279
Min. Negotiated Rate	$5.69
Max. Negotiated Rate	$118.00
Rate for Payer: Aetna Commercial	$89.68
Rate for Payer: Aetna Medicare Advantage	$70.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.18
Rate for Payer: Cigna Commercial	$118.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.80
Rate for Payer: Oxford Commercial	$47.20
Rate for Payer: Qualcare PPO/HMO/WC	$35.40
Rate for Payer: UnitedHealthcare Commercial	$47.20
Rate for Payer: UnitedHealthcare Community & State	$5.69
Rate for Payer: Wellpoint Medicaid Managed Care	$6.25

CANNULA GEMINI SR8 ARTHREX

Facility

$160.00

Hospital Charge Code	270660887
Hospital Revenue Code	272
Min. Negotiated Rate	$3.86
Max. Negotiated Rate	$80.00
Rate for Payer: Aetna Commercial	$60.80
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.00
Rate for Payer: Oxford Commercial	$32.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$32.00
Rate for Payer: UnitedHealthcare Community & State	$3.86
Rate for Payer: Wellpoint Medicaid Managed Care	$4.24

CANNULA GEMINI SR8 ARTHREX

Facility

$160.00

Hospital Charge Code	270660887
Hospital Revenue Code	272
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

CANNULA II WITH OBTURATOR

Facility

$1,975.00

Hospital Charge Code	270673922
Hospital Revenue Code	272
Min. Negotiated Rate	$296.25
Max. Negotiated Rate	$296.25
Rate for Payer: Qualcare PPO/HMO/WC	$296.25

CANNULA II WITH OBTURATOR

Facility

$1,975.00

Hospital Charge Code	270673922
Hospital Revenue Code	272
Min. Negotiated Rate	$47.60
Max. Negotiated Rate	$987.50
Rate for Payer: Aetna Commercial	$750.50
Rate for Payer: Aetna Medicare Advantage	$592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.62
Rate for Payer: Cigna Commercial	$987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.50
Rate for Payer: Oxford Commercial	$395.00
Rate for Payer: Qualcare PPO/HMO/WC	$296.25
Rate for Payer: UnitedHealthcare Commercial	$395.00
Rate for Payer: UnitedHealthcare Community & State	$47.60
Rate for Payer: Wellpoint Medicaid Managed Care	$52.34

CANNULA INFANT

Facility

$6.98

Hospital Charge Code	270635034
Hospital Revenue Code	270
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

CANNULA INFANT

Facility

$6.98

Hospital Charge Code	270635034
Hospital Revenue Code	270
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.49
Rate for Payer: Aetna Commercial	$2.65
Rate for Payer: Aetna Medicare Advantage	$2.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.09
Rate for Payer: Oxford Commercial	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$1.40
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

CANNULA INNER 6.0 XLT 77100060

Facility

$19.90

Hospital Charge Code	270633235
Hospital Revenue Code	272
Min. Negotiated Rate	$2.98
Max. Negotiated Rate	$2.98
Rate for Payer: Qualcare PPO/HMO/WC	$2.98

CANNULA INNER 6.0 XLT 77100060

Facility

$19.90

Hospital Charge Code	270633235
Hospital Revenue Code	272
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$9.95
Rate for Payer: Aetna Commercial	$7.56
Rate for Payer: Aetna Medicare Advantage	$5.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.07
Rate for Payer: Cigna Commercial	$9.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.97
Rate for Payer: Oxford Commercial	$3.98
Rate for Payer: Qualcare PPO/HMO/WC	$2.98
Rate for Payer: UnitedHealthcare Commercial	$3.98
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

CANNULA INNER 7.0 XLT 70XLTIN

Facility

$31.70

Hospital Charge Code	270642877
Hospital Revenue Code	272
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$15.85
Rate for Payer: Aetna Commercial	$12.05
Rate for Payer: Aetna Medicare Advantage	$9.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.08
Rate for Payer: Cigna Commercial	$15.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.51
Rate for Payer: Oxford Commercial	$6.34
Rate for Payer: Qualcare PPO/HMO/WC	$4.75
Rate for Payer: UnitedHealthcare Commercial	$6.34
Rate for Payer: UnitedHealthcare Community & State	$0.76
Rate for Payer: Wellpoint Medicaid Managed Care	$0.84

CANNULA INNER 7.0 XLT 70XLTIN

Facility

$31.70

Hospital Charge Code	270642877
Hospital Revenue Code	272
Min. Negotiated Rate	$4.75
Max. Negotiated Rate	$4.75
Rate for Payer: Qualcare PPO/HMO/WC	$4.75

CANNULA INNER DISP 8.0XLT

Facility

$27.09

Hospital Charge Code	270632703
Hospital Revenue Code	272
Min. Negotiated Rate	$4.06
Max. Negotiated Rate	$4.06
Rate for Payer: Qualcare PPO/HMO/WC	$4.06

CANNULA INNER DISP 8.0XLT

Facility

$27.09

Hospital Charge Code	270632703
Hospital Revenue Code	272
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$13.54
Rate for Payer: Aetna Commercial	$10.29
Rate for Payer: Aetna Medicare Advantage	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.91
Rate for Payer: Cigna Commercial	$13.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.13
Rate for Payer: Oxford Commercial	$5.42
Rate for Payer: Qualcare PPO/HMO/WC	$4.06
Rate for Payer: UnitedHealthcare Commercial	$5.42
Rate for Payer: UnitedHealthcare Community & State	$0.65
Rate for Payer: Wellpoint Medicaid Managed Care	$0.72

CANNULA INNER FENESTRD #6

Facility

$18.00

Hospital Charge Code	270643740
Hospital Revenue Code	270
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.40
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

CANNULA INNER FENESTRD #6

Facility

$18.00

Hospital Charge Code	270643740
Hospital Revenue Code	270
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

CANNULA INNER TRACH #4

Facility

$39.25

Hospital Charge Code	270600033
Hospital Revenue Code	272
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$19.62
Rate for Payer: Aetna Commercial	$14.91
Rate for Payer: Aetna Medicare Advantage	$11.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.01
Rate for Payer: Cigna Commercial	$19.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.78
Rate for Payer: Oxford Commercial	$7.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.89
Rate for Payer: UnitedHealthcare Commercial	$7.85
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

CANNULA INNER TRACH #4

Facility

$39.25

Hospital Charge Code	270600033
Hospital Revenue Code	272
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$5.89
Rate for Payer: Qualcare PPO/HMO/WC	$5.89

CANNULA INNER TRACH #6

Facility

$39.25

Hospital Charge Code	270600035
Hospital Revenue Code	272
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$5.89
Rate for Payer: Qualcare PPO/HMO/WC	$5.89

CANNULA INNER TRACH #6

Facility

$39.25

Hospital Charge Code	270600035
Hospital Revenue Code	272
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$19.62
Rate for Payer: Aetna Commercial	$14.91
Rate for Payer: Aetna Medicare Advantage	$11.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.01
Rate for Payer: Cigna Commercial	$19.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.78
Rate for Payer: Oxford Commercial	$7.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.89
Rate for Payer: UnitedHealthcare Commercial	$7.85
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

Know your out-of-pocket cost for care.

All Charges