Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CANNULA INNER TRACH #8

Facility

$39.25

Hospital Charge Code	270600036
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 #8

Facility

$39.25

Hospital Charge Code	270600036
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 DISP 4-8**

Facility

$17.00

Hospital Charge Code	8004327
Hospital Revenue Code	272
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.50
Rate for Payer: Aetna Commercial	$6.46
Rate for Payer: Aetna Medicare Advantage	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.33
Rate for Payer: Cigna Commercial	$8.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.10
Rate for Payer: Oxford Commercial	$3.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.55
Rate for Payer: UnitedHealthcare Commercial	$3.40
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

CANNULA INNER TRACH DISP 4-8**

Facility

$17.00

Hospital Charge Code	8004327
Hospital Revenue Code	272
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.55
Rate for Payer: Qualcare PPO/HMO/WC	$2.55

CANNULA JABCZENSKI DUCTOGRAM

Facility

$130.90

Hospital Charge Code	270678969
Hospital Revenue Code	272
Min. Negotiated Rate	$19.64
Max. Negotiated Rate	$19.64
Rate for Payer: Qualcare PPO/HMO/WC	$19.64

CANNULA JABCZENSKI DUCTOGRAM

Facility

$130.90

Hospital Charge Code	270678969
Hospital Revenue Code	272
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$65.45
Rate for Payer: Aetna Commercial	$49.74
Rate for Payer: Aetna Medicare Advantage	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.38
Rate for Payer: Cigna Commercial	$65.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.27
Rate for Payer: Oxford Commercial	$26.18
Rate for Payer: Qualcare PPO/HMO/WC	$19.64
Rate for Payer: UnitedHealthcare Commercial	$26.18
Rate for Payer: UnitedHealthcare Community & State	$3.15
Rate for Payer: Wellpoint Medicaid Managed Care	$3.47

CANNULA JABCZENSKI DUCTOGRAM

Facility

$130.90

Hospital Charge Code	270678969R
Hospital Revenue Code	272
Min. Negotiated Rate	$19.64
Max. Negotiated Rate	$19.64
Rate for Payer: Qualcare PPO/HMO/WC	$19.64

CANNULA JABCZENSKI DUCTOGRAM

Facility

$130.90

Hospital Charge Code	270678969R
Hospital Revenue Code	272
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$65.45
Rate for Payer: Aetna Commercial	$49.74
Rate for Payer: Aetna Medicare Advantage	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.38
Rate for Payer: Cigna Commercial	$65.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.27
Rate for Payer: Oxford Commercial	$26.18
Rate for Payer: Qualcare PPO/HMO/WC	$19.64
Rate for Payer: UnitedHealthcare Commercial	$26.18
Rate for Payer: UnitedHealthcare Community & State	$3.15
Rate for Payer: Wellpoint Medicaid Managed Care	$3.47

CANNULA J-SHAPED

Facility

$27.00

Hospital Charge Code	1608264
Hospital Revenue Code	251
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

CANNULA J-SHAPED

Facility

$27.00

Hospital Charge Code	1608264
Hospital Revenue Code	251
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$13.50
Rate for Payer: Aetna Commercial	$10.26
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.10
Rate for Payer: Oxford Commercial	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$5.40
Rate for Payer: UnitedHealthcare Community & State	$0.65
Rate for Payer: Wellpoint Medicaid Managed Care	$0.72

CANNULA KNEE SCP ACCUPORT

Facility

$21,825.00

Hospital Charge Code	270688752
Hospital Revenue Code	272
Min. Negotiated Rate	$525.98
Max. Negotiated Rate	$10,912.50
Rate for Payer: Aetna Commercial	$8,293.50
Rate for Payer: Aetna Medicare Advantage	$6,547.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,565.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,565.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,565.38
Rate for Payer: Cigna Commercial	$10,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,547.50
Rate for Payer: Oxford Commercial	$4,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,273.75
Rate for Payer: UnitedHealthcare Commercial	$4,365.00
Rate for Payer: UnitedHealthcare Community & State	$525.98
Rate for Payer: Wellpoint Medicaid Managed Care	$578.36

CANNULA KNEE SCP ACCUPORT

Facility

$21,825.00

Hospital Charge Code	270688752
Hospital Revenue Code	272
Min. Negotiated Rate	$3,273.75
Max. Negotiated Rate	$3,273.75
Rate for Payer: Qualcare PPO/HMO/WC	$3,273.75

CANNULA LIPIVAGE HARVESTER

Facility

$950.00

Service Code	HCPCS A4649
Hospital Charge Code	270699918
Hospital Revenue Code	272
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$142.50
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

CANNULA LIPIVAGE HARVESTER

Facility

$950.00

Service Code	HCPCS A4649
Hospital Charge Code	270699918
Hospital Revenue Code	272
Min. Negotiated Rate	$22.89
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$361.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$285.00
Rate for Payer: Oxford Commercial	$190.00
Rate for Payer: Qualcare PPO/HMO/WC	$142.50
Rate for Payer: UnitedHealthcare Commercial	$190.00
Rate for Payer: UnitedHealthcare Community & State	$22.89
Rate for Payer: Wellpoint Medicaid Managed Care	$25.18

CANNULA LK 3.0-11.5 BEVEL TIP

Facility

$1,099.15

Hospital Charge Code	270670668
Hospital Revenue Code	272
Min. Negotiated Rate	$164.87
Max. Negotiated Rate	$164.87
Rate for Payer: Qualcare PPO/HMO/WC	$164.87

CANNULA LK 3.0-11.5 BEVEL TIP

Facility

$1,099.15

Hospital Charge Code	270670668
Hospital Revenue Code	272
Min. Negotiated Rate	$26.49
Max. Negotiated Rate	$549.58
Rate for Payer: Aetna Commercial	$417.68
Rate for Payer: Aetna Medicare Advantage	$329.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.28
Rate for Payer: Cigna Commercial	$549.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.75
Rate for Payer: Oxford Commercial	$219.83
Rate for Payer: Qualcare PPO/HMO/WC	$164.87
Rate for Payer: UnitedHealthcare Commercial	$219.83
Rate for Payer: UnitedHealthcare Community & State	$26.49
Rate for Payer: Wellpoint Medicaid Managed Care	$29.13

CANNULA LOCKING 3 DMD TIP LNG

Facility

$1,099.15

Hospital Charge Code	270670672
Hospital Revenue Code	272
Min. Negotiated Rate	$164.87
Max. Negotiated Rate	$164.87
Rate for Payer: Qualcare PPO/HMO/WC	$164.87

CANNULA LOCKING 3 DMD TIP LNG

Facility

$1,099.15

Hospital Charge Code	270670672
Hospital Revenue Code	272
Min. Negotiated Rate	$26.49
Max. Negotiated Rate	$549.58
Rate for Payer: Aetna Commercial	$417.68
Rate for Payer: Aetna Medicare Advantage	$329.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.28
Rate for Payer: Cigna Commercial	$549.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.75
Rate for Payer: Oxford Commercial	$219.83
Rate for Payer: Qualcare PPO/HMO/WC	$164.87
Rate for Payer: UnitedHealthcare Commercial	$219.83
Rate for Payer: UnitedHealthcare Community & State	$26.49
Rate for Payer: Wellpoint Medicaid Managed Care	$29.13

CANNULA MCV CONTOUR 5 3085

Facility

$433.65

Hospital Charge Code	270604748
Hospital Revenue Code	272
Min. Negotiated Rate	$10.45
Max. Negotiated Rate	$216.82
Rate for Payer: Aetna Commercial	$164.79
Rate for Payer: Aetna Medicare Advantage	$130.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.58
Rate for Payer: Cigna Commercial	$216.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.09
Rate for Payer: Oxford Commercial	$86.73
Rate for Payer: Qualcare PPO/HMO/WC	$65.05
Rate for Payer: UnitedHealthcare Commercial	$86.73
Rate for Payer: UnitedHealthcare Community & State	$10.45
Rate for Payer: Wellpoint Medicaid Managed Care	$11.49

CANNULA MCV CONTOUR 5 3085

Facility

$433.65

Hospital Charge Code	270604748
Hospital Revenue Code	272
Min. Negotiated Rate	$65.05
Max. Negotiated Rate	$65.05
Rate for Payer: Qualcare PPO/HMO/WC	$65.05

CANNULA MCV CONTOUR 6****

Facility

$168.00

Hospital Charge Code	270604749
Hospital Revenue Code	279
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$84.00
Rate for Payer: Aetna Commercial	$63.84
Rate for Payer: Aetna Medicare Advantage	$50.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.84
Rate for Payer: Cigna Commercial	$84.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.40
Rate for Payer: Oxford Commercial	$33.60
Rate for Payer: Qualcare PPO/HMO/WC	$25.20
Rate for Payer: UnitedHealthcare Commercial	$33.60
Rate for Payer: UnitedHealthcare Community & State	$4.05
Rate for Payer: Wellpoint Medicaid Managed Care	$4.45

CANNULA MCV CONTOUR 6****

Facility

$168.00

Hospital Charge Code	270604749
Hospital Revenue Code	279
Min. Negotiated Rate	$25.20
Max. Negotiated Rate	$25.20
Rate for Payer: Qualcare PPO/HMO/WC	$25.20

CANNULA MCV CONTOUR 7 3087

Facility

$227.45

Hospital Charge Code	270604750
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 MCV CONTOUR 7 3087

Facility

$227.45

Hospital Charge Code	270604750
Hospital Revenue Code	272
Min. Negotiated Rate	$34.12
Max. Negotiated Rate	$34.12
Rate for Payer: Qualcare PPO/HMO/WC	$34.12

CANNULA MCV CONTOUR 9 3089

Facility

$433.65

Hospital Charge Code	270604752
Hospital Revenue Code	272
Min. Negotiated Rate	$65.05
Max. Negotiated Rate	$65.05
Rate for Payer: Qualcare PPO/HMO/WC	$65.05

Know your out-of-pocket cost for care.

All Charges