Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CANNULA OXYGEN NASAL LOW FLOW

Facility

$23.00

Hospital Charge Code	270674878
Hospital Revenue Code	272
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

CANNULA PASSPORT 8MMx3CM BU

Facility

$230.00

Hospital Charge Code	270665942
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 PASSPORT 8MMx3CM BU

Facility

$230.00

Hospital Charge Code	270665942
Hospital Revenue Code	272
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

CANNULA PASSPORT BUTTON

Facility

$160.00

Hospital Charge Code	270660885
Hospital Revenue Code	270
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

CANNULA PASSPORT BUTTON

Facility

$160.00

Hospital Charge Code	270660885
Hospital Revenue Code	270
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 PASSPORT BUTTON 30 MM

Facility

$300.00

Hospital Charge Code	270688469
Hospital Revenue Code	272
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.00
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$60.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

CANNULA PASSPORT BUTTON 30 MM

Facility

$300.00

Hospital Charge Code	270688469
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

CANNULA PASSPORT BUTTON 40 MM

Facility

$300.00

Hospital Charge Code	270688470
Hospital Revenue Code	272
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.00
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$60.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

CANNULA PASSPORT BUTTON 40 MM

Facility

$300.00

Hospital Charge Code	270688470
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

CANNULA PASSPORT BUTTON 8X3CM

Facility

$160.00

Hospital Charge Code	270664263
Hospital Revenue Code	270
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

CANNULA PASSPORT BUTTON 8X3CM

Facility

$160.00

Hospital Charge Code	270664263
Hospital Revenue Code	270
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 PCL

Facility

$380.00

Hospital Charge Code	270666964
Hospital Revenue Code	272
Min. Negotiated Rate	$9.16
Max. Negotiated Rate	$190.00
Rate for Payer: Aetna Commercial	$144.40
Rate for Payer: Aetna Medicare Advantage	$114.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.90
Rate for Payer: Cigna Commercial	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.00
Rate for Payer: Oxford Commercial	$76.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.00
Rate for Payer: UnitedHealthcare Commercial	$76.00
Rate for Payer: UnitedHealthcare Community & State	$9.16
Rate for Payer: Wellpoint Medicaid Managed Care	$10.07

CANNULA PCL

Facility

$380.00

Hospital Charge Code	270666964
Hospital Revenue Code	272
Min. Negotiated Rate	$57.00
Max. Negotiated Rate	$57.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.00

CANNULA PROSOFT ADULT

Facility

$67.50

Hospital Charge Code	270689828
Hospital Revenue Code	272
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$33.75
Rate for Payer: Aetna Commercial	$25.65
Rate for Payer: Aetna Medicare Advantage	$20.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.21
Rate for Payer: Cigna Commercial	$33.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.25
Rate for Payer: Oxford Commercial	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.12
Rate for Payer: UnitedHealthcare Commercial	$13.50
Rate for Payer: UnitedHealthcare Community & State	$1.63
Rate for Payer: Wellpoint Medicaid Managed Care	$1.79

CANNULA PROSOFT ADULT

Facility

$67.50

Hospital Charge Code	270689828
Hospital Revenue Code	272
Min. Negotiated Rate	$10.12
Max. Negotiated Rate	$10.12
Rate for Payer: Qualcare PPO/HMO/WC	$10.12

CANNULA PROSOFT INFANT

Facility

$67.50

Hospital Charge Code	270689831
Hospital Revenue Code	272
Min. Negotiated Rate	$10.12
Max. Negotiated Rate	$10.12
Rate for Payer: Qualcare PPO/HMO/WC	$10.12

CANNULA PROSOFT INFANT

Facility

$67.50

Hospital Charge Code	270689831
Hospital Revenue Code	272
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$33.75
Rate for Payer: Aetna Commercial	$25.65
Rate for Payer: Aetna Medicare Advantage	$20.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.21
Rate for Payer: Cigna Commercial	$33.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.25
Rate for Payer: Oxford Commercial	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.12
Rate for Payer: UnitedHealthcare Commercial	$13.50
Rate for Payer: UnitedHealthcare Community & State	$1.63
Rate for Payer: Wellpoint Medicaid Managed Care	$1.79

CANNULA PROSOFT NEONATE

Facility

$67.50

Hospital Charge Code	270689832
Hospital Revenue Code	272
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$33.75
Rate for Payer: Aetna Commercial	$25.65
Rate for Payer: Aetna Medicare Advantage	$20.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.21
Rate for Payer: Cigna Commercial	$33.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.25
Rate for Payer: Oxford Commercial	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.12
Rate for Payer: UnitedHealthcare Commercial	$13.50
Rate for Payer: UnitedHealthcare Community & State	$1.63
Rate for Payer: Wellpoint Medicaid Managed Care	$1.79

CANNULA PROSOFT NEONATE

Facility

$67.50

Hospital Charge Code	270689832
Hospital Revenue Code	272
Min. Negotiated Rate	$10.12
Max. Negotiated Rate	$10.12
Rate for Payer: Qualcare PPO/HMO/WC	$10.12

CANNULA PROSOFT PEDS/ADULT SML

Facility

$67.50

Hospital Charge Code	270689829
Hospital Revenue Code	272
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$33.75
Rate for Payer: Aetna Commercial	$25.65
Rate for Payer: Aetna Medicare Advantage	$20.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.21
Rate for Payer: Cigna Commercial	$33.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.25
Rate for Payer: Oxford Commercial	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.12
Rate for Payer: UnitedHealthcare Commercial	$13.50
Rate for Payer: UnitedHealthcare Community & State	$1.63
Rate for Payer: Wellpoint Medicaid Managed Care	$1.79

CANNULA PROSOFT PEDS/ADULT SML

Facility

$67.50

Hospital Charge Code	270689829
Hospital Revenue Code	272
Min. Negotiated Rate	$10.12
Max. Negotiated Rate	$10.12
Rate for Payer: Qualcare PPO/HMO/WC	$10.12

CANNULA PROSOFT-XL

Facility

$67.50

Hospital Charge Code	270689830
Hospital Revenue Code	272
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$33.75
Rate for Payer: Aetna Commercial	$25.65
Rate for Payer: Aetna Medicare Advantage	$20.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.21
Rate for Payer: Cigna Commercial	$33.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.25
Rate for Payer: Oxford Commercial	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.12
Rate for Payer: UnitedHealthcare Commercial	$13.50
Rate for Payer: UnitedHealthcare Community & State	$1.63
Rate for Payer: Wellpoint Medicaid Managed Care	$1.79

CANNULA PROSOFT-XL

Facility

$67.50

Hospital Charge Code	270689830
Hospital Revenue Code	272
Min. Negotiated Rate	$10.12
Max. Negotiated Rate	$10.12
Rate for Payer: Qualcare PPO/HMO/WC	$10.12

CANNULA P/THD 7MMX11CM

Facility

$25.75

Hospital Charge Code	270675728
Hospital Revenue Code	279
Min. Negotiated Rate	$3.86
Max. Negotiated Rate	$3.86
Rate for Payer: Qualcare PPO/HMO/WC	$3.86

CANNULA P/THD 7MMX11CM

Facility

$25.75

Hospital Charge Code	270675728
Hospital Revenue Code	279
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$12.88
Rate for Payer: Aetna Commercial	$9.79
Rate for Payer: Aetna Medicare Advantage	$7.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.57
Rate for Payer: Cigna Commercial	$12.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.72
Rate for Payer: Oxford Commercial	$5.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.86
Rate for Payer: UnitedHealthcare Commercial	$5.15
Rate for Payer: UnitedHealthcare Community & State	$0.62
Rate for Payer: Wellpoint Medicaid Managed Care	$0.68

Know your out-of-pocket cost for care.

All Charges