Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CANNULA UNIV KIT 7X76MM 012421

Facility

$1,433.65

Hospital Charge Code	270612233
Hospital Revenue Code	272
Min. Negotiated Rate	$215.05
Max. Negotiated Rate	$215.05
Rate for Payer: Qualcare PPO/HMO/WC	$215.05

CANNULA UNIV KIT 7X76MM 012421

Facility

$1,433.65

Hospital Charge Code	270612233
Hospital Revenue Code	272
Min. Negotiated Rate	$34.55
Max. Negotiated Rate	$716.83
Rate for Payer: Aetna Commercial	$544.79
Rate for Payer: Aetna Medicare Advantage	$430.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$365.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$365.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$365.58
Rate for Payer: Cigna Commercial	$716.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$430.10
Rate for Payer: Oxford Commercial	$286.73
Rate for Payer: Qualcare PPO/HMO/WC	$215.05
Rate for Payer: UnitedHealthcare Commercial	$286.73
Rate for Payer: UnitedHealthcare Community & State	$34.55
Rate for Payer: Wellpoint Medicaid Managed Care	$37.99

CANNULA UNIV STD FIX 5MM

Facility

$44.70

Hospital Charge Code	270675263
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.35
Rate for Payer: Aetna Commercial	$16.99
Rate for Payer: Aetna Medicare Advantage	$13.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.40
Rate for Payer: Cigna Commercial	$22.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.41
Rate for Payer: Oxford Commercial	$8.94
Rate for Payer: Qualcare PPO/HMO/WC	$6.71
Rate for Payer: UnitedHealthcare Commercial	$8.94
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.18

CANNULA UNIV STD FIX 5MM

Facility

$44.70

Hospital Charge Code	270675263
Hospital Revenue Code	272
Min. Negotiated Rate	$6.71
Max. Negotiated Rate	$6.71
Rate for Payer: Qualcare PPO/HMO/WC	$6.71

CANNULA WITH OUTLET 8MM

Facility

$4,800.00

Hospital Charge Code	270663993
Hospital Revenue Code	270
Min. Negotiated Rate	$115.68
Max. Negotiated Rate	$2,400.00
Rate for Payer: Aetna Commercial	$1,824.00
Rate for Payer: Aetna Medicare Advantage	$1,440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,224.00
Rate for Payer: Cigna Commercial	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,440.00
Rate for Payer: Oxford Commercial	$960.00
Rate for Payer: Qualcare PPO/HMO/WC	$720.00
Rate for Payer: UnitedHealthcare Commercial	$960.00
Rate for Payer: UnitedHealthcare Community & State	$115.68
Rate for Payer: Wellpoint Medicaid Managed Care	$127.20

CANNULA WITH OUTLET 8MM

Facility

$4,800.00

Hospital Charge Code	270663993
Hospital Revenue Code	270
Min. Negotiated Rate	$720.00
Max. Negotiated Rate	$720.00
Rate for Payer: Qualcare PPO/HMO/WC	$720.00

CANNULA W/OBTURATOR 8.4mmx75mm

Facility

$50.00

Hospital Charge Code	270639292
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 W/OBTURATOR 8.4mmx75mm

Facility

$50.00

Hospital Charge Code	270639292
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

CANNULA XL 7fr-5.5fr RX 4582

Facility

$391.90

Hospital Charge Code	270627939
Hospital Revenue Code	272
Min. Negotiated Rate	$9.44
Max. Negotiated Rate	$195.95
Rate for Payer: Aetna Commercial	$148.92
Rate for Payer: Aetna Medicare Advantage	$117.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.93
Rate for Payer: Cigna Commercial	$195.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.57
Rate for Payer: Oxford Commercial	$78.38
Rate for Payer: Qualcare PPO/HMO/WC	$58.78
Rate for Payer: UnitedHealthcare Commercial	$78.38
Rate for Payer: UnitedHealthcare Community & State	$9.44
Rate for Payer: Wellpoint Medicaid Managed Care	$10.39

CANNULA XL 7fr-5.5fr RX 4582

Facility

$391.90

Hospital Charge Code	270627939
Hospital Revenue Code	272
Min. Negotiated Rate	$58.78
Max. Negotiated Rate	$58.78
Rate for Payer: Qualcare PPO/HMO/WC	$58.78

CANNULE RF NEEDLE 150MM 20G

Facility

$240.70

Hospital Charge Code	270654886
Hospital Revenue Code	272
Min. Negotiated Rate	$5.80
Max. Negotiated Rate	$120.35
Rate for Payer: Aetna Commercial	$91.47
Rate for Payer: Aetna Medicare Advantage	$72.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.38
Rate for Payer: Cigna Commercial	$120.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.21
Rate for Payer: Oxford Commercial	$48.14
Rate for Payer: Qualcare PPO/HMO/WC	$36.10
Rate for Payer: UnitedHealthcare Commercial	$48.14
Rate for Payer: UnitedHealthcare Community & State	$5.80
Rate for Payer: Wellpoint Medicaid Managed Care	$6.38

CANNULE RF NEEDLE 150MM 20G

Facility

$240.70

Hospital Charge Code	270654886
Hospital Revenue Code	272
Min. Negotiated Rate	$36.10
Max. Negotiated Rate	$36.10
Rate for Payer: Qualcare PPO/HMO/WC	$36.10

CANNULLA RF 18G 10X100MM

Facility

$2,665.00

Hospital Charge Code	270691392
Hospital Revenue Code	279
Min. Negotiated Rate	$399.75
Max. Negotiated Rate	$399.75
Rate for Payer: Qualcare PPO/HMO/WC	$399.75

CANNULLA RF 18G 10X100MM

Facility

$2,665.00

Hospital Charge Code	270691392
Hospital Revenue Code	279
Min. Negotiated Rate	$64.23
Max. Negotiated Rate	$1,332.50
Rate for Payer: Aetna Commercial	$1,012.70
Rate for Payer: Aetna Medicare Advantage	$799.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$679.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$679.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$679.58
Rate for Payer: Cigna Commercial	$1,332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$799.50
Rate for Payer: Oxford Commercial	$533.00
Rate for Payer: Qualcare PPO/HMO/WC	$399.75
Rate for Payer: UnitedHealthcare Commercial	$533.00
Rate for Payer: UnitedHealthcare Community & State	$64.23
Rate for Payer: Wellpoint Medicaid Managed Care	$70.62

CANOPY RESP 2342

Facility

$63.25

Hospital Charge Code	270200060
Hospital Revenue Code	270
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$9.49
Rate for Payer: Qualcare PPO/HMO/WC	$9.49

CANOPY RESP 2342

Facility

$63.25

Hospital Charge Code	270200060
Hospital Revenue Code	270
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$31.62
Rate for Payer: Aetna Commercial	$24.04
Rate for Payer: Aetna Medicare Advantage	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.13
Rate for Payer: Cigna Commercial	$31.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.98
Rate for Payer: Oxford Commercial	$12.65
Rate for Payer: Qualcare PPO/HMO/WC	$9.49
Rate for Payer: UnitedHealthcare Commercial	$12.65
Rate for Payer: UnitedHealthcare Community & State	$1.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1.68

CANULA 6 X 75m 214661

Facility

$105.00

Hospital Charge Code	270635851
Hospital Revenue Code	272
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$15.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

CANULA 6 X 75m 214661

Facility

$105.00

Hospital Charge Code	270635851
Hospital Revenue Code	272
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$52.50
Rate for Payer: Aetna Commercial	$39.90
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.50
Rate for Payer: Oxford Commercial	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Community & State	$2.53
Rate for Payer: Wellpoint Medicaid Managed Care	$2.78

CAN USE

Facility

$65.00

Hospital Charge Code	6501290
Hospital Revenue Code	410
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$24.70
Rate for Payer: Aetna Medicare Advantage	$19.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.57
Rate for Payer: Cigna Commercial	$32.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.75
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$1.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1.72

CAN USE

Facility

$65.00

Hospital Charge Code	6501290
Hospital Revenue Code	410
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

CAN USE -ERROR

Facility

$116.48

Hospital Charge Code	2700400
Hospital Revenue Code	260
Min. Negotiated Rate	$2.81
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$44.26
Rate for Payer: Aetna Medicare Advantage	$34.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.70
Rate for Payer: Cigna Commercial	$58.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.94
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.47
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$2.81
Rate for Payer: Wellpoint Medicaid Managed Care	$3.09

CAN USE -ERROR

Facility

$116.48

Hospital Charge Code	2700400
Hospital Revenue Code	260
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$17.47
Rate for Payer: Qualcare PPO/HMO/WC	$17.47

CAN USE INCORRECT MM NUMBER

Facility

$850.00

Hospital Charge Code	270945239
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

CAN USE INCORRECT MM NUMBER

Facility

$850.00

Hospital Charge Code	270945239
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.00
Rate for Payer: Oxford Commercial	$170.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$170.00
Rate for Payer: UnitedHealthcare Community & State	$20.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.52

CAN USE THIS NUMBER--ERROR

Facility

$116.48

Hospital Charge Code	5700998
Hospital Revenue Code	260
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$17.47
Rate for Payer: Qualcare PPO/HMO/WC	$17.47

Know your out-of-pocket cost for care.

All Charges