Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH GUIDING 6FR MACH I VL 5.0

Facility

$255.00

Hospital Charge Code	270641798
Hospital Revenue Code	278
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$127.50
Rate for Payer: Aetna Commercial	$96.90
Rate for Payer: Aetna Medicare Advantage	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.03
Rate for Payer: Cigna Commercial	$127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$56.10
Rate for Payer: Qualcare PPO/HMO/WC	$38.25
Rate for Payer: UnitedHealthcare Community & State	$6.15
Rate for Payer: Wellpoint Medicaid Managed Care	$6.76

CATH GUIDING 8F JR 3 5 588855

Facility

$280.00

Hospital Charge Code	270637737
Hospital Revenue Code	278
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$67.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.60
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

CATH GUIDING 8F JR 3 5 588855

Facility

$280.00

Hospital Charge Code	270637737
Hospital Revenue Code	278
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$106.40
Rate for Payer: Aetna Medicare Advantage	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.40
Rate for Payer: Cigna Commercial	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.60
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Community & State	$6.75
Rate for Payer: Wellpoint Medicaid Managed Care	$7.42

CATH GUIDING 8 XB 3 5 588882

Facility

$279.85

Hospital Charge Code	270637963
Hospital Revenue Code	278
Min. Negotiated Rate	$6.74
Max. Negotiated Rate	$139.93
Rate for Payer: Aetna Commercial	$106.34
Rate for Payer: Aetna Medicare Advantage	$83.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.36
Rate for Payer: Cigna Commercial	$139.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.57
Rate for Payer: Qualcare PPO/HMO/WC	$41.98
Rate for Payer: UnitedHealthcare Community & State	$6.74
Rate for Payer: Wellpoint Medicaid Managed Care	$7.42

CATH GUIDING 8 XB 3 5 588882

Facility

$279.85

Hospital Charge Code	270637963
Hospital Revenue Code	278
Min. Negotiated Rate	$41.98
Max. Negotiated Rate	$67.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.57
Rate for Payer: Qualcare PPO/HMO/WC	$41.98

CATH HAWKONE ATHERECTOMY EXT

Facility

$16,750.00

Hospital Charge Code	270277280
Hospital Revenue Code	278
Min. Negotiated Rate	$403.68
Max. Negotiated Rate	$8,375.00
Rate for Payer: Aetna Commercial	$6,365.00
Rate for Payer: Aetna Medicare Advantage	$5,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,271.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,271.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,271.25
Rate for Payer: Cigna Commercial	$8,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,053.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,685.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,512.50
Rate for Payer: UnitedHealthcare Community & State	$403.68
Rate for Payer: Wellpoint Medicaid Managed Care	$443.88

CATH HAWKONE ATHERECTOMY EXT

Facility

$16,750.00

Hospital Charge Code	270277280
Hospital Revenue Code	278
Min. Negotiated Rate	$2,512.50
Max. Negotiated Rate	$4,053.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,053.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,685.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,512.50

CATH HEMOD DURAFLOW 15.5F 24CM

Facility

$850.00

Service Code	HCPCS C1750
Hospital Charge Code	270698674
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

CATH HEMOD DURAFLOW 15.5F 24CM

Facility

$850.00

Service Code	HCPCS C1750
Hospital Charge Code	270698674
Hospital Revenue Code	278
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) NJ Health	$170.00
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	$205.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Community & State	$20.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.52

CATH HEMOD DURAFLOW 15.5F 28CM

Facility

$850.00

Service Code	HCPCS C1750
Hospital Charge Code	270698675
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

CATH HEMOD DURAFLOW 15.5F 28CM

Facility

$850.00

Service Code	HCPCS C1750
Hospital Charge Code	270698675
Hospital Revenue Code	278
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) NJ Health	$170.00
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	$205.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Community & State	$20.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.52

CATH HEMO DUALL LM W/CF #SL28

Facility

$688.00

Hospital Charge Code	270607038
Hospital Revenue Code	272
Min. Negotiated Rate	$16.58
Max. Negotiated Rate	$344.00
Rate for Payer: Aetna Commercial	$261.44
Rate for Payer: Aetna Medicare Advantage	$206.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.44
Rate for Payer: Cigna Commercial	$344.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.40
Rate for Payer: Oxford Commercial	$137.60
Rate for Payer: Qualcare PPO/HMO/WC	$103.20
Rate for Payer: UnitedHealthcare Commercial	$137.60
Rate for Payer: UnitedHealthcare Community & State	$16.58
Rate for Payer: Wellpoint Medicaid Managed Care	$18.23

CATH HEMO DUALL LM W/CF #SL28

Facility

$688.00

Hospital Charge Code	270607038
Hospital Revenue Code	272
Min. Negotiated Rate	$103.20
Max. Negotiated Rate	$103.20
Rate for Payer: Qualcare PPO/HMO/WC	$103.20

CATH HEMOSPILT 42CM 5734423

Facility

$1,925.00

Hospital Charge Code	270641384
Hospital Revenue Code	278
Min. Negotiated Rate	$46.39
Max. Negotiated Rate	$962.50
Rate for Payer: Aetna Commercial	$731.50
Rate for Payer: Aetna Medicare Advantage	$577.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$385.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$490.88
Rate for Payer: Cigna Commercial	$962.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$465.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$288.75
Rate for Payer: UnitedHealthcare Community & State	$46.39
Rate for Payer: Wellpoint Medicaid Managed Care	$51.01

CATH HEMOSPILT 42CM 5734423

Facility

$1,925.00

Hospital Charge Code	270641384
Hospital Revenue Code	278
Min. Negotiated Rate	$288.75
Max. Negotiated Rate	$465.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$465.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$288.75

CATH HEMOSPLIT 35CM 5733353

Facility

$1,925.00

Hospital Charge Code	270641383
Hospital Revenue Code	278
Min. Negotiated Rate	$288.75
Max. Negotiated Rate	$465.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$465.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$288.75

CATH HEMOSPLIT 35CM 5733353

Facility

$1,925.00

Hospital Charge Code	270641383
Hospital Revenue Code	278
Min. Negotiated Rate	$46.39
Max. Negotiated Rate	$962.50
Rate for Payer: Aetna Commercial	$731.50
Rate for Payer: Aetna Medicare Advantage	$577.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$385.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$490.88
Rate for Payer: Cigna Commercial	$962.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$465.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$288.75
Rate for Payer: UnitedHealthcare Community & State	$46.39
Rate for Payer: Wellpoint Medicaid Managed Care	$51.01

CATH HEMOSPLIT STD 19CM

Facility

$1,488.00

Service Code	HCPCS C1750
Hospital Charge Code	270657877
Hospital Revenue Code	278
Min. Negotiated Rate	$35.86
Max. Negotiated Rate	$744.00
Rate for Payer: Aetna Commercial	$565.44
Rate for Payer: Aetna Medicare Advantage	$446.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$379.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$379.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$297.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$379.44
Rate for Payer: Cigna Commercial	$744.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$327.36
Rate for Payer: Qualcare PPO/HMO/WC	$223.20
Rate for Payer: UnitedHealthcare Community & State	$35.86
Rate for Payer: Wellpoint Medicaid Managed Care	$39.43

CATH HEMOSPLIT STD 19CM

Facility

$1,488.00

Service Code	HCPCS C1750
Hospital Charge Code	270657877
Hospital Revenue Code	278
Min. Negotiated Rate	$223.20
Max. Negotiated Rate	$360.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$297.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$327.36
Rate for Payer: Qualcare PPO/HMO/WC	$223.20

CATH HEMOSPLIT STD 19CM

Facility

$1,488.00

Service Code	HCPCS C1750
Hospital Charge Code	270657877S
Hospital Revenue Code	278
Min. Negotiated Rate	$35.86
Max. Negotiated Rate	$744.00
Rate for Payer: Aetna Commercial	$565.44
Rate for Payer: Aetna Medicare Advantage	$446.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$379.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$379.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$297.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$379.44
Rate for Payer: Cigna Commercial	$744.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$327.36
Rate for Payer: Qualcare PPO/HMO/WC	$223.20
Rate for Payer: UnitedHealthcare Community & State	$35.86
Rate for Payer: Wellpoint Medicaid Managed Care	$39.43

CATH HEMOSPLIT STD 19CM

Facility

$1,488.00

Service Code	HCPCS C1750
Hospital Charge Code	270657877S
Hospital Revenue Code	278
Min. Negotiated Rate	$223.20
Max. Negotiated Rate	$360.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$297.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$327.36
Rate for Payer: Qualcare PPO/HMO/WC	$223.20

CATH HEMOSPLIT STD 23CM

Facility

$1,775.00

Service Code	HCPCS C1750
Hospital Charge Code	270657882
Hospital Revenue Code	278
Min. Negotiated Rate	$42.78
Max. Negotiated Rate	$887.50
Rate for Payer: Aetna Commercial	$674.50
Rate for Payer: Aetna Medicare Advantage	$532.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$452.62
Rate for Payer: Cigna Commercial	$887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$390.50
Rate for Payer: Qualcare PPO/HMO/WC	$266.25
Rate for Payer: UnitedHealthcare Community & State	$42.78
Rate for Payer: Wellpoint Medicaid Managed Care	$47.04

CATH HEMOSPLIT STD 23CM

Facility

$1,775.00

Service Code	HCPCS C1750
Hospital Charge Code	270657882S
Hospital Revenue Code	278
Min. Negotiated Rate	$266.25
Max. Negotiated Rate	$429.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$355.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$390.50
Rate for Payer: Qualcare PPO/HMO/WC	$266.25

CATH HEMOSPLIT STD 23CM

Facility

$1,775.00

Service Code	HCPCS C1750
Hospital Charge Code	270657882S
Hospital Revenue Code	278
Min. Negotiated Rate	$42.78
Max. Negotiated Rate	$887.50
Rate for Payer: Aetna Commercial	$674.50
Rate for Payer: Aetna Medicare Advantage	$532.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$452.62
Rate for Payer: Cigna Commercial	$887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$390.50
Rate for Payer: Qualcare PPO/HMO/WC	$266.25
Rate for Payer: UnitedHealthcare Community & State	$42.78
Rate for Payer: Wellpoint Medicaid Managed Care	$47.04

CATH HEMOSPLIT STD 23CM

Facility

$1,775.00

Service Code	HCPCS C1750
Hospital Charge Code	270657882
Hospital Revenue Code	278
Min. Negotiated Rate	$266.25
Max. Negotiated Rate	$429.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$355.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$390.50
Rate for Payer: Qualcare PPO/HMO/WC	$266.25

Know your out-of-pocket cost for care.

All Charges