Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH HS SH 6F

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636317
Hospital Revenue Code	278
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Community & State	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$6.36

CATH HS SH 6F

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636317
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATH HS SH 7F 778-279-00

Facility

$54.95

Hospital Charge Code	270636374
Hospital Revenue Code	278
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$27.48
Rate for Payer: Aetna Commercial	$20.88
Rate for Payer: Aetna Medicare Advantage	$16.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.01
Rate for Payer: Cigna Commercial	$27.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.09
Rate for Payer: Qualcare PPO/HMO/WC	$8.24
Rate for Payer: UnitedHealthcare Community & State	$1.32
Rate for Payer: Wellpoint Medicaid Managed Care	$1.46

CATH HS SH 7F 778-279-00

Facility

$54.95

Hospital Charge Code	270636374
Hospital Revenue Code	278
Min. Negotiated Rate	$8.24
Max. Negotiated Rate	$13.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.09
Rate for Payer: Qualcare PPO/HMO/WC	$8.24

CATH HYDRO 10FR 3CC

Facility

$32.76

Hospital Charge Code	270302515
Hospital Revenue Code	272
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$16.38
Rate for Payer: Aetna Commercial	$12.45
Rate for Payer: Aetna Medicare Advantage	$9.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.35
Rate for Payer: Cigna Commercial	$16.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.83
Rate for Payer: Oxford Commercial	$6.55
Rate for Payer: Qualcare PPO/HMO/WC	$4.91
Rate for Payer: UnitedHealthcare Commercial	$6.55
Rate for Payer: UnitedHealthcare Community & State	$0.79
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

CATH HYDRO 10FR 3CC

Facility

$32.76

Hospital Charge Code	270302515
Hospital Revenue Code	272
Min. Negotiated Rate	$4.91
Max. Negotiated Rate	$4.91
Rate for Payer: Qualcare PPO/HMO/WC	$4.91

CATH HYDRO BERN IMPRESS 5FX100

Facility

$235.00

Service Code	HCPCS C1887
Hospital Charge Code	270657628S
Hospital Revenue Code	278
Min. Negotiated Rate	$5.66
Max. Negotiated Rate	$117.50
Rate for Payer: Aetna Commercial	$89.30
Rate for Payer: Aetna Medicare Advantage	$70.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.92
Rate for Payer: Cigna Commercial	$117.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$51.70
Rate for Payer: Qualcare PPO/HMO/WC	$35.25
Rate for Payer: UnitedHealthcare Community & State	$5.66
Rate for Payer: Wellpoint Medicaid Managed Care	$6.23

CATH HYDRO BERN IMPRESS 5FX100

Facility

$235.00

Service Code	HCPCS C1887
Hospital Charge Code	270657628S
Hospital Revenue Code	278
Min. Negotiated Rate	$35.25
Max. Negotiated Rate	$56.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$51.70
Rate for Payer: Qualcare PPO/HMO/WC	$35.25

CATH IABP 0.34CC

Facility

$3,246.45

Hospital Charge Code	270600703
Hospital Revenue Code	272
Min. Negotiated Rate	$78.24
Max. Negotiated Rate	$1,623.22
Rate for Payer: Aetna Commercial	$1,233.65
Rate for Payer: Aetna Medicare Advantage	$973.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$827.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$827.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$827.84
Rate for Payer: Cigna Commercial	$1,623.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$973.93
Rate for Payer: Oxford Commercial	$649.29
Rate for Payer: Qualcare PPO/HMO/WC	$486.97
Rate for Payer: UnitedHealthcare Commercial	$649.29
Rate for Payer: UnitedHealthcare Community & State	$78.24
Rate for Payer: Wellpoint Medicaid Managed Care	$86.03

CATH IABP 0.34CC

Facility

$3,246.45

Hospital Charge Code	270600703
Hospital Revenue Code	272
Min. Negotiated Rate	$486.97
Max. Negotiated Rate	$486.97
Rate for Payer: Qualcare PPO/HMO/WC	$486.97

CATH IABP 0.40CC

Facility

$3,246.45

Hospital Charge Code	270600702
Hospital Revenue Code	272
Min. Negotiated Rate	$486.97
Max. Negotiated Rate	$486.97
Rate for Payer: Qualcare PPO/HMO/WC	$486.97

CATH IABP 0.40CC

Facility

$3,246.45

Hospital Charge Code	270600702
Hospital Revenue Code	272
Min. Negotiated Rate	$78.24
Max. Negotiated Rate	$1,623.22
Rate for Payer: Aetna Commercial	$1,233.65
Rate for Payer: Aetna Medicare Advantage	$973.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$827.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$827.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$827.84
Rate for Payer: Cigna Commercial	$1,623.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$973.93
Rate for Payer: Oxford Commercial	$649.29
Rate for Payer: Qualcare PPO/HMO/WC	$486.97
Rate for Payer: UnitedHealthcare Commercial	$649.29
Rate for Payer: UnitedHealthcare Community & State	$78.24
Rate for Payer: Wellpoint Medicaid Managed Care	$86.03

CATH ILIAC UDT 7-4 75cm

Facility

$1,011.90

Hospital Charge Code	270623523
Hospital Revenue Code	272
Min. Negotiated Rate	$151.78
Max. Negotiated Rate	$151.78
Rate for Payer: Qualcare PPO/HMO/WC	$151.78

CATH ILIAC UDT 7-4 75cm

Facility

$1,011.90

Hospital Charge Code	270623523
Hospital Revenue Code	272
Min. Negotiated Rate	$24.39
Max. Negotiated Rate	$505.95
Rate for Payer: Aetna Commercial	$384.52
Rate for Payer: Aetna Medicare Advantage	$303.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$258.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$258.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$258.03
Rate for Payer: Cigna Commercial	$505.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.57
Rate for Payer: Oxford Commercial	$202.38
Rate for Payer: Qualcare PPO/HMO/WC	$151.78
Rate for Payer: UnitedHealthcare Commercial	$202.38
Rate for Payer: UnitedHealthcare Community & State	$24.39
Rate for Payer: Wellpoint Medicaid Managed Care	$26.82

CATH IM 6FR 670-190-00

Facility

$277.70

Service Code	HCPCS C1887
Hospital Charge Code	270636314N
Hospital Revenue Code	278
Min. Negotiated Rate	$6.69
Max. Negotiated Rate	$138.85
Rate for Payer: Aetna Commercial	$105.53
Rate for Payer: Aetna Medicare Advantage	$83.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.81
Rate for Payer: Cigna Commercial	$138.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.09
Rate for Payer: Qualcare PPO/HMO/WC	$41.66
Rate for Payer: UnitedHealthcare Community & State	$6.69
Rate for Payer: Wellpoint Medicaid Managed Care	$7.36

CATH IM 6FR 670-190-00

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636314
Hospital Revenue Code	278
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Community & State	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$6.36

CATH IM 6FR 670-190-00

Facility

$277.70

Service Code	HCPCS C1887
Hospital Charge Code	270636314N
Hospital Revenue Code	278
Min. Negotiated Rate	$41.66
Max. Negotiated Rate	$67.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.09
Rate for Payer: Qualcare PPO/HMO/WC	$41.66

CATH IM 6FR 670-190-00

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636314
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATH IM 7FR 778-190-00

Facility

$277.70

Hospital Charge Code	270636371
Hospital Revenue Code	278
Min. Negotiated Rate	$41.66
Max. Negotiated Rate	$67.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.09
Rate for Payer: Qualcare PPO/HMO/WC	$41.66

CATH IM 7FR 778-190-00

Facility

$277.70

Hospital Charge Code	270636371
Hospital Revenue Code	278
Min. Negotiated Rate	$6.69
Max. Negotiated Rate	$138.85
Rate for Payer: Aetna Commercial	$105.53
Rate for Payer: Aetna Medicare Advantage	$83.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.81
Rate for Payer: Cigna Commercial	$138.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.09
Rate for Payer: Qualcare PPO/HMO/WC	$41.66
Rate for Payer: UnitedHealthcare Community & State	$6.69
Rate for Payer: Wellpoint Medicaid Managed Care	$7.36

CATH IMAG2/5FR BERN40CM 0.35

Facility

$54.74

Hospital Charge Code	2709000333
Hospital Revenue Code	272
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$27.37
Rate for Payer: Aetna Commercial	$20.80
Rate for Payer: Aetna Medicare Advantage	$16.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.96
Rate for Payer: Cigna Commercial	$27.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.42
Rate for Payer: Oxford Commercial	$10.95
Rate for Payer: Qualcare PPO/HMO/WC	$8.21
Rate for Payer: UnitedHealthcare Commercial	$10.95
Rate for Payer: UnitedHealthcare Community & State	$1.32
Rate for Payer: Wellpoint Medicaid Managed Care	$1.45

CATH IMAG2/5FR BERN40CM 0.35

Facility

$54.74

Hospital Charge Code	2709000333
Hospital Revenue Code	272
Min. Negotiated Rate	$8.21
Max. Negotiated Rate	$8.21
Rate for Payer: Qualcare PPO/HMO/WC	$8.21

CATH IMAGER II 4FR 100cm .035

Facility

$27.91

Hospital Charge Code	270640686
Hospital Revenue Code	272
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$13.96
Rate for Payer: Aetna Commercial	$10.61
Rate for Payer: Aetna Medicare Advantage	$8.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.12
Rate for Payer: Cigna Commercial	$13.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.37
Rate for Payer: Oxford Commercial	$5.58
Rate for Payer: Qualcare PPO/HMO/WC	$4.19
Rate for Payer: UnitedHealthcare Commercial	$5.58
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

CATH IMAGER II 4FR 100cm .035

Facility

$89.00

Hospital Charge Code	270640686C
Hospital Revenue Code	272
Min. Negotiated Rate	$13.35
Max. Negotiated Rate	$13.35
Rate for Payer: Qualcare PPO/HMO/WC	$13.35

CATH IMAGER II 4FR 100cm .035

Facility

$27.91

Hospital Charge Code	270640686
Hospital Revenue Code	272
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$4.19
Rate for Payer: Qualcare PPO/HMO/WC	$4.19

Know your out-of-pocket cost for care.

All Charges