Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH MEWEN 5F 035 100CM 46411

Facility

$408.85

Hospital Charge Code	270626088
Hospital Revenue Code	272
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$204.43
Rate for Payer: Aetna Commercial	$155.36
Rate for Payer: Aetna Medicare Advantage	$122.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.26
Rate for Payer: Cigna Commercial	$204.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.66
Rate for Payer: Oxford Commercial	$81.77
Rate for Payer: Qualcare PPO/HMO/WC	$61.33
Rate for Payer: UnitedHealthcare Commercial	$81.77
Rate for Payer: UnitedHealthcare Community & State	$9.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.83

CATH MEWEN 5F 035 100CM 46411

Facility

$408.85

Hospital Charge Code	270626088
Hospital Revenue Code	272
Min. Negotiated Rate	$61.33
Max. Negotiated Rate	$61.33
Rate for Payer: Qualcare PPO/HMO/WC	$61.33

CATH MEWEN 5F 035 100CM 46411

Facility

$408.85

Hospital Charge Code	270626088V
Hospital Revenue Code	278
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$204.43
Rate for Payer: Aetna Commercial	$155.36
Rate for Payer: Aetna Medicare Advantage	$122.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.26
Rate for Payer: Cigna Commercial	$204.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$89.95
Rate for Payer: Qualcare PPO/HMO/WC	$61.33
Rate for Payer: UnitedHealthcare Community & State	$9.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.83

CATH MEWEN 5F 035 100CM 46411

Facility

$408.85

Hospital Charge Code	270626088V
Hospital Revenue Code	278
Min. Negotiated Rate	$61.33
Max. Negotiated Rate	$98.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$89.95
Rate for Payer: Qualcare PPO/HMO/WC	$61.33

CATH MICRO EXCELSIOR XT-17

Facility

$4,836.15

Service Code	HCPCS C1887
Hospital Charge Code	270695290S
Hospital Revenue Code	278
Min. Negotiated Rate	$725.42
Max. Negotiated Rate	$1,170.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$967.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,170.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,063.95
Rate for Payer: Qualcare PPO/HMO/WC	$725.42

CATH MICRO EXCELSIOR XT-17

Facility

$4,836.15

Service Code	HCPCS C1887
Hospital Charge Code	270695290S
Hospital Revenue Code	278
Min. Negotiated Rate	$116.55
Max. Negotiated Rate	$2,418.07
Rate for Payer: Aetna Commercial	$1,837.74
Rate for Payer: Aetna Medicare Advantage	$1,450.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,233.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,233.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$967.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,233.22
Rate for Payer: Cigna Commercial	$2,418.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,170.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,063.95
Rate for Payer: Qualcare PPO/HMO/WC	$725.42
Rate for Payer: UnitedHealthcare Community & State	$116.55
Rate for Payer: Wellpoint Medicaid Managed Care	$128.16

CATH MICRO EXCEL SL 10STR 2TIP

Facility

$4,726.25

Service Code	HCPCS C1769
Hospital Charge Code	278689725S
Hospital Revenue Code	278
Min. Negotiated Rate	$708.94
Max. Negotiated Rate	$1,143.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$945.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,143.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,039.78
Rate for Payer: Qualcare PPO/HMO/WC	$708.94

CATH MICRO EXCEL SL 10STR 2TIP

Facility

$4,726.25

Service Code	HCPCS C1769
Hospital Charge Code	270689725S
Hospital Revenue Code	278
Min. Negotiated Rate	$708.94
Max. Negotiated Rate	$1,143.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$945.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,143.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,039.78
Rate for Payer: Qualcare PPO/HMO/WC	$708.94

CATH MICRO EXCEL SL 10STR 2TIP

Facility

$4,726.25

Service Code	HCPCS C1769
Hospital Charge Code	270689725S
Hospital Revenue Code	278
Min. Negotiated Rate	$113.90
Max. Negotiated Rate	$2,363.12
Rate for Payer: Aetna Commercial	$1,795.97
Rate for Payer: Aetna Medicare Advantage	$1,417.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,205.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,205.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$945.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,205.19
Rate for Payer: Cigna Commercial	$2,363.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,143.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,039.78
Rate for Payer: Qualcare PPO/HMO/WC	$708.94
Rate for Payer: UnitedHealthcare Community & State	$113.90
Rate for Payer: Wellpoint Medicaid Managed Care	$125.25

CATH MICRO EXCEL SL 10STR 2TIP

Facility

$4,726.25

Service Code	HCPCS C1769
Hospital Charge Code	278689725S
Hospital Revenue Code	278
Min. Negotiated Rate	$113.90
Max. Negotiated Rate	$2,363.12
Rate for Payer: Aetna Commercial	$1,795.97
Rate for Payer: Aetna Medicare Advantage	$1,417.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,205.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,205.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$945.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,205.19
Rate for Payer: Cigna Commercial	$2,363.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,143.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,039.78
Rate for Payer: Qualcare PPO/HMO/WC	$708.94
Rate for Payer: UnitedHealthcare Community & State	$113.90
Rate for Payer: Wellpoint Medicaid Managed Care	$125.25

CATH MIK 5FR

Facility

$200.85

Service Code	HCPCS C1887
Hospital Charge Code	270677003
Hospital Revenue Code	272
Min. Negotiated Rate	$30.13
Max. Negotiated Rate	$30.13
Rate for Payer: Qualcare PPO/HMO/WC	$30.13

CATH MIK 5FR

Facility

$200.85

Service Code	HCPCS C1887
Hospital Charge Code	270677003
Hospital Revenue Code	272
Min. Negotiated Rate	$4.84
Max. Negotiated Rate	$100.42
Rate for Payer: Aetna Commercial	$76.32
Rate for Payer: Aetna Medicare Advantage	$60.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.22
Rate for Payer: Cigna Commercial	$100.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.26
Rate for Payer: Oxford Commercial	$40.17
Rate for Payer: Qualcare PPO/HMO/WC	$30.13
Rate for Payer: UnitedHealthcare Commercial	$40.17
Rate for Payer: UnitedHealthcare Community & State	$4.84
Rate for Payer: Wellpoint Medicaid Managed Care	$5.32

CATH MIKAELSON CVD 5F 559413**

Facility

$46.00

Hospital Charge Code	270559413
Hospital Revenue Code	272
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$23.00
Rate for Payer: Aetna Commercial	$17.48
Rate for Payer: Aetna Medicare Advantage	$13.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.73
Rate for Payer: Cigna Commercial	$23.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.80
Rate for Payer: Oxford Commercial	$9.20
Rate for Payer: Qualcare PPO/HMO/WC	$6.90
Rate for Payer: UnitedHealthcare Commercial	$9.20
Rate for Payer: UnitedHealthcare Community & State	$1.11
Rate for Payer: Wellpoint Medicaid Managed Care	$1.22

CATH MIKAELSON CVD 5F 559413**

Facility

$46.00

Hospital Charge Code	270559413
Hospital Revenue Code	272
Min. Negotiated Rate	$6.90
Max. Negotiated Rate	$6.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.90

CATH MM COBRA 1 5F 541213

Facility

$52.00

Hospital Charge Code	270623749
Hospital Revenue Code	272
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

CATH MM COBRA 1 5F 541213

Facility

$52.00

Hospital Charge Code	270623749
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$10.40
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$10.40
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

CATH MM MIKAELSON CV 5F 559413

Facility

$52.85

Hospital Charge Code	270623744
Hospital Revenue Code	272
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$26.43
Rate for Payer: Aetna Commercial	$20.08
Rate for Payer: Aetna Medicare Advantage	$15.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.48
Rate for Payer: Cigna Commercial	$26.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.86
Rate for Payer: Oxford Commercial	$10.57
Rate for Payer: Qualcare PPO/HMO/WC	$7.93
Rate for Payer: UnitedHealthcare Commercial	$10.57
Rate for Payer: UnitedHealthcare Community & State	$1.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.40

CATH MM MIKAELSON CV 5F 559413

Facility

$52.85

Hospital Charge Code	270623744
Hospital Revenue Code	272
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$7.93
Rate for Payer: Qualcare PPO/HMO/WC	$7.93

CATH MM NEWTON 2 5F 5563-23

Facility

$52.00

Hospital Charge Code	270623742
Hospital Revenue Code	272
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

CATH MM NEWTON 2 5F 5563-23

Facility

$52.00

Hospital Charge Code	270623742
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$10.40
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$10.40
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

CATH MM PERFORMA DVS 5F 559533

Facility

$52.00

Hospital Charge Code	270623746
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$10.40
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$10.40
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

CATH MM PERFORMA DVS 5F 559533

Facility

$52.00

Hospital Charge Code	270623746
Hospital Revenue Code	272
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

CATH MM PIGTAIL 5F 553991

Facility

$52.00

Hospital Charge Code	270623748
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$10.40
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$10.40
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

CATH MM PIGTAIL 5F 553991

Facility

$52.00

Hospital Charge Code	270623748
Hospital Revenue Code	272
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

CATH MM PIGTAIL 5F 760220M65

Facility

$52.00

Hospital Charge Code	270623743
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$10.40
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$10.40
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

Know your out-of-pocket cost for care.

All Charges