Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH MT BLMX 8/4/5.8 12-239

Facility

$2,404.00

Hospital Charge Code	270601083
Hospital Revenue Code	272
Min. Negotiated Rate	$57.94
Max. Negotiated Rate	$1,202.00
Rate for Payer: Aetna Commercial	$913.52
Rate for Payer: Aetna Medicare Advantage	$721.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$613.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$613.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$613.02
Rate for Payer: Cigna Commercial	$1,202.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$721.20
Rate for Payer: Oxford Commercial	$480.80
Rate for Payer: Qualcare PPO/HMO/WC	$360.60
Rate for Payer: UnitedHealthcare Commercial	$480.80
Rate for Payer: UnitedHealthcare Community & State	$57.94
Rate for Payer: Wellpoint Medicaid Managed Care	$63.71

CATH MT BLMX BALN HI PRESS****

Facility

$947.00

Hospital Charge Code	1604537
Hospital Revenue Code	272
Min. Negotiated Rate	$142.05
Max. Negotiated Rate	$142.05
Rate for Payer: Qualcare PPO/HMO/WC	$142.05

CATH MT BLMX BALN HI PRESS****

Facility

$947.00

Hospital Charge Code	1604537
Hospital Revenue Code	272
Min. Negotiated Rate	$22.82
Max. Negotiated Rate	$473.50
Rate for Payer: Aetna Commercial	$359.86
Rate for Payer: Aetna Medicare Advantage	$284.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$241.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$241.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$241.49
Rate for Payer: Cigna Commercial	$473.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.10
Rate for Payer: Oxford Commercial	$189.40
Rate for Payer: Qualcare PPO/HMO/WC	$142.05
Rate for Payer: UnitedHealthcare Commercial	$189.40
Rate for Payer: UnitedHealthcare Community & State	$22.82
Rate for Payer: Wellpoint Medicaid Managed Care	$25.10

CATH MT EXPRESS 8 37 38046

Facility

$6,975.00

Hospital Charge Code	270628305V
Hospital Revenue Code	278
Min. Negotiated Rate	$168.10
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,650.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,534.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25
Rate for Payer: UnitedHealthcare Community & State	$168.10
Rate for Payer: Wellpoint Medicaid Managed Care	$184.84

CATH MT EXPRESS 8 37 38046

Facility

$6,975.00

Hospital Charge Code	270628305V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,687.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,534.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

CATH MT FLUSH 5F 31528

Facility

$471.25

Hospital Charge Code	270629704
Hospital Revenue Code	272
Min. Negotiated Rate	$70.69
Max. Negotiated Rate	$70.69
Rate for Payer: Qualcare PPO/HMO/WC	$70.69

CATH MT FLUSH 5F 31528

Facility

$471.25

Hospital Charge Code	270629704
Hospital Revenue Code	272
Min. Negotiated Rate	$11.36
Max. Negotiated Rate	$235.62
Rate for Payer: Aetna Commercial	$179.07
Rate for Payer: Aetna Medicare Advantage	$141.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.17
Rate for Payer: Cigna Commercial	$235.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.38
Rate for Payer: Oxford Commercial	$94.25
Rate for Payer: Qualcare PPO/HMO/WC	$70.69
Rate for Payer: UnitedHealthcare Commercial	$94.25
Rate for Payer: UnitedHealthcare Community & State	$11.36
Rate for Payer: Wellpoint Medicaid Managed Care	$12.49

CATH MT GLIDE 5 100 32-139

Facility

$253.25

Service Code	HCPCS C1887
Hospital Charge Code	270623514
Hospital Revenue Code	278
Min. Negotiated Rate	$6.10
Max. Negotiated Rate	$126.62
Rate for Payer: Aetna Commercial	$96.23
Rate for Payer: Aetna Medicare Advantage	$75.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.58
Rate for Payer: Cigna Commercial	$126.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.72
Rate for Payer: Qualcare PPO/HMO/WC	$37.99
Rate for Payer: UnitedHealthcare Community & State	$6.10
Rate for Payer: Wellpoint Medicaid Managed Care	$6.71

CATH MT GLIDE 5 100 32-139

Facility

$253.25

Service Code	HCPCS C1887
Hospital Charge Code	270623514
Hospital Revenue Code	278
Min. Negotiated Rate	$37.99
Max. Negotiated Rate	$61.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.72
Rate for Payer: Qualcare PPO/HMO/WC	$37.99

CATH MT GLIDE 5 100 32-139

Facility

$71.50

Service Code	HCPCS C1887
Hospital Charge Code	270623514N
Hospital Revenue Code	278
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$35.75
Rate for Payer: Aetna Commercial	$27.17
Rate for Payer: Aetna Medicare Advantage	$21.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.23
Rate for Payer: Cigna Commercial	$35.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.73
Rate for Payer: Qualcare PPO/HMO/WC	$10.72
Rate for Payer: UnitedHealthcare Community & State	$1.72
Rate for Payer: Wellpoint Medicaid Managed Care	$1.89

CATH MT GLIDE 5 100 32-139

Facility

$253.25

Service Code	HCPCS C1887
Hospital Charge Code	270623514S
Hospital Revenue Code	278
Min. Negotiated Rate	$37.99
Max. Negotiated Rate	$61.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.72
Rate for Payer: Qualcare PPO/HMO/WC	$37.99

CATH MT GLIDE 5 100 32-139

Facility

$253.25

Service Code	HCPCS C1887
Hospital Charge Code	270623514S
Hospital Revenue Code	278
Min. Negotiated Rate	$6.10
Max. Negotiated Rate	$126.62
Rate for Payer: Aetna Commercial	$96.23
Rate for Payer: Aetna Medicare Advantage	$75.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.58
Rate for Payer: Cigna Commercial	$126.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.72
Rate for Payer: Qualcare PPO/HMO/WC	$37.99
Rate for Payer: UnitedHealthcare Community & State	$6.10
Rate for Payer: Wellpoint Medicaid Managed Care	$6.71

CATH MT GLIDE 5 100 32-139

Facility

$253.25

Service Code	HCPCS C1887
Hospital Charge Code	270623514O
Hospital Revenue Code	278
Min. Negotiated Rate	$6.10
Max. Negotiated Rate	$126.62
Rate for Payer: Aetna Commercial	$96.23
Rate for Payer: Aetna Medicare Advantage	$75.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.58
Rate for Payer: Cigna Commercial	$126.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.72
Rate for Payer: Qualcare PPO/HMO/WC	$37.99
Rate for Payer: UnitedHealthcare Community & State	$6.10
Rate for Payer: Wellpoint Medicaid Managed Care	$6.71

CATH MT GLIDE 5 100 32-139

Facility

$253.25

Service Code	HCPCS C1887
Hospital Charge Code	270623514O
Hospital Revenue Code	278
Min. Negotiated Rate	$37.99
Max. Negotiated Rate	$61.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.72
Rate for Payer: Qualcare PPO/HMO/WC	$37.99

CATH MT GLIDE 5 100 32-139

Facility

$71.50

Service Code	HCPCS C1887
Hospital Charge Code	270623514N
Hospital Revenue Code	278
Min. Negotiated Rate	$10.72
Max. Negotiated Rate	$17.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.73
Rate for Payer: Qualcare PPO/HMO/WC	$10.72

CATH MT NEPHROSTOMY 10F 27-180

Facility

$435.25

Hospital Charge Code	270623766V
Hospital Revenue Code	278
Min. Negotiated Rate	$10.49
Max. Negotiated Rate	$217.62
Rate for Payer: Aetna Commercial	$165.40
Rate for Payer: Aetna Medicare Advantage	$130.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.99
Rate for Payer: Cigna Commercial	$217.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$95.75
Rate for Payer: Qualcare PPO/HMO/WC	$65.29
Rate for Payer: UnitedHealthcare Community & State	$10.49
Rate for Payer: Wellpoint Medicaid Managed Care	$11.53

CATH MT NEPHROSTOMY 10F 27-180

Facility

$435.25

Hospital Charge Code	270623766V
Hospital Revenue Code	278
Min. Negotiated Rate	$65.29
Max. Negotiated Rate	$105.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$95.75
Rate for Payer: Qualcare PPO/HMO/WC	$65.29

CATH MT NEPHROSTOMY 12F 27-181

Facility

$435.25

Hospital Charge Code	270623971V
Hospital Revenue Code	278
Min. Negotiated Rate	$65.29
Max. Negotiated Rate	$105.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$95.75
Rate for Payer: Qualcare PPO/HMO/WC	$65.29

CATH MT NEPHROSTOMY 12F 27-181

Facility

$435.25

Hospital Charge Code	270623971V
Hospital Revenue Code	278
Min. Negotiated Rate	$10.49
Max. Negotiated Rate	$217.62
Rate for Payer: Aetna Commercial	$165.40
Rate for Payer: Aetna Medicare Advantage	$130.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.99
Rate for Payer: Cigna Commercial	$217.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$95.75
Rate for Payer: Qualcare PPO/HMO/WC	$65.29
Rate for Payer: UnitedHealthcare Community & State	$10.49
Rate for Payer: Wellpoint Medicaid Managed Care	$11.53

CATH MT SYNERGY 10M 4C 19 481

Facility

$1,344.00

Hospital Charge Code	270625145
Hospital Revenue Code	278
Min. Negotiated Rate	$32.39
Max. Negotiated Rate	$672.00
Rate for Payer: Aetna Commercial	$510.72
Rate for Payer: Aetna Medicare Advantage	$403.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$342.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$342.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$342.72
Rate for Payer: Cigna Commercial	$672.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$295.68
Rate for Payer: Qualcare PPO/HMO/WC	$201.60
Rate for Payer: UnitedHealthcare Community & State	$32.39
Rate for Payer: Wellpoint Medicaid Managed Care	$35.62

CATH MT SYNERGY 10M 4C 19 481

Facility

$1,344.00

Hospital Charge Code	270625145
Hospital Revenue Code	278
Min. Negotiated Rate	$201.60
Max. Negotiated Rate	$325.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$295.68
Rate for Payer: Qualcare PPO/HMO/WC	$201.60

CATH MT SYNERGY 5X4 19-328

Facility

$1,418.45

Hospital Charge Code	270625134
Hospital Revenue Code	278
Min. Negotiated Rate	$34.18
Max. Negotiated Rate	$709.23
Rate for Payer: Aetna Commercial	$539.01
Rate for Payer: Aetna Medicare Advantage	$425.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$361.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$361.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$283.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$361.70
Rate for Payer: Cigna Commercial	$709.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$343.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$312.06
Rate for Payer: Qualcare PPO/HMO/WC	$212.77
Rate for Payer: UnitedHealthcare Community & State	$34.18
Rate for Payer: Wellpoint Medicaid Managed Care	$37.59

CATH MT SYNERGY 5X4 19-328

Facility

$1,418.45

Hospital Charge Code	270625134
Hospital Revenue Code	278
Min. Negotiated Rate	$212.77
Max. Negotiated Rate	$343.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$283.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$343.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$312.06
Rate for Payer: Qualcare PPO/HMO/WC	$212.77

CATH MT UDT/10-4/5/75 16-525

Facility

$1,224.85

Hospital Charge Code	270623525
Hospital Revenue Code	272
Min. Negotiated Rate	$183.73
Max. Negotiated Rate	$183.73
Rate for Payer: Qualcare PPO/HMO/WC	$183.73

CATH MT UDT/10-4/5/75 16-525

Facility

$1,224.85

Hospital Charge Code	270623525
Hospital Revenue Code	272
Min. Negotiated Rate	$29.52
Max. Negotiated Rate	$612.42
Rate for Payer: Aetna Commercial	$465.44
Rate for Payer: Aetna Medicare Advantage	$367.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$312.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$312.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$312.34
Rate for Payer: Cigna Commercial	$612.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$367.45
Rate for Payer: Oxford Commercial	$244.97
Rate for Payer: Qualcare PPO/HMO/WC	$183.73
Rate for Payer: UnitedHealthcare Commercial	$244.97
Rate for Payer: UnitedHealthcare Community & State	$29.52
Rate for Payer: Wellpoint Medicaid Managed Care	$32.46

Know your out-of-pocket cost for care.

All Charges