Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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

Facility

$1,224.85

Hospital Charge Code	270623525V
Hospital Revenue Code	278
Min. Negotiated Rate	$183.73
Max. Negotiated Rate	$296.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.47
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	270623525V
Hospital Revenue Code	278
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) NJ Health	$244.97
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	$296.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.47
Rate for Payer: Qualcare PPO/HMO/WC	$183.73
Rate for Payer: UnitedHealthcare Community & State	$29.52
Rate for Payer: Wellpoint Medicaid Managed Care	$32.46

CATH MT UDT/5-4/5/75 16-443

Facility

$1,895.25

Hospital Charge Code	270618562V
Hospital Revenue Code	272
Min. Negotiated Rate	$45.68
Max. Negotiated Rate	$947.62
Rate for Payer: Aetna Commercial	$720.20
Rate for Payer: Aetna Medicare Advantage	$568.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$483.29
Rate for Payer: Cigna Commercial	$947.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$568.58
Rate for Payer: Oxford Commercial	$379.05
Rate for Payer: Qualcare PPO/HMO/WC	$284.29
Rate for Payer: UnitedHealthcare Commercial	$379.05
Rate for Payer: UnitedHealthcare Community & State	$45.68
Rate for Payer: Wellpoint Medicaid Managed Care	$50.22

CATH MT UDT/5-4/5/75 16-443

Facility

$1,895.25

Hospital Charge Code	270618562V
Hospital Revenue Code	272
Min. Negotiated Rate	$284.29
Max. Negotiated Rate	$284.29
Rate for Payer: Qualcare PPO/HMO/WC	$284.29

CATH MT UDT/8-4/5.8T/75 16-505

Facility

$1,954.45

Hospital Charge Code	270616370V
Hospital Revenue Code	278
Min. Negotiated Rate	$47.10
Max. Negotiated Rate	$977.23
Rate for Payer: Aetna Commercial	$742.69
Rate for Payer: Aetna Medicare Advantage	$586.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$498.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$498.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$390.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$498.38
Rate for Payer: Cigna Commercial	$977.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$472.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$429.98
Rate for Payer: Qualcare PPO/HMO/WC	$293.17
Rate for Payer: UnitedHealthcare Community & State	$47.10
Rate for Payer: Wellpoint Medicaid Managed Care	$51.79

CATH MT UDT/8-4/5.8T/75 16-505

Facility

$1,954.45

Hospital Charge Code	270616370V
Hospital Revenue Code	278
Min. Negotiated Rate	$293.17
Max. Negotiated Rate	$472.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$390.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$472.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$429.98
Rate for Payer: Qualcare PPO/HMO/WC	$293.17

CATH MT URET UT/4 4/5/75 14309

Facility

$1,821.65

Hospital Charge Code	270601085
Hospital Revenue Code	272
Min. Negotiated Rate	$273.25
Max. Negotiated Rate	$273.25
Rate for Payer: Qualcare PPO/HMO/WC	$273.25

CATH MT URET UT/4 4/5/75 14309

Facility

$1,821.65

Hospital Charge Code	270601085
Hospital Revenue Code	272
Min. Negotiated Rate	$43.90
Max. Negotiated Rate	$910.83
Rate for Payer: Aetna Commercial	$692.23
Rate for Payer: Aetna Medicare Advantage	$546.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$464.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$464.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$464.52
Rate for Payer: Cigna Commercial	$910.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$546.50
Rate for Payer: Oxford Commercial	$364.33
Rate for Payer: Qualcare PPO/HMO/WC	$273.25
Rate for Payer: UnitedHealthcare Commercial	$364.33
Rate for Payer: UnitedHealthcare Community & State	$43.90
Rate for Payer: Wellpoint Medicaid Managed Care	$48.27

CATH MT URET UT/5-4/5/75 14318

Facility

$2,301.65

Hospital Charge Code	270601086
Hospital Revenue Code	272
Min. Negotiated Rate	$55.47
Max. Negotiated Rate	$1,150.83
Rate for Payer: Aetna Commercial	$874.63
Rate for Payer: Aetna Medicare Advantage	$690.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$586.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$586.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$586.92
Rate for Payer: Cigna Commercial	$1,150.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$690.50
Rate for Payer: Oxford Commercial	$460.33
Rate for Payer: Qualcare PPO/HMO/WC	$345.25
Rate for Payer: UnitedHealthcare Commercial	$460.33
Rate for Payer: UnitedHealthcare Community & State	$55.47
Rate for Payer: Wellpoint Medicaid Managed Care	$60.99

CATH MT URET UT/5-4/5/75 14318

Facility

$2,301.65

Hospital Charge Code	270601086
Hospital Revenue Code	272
Min. Negotiated Rate	$345.25
Max. Negotiated Rate	$345.25
Rate for Payer: Qualcare PPO/HMO/WC	$345.25

CATH MT UT BALLN 10-4/5 16-526

Facility

$1,071.25

Hospital Charge Code	270627286
Hospital Revenue Code	278
Min. Negotiated Rate	$160.69
Max. Negotiated Rate	$259.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.68
Rate for Payer: Qualcare PPO/HMO/WC	$160.69

CATH MT UT BALLN 10-4/5 16-526

Facility

$1,071.25

Hospital Charge Code	270627286
Hospital Revenue Code	278
Min. Negotiated Rate	$25.82
Max. Negotiated Rate	$535.62
Rate for Payer: Aetna Commercial	$407.07
Rate for Payer: Aetna Medicare Advantage	$321.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$273.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$273.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$273.17
Rate for Payer: Cigna Commercial	$535.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.68
Rate for Payer: Qualcare PPO/HMO/WC	$160.69
Rate for Payer: UnitedHealthcare Community & State	$25.82
Rate for Payer: Wellpoint Medicaid Managed Care	$28.39

CATH MT UT SDS 5.3 76 17-656

Facility

$1,010.45

Hospital Charge Code	270626932
Hospital Revenue Code	278
Min. Negotiated Rate	$151.57
Max. Negotiated Rate	$244.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$202.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$222.30
Rate for Payer: Qualcare PPO/HMO/WC	$151.57

CATH MT UT SDS 5.3 76 17-656

Facility

$1,010.45

Hospital Charge Code	270626932
Hospital Revenue Code	278
Min. Negotiated Rate	$24.35
Max. Negotiated Rate	$505.23
Rate for Payer: Aetna Commercial	$383.97
Rate for Payer: Aetna Medicare Advantage	$303.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$257.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$257.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$202.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$257.66
Rate for Payer: Cigna Commercial	$505.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$222.30
Rate for Payer: Qualcare PPO/HMO/WC	$151.57
Rate for Payer: UnitedHealthcare Community & State	$24.35
Rate for Payer: Wellpoint Medicaid Managed Care	$26.78

CATH MUSHROOM 26F

Facility

$108.00

Hospital Charge Code	270060470
Hospital Revenue Code	272
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$54.00
Rate for Payer: Aetna Commercial	$41.04
Rate for Payer: Aetna Medicare Advantage	$32.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.54
Rate for Payer: Cigna Commercial	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.40
Rate for Payer: Oxford Commercial	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$16.20
Rate for Payer: UnitedHealthcare Commercial	$21.60
Rate for Payer: UnitedHealthcare Community & State	$2.60
Rate for Payer: Wellpoint Medicaid Managed Care	$2.86

CATH MUSHROOM 26F

Facility

$108.00

Hospital Charge Code	270060470
Hospital Revenue Code	272
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$16.20
Rate for Payer: Qualcare PPO/HMO/WC	$16.20

CATH MUSHROOM 28F

Facility

$88.00

Hospital Charge Code	270060475
Hospital Revenue Code	272
Min. Negotiated Rate	$13.20
Max. Negotiated Rate	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$13.20

CATH MUSHROOM 28F

Facility

$88.00

Hospital Charge Code	270060475
Hospital Revenue Code	272
Min. Negotiated Rate	$2.12
Max. Negotiated Rate	$44.00
Rate for Payer: Aetna Commercial	$33.44
Rate for Payer: Aetna Medicare Advantage	$26.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.44
Rate for Payer: Cigna Commercial	$44.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.40
Rate for Payer: Oxford Commercial	$17.60
Rate for Payer: Qualcare PPO/HMO/WC	$13.20
Rate for Payer: UnitedHealthcare Commercial	$17.60
Rate for Payer: UnitedHealthcare Community & State	$2.12
Rate for Payer: Wellpoint Medicaid Managed Care	$2.33

CATH MUSHROOM 30F

Facility

$108.00

Hospital Charge Code	270060500
Hospital Revenue Code	272
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$16.20
Rate for Payer: Qualcare PPO/HMO/WC	$16.20

CATH MUSHROOM 30F

Facility

$108.00

Hospital Charge Code	270060500
Hospital Revenue Code	272
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$54.00
Rate for Payer: Aetna Commercial	$41.04
Rate for Payer: Aetna Medicare Advantage	$32.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.54
Rate for Payer: Cigna Commercial	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.40
Rate for Payer: Oxford Commercial	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$16.20
Rate for Payer: UnitedHealthcare Commercial	$21.60
Rate for Payer: UnitedHealthcare Community & State	$2.60
Rate for Payer: Wellpoint Medicaid Managed Care	$2.86

CATH MUSHROOM 32F *******

Facility

$39.00

Hospital Charge Code	1600725
Hospital Revenue Code	272
Min. Negotiated Rate	$5.85
Max. Negotiated Rate	$5.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.85

CATH MUSHROOM 32F *******

Facility

$39.00

Hospital Charge Code	1600725
Hospital Revenue Code	272
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$19.50
Rate for Payer: Aetna Commercial	$14.82
Rate for Payer: Aetna Medicare Advantage	$11.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.95
Rate for Payer: Cigna Commercial	$19.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.70
Rate for Payer: Oxford Commercial	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$5.85
Rate for Payer: UnitedHealthcare Commercial	$7.80
Rate for Payer: UnitedHealthcare Community & State	$0.94
Rate for Payer: Wellpoint Medicaid Managed Care	$1.03

CATH MUSTANG BALLOON 6MMx200CM

Facility

$1,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270673900
Hospital Revenue Code	278
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

CATH MUSTANG BALLOON 6MMx200CM

Facility

$1,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270673900
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

CATH NAVIEN DSC ST LP 5F 105CM

Facility

$6,750.00

Service Code	HCPCS C1887
Hospital Charge Code	270695993S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

Know your out-of-pocket cost for care.

All Charges