Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH PERF RT4FR AR2

Facility

$40.00

Hospital Charge Code	2709006894
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CATH PERF RT4FR ARMOD

Facility

$40.00

Hospital Charge Code	2709006893
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.00
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$8.00
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

CATH PERF RT4FR ARMOD

Facility

$40.00

Hospital Charge Code	2709006893
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CATH PERF RT4FR JR5.0

Facility

$40.00

Hospital Charge Code	2709006888
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CATH PERF RT4FR JR5.0

Facility

$40.00

Hospital Charge Code	2709006888
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.00
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$8.00
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

CATH PERF RT4FR JR6.0

Facility

$40.00

Hospital Charge Code	2709006889
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CATH PERF RT4FR JR6.0

Facility

$40.00

Hospital Charge Code	2709006889
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.00
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$8.00
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

CATH PERFUSION W/ASP TB RED43

Facility

$11,950.00

Service Code	HCPCS C1887
Hospital Charge Code	270700022S
Hospital Revenue Code	278
Min. Negotiated Rate	$288.00
Max. Negotiated Rate	$5,975.00
Rate for Payer: Aetna Commercial	$4,541.00
Rate for Payer: Aetna Medicare Advantage	$3,585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,047.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,047.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,047.25
Rate for Payer: Cigna Commercial	$5,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,891.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,629.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,792.50
Rate for Payer: UnitedHealthcare Community & State	$288.00
Rate for Payer: Wellpoint Medicaid Managed Care	$316.68

CATH PERFUSION W/ASP TB RED43

Facility

$11,950.00

Service Code	HCPCS C1887
Hospital Charge Code	270700022S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,792.50
Max. Negotiated Rate	$2,891.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,891.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,629.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,792.50

CATH PERIL DIAL KIT 15F MPD242

Facility

$2,450.00

Hospital Charge Code	270644735
Hospital Revenue Code	278
Min. Negotiated Rate	$367.50
Max. Negotiated Rate	$592.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$539.00
Rate for Payer: Qualcare PPO/HMO/WC	$367.50

CATH PERIL DIAL KIT 15F MPD242

Facility

$2,450.00

Hospital Charge Code	270644735
Hospital Revenue Code	278
Min. Negotiated Rate	$59.05
Max. Negotiated Rate	$1,225.00
Rate for Payer: Aetna Commercial	$931.00
Rate for Payer: Aetna Medicare Advantage	$735.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$490.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$624.75
Rate for Payer: Cigna Commercial	$1,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$539.00
Rate for Payer: Qualcare PPO/HMO/WC	$367.50
Rate for Payer: UnitedHealthcare Community & State	$59.05
Rate for Payer: Wellpoint Medicaid Managed Care	$64.92

CATH PERITONEAL 42CM ST PD422S

Facility

$486.15

Hospital Charge Code	270626550
Hospital Revenue Code	278
Min. Negotiated Rate	$11.72
Max. Negotiated Rate	$243.07
Rate for Payer: Aetna Commercial	$184.74
Rate for Payer: Aetna Medicare Advantage	$145.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.97
Rate for Payer: Cigna Commercial	$243.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$106.95
Rate for Payer: Qualcare PPO/HMO/WC	$72.92
Rate for Payer: UnitedHealthcare Community & State	$11.72
Rate for Payer: Wellpoint Medicaid Managed Care	$12.88

CATH PERITONEAL 42CM ST PD422S

Facility

$486.15

Hospital Charge Code	270626550
Hospital Revenue Code	278
Min. Negotiated Rate	$72.92
Max. Negotiated Rate	$117.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$106.95
Rate for Payer: Qualcare PPO/HMO/WC	$72.92

CATH PERITONEAL CURL KIT 60CM

Facility

$589.50

Service Code	HCPCS C1750
Hospital Charge Code	270693168
Hospital Revenue Code	278
Min. Negotiated Rate	$88.42
Max. Negotiated Rate	$142.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$129.69
Rate for Payer: Qualcare PPO/HMO/WC	$88.42

CATH PERITONEAL CURL KIT 60CM

Facility

$589.50

Service Code	HCPCS C1750
Hospital Charge Code	270693168
Hospital Revenue Code	278
Min. Negotiated Rate	$14.21
Max. Negotiated Rate	$294.75
Rate for Payer: Aetna Commercial	$224.01
Rate for Payer: Aetna Medicare Advantage	$176.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.32
Rate for Payer: Cigna Commercial	$294.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$129.69
Rate for Payer: Qualcare PPO/HMO/WC	$88.42
Rate for Payer: UnitedHealthcare Community & State	$14.21
Rate for Payer: Wellpoint Medicaid Managed Care	$15.62

CATH PFLX BLN 12x4x80 4202040S

Facility

$1,314.45

Hospital Charge Code	270632653
Hospital Revenue Code	278
Min. Negotiated Rate	$31.68
Max. Negotiated Rate	$657.23
Rate for Payer: Aetna Commercial	$499.49
Rate for Payer: Aetna Medicare Advantage	$394.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$262.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.18
Rate for Payer: Cigna Commercial	$657.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$289.18
Rate for Payer: Qualcare PPO/HMO/WC	$197.17
Rate for Payer: UnitedHealthcare Community & State	$31.68
Rate for Payer: Wellpoint Medicaid Managed Care	$34.83

CATH PFLX BLN 12x4x80 4202040S

Facility

$1,314.45

Hospital Charge Code	270632653
Hospital Revenue Code	278
Min. Negotiated Rate	$197.17
Max. Negotiated Rate	$318.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$262.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$289.18
Rate for Payer: Qualcare PPO/HMO/WC	$197.17

CATH PFX BLN 8x3 135c 4208030X

Facility

$1,264.00

Hospital Charge Code	270624399
Hospital Revenue Code	272
Min. Negotiated Rate	$189.60
Max. Negotiated Rate	$189.60
Rate for Payer: Qualcare PPO/HMO/WC	$189.60

CATH PFX BLN 8x3 135c 4208030X

Facility

$1,264.00

Hospital Charge Code	270624399
Hospital Revenue Code	272
Min. Negotiated Rate	$30.46
Max. Negotiated Rate	$632.00
Rate for Payer: Aetna Commercial	$480.32
Rate for Payer: Aetna Medicare Advantage	$379.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$322.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$322.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$322.32
Rate for Payer: Cigna Commercial	$632.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$379.20
Rate for Payer: Oxford Commercial	$252.80
Rate for Payer: Qualcare PPO/HMO/WC	$189.60
Rate for Payer: UnitedHealthcare Commercial	$252.80
Rate for Payer: UnitedHealthcare Community & State	$30.46
Rate for Payer: Wellpoint Medicaid Managed Care	$33.50

CATH PH-24 HOUR***

Facility

$319.20

Hospital Charge Code	2300838
Hospital Revenue Code	279
Min. Negotiated Rate	$47.88
Max. Negotiated Rate	$47.88
Rate for Payer: Qualcare PPO/HMO/WC	$47.88

CATH PH-24 HOUR***

Facility

$319.20

Hospital Charge Code	2300838
Hospital Revenue Code	279
Min. Negotiated Rate	$7.69
Max. Negotiated Rate	$159.60
Rate for Payer: Aetna Commercial	$121.30
Rate for Payer: Aetna Medicare Advantage	$95.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.40
Rate for Payer: Cigna Commercial	$159.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.76
Rate for Payer: Oxford Commercial	$63.84
Rate for Payer: Qualcare PPO/HMO/WC	$47.88
Rate for Payer: UnitedHealthcare Commercial	$63.84
Rate for Payer: UnitedHealthcare Community & State	$7.69
Rate for Payer: Wellpoint Medicaid Managed Care	$8.46

CATH PICC 4FR DUAL LUMEN

Facility

$518.50

Service Code	HCPCS C1751
Hospital Charge Code	675028
Hospital Revenue Code	278
Min. Negotiated Rate	$12.50
Max. Negotiated Rate	$259.25
Rate for Payer: Aetna Commercial	$197.03
Rate for Payer: Aetna Medicare Advantage	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.22
Rate for Payer: Cigna Commercial	$259.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.07
Rate for Payer: Qualcare PPO/HMO/WC	$77.78
Rate for Payer: UnitedHealthcare Community & State	$12.50
Rate for Payer: Wellpoint Medicaid Managed Care	$13.74

CATH PICC 4FR DUAL LUMEN

Facility

$518.50

Service Code	HCPCS C1751
Hospital Charge Code	675028
Hospital Revenue Code	278
Min. Negotiated Rate	$77.78
Max. Negotiated Rate	$125.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.07
Rate for Payer: Qualcare PPO/HMO/WC	$77.78

CATH PICC 5FR SNGL LUMEN

Facility

$472.00

Service Code	HCPCS C1751
Hospital Charge Code	270664312S
Hospital Revenue Code	278
Min. Negotiated Rate	$11.38
Max. Negotiated Rate	$236.00
Rate for Payer: Aetna Commercial	$179.36
Rate for Payer: Aetna Medicare Advantage	$141.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.36
Rate for Payer: Cigna Commercial	$236.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$103.84
Rate for Payer: Qualcare PPO/HMO/WC	$70.80
Rate for Payer: UnitedHealthcare Community & State	$11.38
Rate for Payer: Wellpoint Medicaid Managed Care	$12.51

CATH PICC 5FR SNGL LUMEN

Facility

$472.00

Service Code	HCPCS C1751
Hospital Charge Code	270664312
Hospital Revenue Code	278
Min. Negotiated Rate	$70.80
Max. Negotiated Rate	$114.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$103.84
Rate for Payer: Qualcare PPO/HMO/WC	$70.80

Know your out-of-pocket cost for care.

All Charges