Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH PICC 5FR SNGL LUMEN

Facility

$472.00

Service Code	HCPCS C1751
Hospital Charge Code	270664312S
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

CATH PICC 5FR SNGL LUMEN

Facility

$472.00

Service Code	HCPCS C1751
Hospital Charge Code	270664312
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

$475.00

Service Code	HCPCS C1751
Hospital Charge Code	270664312N
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

CATH PICC 5FR SNGL LUMEN

Facility

$475.00

Service Code	HCPCS C1751
Hospital Charge Code	270664312N
Hospital Revenue Code	278
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$180.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Community & State	$11.45
Rate for Payer: Wellpoint Medicaid Managed Care	$12.59

CATH PICC LINE 5F DUAL 0720515

Facility

$9,875.00

Hospital Charge Code	270661311
Hospital Revenue Code	278
Min. Negotiated Rate	$237.99
Max. Negotiated Rate	$4,937.50
Rate for Payer: Aetna Commercial	$3,752.50
Rate for Payer: Aetna Medicare Advantage	$2,962.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,518.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,518.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,518.12
Rate for Payer: Cigna Commercial	$4,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,389.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,172.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,481.25
Rate for Payer: UnitedHealthcare Community & State	$237.99
Rate for Payer: Wellpoint Medicaid Managed Care	$261.69

CATH PICC LINE 5F DUAL 0720515

Facility

$9,875.00

Hospital Charge Code	270661311
Hospital Revenue Code	278
Min. Negotiated Rate	$1,481.25
Max. Negotiated Rate	$2,389.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,389.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,172.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,481.25

CATH PIGT 5F 110C CRD 451593L5

Facility

$88.85

Hospital Charge Code	270624703
Hospital Revenue Code	272
Min. Negotiated Rate	$13.33
Max. Negotiated Rate	$13.33
Rate for Payer: Qualcare PPO/HMO/WC	$13.33

CATH PIGT 5F 110C CRD 451593L5

Facility

$88.85

Hospital Charge Code	270624703
Hospital Revenue Code	272
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$44.42
Rate for Payer: Aetna Commercial	$33.76
Rate for Payer: Aetna Medicare Advantage	$26.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.66
Rate for Payer: Cigna Commercial	$44.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.66
Rate for Payer: Oxford Commercial	$17.77
Rate for Payer: Qualcare PPO/HMO/WC	$13.33
Rate for Payer: UnitedHealthcare Commercial	$17.77
Rate for Payer: UnitedHealthcare Community & State	$2.14
Rate for Payer: Wellpoint Medicaid Managed Care	$2.35

CATH PIGTAIL 145 5FR 110cm

Facility

$44.50

Hospital Charge Code	270644615C
Hospital Revenue Code	272
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$22.25
Rate for Payer: Aetna Commercial	$16.91
Rate for Payer: Aetna Medicare Advantage	$13.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.35
Rate for Payer: Cigna Commercial	$22.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.35
Rate for Payer: Oxford Commercial	$8.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.67
Rate for Payer: UnitedHealthcare Commercial	$8.90
Rate for Payer: UnitedHealthcare Community & State	$1.07
Rate for Payer: Wellpoint Medicaid Managed Care	$1.18

CATH PIGTAIL 145 5FR 110cm

Facility

$44.50

Hospital Charge Code	270644615C
Hospital Revenue Code	272
Min. Negotiated Rate	$6.67
Max. Negotiated Rate	$6.67
Rate for Payer: Qualcare PPO/HMO/WC	$6.67

CATH PIGTAIL 5/90 10500104

Facility

$159.25

Hospital Charge Code	270607200
Hospital Revenue Code	270
Min. Negotiated Rate	$23.89
Max. Negotiated Rate	$23.89
Rate for Payer: Qualcare PPO/HMO/WC	$23.89

CATH PIGTAIL 5/90 10500104

Facility

$159.25

Hospital Charge Code	270607200
Hospital Revenue Code	270
Min. Negotiated Rate	$3.84
Max. Negotiated Rate	$79.62
Rate for Payer: Aetna Commercial	$60.52
Rate for Payer: Aetna Medicare Advantage	$47.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.61
Rate for Payer: Cigna Commercial	$79.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.77
Rate for Payer: Oxford Commercial	$31.85
Rate for Payer: Qualcare PPO/HMO/WC	$23.89
Rate for Payer: UnitedHealthcare Commercial	$31.85
Rate for Payer: UnitedHealthcare Community & State	$3.84
Rate for Payer: Wellpoint Medicaid Managed Care	$4.22

CATH PIGTAIL 5FR 110cm

Facility

$42.50

Hospital Charge Code	270644611C
Hospital Revenue Code	272
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$21.25
Rate for Payer: Aetna Commercial	$16.15
Rate for Payer: Aetna Medicare Advantage	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.84
Rate for Payer: Cigna Commercial	$21.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.75
Rate for Payer: Oxford Commercial	$8.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.38
Rate for Payer: UnitedHealthcare Commercial	$8.50
Rate for Payer: UnitedHealthcare Community & State	$1.02
Rate for Payer: Wellpoint Medicaid Managed Care	$1.13

CATH PIGTAIL 5FR 110cm

Facility

$42.50

Hospital Charge Code	270644611C
Hospital Revenue Code	272
Min. Negotiated Rate	$6.38
Max. Negotiated Rate	$6.38
Rate for Payer: Qualcare PPO/HMO/WC	$6.38

CATH PIGTAIL 5FR 145 110cm

Facility

$275.00

Hospital Charge Code	270644615
Hospital Revenue Code	279
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.50
Rate for Payer: Oxford Commercial	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Commercial	$55.00
Rate for Payer: UnitedHealthcare Community & State	$6.63
Rate for Payer: Wellpoint Medicaid Managed Care	$7.29

CATH PIGTAIL 5FR 145 110cm

Facility

$275.00

Hospital Charge Code	270644615
Hospital Revenue Code	279
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CATH PIGTAIL 6FR ANGLED

Facility

$37.35

Hospital Charge Code	270653800N
Hospital Revenue Code	272
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$18.68
Rate for Payer: Aetna Commercial	$14.19
Rate for Payer: Aetna Medicare Advantage	$11.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.52
Rate for Payer: Cigna Commercial	$18.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.21
Rate for Payer: Oxford Commercial	$7.47
Rate for Payer: Qualcare PPO/HMO/WC	$5.60
Rate for Payer: UnitedHealthcare Commercial	$7.47
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

CATH PIGTAIL 6FR ANGLED

Facility

$37.90

Hospital Charge Code	270653800
Hospital Revenue Code	272
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$5.68
Rate for Payer: Qualcare PPO/HMO/WC	$5.68

CATH PIGTAIL 6FR ANGLED

Facility

$37.90

Hospital Charge Code	270653800S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$18.95
Rate for Payer: Aetna Commercial	$14.40
Rate for Payer: Aetna Medicare Advantage	$11.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.66
Rate for Payer: Cigna Commercial	$18.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.37
Rate for Payer: Oxford Commercial	$7.58
Rate for Payer: Qualcare PPO/HMO/WC	$5.68
Rate for Payer: UnitedHealthcare Commercial	$7.58
Rate for Payer: UnitedHealthcare Community & State	$0.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

CATH PIGTAIL 6FR ANGLED

Facility

$37.35

Hospital Charge Code	270653800N
Hospital Revenue Code	272
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$5.60

CATH PIGTAIL 6FR ANGLED

Facility

$37.90

Hospital Charge Code	270653800
Hospital Revenue Code	272
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$18.95
Rate for Payer: Aetna Commercial	$14.40
Rate for Payer: Aetna Medicare Advantage	$11.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.66
Rate for Payer: Cigna Commercial	$18.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.37
Rate for Payer: Oxford Commercial	$7.58
Rate for Payer: Qualcare PPO/HMO/WC	$5.68
Rate for Payer: UnitedHealthcare Commercial	$7.58
Rate for Payer: UnitedHealthcare Community & State	$0.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

CATH PIGTAIL 6FR ANGLED

Facility

$37.90

Hospital Charge Code	270653800S
Hospital Revenue Code	272
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$5.68
Rate for Payer: Qualcare PPO/HMO/WC	$5.68

CATH PIGTAIL 6FR DUAL LUMEN

Facility

$695.00

Hospital Charge Code	270653766
Hospital Revenue Code	270
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$104.25
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

CATH PIGTAIL 6FR DUAL LUMEN

Facility

$695.00

Hospital Charge Code	270653766C
Hospital Revenue Code	270
Min. Negotiated Rate	$16.75
Max. Negotiated Rate	$347.50
Rate for Payer: Aetna Commercial	$264.10
Rate for Payer: Aetna Medicare Advantage	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.22
Rate for Payer: Cigna Commercial	$347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.50
Rate for Payer: Oxford Commercial	$139.00
Rate for Payer: Qualcare PPO/HMO/WC	$104.25
Rate for Payer: UnitedHealthcare Commercial	$139.00
Rate for Payer: UnitedHealthcare Community & State	$16.75
Rate for Payer: Wellpoint Medicaid Managed Care	$18.42

CATH PIGTAIL 6FR DUAL LUMEN

Facility

$595.00

Hospital Charge Code	270653766N
Hospital Revenue Code	270
Min. Negotiated Rate	$89.25
Max. Negotiated Rate	$89.25
Rate for Payer: Qualcare PPO/HMO/WC	$89.25

Know your out-of-pocket cost for care.

All Charges