Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH PIGTAIL 6FR DUAL LUMEN

Facility

$695.00

Hospital Charge Code	270653766S
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

$595.00

Hospital Charge Code	270653766N
Hospital Revenue Code	270
Min. Negotiated Rate	$14.34
Max. Negotiated Rate	$297.50
Rate for Payer: Aetna Commercial	$226.10
Rate for Payer: Aetna Medicare Advantage	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.72
Rate for Payer: Cigna Commercial	$297.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.50
Rate for Payer: Oxford Commercial	$119.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.25
Rate for Payer: UnitedHealthcare Commercial	$119.00
Rate for Payer: UnitedHealthcare Community & State	$14.34
Rate for Payer: Wellpoint Medicaid Managed Care	$15.77

CATH PIGTAIL 6FR DUAL LUMEN

Facility

$695.00

Hospital Charge Code	270653766C
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	270653766S
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

$695.00

Hospital Charge Code	270653766
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 SOFT-VU 5FX90CM

Facility

$90.00

Service Code	HCPCS C1887
Hospital Charge Code	270678515C
Hospital Revenue Code	278
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Community & State	$2.17
Rate for Payer: Wellpoint Medicaid Managed Care	$2.38

CATH PIGTAIL SOFT-VU 5FX90CM

Facility

$90.00

Service Code	HCPCS C1887
Hospital Charge Code	270678515C
Hospital Revenue Code	278
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$21.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

CATH PIG TEMPO 5F 65c 451503V5

Facility

$88.85

Hospital Charge Code	270624915
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 PIG TEMPO 5F 65c 451503V5

Facility

$88.85

Hospital Charge Code	270624915
Hospital Revenue Code	272
Min. Negotiated Rate	$13.33
Max. Negotiated Rate	$13.33
Rate for Payer: Qualcare PPO/HMO/WC	$13.33

CATH PLACE CARDIO BRACHYTX

Facility

$12,500.00

Service Code	HCPCS 92974
Hospital Charge Code	411092974
Hospital Revenue Code	481
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$1,875.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

CATH PLACE CARDIO BRACHYTX

Facility

$12,500.00

Service Code	HCPCS 92974
Hospital Charge Code	411092974
Hospital Revenue Code	481
Min. Negotiated Rate	$301.25
Max. Negotiated Rate	$6,600.00
Rate for Payer: Aetna Commercial	$4,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,750.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$301.25
Rate for Payer: Wellpoint Medicaid Managed Care	$331.25

CATH PLACEMENT VEN 2ND LT

Facility

$2,919.00

Service Code	HCPCS 36012LT
Hospital Charge Code	7412048
Hospital Revenue Code	361
Min. Negotiated Rate	$70.35
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$1,109.22
Rate for Payer: Aetna Medicare Advantage	$875.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$744.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$744.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$744.35
Rate for Payer: Cigna Commercial	$1,459.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$875.70
Rate for Payer: Qualcare PPO/HMO/WC	$437.85
Rate for Payer: UnitedHealthcare Community & State	$70.35
Rate for Payer: Wellpoint Medicaid Managed Care	$77.35

CATH PLACEMENT VEN 2ND LT

Facility

$2,919.00

Service Code	HCPCS 36012LT
Hospital Charge Code	7412048
Hospital Revenue Code	361
Min. Negotiated Rate	$437.85
Max. Negotiated Rate	$437.85
Rate for Payer: Qualcare PPO/HMO/WC	$437.85

CATH PLACEMENT VEN 2ND RT

Facility

$2,919.00

Service Code	HCPCS 36012RT
Hospital Charge Code	7412049
Hospital Revenue Code	361
Min. Negotiated Rate	$70.35
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$1,109.22
Rate for Payer: Aetna Medicare Advantage	$875.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$744.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$744.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$744.35
Rate for Payer: Cigna Commercial	$1,459.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$875.70
Rate for Payer: Qualcare PPO/HMO/WC	$437.85
Rate for Payer: UnitedHealthcare Community & State	$70.35
Rate for Payer: Wellpoint Medicaid Managed Care	$77.35

CATH PLACEMENT VEN 2ND RT

Facility

$2,919.00

Service Code	HCPCS 36012RT
Hospital Charge Code	7412049
Hospital Revenue Code	361
Min. Negotiated Rate	$437.85
Max. Negotiated Rate	$437.85
Rate for Payer: Qualcare PPO/HMO/WC	$437.85

CATH PLUG/DRAIN TUBE

Facility

$1.34

Hospital Charge Code	270649624
Hospital Revenue Code	270
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.20

CATH PLUG/DRAIN TUBE

Facility

$1.34

Hospital Charge Code	270649624
Hospital Revenue Code	270
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.67
Rate for Payer: Aetna Commercial	$0.51
Rate for Payer: Aetna Medicare Advantage	$0.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.34
Rate for Payer: Cigna Commercial	$0.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.40
Rate for Payer: Oxford Commercial	$0.27
Rate for Payer: Qualcare PPO/HMO/WC	$0.20
Rate for Payer: UnitedHealthcare Commercial	$0.27
Rate for Payer: UnitedHealthcare Community & State	$0.03
Rate for Payer: Wellpoint Medicaid Managed Care	$0.04

CATH PLX BLN 5x3 135c 4205030X

Facility

$1,264.00

Hospital Charge Code	270624435
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 PLX BLN 5x3 135c 4205030X

Facility

$1,264.00

Hospital Charge Code	270624435
Hospital Revenue Code	272
Min. Negotiated Rate	$189.60
Max. Negotiated Rate	$189.60
Rate for Payer: Qualcare PPO/HMO/WC	$189.60

CATH PLX BLN 6x3 135c 4208030X

Facility

$1,264.00

Hospital Charge Code	270624397
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 PLX BLN 6x3 135c 4208030X

Facility

$1,264.00

Hospital Charge Code	270624397
Hospital Revenue Code	272
Min. Negotiated Rate	$189.60
Max. Negotiated Rate	$189.60
Rate for Payer: Qualcare PPO/HMO/WC	$189.60

CATH POWERMIDLINE PICC KT 3FR

Facility

$735.00

Service Code	HCPCS C1751
Hospital Charge Code	270684374S
Hospital Revenue Code	278
Min. Negotiated Rate	$17.71
Max. Negotiated Rate	$367.50
Rate for Payer: Aetna Commercial	$279.30
Rate for Payer: Aetna Medicare Advantage	$220.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$187.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$187.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$187.43
Rate for Payer: Cigna Commercial	$367.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$161.70
Rate for Payer: Qualcare PPO/HMO/WC	$110.25
Rate for Payer: UnitedHealthcare Community & State	$17.71
Rate for Payer: Wellpoint Medicaid Managed Care	$19.48

CATH POWERMIDLINE PICC KT 3FR

Facility

$735.00

Service Code	HCPCS C1751
Hospital Charge Code	270684374N
Hospital Revenue Code	278
Min. Negotiated Rate	$17.71
Max. Negotiated Rate	$367.50
Rate for Payer: Aetna Commercial	$279.30
Rate for Payer: Aetna Medicare Advantage	$220.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$187.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$187.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$187.43
Rate for Payer: Cigna Commercial	$367.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$161.70
Rate for Payer: Qualcare PPO/HMO/WC	$110.25
Rate for Payer: UnitedHealthcare Community & State	$17.71
Rate for Payer: Wellpoint Medicaid Managed Care	$19.48

CATH POWERMIDLINE PICC KT 3FR

Facility

$735.00

Service Code	HCPCS C1751
Hospital Charge Code	270684374S
Hospital Revenue Code	278
Min. Negotiated Rate	$110.25
Max. Negotiated Rate	$177.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$161.70
Rate for Payer: Qualcare PPO/HMO/WC	$110.25

CATH POWERMIDLINE PICC KT 3FR

Facility

$735.00

Service Code	HCPCS C1751
Hospital Charge Code	270684374N
Hospital Revenue Code	278
Min. Negotiated Rate	$110.25
Max. Negotiated Rate	$177.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$161.70
Rate for Payer: Qualcare PPO/HMO/WC	$110.25

Know your out-of-pocket cost for care.

All Charges