Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH POWER PICC SOLO S/LUM 4FR

Facility

$1,015.00

Service Code	HCPCS C1751
Hospital Charge Code	270649056N
Hospital Revenue Code	278
Min. Negotiated Rate	$24.46
Max. Negotiated Rate	$507.50
Rate for Payer: Aetna Commercial	$385.70
Rate for Payer: Aetna Medicare Advantage	$304.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$258.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$258.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$258.82
Rate for Payer: Cigna Commercial	$507.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$223.30
Rate for Payer: Qualcare PPO/HMO/WC	$152.25
Rate for Payer: UnitedHealthcare Community & State	$24.46
Rate for Payer: Wellpoint Medicaid Managed Care	$26.90

CATH POWER PICC SOLO S/LUM 4FR

Facility

$1,015.00

Service Code	HCPCS C1751
Hospital Charge Code	270649056N
Hospital Revenue Code	278
Min. Negotiated Rate	$152.25
Max. Negotiated Rate	$245.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$223.30
Rate for Payer: Qualcare PPO/HMO/WC	$152.25

CATH POWER PICC SOLO S/LUM 4FR

Facility

$1,111.00

Service Code	HCPCS C1751
Hospital Charge Code	270649056S
Hospital Revenue Code	278
Min. Negotiated Rate	$166.65
Max. Negotiated Rate	$268.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$244.42
Rate for Payer: Qualcare PPO/HMO/WC	$166.65

CATH POWER PICC SOLO T/LUM 5FR

Facility

$1,350.00

Hospital Charge Code	270668310
Hospital Revenue Code	272
Min. Negotiated Rate	$32.53
Max. Negotiated Rate	$675.00
Rate for Payer: Aetna Commercial	$513.00
Rate for Payer: Aetna Medicare Advantage	$405.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$344.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$344.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$344.25
Rate for Payer: Cigna Commercial	$675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$405.00
Rate for Payer: Oxford Commercial	$270.00
Rate for Payer: Qualcare PPO/HMO/WC	$202.50
Rate for Payer: UnitedHealthcare Commercial	$270.00
Rate for Payer: UnitedHealthcare Community & State	$32.53
Rate for Payer: Wellpoint Medicaid Managed Care	$35.77

CATH POWER PICC SOLO T/LUM 5FR

Facility

$1,350.00

Hospital Charge Code	270668310
Hospital Revenue Code	272
Min. Negotiated Rate	$202.50
Max. Negotiated Rate	$202.50
Rate for Payer: Qualcare PPO/HMO/WC	$202.50

CATH POWFLX BLN 135cm 4207030X

Facility

$1,314.45

Hospital Charge Code	270624398
Hospital Revenue Code	272
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) PPO	$335.18
Rate for Payer: Cigna Commercial	$657.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$394.33
Rate for Payer: Oxford Commercial	$262.89
Rate for Payer: Qualcare PPO/HMO/WC	$197.17
Rate for Payer: UnitedHealthcare Commercial	$262.89
Rate for Payer: UnitedHealthcare Community & State	$31.68
Rate for Payer: Wellpoint Medicaid Managed Care	$34.83

CATH POWFLX BLN 135cm 4207030X

Facility

$1,314.45

Hospital Charge Code	270624398
Hospital Revenue Code	272
Min. Negotiated Rate	$197.17
Max. Negotiated Rate	$197.17
Rate for Payer: Qualcare PPO/HMO/WC	$197.17

CATH PREDATOR 1.50MM

Facility

$3,195.00

Hospital Charge Code	270644721
Hospital Revenue Code	278
Min. Negotiated Rate	$479.25
Max. Negotiated Rate	$773.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$639.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$773.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$702.90
Rate for Payer: Qualcare PPO/HMO/WC	$479.25

CATH PREDATOR 1.50MM

Facility

$3,195.00

Hospital Charge Code	270644721
Hospital Revenue Code	278
Min. Negotiated Rate	$77.00
Max. Negotiated Rate	$1,597.50
Rate for Payer: Aetna Commercial	$1,214.10
Rate for Payer: Aetna Medicare Advantage	$958.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$814.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$814.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$639.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$814.73
Rate for Payer: Cigna Commercial	$1,597.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$773.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$702.90
Rate for Payer: Qualcare PPO/HMO/WC	$479.25
Rate for Payer: UnitedHealthcare Community & State	$77.00
Rate for Payer: Wellpoint Medicaid Managed Care	$84.67

CATH PREDATOR 1.75MM

Facility

$15,975.00

Hospital Charge Code	270644966
Hospital Revenue Code	278
Min. Negotiated Rate	$2,396.25
Max. Negotiated Rate	$3,865.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,865.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,514.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25

CATH PREDATOR 1.75MM

Facility

$15,975.00

Hospital Charge Code	270644966
Hospital Revenue Code	278
Min. Negotiated Rate	$385.00
Max. Negotiated Rate	$7,987.50
Rate for Payer: Aetna Commercial	$6,070.50
Rate for Payer: Aetna Medicare Advantage	$4,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,073.62
Rate for Payer: Cigna Commercial	$7,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,865.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,514.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25
Rate for Payer: UnitedHealthcare Community & State	$385.00
Rate for Payer: Wellpoint Medicaid Managed Care	$423.34

CATH PREDATOR 2.0mm

Facility

$15,975.00

Hospital Charge Code	270644720C
Hospital Revenue Code	270
Min. Negotiated Rate	$385.00
Max. Negotiated Rate	$7,987.50
Rate for Payer: Aetna Commercial	$6,070.50
Rate for Payer: Aetna Medicare Advantage	$4,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,073.62
Rate for Payer: Cigna Commercial	$7,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,792.50
Rate for Payer: Oxford Commercial	$3,195.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25
Rate for Payer: UnitedHealthcare Commercial	$3,195.00
Rate for Payer: UnitedHealthcare Community & State	$385.00
Rate for Payer: Wellpoint Medicaid Managed Care	$423.34

CATH PREDATOR 2.0mm

Facility

$15,975.00

Hospital Charge Code	270644720C
Hospital Revenue Code	270
Min. Negotiated Rate	$2,396.25
Max. Negotiated Rate	$2,396.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25

CATH PREDATOR 2.25mm 145cmL

Facility

$15,975.00

Hospital Charge Code	270644587C
Hospital Revenue Code	270
Min. Negotiated Rate	$385.00
Max. Negotiated Rate	$7,987.50
Rate for Payer: Aetna Commercial	$6,070.50
Rate for Payer: Aetna Medicare Advantage	$4,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,073.62
Rate for Payer: Cigna Commercial	$7,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,792.50
Rate for Payer: Oxford Commercial	$3,195.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25
Rate for Payer: UnitedHealthcare Commercial	$3,195.00
Rate for Payer: UnitedHealthcare Community & State	$385.00
Rate for Payer: Wellpoint Medicaid Managed Care	$423.34

CATH PREDATOR 2.25mm 145cmL

Facility

$15,975.00

Hospital Charge Code	270644587C
Hospital Revenue Code	270
Min. Negotiated Rate	$2,396.25
Max. Negotiated Rate	$2,396.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25

CATH PREDATOR360SLIDCRWN1.25MM

Facility

$3,195.00

Hospital Charge Code	270644722
Hospital Revenue Code	272
Min. Negotiated Rate	$479.25
Max. Negotiated Rate	$479.25
Rate for Payer: Qualcare PPO/HMO/WC	$479.25

CATH PREDATOR360SLIDCRWN1.25MM

Facility

$3,195.00

Hospital Charge Code	270644722
Hospital Revenue Code	272
Min. Negotiated Rate	$77.00
Max. Negotiated Rate	$1,597.50
Rate for Payer: Aetna Commercial	$1,214.10
Rate for Payer: Aetna Medicare Advantage	$958.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$814.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$814.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$814.73
Rate for Payer: Cigna Commercial	$1,597.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$958.50
Rate for Payer: Oxford Commercial	$639.00
Rate for Payer: Qualcare PPO/HMO/WC	$479.25
Rate for Payer: UnitedHealthcare Commercial	$639.00
Rate for Payer: UnitedHealthcare Community & State	$77.00
Rate for Payer: Wellpoint Medicaid Managed Care	$84.67

CATH PREF RT4FR JR4.0

Facility

$40.00

Hospital Charge Code	2709006887
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 PREF RT4FR JR4.0

Facility

$40.00

Hospital Charge Code	2709006887
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CATH PRESEP OXIM 8.5F 20CM

Facility

$2,137.50

Hospital Charge Code	270660557
Hospital Revenue Code	278
Min. Negotiated Rate	$51.51
Max. Negotiated Rate	$1,068.75
Rate for Payer: Aetna Commercial	$812.25
Rate for Payer: Aetna Medicare Advantage	$641.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$545.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$545.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$427.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$545.06
Rate for Payer: Cigna Commercial	$1,068.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$517.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$470.25
Rate for Payer: Qualcare PPO/HMO/WC	$320.62
Rate for Payer: UnitedHealthcare Community & State	$51.51
Rate for Payer: Wellpoint Medicaid Managed Care	$56.64

CATH PRESEP OXIM 8.5F 20CM

Facility

$2,137.50

Hospital Charge Code	270660557
Hospital Revenue Code	278
Min. Negotiated Rate	$320.62
Max. Negotiated Rate	$517.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$427.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$517.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$470.25
Rate for Payer: Qualcare PPO/HMO/WC	$320.62

CATH PRFRMA JUDKNS LFT 4FRJL6

Facility

$40.00

Hospital Charge Code	270658178
Hospital Revenue Code	278
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) NJ Health	$8.00
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	$9.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

CATH PRFRMA JUDKNS LFT 4FRJL6

Facility

$40.00

Hospital Charge Code	270658178
Hospital Revenue Code	278
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$9.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CATH PRO-LINE 6FR 60CM D/LUMEN

Facility

$1,125.00

Hospital Charge Code	270678223
Hospital Revenue Code	278
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

CATH PRO-LINE 6FR 60CM D/LUMEN

Facility

$1,125.00

Hospital Charge Code	270678223
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

Know your out-of-pocket cost for care.

All Charges