Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH PRONTO EXTRACTION

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270636440
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

CATH PRONTO EXTRACTION

Facility

$2,455.25

Service Code	HCPCS C1757
Hospital Charge Code	270636440N
Hospital Revenue Code	278
Min. Negotiated Rate	$59.17
Max. Negotiated Rate	$1,227.62
Rate for Payer: Aetna Commercial	$933.00
Rate for Payer: Aetna Medicare Advantage	$736.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$626.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$626.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$626.09
Rate for Payer: Cigna Commercial	$1,227.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$540.15
Rate for Payer: Qualcare PPO/HMO/WC	$368.29
Rate for Payer: UnitedHealthcare Community & State	$59.17
Rate for Payer: Wellpoint Medicaid Managed Care	$65.06

CATH PRONTO EXTRACTION

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270636440S
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

CATH PRONTO EXTRACTION

Facility

$2,455.25

Service Code	HCPCS C1757
Hospital Charge Code	270636440N
Hospital Revenue Code	278
Min. Negotiated Rate	$368.29
Max. Negotiated Rate	$594.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$540.15
Rate for Payer: Qualcare PPO/HMO/WC	$368.29

CATH PRONTO EXTRACTION

Facility

$2,455.25

Hospital Charge Code	270636440V
Hospital Revenue Code	278
Min. Negotiated Rate	$59.17
Max. Negotiated Rate	$1,227.62
Rate for Payer: Aetna Commercial	$933.00
Rate for Payer: Aetna Medicare Advantage	$736.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$626.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$626.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$626.09
Rate for Payer: Cigna Commercial	$1,227.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$540.15
Rate for Payer: Qualcare PPO/HMO/WC	$368.29
Rate for Payer: UnitedHealthcare Community & State	$59.17
Rate for Payer: Wellpoint Medicaid Managed Care	$65.06

CATH PRONTO EXTRACTION

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270636440S
Hospital Revenue Code	278
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

CATH PRONTO EXTRACTION

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270636440
Hospital Revenue Code	278
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

CATH PRONTO EXTRACTION

Facility

$2,455.25

Hospital Charge Code	270636440V
Hospital Revenue Code	278
Min. Negotiated Rate	$368.29
Max. Negotiated Rate	$594.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$540.15
Rate for Payer: Qualcare PPO/HMO/WC	$368.29

CATH PRONTO LP 5FR .014x138CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676760S
Hospital Revenue Code	278
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

CATH PRONTO LP 5FR .014x138CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676760S
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

CATH PRONTO LP 5FR .014x138CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676760N
Hospital Revenue Code	278
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

CATH PRONTO LP 5FR .014x138CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676760N
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

CATH PRONTO LP 5FR .014x138CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676760
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

CATH PRONTO LP 5FR .014x138CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676760
Hospital Revenue Code	278
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

CATH PRONTO LP 6FR .014x140CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676762
Hospital Revenue Code	272
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$442.50
Rate for Payer: Oxford Commercial	$295.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$295.00
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

CATH PRONTO LP 6FR .014x140CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676762
Hospital Revenue Code	272
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$221.25
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

CATH PRONTO LP 6FR .014x140CM

Facility

$1,475.00

Hospital Charge Code	270676761
Hospital Revenue Code	278
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

CATH PRONTO LP 6FR .014x140CM

Facility

$1,475.00

Hospital Charge Code	270676761
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

CATH PRONTO V4 6FR .014x138CM

Facility

$2,475.00

Hospital Charge Code	270678227
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

CATH PRONTO V4 6FR .014x138CM

Facility

$2,475.00

Hospital Charge Code	270678227
Hospital Revenue Code	278
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

CATH PROTECT IV 18G

Facility

$24.85

Hospital Charge Code	270600738
Hospital Revenue Code	272
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.43
Rate for Payer: Aetna Commercial	$9.44
Rate for Payer: Aetna Medicare Advantage	$7.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.34
Rate for Payer: Cigna Commercial	$12.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.46
Rate for Payer: Oxford Commercial	$4.97
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
Rate for Payer: UnitedHealthcare Commercial	$4.97
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

CATH PROTECT IV 18G

Facility

$24.85

Hospital Charge Code	270600738
Hospital Revenue Code	272
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

CATH PROTECT IV 20G

Facility

$24.85

Hospital Charge Code	270605145
Hospital Revenue Code	272
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

CATH PROTECT IV 20G

Facility

$24.85

Hospital Charge Code	270605145
Hospital Revenue Code	272
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.43
Rate for Payer: Aetna Commercial	$9.44
Rate for Payer: Aetna Medicare Advantage	$7.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.34
Rate for Payer: Cigna Commercial	$12.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.46
Rate for Payer: Oxford Commercial	$4.97
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
Rate for Payer: UnitedHealthcare Commercial	$4.97
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

CATH PROTECT IV 22G

Facility

$24.85

Hospital Charge Code	270600761
Hospital Revenue Code	272
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

Know your out-of-pocket cost for care.

All Charges