Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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

CATH PROTECT IV 24G

Facility

$24.85

Hospital Charge Code	270600762
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 24G

Facility

$24.85

Hospital Charge Code	270600762
Hospital Revenue Code	272
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

CATH PROWLER PL 20CM TIP 450

Facility

$5,587.55

Service Code	HCPCS C1887
Hospital Charge Code	270700023S
Hospital Revenue Code	278
Min. Negotiated Rate	$134.66
Max. Negotiated Rate	$2,793.78
Rate for Payer: Aetna Commercial	$2,123.27
Rate for Payer: Aetna Medicare Advantage	$1,676.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,424.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,424.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,424.83
Rate for Payer: Cigna Commercial	$2,793.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,352.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,229.26
Rate for Payer: Qualcare PPO/HMO/WC	$838.13
Rate for Payer: UnitedHealthcare Community & State	$134.66
Rate for Payer: Wellpoint Medicaid Managed Care	$148.07

CATH PROWLER PL 20CM TIP 450

Facility

$5,587.55

Service Code	HCPCS C1887
Hospital Charge Code	270700023S
Hospital Revenue Code	278
Min. Negotiated Rate	$838.13
Max. Negotiated Rate	$1,352.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,352.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,229.26
Rate for Payer: Qualcare PPO/HMO/WC	$838.13

CATH PROWLER PL 20CM TIP 900

Facility

$5,587.55

Service Code	HCPCS C1887
Hospital Charge Code	270700024S
Hospital Revenue Code	278
Min. Negotiated Rate	$838.13
Max. Negotiated Rate	$1,352.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,352.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,229.26
Rate for Payer: Qualcare PPO/HMO/WC	$838.13

CATH PROWLER PL 20CM TIP 900

Facility

$5,587.55

Service Code	HCPCS C1887
Hospital Charge Code	270700024S
Hospital Revenue Code	278
Min. Negotiated Rate	$134.66
Max. Negotiated Rate	$2,793.78
Rate for Payer: Aetna Commercial	$2,123.27
Rate for Payer: Aetna Medicare Advantage	$1,676.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,424.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,424.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,424.83
Rate for Payer: Cigna Commercial	$2,793.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,352.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,229.26
Rate for Payer: Qualcare PPO/HMO/WC	$838.13
Rate for Payer: UnitedHealthcare Community & State	$134.66
Rate for Payer: Wellpoint Medicaid Managed Care	$148.07

CATH PROWLER SEL PL 45 150CM

Facility

$5,585.75

Service Code	HCPCS C1887
Hospital Charge Code	270700025S
Hospital Revenue Code	278
Min. Negotiated Rate	$134.62
Max. Negotiated Rate	$2,792.88
Rate for Payer: Aetna Commercial	$2,122.59
Rate for Payer: Aetna Medicare Advantage	$1,675.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,424.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,424.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,424.37
Rate for Payer: Cigna Commercial	$2,792.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,351.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,228.87
Rate for Payer: Qualcare PPO/HMO/WC	$837.86
Rate for Payer: UnitedHealthcare Community & State	$134.62
Rate for Payer: Wellpoint Medicaid Managed Care	$148.02

CATH PROWLER SEL PL 45 150CM

Facility

$5,585.75

Service Code	HCPCS C1887
Hospital Charge Code	270700025S
Hospital Revenue Code	278
Min. Negotiated Rate	$837.86
Max. Negotiated Rate	$1,351.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,351.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,228.87
Rate for Payer: Qualcare PPO/HMO/WC	$837.86

CATH PROWLER SEL PL 90 150CM

Facility

$5,587.55

Service Code	HCPCS C1887
Hospital Charge Code	270700026S
Hospital Revenue Code	278
Min. Negotiated Rate	$838.13
Max. Negotiated Rate	$1,352.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,352.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,229.26
Rate for Payer: Qualcare PPO/HMO/WC	$838.13

CATH PROWLER SEL PL 90 150CM

Facility

$5,587.55

Service Code	HCPCS C1887
Hospital Charge Code	270700026S
Hospital Revenue Code	278
Min. Negotiated Rate	$134.66
Max. Negotiated Rate	$2,793.78
Rate for Payer: Aetna Commercial	$2,123.27
Rate for Payer: Aetna Medicare Advantage	$1,676.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,424.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,424.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,424.83
Rate for Payer: Cigna Commercial	$2,793.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,352.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,229.26
Rate for Payer: Qualcare PPO/HMO/WC	$838.13
Rate for Payer: UnitedHealthcare Community & State	$134.66
Rate for Payer: Wellpoint Medicaid Managed Care	$148.07

CATH PRUITT AORTIC OCCLUSION

Facility

$1,345.00

Hospital Charge Code	270606466
Hospital Revenue Code	278
Min. Negotiated Rate	$32.41
Max. Negotiated Rate	$672.50
Rate for Payer: Aetna Commercial	$511.10
Rate for Payer: Aetna Medicare Advantage	$403.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$342.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$342.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$269.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$342.98
Rate for Payer: Cigna Commercial	$672.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$295.90
Rate for Payer: Qualcare PPO/HMO/WC	$201.75
Rate for Payer: UnitedHealthcare Community & State	$32.41
Rate for Payer: Wellpoint Medicaid Managed Care	$35.64

CATH PRUITT AORTIC OCCLUSION

Facility

$1,345.00

Hospital Charge Code	270606466
Hospital Revenue Code	278
Min. Negotiated Rate	$201.75
Max. Negotiated Rate	$325.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$269.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$295.90
Rate for Payer: Qualcare PPO/HMO/WC	$201.75

CATH PTA AVATR 5x40 422-5040X

Facility

$2,281.65

Hospital Charge Code	270634581
Hospital Revenue Code	278
Min. Negotiated Rate	$342.25
Max. Negotiated Rate	$552.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$501.96
Rate for Payer: Qualcare PPO/HMO/WC	$342.25

CATH PTA AVATR 5x40 422-5040X

Facility

$2,281.65

Hospital Charge Code	270634581
Hospital Revenue Code	278
Min. Negotiated Rate	$54.99
Max. Negotiated Rate	$1,140.83
Rate for Payer: Aetna Commercial	$867.03
Rate for Payer: Aetna Medicare Advantage	$684.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$581.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$581.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$581.82
Rate for Payer: Cigna Commercial	$1,140.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$501.96
Rate for Payer: Qualcare PPO/HMO/WC	$342.25
Rate for Payer: UnitedHealthcare Community & State	$54.99
Rate for Payer: Wellpoint Medicaid Managed Care	$60.46

CATH PTA AVIA 4x20x75 4224020S

Facility

$2,281.65

Hospital Charge Code	270633138
Hospital Revenue Code	278
Min. Negotiated Rate	$342.25
Max. Negotiated Rate	$552.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$501.96
Rate for Payer: Qualcare PPO/HMO/WC	$342.25

CATH PTA AVIA 4x20x75 4224020S

Facility

$2,281.65

Hospital Charge Code	270633138
Hospital Revenue Code	278
Min. Negotiated Rate	$54.99
Max. Negotiated Rate	$1,140.83
Rate for Payer: Aetna Commercial	$867.03
Rate for Payer: Aetna Medicare Advantage	$684.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$581.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$581.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$581.82
Rate for Payer: Cigna Commercial	$1,140.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$501.96
Rate for Payer: Qualcare PPO/HMO/WC	$342.25
Rate for Payer: UnitedHealthcare Community & State	$54.99
Rate for Payer: Wellpoint Medicaid Managed Care	$60.46

CATH PTA AVIAT 5.0x20 4225020S

Facility

$456.40

Hospital Charge Code	270631233
Hospital Revenue Code	278
Min. Negotiated Rate	$11.00
Max. Negotiated Rate	$228.20
Rate for Payer: Aetna Commercial	$173.43
Rate for Payer: Aetna Medicare Advantage	$136.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.38
Rate for Payer: Cigna Commercial	$228.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$100.41
Rate for Payer: Qualcare PPO/HMO/WC	$68.46
Rate for Payer: UnitedHealthcare Community & State	$11.00
Rate for Payer: Wellpoint Medicaid Managed Care	$12.09

CATH PTA AVIAT 5.0x20 4225020S

Facility

$456.40

Hospital Charge Code	270631233
Hospital Revenue Code	278
Min. Negotiated Rate	$68.46
Max. Negotiated Rate	$110.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$100.41
Rate for Payer: Qualcare PPO/HMO/WC	$68.46

CATH PTA AVIAT 5.0x20 4225020S

Facility

$2,300.00

Hospital Charge Code	270631233V
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$556.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$506.00
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

CATH PTA AVIAT 5.0x20 4225020S

Facility

$2,300.00

Hospital Charge Code	270631233V
Hospital Revenue Code	278
Min. Negotiated Rate	$55.43
Max. Negotiated Rate	$1,150.00
Rate for Payer: Aetna Commercial	$874.00
Rate for Payer: Aetna Medicare Advantage	$690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$586.50
Rate for Payer: Cigna Commercial	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$506.00
Rate for Payer: Qualcare PPO/HMO/WC	$345.00
Rate for Payer: UnitedHealthcare Community & State	$55.43
Rate for Payer: Wellpoint Medicaid Managed Care	$60.95

CATH PTA AVIATOR 4X20 135CM

Facility

$2,300.00

Hospital Charge Code	270633271
Hospital Revenue Code	272
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$345.00
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

CATH PTA AVIATOR 4X20 135CM

Facility

$2,300.00

Hospital Charge Code	270633271
Hospital Revenue Code	272
Min. Negotiated Rate	$55.43
Max. Negotiated Rate	$1,150.00
Rate for Payer: Aetna Commercial	$874.00
Rate for Payer: Aetna Medicare Advantage	$690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$586.50
Rate for Payer: Cigna Commercial	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$690.00
Rate for Payer: Oxford Commercial	$460.00
Rate for Payer: Qualcare PPO/HMO/WC	$345.00
Rate for Payer: UnitedHealthcare Commercial	$460.00
Rate for Payer: UnitedHealthcare Community & State	$55.43
Rate for Payer: Wellpoint Medicaid Managed Care	$60.95

CATH PTA AVIATOR 5X20 142CM

Facility

$2,300.00

Hospital Charge Code	270631233C
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$556.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$506.00
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

CATH PTA AVIATOR 5X20 142CM

Facility

$2,300.00

Hospital Charge Code	270631233C
Hospital Revenue Code	278
Min. Negotiated Rate	$55.43
Max. Negotiated Rate	$1,150.00
Rate for Payer: Aetna Commercial	$874.00
Rate for Payer: Aetna Medicare Advantage	$690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$586.50
Rate for Payer: Cigna Commercial	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$506.00
Rate for Payer: Qualcare PPO/HMO/WC	$345.00
Rate for Payer: UnitedHealthcare Community & State	$55.43
Rate for Payer: Wellpoint Medicaid Managed Care	$60.95

Know your out-of-pocket cost for care.

All Charges