Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH SCULP US PTA 6x20mm 137cm

Facility

$4,875.00

Service Code	HCPCS C1725
Hospital Charge Code	270670705
Hospital Revenue Code	278
Min. Negotiated Rate	$117.49
Max. Negotiated Rate	$2,437.50
Rate for Payer: Aetna Commercial	$1,852.50
Rate for Payer: Aetna Medicare Advantage	$1,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,243.12
Rate for Payer: Cigna Commercial	$2,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,072.50
Rate for Payer: Qualcare PPO/HMO/WC	$731.25
Rate for Payer: UnitedHealthcare Community & State	$117.49
Rate for Payer: Wellpoint Medicaid Managed Care	$129.19

CATH SCULP US PTA 6x20mm 137cm

Facility

$4,875.00

Service Code	HCPCS C1725
Hospital Charge Code	270670705
Hospital Revenue Code	278
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$1,179.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,072.50
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

CATH SCULP US PTA 6x40mm 137cm

Facility

$5,000.00

Service Code	HCPCS C1725
Hospital Charge Code	270665648
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

CATH SCULP US PTA 6x40mm 137cm

Facility

$5,000.00

Service Code	HCPCS C1725
Hospital Charge Code	270665648
Hospital Revenue Code	278
Min. Negotiated Rate	$120.50
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$120.50
Rate for Payer: Wellpoint Medicaid Managed Care	$132.50

CATH SELECTIVE OMNI SOS 80CM

Facility

$90.00

Service Code	HCPCS C1751
Hospital Charge Code	270668503
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 SELECTIVE OMNI SOS 80CM

Facility

$90.00

Service Code	HCPCS C1751
Hospital Charge Code	270668503
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 SET CYSTOST 12F

Facility

$558.45

Hospital Charge Code	270600156
Hospital Revenue Code	272
Min. Negotiated Rate	$13.46
Max. Negotiated Rate	$279.23
Rate for Payer: Aetna Commercial	$212.21
Rate for Payer: Aetna Medicare Advantage	$167.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.40
Rate for Payer: Cigna Commercial	$279.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.53
Rate for Payer: Oxford Commercial	$111.69
Rate for Payer: Qualcare PPO/HMO/WC	$83.77
Rate for Payer: UnitedHealthcare Commercial	$111.69
Rate for Payer: UnitedHealthcare Community & State	$13.46
Rate for Payer: Wellpoint Medicaid Managed Care	$14.80

CATH SET CYSTOST 12F

Facility

$558.45

Hospital Charge Code	270600156
Hospital Revenue Code	272
Min. Negotiated Rate	$83.77
Max. Negotiated Rate	$83.77
Rate for Payer: Qualcare PPO/HMO/WC	$83.77

CATH SET CYSTOST 8F

Facility

$561.65

Hospital Charge Code	270600157
Hospital Revenue Code	272
Min. Negotiated Rate	$84.25
Max. Negotiated Rate	$84.25
Rate for Payer: Qualcare PPO/HMO/WC	$84.25

CATH SET CYSTOST 8F

Facility

$561.65

Hospital Charge Code	270600157
Hospital Revenue Code	272
Min. Negotiated Rate	$13.54
Max. Negotiated Rate	$280.82
Rate for Payer: Aetna Commercial	$213.43
Rate for Payer: Aetna Medicare Advantage	$168.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.22
Rate for Payer: Cigna Commercial	$280.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.50
Rate for Payer: Oxford Commercial	$112.33
Rate for Payer: Qualcare PPO/HMO/WC	$84.25
Rate for Payer: UnitedHealthcare Commercial	$112.33
Rate for Payer: UnitedHealthcare Community & State	$13.54
Rate for Payer: Wellpoint Medicaid Managed Care	$14.88

CATH SET INDWELLING SLIT

Facility

$377.50

Hospital Charge Code	270661703
Hospital Revenue Code	272
Min. Negotiated Rate	$9.10
Max. Negotiated Rate	$188.75
Rate for Payer: Aetna Commercial	$143.45
Rate for Payer: Aetna Medicare Advantage	$113.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.26
Rate for Payer: Cigna Commercial	$188.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.25
Rate for Payer: Oxford Commercial	$75.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.62
Rate for Payer: UnitedHealthcare Commercial	$75.50
Rate for Payer: UnitedHealthcare Community & State	$9.10
Rate for Payer: Wellpoint Medicaid Managed Care	$10.00

CATH SET INDWELLING SLIT

Facility

$377.50

Hospital Charge Code	270661703
Hospital Revenue Code	272
Min. Negotiated Rate	$56.62
Max. Negotiated Rate	$56.62
Rate for Payer: Qualcare PPO/HMO/WC	$56.62

CATH SET JEJUNOSTOMY 10 2X52

Facility

$760.00

Hospital Charge Code	270659166
Hospital Revenue Code	272
Min. Negotiated Rate	$18.32
Max. Negotiated Rate	$380.00
Rate for Payer: Aetna Commercial	$288.80
Rate for Payer: Aetna Medicare Advantage	$228.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$193.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$193.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$193.80
Rate for Payer: Cigna Commercial	$380.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.00
Rate for Payer: Oxford Commercial	$152.00
Rate for Payer: Qualcare PPO/HMO/WC	$114.00
Rate for Payer: UnitedHealthcare Commercial	$152.00
Rate for Payer: UnitedHealthcare Community & State	$18.32
Rate for Payer: Wellpoint Medicaid Managed Care	$20.14

CATH SET JEJUNOSTOMY 10 2X52

Facility

$760.00

Hospital Charge Code	270659166
Hospital Revenue Code	272
Min. Negotiated Rate	$114.00
Max. Negotiated Rate	$114.00
Rate for Payer: Qualcare PPO/HMO/WC	$114.00

CATH SET UTERINE INJ

Facility

$157.99

Hospital Charge Code	270614416
Hospital Revenue Code	272
Min. Negotiated Rate	$3.81
Max. Negotiated Rate	$79.00
Rate for Payer: Aetna Commercial	$60.04
Rate for Payer: Aetna Medicare Advantage	$47.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.29
Rate for Payer: Cigna Commercial	$79.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.40
Rate for Payer: Oxford Commercial	$31.60
Rate for Payer: Qualcare PPO/HMO/WC	$23.70
Rate for Payer: UnitedHealthcare Commercial	$31.60
Rate for Payer: UnitedHealthcare Community & State	$3.81
Rate for Payer: Wellpoint Medicaid Managed Care	$4.19

CATH SET UTERINE INJ

Facility

$157.99

Hospital Charge Code	270614416
Hospital Revenue Code	272
Min. Negotiated Rate	$23.70
Max. Negotiated Rate	$23.70
Rate for Payer: Qualcare PPO/HMO/WC	$23.70

CATH SHEP COOK 6F 3.5 LA6SCR35

Facility

$650.00

Service Code	HCPCS C1887
Hospital Charge Code	270638300
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

CATH SHEP COOK 6F 3.5 LA6SCR35

Facility

$650.00

Service Code	HCPCS C1887
Hospital Charge Code	270638300
Hospital Revenue Code	278
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

CATH SHEP COOK 6FR 4.0LA6SCR40

Facility

$650.00

Service Code	HCPCS C1887
Hospital Charge Code	270638301
Hospital Revenue Code	278
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

CATH SHEP COOK 6FR 4.0LA6SCR40

Facility

$650.00

Service Code	HCPCS C1887
Hospital Charge Code	270638301
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

CATH SHEPHERDS COOK 6FR 5.0

Facility

$245.00

Hospital Charge Code	270638302
Hospital Revenue Code	278
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$59.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.90
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

CATH SHEPHERDS COOK 6FR 5.0

Facility

$245.00

Hospital Charge Code	270638302
Hospital Revenue Code	278
Min. Negotiated Rate	$5.90
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial	$93.10
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.90
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Community & State	$5.90
Rate for Payer: Wellpoint Medicaid Managed Care	$6.49

CATH SH LNCHR 7FR EBU3.5

Facility

$245.00

Hospital Charge Code	270645941C
Hospital Revenue Code	278
Min. Negotiated Rate	$5.90
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial	$93.10
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.90
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Community & State	$5.90
Rate for Payer: Wellpoint Medicaid Managed Care	$6.49

CATH SH LNCHR 7FR EBU3.5

Facility

$245.00

Hospital Charge Code	270645941C
Hospital Revenue Code	278
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$59.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.90
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

CATH SH LNCHR 7FR EBU 4.0

Facility

$245.00

Hospital Charge Code	270645943C
Hospital Revenue Code	278
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$59.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.90
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

Know your out-of-pocket cost for care.

All Charges