Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH SILVERHAWK LS 110x6 P4012

Facility

$14,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270634056
Hospital Revenue Code	278
Min. Negotiated Rate	$2,246.25
Max. Negotiated Rate	$3,623.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,623.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,294.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,246.25

CATHSILVERHAWKLSMLGVESTIPW/ME

Facility

$15,625.00

Hospital Charge Code	2709004022
Hospital Revenue Code	272
Min. Negotiated Rate	$376.56
Max. Negotiated Rate	$7,812.50
Rate for Payer: Aetna Commercial	$5,937.50
Rate for Payer: Aetna Medicare Advantage	$4,687.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,984.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,984.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,984.38
Rate for Payer: Cigna Commercial	$7,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,687.50
Rate for Payer: Oxford Commercial	$3,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,343.75
Rate for Payer: UnitedHealthcare Commercial	$3,125.00
Rate for Payer: UnitedHealthcare Community & State	$376.56
Rate for Payer: Wellpoint Medicaid Managed Care	$414.06

CATHSILVERHAWKLSMLGVESTIPW/ME

Facility

$15,625.00

Hospital Charge Code	2709004022
Hospital Revenue Code	272
Min. Negotiated Rate	$2,343.75
Max. Negotiated Rate	$2,343.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,343.75

CATH SILVERHAWK MS-M 6.0cm

Facility

$15,325.00

Service Code	HCPCS C1714
Hospital Charge Code	270643309
Hospital Revenue Code	278
Min. Negotiated Rate	$369.33
Max. Negotiated Rate	$7,662.50
Rate for Payer: Aetna Commercial	$5,823.50
Rate for Payer: Aetna Medicare Advantage	$4,597.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,907.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,907.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,065.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,907.88
Rate for Payer: Cigna Commercial	$7,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,708.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,371.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,298.75
Rate for Payer: UnitedHealthcare Community & State	$369.33
Rate for Payer: Wellpoint Medicaid Managed Care	$406.11

CATH SILVERHAWK MS-M 6.0cm

Facility

$15,325.00

Service Code	HCPCS C1714
Hospital Charge Code	270643309
Hospital Revenue Code	278
Min. Negotiated Rate	$2,298.75
Max. Negotiated Rate	$3,708.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,065.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,708.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,371.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,298.75

CATHSILVERHAWKMSMMEDVESTIPSTDW

Facility

$15,625.00

Hospital Charge Code	2709004024
Hospital Revenue Code	272
Min. Negotiated Rate	$2,343.75
Max. Negotiated Rate	$2,343.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,343.75

CATHSILVERHAWKMSMMEDVESTIPSTDW

Facility

$15,625.00

Hospital Charge Code	2709004024
Hospital Revenue Code	272
Min. Negotiated Rate	$376.56
Max. Negotiated Rate	$7,812.50
Rate for Payer: Aetna Commercial	$5,937.50
Rate for Payer: Aetna Medicare Advantage	$4,687.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,984.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,984.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,984.38
Rate for Payer: Cigna Commercial	$7,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,687.50
Rate for Payer: Oxford Commercial	$3,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,343.75
Rate for Payer: UnitedHealthcare Commercial	$3,125.00
Rate for Payer: UnitedHealthcare Community & State	$376.56
Rate for Payer: Wellpoint Medicaid Managed Care	$414.06

CATH SILVERHAWK SS+ P4030

Facility

$15,725.00

Hospital Charge Code	270643355C
Hospital Revenue Code	278
Min. Negotiated Rate	$378.97
Max. Negotiated Rate	$7,862.50
Rate for Payer: Aetna Commercial	$5,975.50
Rate for Payer: Aetna Medicare Advantage	$4,717.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,009.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,009.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,009.88
Rate for Payer: Cigna Commercial	$7,862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,805.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,459.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,358.75
Rate for Payer: UnitedHealthcare Community & State	$378.97
Rate for Payer: Wellpoint Medicaid Managed Care	$416.71

CATH SILVERHAWK SS+ P4030

Facility

$14,750.00

Service Code	HCPCS C1714
Hospital Charge Code	270643355
Hospital Revenue Code	278
Min. Negotiated Rate	$2,212.50
Max. Negotiated Rate	$3,569.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,569.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,245.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,212.50

CATH SILVERHAWK SS+ P4030

Facility

$14,750.00

Service Code	HCPCS C1714
Hospital Charge Code	270643355
Hospital Revenue Code	278
Min. Negotiated Rate	$355.48
Max. Negotiated Rate	$7,375.00
Rate for Payer: Aetna Commercial	$5,605.00
Rate for Payer: Aetna Medicare Advantage	$4,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,761.25
Rate for Payer: Cigna Commercial	$7,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,569.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,245.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,212.50
Rate for Payer: UnitedHealthcare Community & State	$355.48
Rate for Payer: Wellpoint Medicaid Managed Care	$390.88

CATH SILVERHAWK SS+ P4030

Facility

$15,725.00

Hospital Charge Code	270643355C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,358.75
Max. Negotiated Rate	$3,805.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,805.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,459.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,358.75

CATH SILVERHAWK SS+ P4030

Facility

$15,725.00

Hospital Charge Code	270643355V
Hospital Revenue Code	272
Min. Negotiated Rate	$2,358.75
Max. Negotiated Rate	$2,358.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,358.75

CATH SILVERHAWK SS+ P4030

Facility

$15,725.00

Hospital Charge Code	270643355V
Hospital Revenue Code	272
Min. Negotiated Rate	$378.97
Max. Negotiated Rate	$7,862.50
Rate for Payer: Aetna Commercial	$5,975.50
Rate for Payer: Aetna Medicare Advantage	$4,717.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,009.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,009.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,009.88
Rate for Payer: Cigna Commercial	$7,862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,717.50
Rate for Payer: Oxford Commercial	$3,145.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,358.75
Rate for Payer: UnitedHealthcare Commercial	$3,145.00
Rate for Payer: UnitedHealthcare Community & State	$378.97
Rate for Payer: Wellpoint Medicaid Managed Care	$416.71

CATH SILVERHAWK SS+ P4044

Facility

$17,150.00

Hospital Charge Code	270643356C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,572.50
Max. Negotiated Rate	$4,150.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,150.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,773.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,572.50

CATH SILVERHAWK SS+ P4044

Facility

$17,150.00

Hospital Charge Code	270643356
Hospital Revenue Code	278
Min. Negotiated Rate	$413.31
Max. Negotiated Rate	$8,575.00
Rate for Payer: Aetna Commercial	$6,517.00
Rate for Payer: Aetna Medicare Advantage	$5,145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,373.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,373.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,430.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,373.25
Rate for Payer: Cigna Commercial	$8,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,150.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,773.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,572.50
Rate for Payer: UnitedHealthcare Community & State	$413.31
Rate for Payer: Wellpoint Medicaid Managed Care	$454.48

CATH SILVERHAWK SS+ P4044

Facility

$17,150.00

Hospital Charge Code	270643356
Hospital Revenue Code	278
Min. Negotiated Rate	$2,572.50
Max. Negotiated Rate	$4,150.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,150.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,773.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,572.50

CATH SILVERHAWK SS+ P4044

Facility

$17,150.00

Hospital Charge Code	270643356C
Hospital Revenue Code	278
Min. Negotiated Rate	$413.31
Max. Negotiated Rate	$8,575.00
Rate for Payer: Aetna Commercial	$6,517.00
Rate for Payer: Aetna Medicare Advantage	$5,145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,373.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,373.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,430.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,373.25
Rate for Payer: Cigna Commercial	$8,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,150.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,773.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,572.50
Rate for Payer: UnitedHealthcare Community & State	$413.31
Rate for Payer: Wellpoint Medicaid Managed Care	$454.48

CATH SILVERHAWK SS+ P4044

Facility

$17,150.00

Hospital Charge Code	270643356S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,572.50
Max. Negotiated Rate	$4,150.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,150.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,773.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,572.50

CATH SILVERHAWK SS+ P4044

Facility

$17,150.00

Hospital Charge Code	270643356V
Hospital Revenue Code	278
Min. Negotiated Rate	$413.31
Max. Negotiated Rate	$8,575.00
Rate for Payer: Aetna Commercial	$6,517.00
Rate for Payer: Aetna Medicare Advantage	$5,145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,373.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,373.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,430.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,373.25
Rate for Payer: Cigna Commercial	$8,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,150.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,773.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,572.50
Rate for Payer: UnitedHealthcare Community & State	$413.31
Rate for Payer: Wellpoint Medicaid Managed Care	$454.48

CATH SILVERHAWK SS+ P4044

Facility

$17,150.00

Hospital Charge Code	270643356S
Hospital Revenue Code	278
Min. Negotiated Rate	$413.31
Max. Negotiated Rate	$8,575.00
Rate for Payer: Aetna Commercial	$6,517.00
Rate for Payer: Aetna Medicare Advantage	$5,145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,373.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,373.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,430.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,373.25
Rate for Payer: Cigna Commercial	$8,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,150.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,773.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,572.50
Rate for Payer: UnitedHealthcare Community & State	$413.31
Rate for Payer: Wellpoint Medicaid Managed Care	$454.48

CATH SILVERHAWK SS+ P4044

Facility

$17,150.00

Hospital Charge Code	270643356V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,572.50
Max. Negotiated Rate	$4,150.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,150.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,773.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,572.50

CATH SILVERHAWK SXL 7.2cm

Facility

$15,725.00

Hospital Charge Code	270643440C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,358.75
Max. Negotiated Rate	$3,805.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,805.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,459.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,358.75

CATH SILVERHAWK SXL 7.2cm

Facility

$15,725.00

Hospital Charge Code	270643440C
Hospital Revenue Code	278
Min. Negotiated Rate	$378.97
Max. Negotiated Rate	$7,862.50
Rate for Payer: Aetna Commercial	$5,975.50
Rate for Payer: Aetna Medicare Advantage	$4,717.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,009.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,009.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,009.88
Rate for Payer: Cigna Commercial	$7,862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,805.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,459.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,358.75
Rate for Payer: UnitedHealthcare Community & State	$378.97
Rate for Payer: Wellpoint Medicaid Managed Care	$416.71

CATH SILVERHK SX 4.3 135 P4023

Facility

$17,475.00

Hospital Charge Code	270634515
Hospital Revenue Code	278
Min. Negotiated Rate	$421.15
Max. Negotiated Rate	$8,737.50
Rate for Payer: Aetna Commercial	$6,640.50
Rate for Payer: Aetna Medicare Advantage	$5,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,456.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,456.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,456.12
Rate for Payer: Cigna Commercial	$8,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,228.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,844.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,621.25
Rate for Payer: UnitedHealthcare Community & State	$421.15
Rate for Payer: Wellpoint Medicaid Managed Care	$463.09

CATH SILVERHK SX 4.3 135 P4023

Facility

$17,475.00

Hospital Charge Code	270634515
Hospital Revenue Code	278
Min. Negotiated Rate	$2,621.25
Max. Negotiated Rate	$4,228.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,228.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,844.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,621.25

Know your out-of-pocket cost for care.

All Charges