Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH STR RED RUBBER 18F

Facility

$13.65

Hospital Charge Code	270300535
Hospital Revenue Code	272
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$6.83
Rate for Payer: Aetna Commercial	$5.19
Rate for Payer: Aetna Medicare Advantage	$4.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.48
Rate for Payer: Cigna Commercial	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.09
Rate for Payer: Oxford Commercial	$2.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.05
Rate for Payer: UnitedHealthcare Commercial	$2.73
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

CATH STR RED RUBBER 8F

Facility

$4.43

Service Code	HCPCS C1758
Hospital Charge Code	270300510
Hospital Revenue Code	278
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.21
Rate for Payer: Aetna Commercial	$1.68
Rate for Payer: Aetna Medicare Advantage	$1.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.13
Rate for Payer: Cigna Commercial	$2.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.66
Rate for Payer: UnitedHealthcare Community & State	$0.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

CATH STR RED RUBBER 8F

Facility

$4.43

Service Code	HCPCS C1758
Hospital Charge Code	270300510
Hospital Revenue Code	278
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$1.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.66

CATH SUB 2x60x130 SUV020060130

Facility

$2,100.00

Hospital Charge Code	270636609V
Hospital Revenue Code	278
Min. Negotiated Rate	$315.00
Max. Negotiated Rate	$508.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$462.00
Rate for Payer: Qualcare PPO/HMO/WC	$315.00

CATH SUB 2x60x130 SUV020060130

Facility

$1,680.00

Hospital Charge Code	270636609
Hospital Revenue Code	278
Min. Negotiated Rate	$252.00
Max. Negotiated Rate	$406.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$336.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$406.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$369.60
Rate for Payer: Qualcare PPO/HMO/WC	$252.00

CATH SUB 2x60x130 SUV020060130

Facility

$2,100.00

Hospital Charge Code	270636609V
Hospital Revenue Code	278
Min. Negotiated Rate	$50.61
Max. Negotiated Rate	$1,050.00
Rate for Payer: Aetna Commercial	$798.00
Rate for Payer: Aetna Medicare Advantage	$630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$535.50
Rate for Payer: Cigna Commercial	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$462.00
Rate for Payer: Qualcare PPO/HMO/WC	$315.00
Rate for Payer: UnitedHealthcare Community & State	$50.61
Rate for Payer: Wellpoint Medicaid Managed Care	$55.65

CATH SUB 2x60x130 SUV020060130

Facility

$1,680.00

Hospital Charge Code	270636609
Hospital Revenue Code	278
Min. Negotiated Rate	$40.49
Max. Negotiated Rate	$840.00
Rate for Payer: Aetna Commercial	$638.40
Rate for Payer: Aetna Medicare Advantage	$504.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$428.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$428.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$428.40
Rate for Payer: Cigna Commercial	$840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$406.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$369.60
Rate for Payer: Qualcare PPO/HMO/WC	$252.00
Rate for Payer: UnitedHealthcare Community & State	$40.49
Rate for Payer: Wellpoint Medicaid Managed Care	$44.52

CATH SUB 5X80X130cm SUV0500801

Facility

$1,890.00

Hospital Charge Code	270638510C
Hospital Revenue Code	278
Min. Negotiated Rate	$283.50
Max. Negotiated Rate	$457.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$378.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$415.80
Rate for Payer: Qualcare PPO/HMO/WC	$283.50

CATH SUB 5X80X130cm SUV0500801

Facility

$1,890.00

Hospital Charge Code	270638510C
Hospital Revenue Code	278
Min. Negotiated Rate	$45.55
Max. Negotiated Rate	$945.00
Rate for Payer: Aetna Commercial	$718.20
Rate for Payer: Aetna Medicare Advantage	$567.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$481.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$481.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$378.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$481.95
Rate for Payer: Cigna Commercial	$945.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$415.80
Rate for Payer: Qualcare PPO/HMO/WC	$283.50
Rate for Payer: UnitedHealthcare Community & State	$45.55
Rate for Payer: Wellpoint Medicaid Managed Care	$50.09

CATH SUBCLAVIAN****

Facility

$495.00

Hospital Charge Code	8001810
Hospital Revenue Code	279
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$74.25
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

CATH SUBCLAVIAN****

Facility

$495.00

Hospital Charge Code	8001810
Hospital Revenue Code	279
Min. Negotiated Rate	$11.93
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$188.10
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.50
Rate for Payer: Oxford Commercial	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.25
Rate for Payer: UnitedHealthcare Commercial	$99.00
Rate for Payer: UnitedHealthcare Community & State	$11.93
Rate for Payer: Wellpoint Medicaid Managed Care	$13.12

CATH SUBMARINE PLUS 2.5x80x130

Facility

$1,100.00

Hospital Charge Code	270636420
Hospital Revenue Code	278
Min. Negotiated Rate	$26.51
Max. Negotiated Rate	$550.00
Rate for Payer: Aetna Commercial	$418.00
Rate for Payer: Aetna Medicare Advantage	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.50
Rate for Payer: Cigna Commercial	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00
Rate for Payer: UnitedHealthcare Community & State	$26.51
Rate for Payer: Wellpoint Medicaid Managed Care	$29.15

CATH SUBMARINE PLUS 2.5x80x130

Facility

$1,100.00

Hospital Charge Code	270636420
Hospital Revenue Code	278
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$266.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

CATH SUBMARINE PLUS 3x120x130

Facility

$1,984.00

Hospital Charge Code	270636263
Hospital Revenue Code	278
Min. Negotiated Rate	$297.60
Max. Negotiated Rate	$480.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$396.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$480.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$436.48
Rate for Payer: Qualcare PPO/HMO/WC	$297.60

CATH SUBMARINE PLUS 3x120x130

Facility

$1,984.00

Hospital Charge Code	270636263
Hospital Revenue Code	278
Min. Negotiated Rate	$47.81
Max. Negotiated Rate	$992.00
Rate for Payer: Aetna Commercial	$753.92
Rate for Payer: Aetna Medicare Advantage	$595.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$505.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$505.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$396.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$505.92
Rate for Payer: Cigna Commercial	$992.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$480.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$436.48
Rate for Payer: Qualcare PPO/HMO/WC	$297.60
Rate for Payer: UnitedHealthcare Community & State	$47.81
Rate for Payer: Wellpoint Medicaid Managed Care	$52.58

CATH SUBMARINE PLUS 3x80x130cm

Facility

$1,000.00

Hospital Charge Code	270639659
Hospital Revenue Code	278
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

CATH SUBMARINE PLUS 3x80x130cm

Facility

$1,000.00

Hospital Charge Code	270639659
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CATH SUBMARINE PLUS 4.5X40X130

Facility

$1,100.00

Hospital Charge Code	270642534
Hospital Revenue Code	278
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$266.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

CATH SUBMARINE PLUS 4.5X40X130

Facility

$1,100.00

Hospital Charge Code	270642534
Hospital Revenue Code	278
Min. Negotiated Rate	$26.51
Max. Negotiated Rate	$550.00
Rate for Payer: Aetna Commercial	$418.00
Rate for Payer: Aetna Medicare Advantage	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.50
Rate for Payer: Cigna Commercial	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00
Rate for Payer: UnitedHealthcare Community & State	$26.51
Rate for Payer: Wellpoint Medicaid Managed Care	$29.15

CATH SUBMARINE PLUS 4x80x130cm

Facility

$1,000.00

Hospital Charge Code	270638508
Hospital Revenue Code	278
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

CATH SUBMARINE PLUS 4x80x130cm

Facility

$1,000.00

Hospital Charge Code	270638508
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CATH SUBMARINE PLUS 5x120x130

Facility

$1,000.00

Hospital Charge Code	270639573
Hospital Revenue Code	278
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

CATH SUBMARINE PLUS 5x120x130

Facility

$1,000.00

Hospital Charge Code	270639573
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CATH SUBMARINE PLUS 5x60x130cm

Facility

$1,100.00

Hospital Charge Code	270638509
Hospital Revenue Code	278
Min. Negotiated Rate	$26.51
Max. Negotiated Rate	$550.00
Rate for Payer: Aetna Commercial	$418.00
Rate for Payer: Aetna Medicare Advantage	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.50
Rate for Payer: Cigna Commercial	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00
Rate for Payer: UnitedHealthcare Community & State	$26.51
Rate for Payer: Wellpoint Medicaid Managed Care	$29.15

CATH SUBMARINE PLUS 5x60x130cm

Facility

$1,100.00

Hospital Charge Code	270638509
Hospital Revenue Code	278
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$266.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

Know your out-of-pocket cost for care.

All Charges