Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH SYNCHRO STRAND STR 215CM

Facility

$3,231.75

Service Code	HCPCS C1769
Hospital Charge Code	270693899
Hospital Revenue Code	278
Min. Negotiated Rate	$484.76
Max. Negotiated Rate	$782.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$646.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$782.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$710.99
Rate for Payer: Qualcare PPO/HMO/WC	$484.76

CATH SYNERGY 5-10 135cm 19343

Facility

$1,387.10

Hospital Charge Code	270634770V
Hospital Revenue Code	278
Min. Negotiated Rate	$208.06
Max. Negotiated Rate	$335.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$305.16
Rate for Payer: Qualcare PPO/HMO/WC	$208.06

CATH SYNERGY 5-10 135cm 19343

Facility

$1,387.10

Hospital Charge Code	270634770V
Hospital Revenue Code	278
Min. Negotiated Rate	$33.43
Max. Negotiated Rate	$693.55
Rate for Payer: Aetna Commercial	$527.10
Rate for Payer: Aetna Medicare Advantage	$416.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$353.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$353.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$353.71
Rate for Payer: Cigna Commercial	$693.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$305.16
Rate for Payer: Qualcare PPO/HMO/WC	$208.06
Rate for Payer: UnitedHealthcare Community & State	$33.43
Rate for Payer: Wellpoint Medicaid Managed Care	$36.76

CATH SYNERGY 5-10 135cm 19343

Facility

$1,376.00

Hospital Charge Code	270634770
Hospital Revenue Code	278
Min. Negotiated Rate	$206.40
Max. Negotiated Rate	$332.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$302.72
Rate for Payer: Qualcare PPO/HMO/WC	$206.40

CATH SYNERGY 5-10 135cm 19343

Facility

$1,376.00

Hospital Charge Code	270634770
Hospital Revenue Code	278
Min. Negotiated Rate	$33.16
Max. Negotiated Rate	$688.00
Rate for Payer: Aetna Commercial	$522.88
Rate for Payer: Aetna Medicare Advantage	$412.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.88
Rate for Payer: Cigna Commercial	$688.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$302.72
Rate for Payer: Qualcare PPO/HMO/WC	$206.40
Rate for Payer: UnitedHealthcare Community & State	$33.16
Rate for Payer: Wellpoint Medicaid Managed Care	$36.46

CATH SYNERGY 6-10 135cm 19378

Facility

$1,387.10

Hospital Charge Code	270634771V
Hospital Revenue Code	278
Min. Negotiated Rate	$33.43
Max. Negotiated Rate	$693.55
Rate for Payer: Aetna Commercial	$527.10
Rate for Payer: Aetna Medicare Advantage	$416.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$353.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$353.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$353.71
Rate for Payer: Cigna Commercial	$693.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$305.16
Rate for Payer: Qualcare PPO/HMO/WC	$208.06
Rate for Payer: UnitedHealthcare Community & State	$33.43
Rate for Payer: Wellpoint Medicaid Managed Care	$36.76

CATH SYNERGY 6-10 135cm 19378

Facility

$1,387.10

Hospital Charge Code	270634771V
Hospital Revenue Code	278
Min. Negotiated Rate	$208.06
Max. Negotiated Rate	$335.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$305.16
Rate for Payer: Qualcare PPO/HMO/WC	$208.06

CATH SYNERGY 6-10 135cm 19378

Facility

$1,387.10

Hospital Charge Code	270634772V
Hospital Revenue Code	278
Min. Negotiated Rate	$208.06
Max. Negotiated Rate	$335.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$305.16
Rate for Payer: Qualcare PPO/HMO/WC	$208.06

CATH SYNERGY 6-10 135cm 19378

Facility

$1,387.10

Hospital Charge Code	270634772V
Hospital Revenue Code	278
Min. Negotiated Rate	$33.43
Max. Negotiated Rate	$693.55
Rate for Payer: Aetna Commercial	$527.10
Rate for Payer: Aetna Medicare Advantage	$416.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$353.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$353.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$353.71
Rate for Payer: Cigna Commercial	$693.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$305.16
Rate for Payer: Qualcare PPO/HMO/WC	$208.06
Rate for Payer: UnitedHealthcare Community & State	$33.43
Rate for Payer: Wellpoint Medicaid Managed Care	$36.76

CATH SYNERGY 6-10 135cm 19378

Facility

$1,376.00

Hospital Charge Code	270634771
Hospital Revenue Code	278
Min. Negotiated Rate	$33.16
Max. Negotiated Rate	$688.00
Rate for Payer: Aetna Commercial	$522.88
Rate for Payer: Aetna Medicare Advantage	$412.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.88
Rate for Payer: Cigna Commercial	$688.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$302.72
Rate for Payer: Qualcare PPO/HMO/WC	$206.40
Rate for Payer: UnitedHealthcare Community & State	$33.16
Rate for Payer: Wellpoint Medicaid Managed Care	$36.46

CATH SYNERGY 6-10 135cm 19378

Facility

$1,376.00

Hospital Charge Code	270634771
Hospital Revenue Code	278
Min. Negotiated Rate	$206.40
Max. Negotiated Rate	$332.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$302.72
Rate for Payer: Qualcare PPO/HMO/WC	$206.40

CATH SYNERGY 6 4 75c 035 19361

Facility

$868.00

Hospital Charge Code	270625137
Hospital Revenue Code	272
Min. Negotiated Rate	$130.20
Max. Negotiated Rate	$130.20
Rate for Payer: Qualcare PPO/HMO/WC	$130.20

CATH SYNERGY 6 4 75c 035 19361

Facility

$868.00

Hospital Charge Code	270625137
Hospital Revenue Code	272
Min. Negotiated Rate	$20.92
Max. Negotiated Rate	$434.00
Rate for Payer: Aetna Commercial	$329.84
Rate for Payer: Aetna Medicare Advantage	$260.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221.34
Rate for Payer: Cigna Commercial	$434.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.40
Rate for Payer: Oxford Commercial	$173.60
Rate for Payer: Qualcare PPO/HMO/WC	$130.20
Rate for Payer: UnitedHealthcare Commercial	$173.60
Rate for Payer: UnitedHealthcare Community & State	$20.92
Rate for Payer: Wellpoint Medicaid Managed Care	$23.00

CATH SYNERGY 7-10 135cm 19413

Facility

$1,376.00

Hospital Charge Code	270634772
Hospital Revenue Code	278
Min. Negotiated Rate	$206.40
Max. Negotiated Rate	$332.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$302.72
Rate for Payer: Qualcare PPO/HMO/WC	$206.40

CATH SYNERGY 7-10 135cm 19413

Facility

$1,376.00

Hospital Charge Code	270634772
Hospital Revenue Code	278
Min. Negotiated Rate	$33.16
Max. Negotiated Rate	$688.00
Rate for Payer: Aetna Commercial	$522.88
Rate for Payer: Aetna Medicare Advantage	$412.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.88
Rate for Payer: Cigna Commercial	$688.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$302.72
Rate for Payer: Qualcare PPO/HMO/WC	$206.40
Rate for Payer: UnitedHealthcare Community & State	$33.16
Rate for Payer: Wellpoint Medicaid Managed Care	$36.46

CATH SYNERGY 7MM 4CM 75CM .035

Facility

$304.00

Hospital Charge Code	270625140
Hospital Revenue Code	278
Min. Negotiated Rate	$7.33
Max. Negotiated Rate	$152.00
Rate for Payer: Aetna Commercial	$115.52
Rate for Payer: Aetna Medicare Advantage	$91.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.52
Rate for Payer: Cigna Commercial	$152.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$66.88
Rate for Payer: Qualcare PPO/HMO/WC	$45.60
Rate for Payer: UnitedHealthcare Community & State	$7.33
Rate for Payer: Wellpoint Medicaid Managed Care	$8.06

CATH SYNERGY 7MM 4CM 75CM .035

Facility

$304.00

Hospital Charge Code	270625140
Hospital Revenue Code	278
Min. Negotiated Rate	$45.60
Max. Negotiated Rate	$73.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$66.88
Rate for Payer: Qualcare PPO/HMO/WC	$45.60

CATH SYNERGY 8m 4c 75c 19431

Facility

$868.00

Hospital Charge Code	270625141
Hospital Revenue Code	272
Min. Negotiated Rate	$130.20
Max. Negotiated Rate	$130.20
Rate for Payer: Qualcare PPO/HMO/WC	$130.20

CATH SYNERGY 8m 4c 75c 19431

Facility

$868.00

Hospital Charge Code	270625141
Hospital Revenue Code	272
Min. Negotiated Rate	$20.92
Max. Negotiated Rate	$434.00
Rate for Payer: Aetna Commercial	$329.84
Rate for Payer: Aetna Medicare Advantage	$260.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221.34
Rate for Payer: Cigna Commercial	$434.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.40
Rate for Payer: Oxford Commercial	$173.60
Rate for Payer: Qualcare PPO/HMO/WC	$130.20
Rate for Payer: UnitedHealthcare Commercial	$173.60
Rate for Payer: UnitedHealthcare Community & State	$20.92
Rate for Payer: Wellpoint Medicaid Managed Care	$23.00

CATH SYNY 5m 2c 135c.035 19318

Facility

$1,416.85

Hospital Charge Code	270625132
Hospital Revenue Code	278
Min. Negotiated Rate	$34.15
Max. Negotiated Rate	$708.42
Rate for Payer: Aetna Commercial	$538.40
Rate for Payer: Aetna Medicare Advantage	$425.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$361.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$361.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$283.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$361.30
Rate for Payer: Cigna Commercial	$708.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$342.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$311.71
Rate for Payer: Qualcare PPO/HMO/WC	$212.53
Rate for Payer: UnitedHealthcare Community & State	$34.15
Rate for Payer: Wellpoint Medicaid Managed Care	$37.55

CATH SYNY 5m 2c 135c.035 19318

Facility

$1,416.85

Hospital Charge Code	270625132
Hospital Revenue Code	278
Min. Negotiated Rate	$212.53
Max. Negotiated Rate	$342.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$283.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$342.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$311.71
Rate for Payer: Qualcare PPO/HMO/WC	$212.53

CATH SYS NEPHRO FLEX 14F 27182

Facility

$425.00

Hospital Charge Code	270624215V
Hospital Revenue Code	278
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

CATH SYS NEPHRO FLEX 14F 27182

Facility

$425.00

Hospital Charge Code	270624215V
Hospital Revenue Code	278
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

CATH TARGET TETRA 2.0MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700071S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$2,544.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,313.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

CATH TARGET TETRA 2.0MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700071S
Hospital Revenue Code	278
Min. Negotiated Rate	$253.44
Max. Negotiated Rate	$5,258.00
Rate for Payer: Aetna Commercial	$3,996.08
Rate for Payer: Aetna Medicare Advantage	$3,154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,681.58
Rate for Payer: Cigna Commercial	$5,258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,313.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40
Rate for Payer: UnitedHealthcare Community & State	$253.44
Rate for Payer: Wellpoint Medicaid Managed Care	$278.67

Know your out-of-pocket cost for care.

All Charges