Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH TARGET TETRA 2.5MMX3.5CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700072S
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

CATH TARGET TETRA 2.5MMX3.5CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700072S
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 2.5MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699379S
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

CATH TARGET TETRA 2.5MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699379S
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 3.0MMX10.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700073S
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 3.0MMX10.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700073S
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

CATH TARGET TETRA 3.0MMX4.5CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699381S
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

CATH TARGET TETRA 3.0MMX4.5CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699381S
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 3.0MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699380S
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 3.0MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699380S
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

CATH TARGET TETRA 3.0MMX6.0CM

Facility

$12,785.00

Service Code	HCPCS C1889
Hospital Charge Code	270699013S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,917.75
Max. Negotiated Rate	$3,093.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,557.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,093.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,812.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,917.75

CATH TARGET TETRA 3.0MMX6.0CM

Facility

$12,785.00

Service Code	HCPCS C1889
Hospital Charge Code	270699013S
Hospital Revenue Code	278
Min. Negotiated Rate	$308.12
Max. Negotiated Rate	$6,392.50
Rate for Payer: Aetna Commercial	$4,858.30
Rate for Payer: Aetna Medicare Advantage	$3,835.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,260.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,260.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,557.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,260.18
Rate for Payer: Cigna Commercial	$6,392.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,093.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,812.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,917.75
Rate for Payer: UnitedHealthcare Community & State	$308.12
Rate for Payer: Wellpoint Medicaid Managed Care	$338.80

CATH TARGET TETRA 3.5MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700074S
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 3.5MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700074S
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

CATH TARGET TETRA 4.0MMX10.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700077S
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

CATH TARGET TETRA 4.0MMX10.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700077S
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 4.0MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700075S
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

CATH TARGET TETRA 4.0MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700075S
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 4.0MMX8.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700076S
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 4.0MMX8.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700076S
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

CATH TARGET TETRA 4.5MMX10.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700078S
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 4.5MMX10.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700078S
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

CATH TENCHOFF****

Facility

$146.00

Hospital Charge Code	8001802
Hospital Revenue Code	279
Min. Negotiated Rate	$21.90
Max. Negotiated Rate	$21.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.90

CATH TENCHOFF****

Facility

$146.00

Hospital Charge Code	8001802
Hospital Revenue Code	279
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$73.00
Rate for Payer: Aetna Commercial	$55.48
Rate for Payer: Aetna Medicare Advantage	$43.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.23
Rate for Payer: Cigna Commercial	$73.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.80
Rate for Payer: Oxford Commercial	$29.20
Rate for Payer: Qualcare PPO/HMO/WC	$21.90
Rate for Payer: UnitedHealthcare Commercial	$29.20
Rate for Payer: UnitedHealthcare Community & State	$3.52
Rate for Payer: Wellpoint Medicaid Managed Care	$3.87

CATH TENCKHOFF

Facility

$288.00

Hospital Charge Code	1608165
Hospital Revenue Code	272
Min. Negotiated Rate	$43.20
Max. Negotiated Rate	$43.20
Rate for Payer: Qualcare PPO/HMO/WC	$43.20

Know your out-of-pocket cost for care.

All Charges