Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH TRIPLE LM 8 AK-25123-F

Facility

$739.25

Hospital Charge Code	270606227
Hospital Revenue Code	272
Min. Negotiated Rate	$110.89
Max. Negotiated Rate	$110.89
Rate for Payer: Qualcare PPO/HMO/WC	$110.89

CATH TRIPLE LM 8 AK-25123-F

Facility

$466.83

Hospital Charge Code	270302229
Hospital Revenue Code	272
Min. Negotiated Rate	$70.02
Max. Negotiated Rate	$70.02
Rate for Payer: Qualcare PPO/HMO/WC	$70.02

CATH TRIPLE LM 8 AK-25123-F

Facility

$739.25

Hospital Charge Code	270606227
Hospital Revenue Code	272
Min. Negotiated Rate	$17.82
Max. Negotiated Rate	$369.62
Rate for Payer: Aetna Commercial	$280.92
Rate for Payer: Aetna Medicare Advantage	$221.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.51
Rate for Payer: Cigna Commercial	$369.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.78
Rate for Payer: Oxford Commercial	$147.85
Rate for Payer: Qualcare PPO/HMO/WC	$110.89
Rate for Payer: UnitedHealthcare Commercial	$147.85
Rate for Payer: UnitedHealthcare Community & State	$17.82
Rate for Payer: Wellpoint Medicaid Managed Care	$19.59

CATH TRIPLE LM 8 AK-25123-F

Facility

$466.83

Hospital Charge Code	270302229
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$233.41
Rate for Payer: Aetna Commercial	$177.40
Rate for Payer: Aetna Medicare Advantage	$140.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.04
Rate for Payer: Cigna Commercial	$233.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.05
Rate for Payer: Oxford Commercial	$93.37
Rate for Payer: Qualcare PPO/HMO/WC	$70.02
Rate for Payer: UnitedHealthcare Commercial	$93.37
Rate for Payer: UnitedHealthcare Community & State	$11.25
Rate for Payer: Wellpoint Medicaid Managed Care	$12.37

CATH TRLBLZR .014 SC-014-150

Facility

$744.80

Service Code	HCPCS C1725
Hospital Charge Code	270643849C
Hospital Revenue Code	278
Min. Negotiated Rate	$17.95
Max. Negotiated Rate	$372.40
Rate for Payer: Aetna Commercial	$283.02
Rate for Payer: Aetna Medicare Advantage	$223.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.92
Rate for Payer: Cigna Commercial	$372.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$163.86
Rate for Payer: Qualcare PPO/HMO/WC	$111.72
Rate for Payer: UnitedHealthcare Community & State	$17.95
Rate for Payer: Wellpoint Medicaid Managed Care	$19.74

CATH TRLBLZR .014 SC-014-150

Facility

$744.80

Service Code	HCPCS C1725
Hospital Charge Code	270643849C
Hospital Revenue Code	278
Min. Negotiated Rate	$111.72
Max. Negotiated Rate	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$163.86
Rate for Payer: Qualcare PPO/HMO/WC	$111.72

CATH TRLBLZR 035 135 SC035135

Facility

$744.80

Service Code	HCPCS C1725
Hospital Charge Code	270643851C
Hospital Revenue Code	278
Min. Negotiated Rate	$17.95
Max. Negotiated Rate	$372.40
Rate for Payer: Aetna Commercial	$283.02
Rate for Payer: Aetna Medicare Advantage	$223.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.92
Rate for Payer: Cigna Commercial	$372.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$163.86
Rate for Payer: Qualcare PPO/HMO/WC	$111.72
Rate for Payer: UnitedHealthcare Community & State	$17.95
Rate for Payer: Wellpoint Medicaid Managed Care	$19.74

CATH TRLBLZR 035 135 SC035135

Facility

$744.80

Service Code	HCPCS C1725
Hospital Charge Code	270643851C
Hospital Revenue Code	278
Min. Negotiated Rate	$111.72
Max. Negotiated Rate	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$163.86
Rate for Payer: Qualcare PPO/HMO/WC	$111.72

CATH TROCAR 10FR

Facility

$111.25

Hospital Charge Code	270608302
Hospital Revenue Code	272
Min. Negotiated Rate	$16.69
Max. Negotiated Rate	$16.69
Rate for Payer: Qualcare PPO/HMO/WC	$16.69

CATH TROCAR 10FR

Facility

$111.25

Hospital Charge Code	270608302
Hospital Revenue Code	272
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$55.62
Rate for Payer: Aetna Commercial	$42.27
Rate for Payer: Aetna Medicare Advantage	$33.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.37
Rate for Payer: Cigna Commercial	$55.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.38
Rate for Payer: Oxford Commercial	$22.25
Rate for Payer: Qualcare PPO/HMO/WC	$16.69
Rate for Payer: UnitedHealthcare Commercial	$22.25
Rate for Payer: UnitedHealthcare Community & State	$2.68
Rate for Payer: Wellpoint Medicaid Managed Care	$2.95

CATH TROCAR 12FR

Facility

$80.12

Hospital Charge Code	270646706
Hospital Revenue Code	272
Min. Negotiated Rate	$12.02
Max. Negotiated Rate	$12.02
Rate for Payer: Qualcare PPO/HMO/WC	$12.02

CATH TROCAR 12FR

Facility

$80.12

Hospital Charge Code	270646706
Hospital Revenue Code	272
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$40.06
Rate for Payer: Aetna Commercial	$30.45
Rate for Payer: Aetna Medicare Advantage	$24.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.43
Rate for Payer: Cigna Commercial	$40.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.04
Rate for Payer: Oxford Commercial	$16.02
Rate for Payer: Qualcare PPO/HMO/WC	$12.02
Rate for Payer: UnitedHealthcare Commercial	$16.02
Rate for Payer: UnitedHealthcare Community & State	$1.93
Rate for Payer: Wellpoint Medicaid Managed Care	$2.12

CATH TROCAR 28FR 8428

Facility

$80.71

Hospital Charge Code	270649078
Hospital Revenue Code	272
Min. Negotiated Rate	$12.11
Max. Negotiated Rate	$12.11
Rate for Payer: Qualcare PPO/HMO/WC	$12.11

CATH TROCAR 28FR 8428

Facility

$80.71

Hospital Charge Code	270649078
Hospital Revenue Code	272
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$40.35
Rate for Payer: Aetna Commercial	$30.67
Rate for Payer: Aetna Medicare Advantage	$24.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.58
Rate for Payer: Cigna Commercial	$40.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.21
Rate for Payer: Oxford Commercial	$16.14
Rate for Payer: Qualcare PPO/HMO/WC	$12.11
Rate for Payer: UnitedHealthcare Commercial	$16.14
Rate for Payer: UnitedHealthcare Community & State	$1.95
Rate for Payer: Wellpoint Medicaid Managed Care	$2.14

CATH TROCAR 8FR

Facility

$160.00

Hospital Charge Code	270678172
Hospital Revenue Code	272
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

CATH TROCAR 8FR

Facility

$160.00

Hospital Charge Code	270678172
Hospital Revenue Code	272
Min. Negotiated Rate	$3.86
Max. Negotiated Rate	$80.00
Rate for Payer: Aetna Commercial	$60.80
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.00
Rate for Payer: Oxford Commercial	$32.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$32.00
Rate for Payer: UnitedHealthcare Community & State	$3.86
Rate for Payer: Wellpoint Medicaid Managed Care	$4.24

CATH TROCAR THORACIC 20FR

Facility

$80.12

Hospital Charge Code	270635997
Hospital Revenue Code	270
Min. Negotiated Rate	$12.02
Max. Negotiated Rate	$12.02
Rate for Payer: Qualcare PPO/HMO/WC	$12.02

CATH TROCAR THORACIC 20FR

Facility

$80.12

Hospital Charge Code	270635997
Hospital Revenue Code	270
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$40.06
Rate for Payer: Aetna Commercial	$30.45
Rate for Payer: Aetna Medicare Advantage	$24.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.43
Rate for Payer: Cigna Commercial	$40.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.04
Rate for Payer: Oxford Commercial	$16.02
Rate for Payer: Qualcare PPO/HMO/WC	$12.02
Rate for Payer: UnitedHealthcare Commercial	$16.02
Rate for Payer: UnitedHealthcare Community & State	$1.93
Rate for Payer: Wellpoint Medicaid Managed Care	$2.12

CATH TROC STER 24FR 8888561050

Facility

$71.95

Hospital Charge Code	270639740
Hospital Revenue Code	272
Min. Negotiated Rate	$1.73
Max. Negotiated Rate	$35.98
Rate for Payer: Aetna Commercial	$27.34
Rate for Payer: Aetna Medicare Advantage	$21.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.35
Rate for Payer: Cigna Commercial	$35.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.59
Rate for Payer: Oxford Commercial	$14.39
Rate for Payer: Qualcare PPO/HMO/WC	$10.79
Rate for Payer: UnitedHealthcare Commercial	$14.39
Rate for Payer: UnitedHealthcare Community & State	$1.73
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

CATH TROC STER 24FR 8888561050

Facility

$71.95

Hospital Charge Code	270639740
Hospital Revenue Code	272
Min. Negotiated Rate	$10.79
Max. Negotiated Rate	$10.79
Rate for Payer: Qualcare PPO/HMO/WC	$10.79

CATH TROC STER 32FR 8888561076

Facility

$71.95

Hospital Charge Code	270639741
Hospital Revenue Code	272
Min. Negotiated Rate	$1.73
Max. Negotiated Rate	$35.98
Rate for Payer: Aetna Commercial	$27.34
Rate for Payer: Aetna Medicare Advantage	$21.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.35
Rate for Payer: Cigna Commercial	$35.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.59
Rate for Payer: Oxford Commercial	$14.39
Rate for Payer: Qualcare PPO/HMO/WC	$10.79
Rate for Payer: UnitedHealthcare Commercial	$14.39
Rate for Payer: UnitedHealthcare Community & State	$1.73
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

CATH TROC STER 32FR 8888561076

Facility

$71.95

Hospital Charge Code	270639741
Hospital Revenue Code	272
Min. Negotiated Rate	$10.79
Max. Negotiated Rate	$10.79
Rate for Payer: Qualcare PPO/HMO/WC	$10.79

CATH TRPL LUMEN BASIC SET 15CM

Facility

$700.00

Service Code	HCPCS C1752
Hospital Charge Code	270689086
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

CATH TRPL LUMEN BASIC SET 15CM

Facility

$700.00

Service Code	HCPCS C1752
Hospital Charge Code	270689086
Hospital Revenue Code	278
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

CATH TUBE CHOLANGIOGRAM #14

Facility

$34.75

Hospital Charge Code	270655499
Hospital Revenue Code	270
Min. Negotiated Rate	$5.21
Max. Negotiated Rate	$5.21
Rate for Payer: Qualcare PPO/HMO/WC	$5.21

Know your out-of-pocket cost for care.

All Charges