Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH TUBE CHOLANGIOGRAM #14

Facility

$34.75

Hospital Charge Code	270655499
Hospital Revenue Code	270
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$17.38
Rate for Payer: Aetna Commercial	$13.21
Rate for Payer: Aetna Medicare Advantage	$10.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.86
Rate for Payer: Cigna Commercial	$17.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.43
Rate for Payer: Oxford Commercial	$6.95
Rate for Payer: Qualcare PPO/HMO/WC	$5.21
Rate for Payer: UnitedHealthcare Commercial	$6.95
Rate for Payer: UnitedHealthcare Community & State	$0.84
Rate for Payer: Wellpoint Medicaid Managed Care	$0.92

CATH TUBE CHOLANGIOGRAM #16

Facility

$34.75

Hospital Charge Code	270655496
Hospital Revenue Code	270
Min. Negotiated Rate	$5.21
Max. Negotiated Rate	$5.21
Rate for Payer: Qualcare PPO/HMO/WC	$5.21

CATH TUBE CHOLANGIOGRAM #16

Facility

$34.75

Hospital Charge Code	270655496
Hospital Revenue Code	270
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$17.38
Rate for Payer: Aetna Commercial	$13.21
Rate for Payer: Aetna Medicare Advantage	$10.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.86
Rate for Payer: Cigna Commercial	$17.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.43
Rate for Payer: Oxford Commercial	$6.95
Rate for Payer: Qualcare PPO/HMO/WC	$5.21
Rate for Payer: UnitedHealthcare Commercial	$6.95
Rate for Payer: UnitedHealthcare Community & State	$0.84
Rate for Payer: Wellpoint Medicaid Managed Care	$0.92

CATH TUBE CHOLANGIOGRAM #18

Facility

$34.75

Hospital Charge Code	270655495
Hospital Revenue Code	270
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$17.38
Rate for Payer: Aetna Commercial	$13.21
Rate for Payer: Aetna Medicare Advantage	$10.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.86
Rate for Payer: Cigna Commercial	$17.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.43
Rate for Payer: Oxford Commercial	$6.95
Rate for Payer: Qualcare PPO/HMO/WC	$5.21
Rate for Payer: UnitedHealthcare Commercial	$6.95
Rate for Payer: UnitedHealthcare Community & State	$0.84
Rate for Payer: Wellpoint Medicaid Managed Care	$0.92

CATH TUBE CHOLANGIOGRAM #18

Facility

$34.75

Hospital Charge Code	270655495
Hospital Revenue Code	270
Min. Negotiated Rate	$5.21
Max. Negotiated Rate	$5.21
Rate for Payer: Qualcare PPO/HMO/WC	$5.21

CATH TURBO 6cm TIP

Facility

$16,975.00

Service Code	HCPCS C1885
Hospital Charge Code	270644411
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,734.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATH TURBO 6cm TIP

Facility

$16,975.00

Service Code	HCPCS C1885
Hospital Charge Code	270644411
Hospital Revenue Code	278
Min. Negotiated Rate	$409.10
Max. Negotiated Rate	$8,487.50
Rate for Payer: Aetna Commercial	$6,450.50
Rate for Payer: Aetna Medicare Advantage	$5,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,328.62
Rate for Payer: Cigna Commercial	$8,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,734.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25
Rate for Payer: UnitedHealthcare Community & State	$409.10
Rate for Payer: Wellpoint Medicaid Managed Care	$449.84

CATH TURBO BOOST 8F 110 518063

Facility

$2,625.00

Hospital Charge Code	270639523C
Hospital Revenue Code	278
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$635.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$577.50
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

CATH TURBO BOOST 8F 110 518063

Facility

$2,625.00

Hospital Charge Code	270639523C
Hospital Revenue Code	278
Min. Negotiated Rate	$63.26
Max. Negotiated Rate	$1,312.50
Rate for Payer: Aetna Commercial	$997.50
Rate for Payer: Aetna Medicare Advantage	$787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.38
Rate for Payer: Cigna Commercial	$1,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$577.50
Rate for Payer: Qualcare PPO/HMO/WC	$393.75
Rate for Payer: UnitedHealthcare Community & State	$63.26
Rate for Payer: Wellpoint Medicaid Managed Care	$69.56

CATH TURBO BOOSTER 7FR 110cm

Facility

$2,625.00

Hospital Charge Code	270639522
Hospital Revenue Code	278
Min. Negotiated Rate	$63.26
Max. Negotiated Rate	$1,312.50
Rate for Payer: Aetna Commercial	$997.50
Rate for Payer: Aetna Medicare Advantage	$787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.38
Rate for Payer: Cigna Commercial	$1,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$577.50
Rate for Payer: Qualcare PPO/HMO/WC	$393.75
Rate for Payer: UnitedHealthcare Community & State	$63.26
Rate for Payer: Wellpoint Medicaid Managed Care	$69.56

CATH TURBO BOOSTER 7FR 110cm

Facility

$2,625.00

Hospital Charge Code	270639522
Hospital Revenue Code	278
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$635.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$577.50
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

CATH TURBO ELITE OTW 2.0

Facility

$12,500.00

Hospital Charge Code	270638468C
Hospital Revenue Code	278
Min. Negotiated Rate	$301.25
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$4,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00
Rate for Payer: UnitedHealthcare Community & State	$301.25
Rate for Payer: Wellpoint Medicaid Managed Care	$331.25

CATH TURBO ELITE OTW 2.0

Facility

$12,500.00

Hospital Charge Code	270638468C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

CATH TURBO ELIT OTW 1 4 414151

Facility

$12,500.00

Hospital Charge Code	270638466V
Hospital Revenue Code	278
Min. Negotiated Rate	$301.25
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$4,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00
Rate for Payer: UnitedHealthcare Community & State	$301.25
Rate for Payer: Wellpoint Medicaid Managed Care	$331.25

CATH TURBO ELIT OTW 1 4 414151

Facility

$12,500.00

Hospital Charge Code	270638466V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

CATH TURBO ELIT OTW 1 7 417152

Facility

$12,500.00

Hospital Charge Code	270638467V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

CATH TURBO ELIT OTW 1 7 417152

Facility

$12,500.00

Hospital Charge Code	270638467V
Hospital Revenue Code	278
Min. Negotiated Rate	$301.25
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$4,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00
Rate for Payer: UnitedHealthcare Community & State	$301.25
Rate for Payer: Wellpoint Medicaid Managed Care	$331.25

CATH TURBO ELIT OTW 2 0 420006

Facility

$12,500.00

Hospital Charge Code	270638468V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

CATH TURBO ELIT OTW 2 0 420006

Facility

$12,500.00

Hospital Charge Code	270638468V
Hospital Revenue Code	278
Min. Negotiated Rate	$301.25
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$4,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00
Rate for Payer: UnitedHealthcare Community & State	$301.25
Rate for Payer: Wellpoint Medicaid Managed Care	$331.25

CATH TURBO ELIT OTW 2 3 423001

Facility

$9,040.00

Service Code	HCPCS C1885
Hospital Charge Code	270638469
Hospital Revenue Code	320
Min. Negotiated Rate	$217.86
Max. Negotiated Rate	$4,520.00
Rate for Payer: Aetna Commercial	$3,435.20
Rate for Payer: Aetna Medicare Advantage	$2,712.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,305.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,305.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,305.20
Rate for Payer: Cigna Commercial	$4,520.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,712.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,356.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$217.86
Rate for Payer: Wellpoint Medicaid Managed Care	$239.56

CATH TURBO ELIT OTW 2 3 423001

Facility

$9,040.00

Service Code	HCPCS C1885
Hospital Charge Code	270638469
Hospital Revenue Code	320
Min. Negotiated Rate	$1,356.00
Max. Negotiated Rate	$1,356.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,356.00

CATH TURBO ELIT OTW 2 3 423001

Facility

$12,500.00

Hospital Charge Code	270638469V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

CATH TURBO ELIT OTW 2 3 423001

Facility

$12,500.00

Hospital Charge Code	270638469V
Hospital Revenue Code	278
Min. Negotiated Rate	$301.25
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$4,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00
Rate for Payer: UnitedHealthcare Community & State	$301.25
Rate for Payer: Wellpoint Medicaid Managed Care	$331.25

CATH TURBO ELTE OTW 0 9 410152

Facility

$12,500.00

Hospital Charge Code	270638465C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

CATH TURBO ELTE OTW 0 9 410152

Facility

$12,500.00

Hospital Charge Code	270638465V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

Know your out-of-pocket cost for care.

All Charges