Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH ULTRA HI-FLO AORTIC FLUSH

Facility

$154.00

Hospital Charge Code	270332261
Hospital Revenue Code	272
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$77.00
Rate for Payer: Aetna Commercial	$58.52
Rate for Payer: Aetna Medicare Advantage	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.27
Rate for Payer: Cigna Commercial	$77.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.20
Rate for Payer: Oxford Commercial	$30.80
Rate for Payer: Qualcare PPO/HMO/WC	$23.10
Rate for Payer: UnitedHealthcare Commercial	$30.80
Rate for Payer: UnitedHealthcare Community & State	$3.71
Rate for Payer: Wellpoint Medicaid Managed Care	$4.08

CATH UREFLEX SOFT 10FR 20CM

Facility

$435.00

Hospital Charge Code	270640681
Hospital Revenue Code	278
Min. Negotiated Rate	$65.25
Max. Negotiated Rate	$105.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$95.70
Rate for Payer: Qualcare PPO/HMO/WC	$65.25

CATH UREFLEX SOFT 10FR 20CM

Facility

$435.00

Hospital Charge Code	270640681
Hospital Revenue Code	278
Min. Negotiated Rate	$10.48
Max. Negotiated Rate	$217.50
Rate for Payer: Aetna Commercial	$165.30
Rate for Payer: Aetna Medicare Advantage	$130.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.92
Rate for Payer: Cigna Commercial	$217.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$95.70
Rate for Payer: Qualcare PPO/HMO/WC	$65.25
Rate for Payer: UnitedHealthcare Community & State	$10.48
Rate for Payer: Wellpoint Medicaid Managed Care	$11.53

CATH UREFLEX SOFT 12FR 20CM

Facility

$445.00

Hospital Charge Code	270640682
Hospital Revenue Code	278
Min. Negotiated Rate	$66.75
Max. Negotiated Rate	$107.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$89.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$97.90
Rate for Payer: Qualcare PPO/HMO/WC	$66.75

CATH UREFLEX SOFT 12FR 20CM

Facility

$445.00

Hospital Charge Code	270640682
Hospital Revenue Code	278
Min. Negotiated Rate	$10.72
Max. Negotiated Rate	$222.50
Rate for Payer: Aetna Commercial	$169.10
Rate for Payer: Aetna Medicare Advantage	$133.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$89.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.47
Rate for Payer: Cigna Commercial	$222.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$97.90
Rate for Payer: Qualcare PPO/HMO/WC	$66.75
Rate for Payer: UnitedHealthcare Community & State	$10.72
Rate for Payer: Wellpoint Medicaid Managed Care	$11.79

CATH UREFLEX SOFT 14FR 22CM

Facility

$445.00

Hospital Charge Code	270640683
Hospital Revenue Code	278
Min. Negotiated Rate	$66.75
Max. Negotiated Rate	$107.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$89.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$97.90
Rate for Payer: Qualcare PPO/HMO/WC	$66.75

CATH UREFLEX SOFT 14FR 22CM

Facility

$445.00

Hospital Charge Code	270640683
Hospital Revenue Code	278
Min. Negotiated Rate	$10.72
Max. Negotiated Rate	$222.50
Rate for Payer: Aetna Commercial	$169.10
Rate for Payer: Aetna Medicare Advantage	$133.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$89.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.47
Rate for Payer: Cigna Commercial	$222.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$97.90
Rate for Payer: Qualcare PPO/HMO/WC	$66.75
Rate for Payer: UnitedHealthcare Community & State	$10.72
Rate for Payer: Wellpoint Medicaid Managed Care	$11.79

CATH URET BARD ********

Facility

$139.00

Hospital Charge Code	1600576
Hospital Revenue Code	272
Min. Negotiated Rate	$20.85
Max. Negotiated Rate	$20.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.85

CATH URET BARD ********

Facility

$139.00

Hospital Charge Code	1600576
Hospital Revenue Code	272
Min. Negotiated Rate	$3.35
Max. Negotiated Rate	$69.50
Rate for Payer: Aetna Commercial	$52.82
Rate for Payer: Aetna Medicare Advantage	$41.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.45
Rate for Payer: Cigna Commercial	$69.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.70
Rate for Payer: Oxford Commercial	$27.80
Rate for Payer: Qualcare PPO/HMO/WC	$20.85
Rate for Payer: UnitedHealthcare Commercial	$27.80
Rate for Payer: UnitedHealthcare Community & State	$3.35
Rate for Payer: Wellpoint Medicaid Managed Care	$3.68

CATH URETERAL 5FR 70cm OPENEND

Facility

$80.56

Hospital Charge Code	270679486
Hospital Revenue Code	272
Min. Negotiated Rate	$12.08
Max. Negotiated Rate	$12.08
Rate for Payer: Qualcare PPO/HMO/WC	$12.08

CATH URETERAL 5FR 70cm OPENEND

Facility

$80.56

Hospital Charge Code	270679486
Hospital Revenue Code	272
Min. Negotiated Rate	$1.94
Max. Negotiated Rate	$40.28
Rate for Payer: Aetna Commercial	$30.61
Rate for Payer: Aetna Medicare Advantage	$24.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.54
Rate for Payer: Cigna Commercial	$40.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.17
Rate for Payer: Oxford Commercial	$16.11
Rate for Payer: Qualcare PPO/HMO/WC	$12.08
Rate for Payer: UnitedHealthcare Commercial	$16.11
Rate for Payer: UnitedHealthcare Community & State	$1.94
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

CATH URETERAL CONE TIP

Facility

$1,611.15

Hospital Charge Code	270658676
Hospital Revenue Code	272
Min. Negotiated Rate	$38.83
Max. Negotiated Rate	$805.58
Rate for Payer: Aetna Commercial	$612.24
Rate for Payer: Aetna Medicare Advantage	$483.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.84
Rate for Payer: Cigna Commercial	$805.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$483.35
Rate for Payer: Oxford Commercial	$322.23
Rate for Payer: Qualcare PPO/HMO/WC	$241.67
Rate for Payer: UnitedHealthcare Commercial	$322.23
Rate for Payer: UnitedHealthcare Community & State	$38.83
Rate for Payer: Wellpoint Medicaid Managed Care	$42.70

CATH URETERAL CONE TIP

Facility

$1,611.15

Hospital Charge Code	270658676
Hospital Revenue Code	272
Min. Negotiated Rate	$241.67
Max. Negotiated Rate	$241.67
Rate for Payer: Qualcare PPO/HMO/WC	$241.67

CATH URETERAL CONE TIP 8FR

Facility

$231.00

Service Code	HCPCS C1758
Hospital Charge Code	270331131
Hospital Revenue Code	278
Min. Negotiated Rate	$34.65
Max. Negotiated Rate	$55.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$50.82
Rate for Payer: Qualcare PPO/HMO/WC	$34.65

CATH URETERAL CONE TIP 8FR

Facility

$231.00

Service Code	HCPCS C1758
Hospital Charge Code	270331131
Hospital Revenue Code	278
Min. Negotiated Rate	$5.57
Max. Negotiated Rate	$115.50
Rate for Payer: Aetna Commercial	$87.78
Rate for Payer: Aetna Medicare Advantage	$69.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.91
Rate for Payer: Cigna Commercial	$115.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$50.82
Rate for Payer: Qualcare PPO/HMO/WC	$34.65
Rate for Payer: UnitedHealthcare Community & State	$5.57
Rate for Payer: Wellpoint Medicaid Managed Care	$6.12

CATH URETERAL CONE TIP 8FR

Facility

$34.40

Service Code	HCPCS C1758
Hospital Charge Code	270658365
Hospital Revenue Code	278
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$17.20
Rate for Payer: Aetna Commercial	$13.07
Rate for Payer: Aetna Medicare Advantage	$10.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.77
Rate for Payer: Cigna Commercial	$17.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7.57
Rate for Payer: Qualcare PPO/HMO/WC	$5.16
Rate for Payer: UnitedHealthcare Community & State	$0.83
Rate for Payer: Wellpoint Medicaid Managed Care	$0.91

CATH URETERAL CONE TIP 8FR

Facility

$34.40

Service Code	HCPCS C1758
Hospital Charge Code	270658365
Hospital Revenue Code	278
Min. Negotiated Rate	$5.16
Max. Negotiated Rate	$8.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7.57
Rate for Payer: Qualcare PPO/HMO/WC	$5.16

CATH URETERAL DUAL LUMAN

Facility

$167.40

Service Code	HCPCS C1758
Hospital Charge Code	270647884
Hospital Revenue Code	278
Min. Negotiated Rate	$25.11
Max. Negotiated Rate	$40.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$36.83
Rate for Payer: Qualcare PPO/HMO/WC	$25.11

CATH URETERAL DUAL LUMAN

Facility

$167.40

Service Code	HCPCS C1758
Hospital Charge Code	270647884
Hospital Revenue Code	278
Min. Negotiated Rate	$4.03
Max. Negotiated Rate	$83.70
Rate for Payer: Aetna Commercial	$63.61
Rate for Payer: Aetna Medicare Advantage	$50.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.69
Rate for Payer: Cigna Commercial	$83.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$36.83
Rate for Payer: Qualcare PPO/HMO/WC	$25.11
Rate for Payer: UnitedHealthcare Community & State	$4.03
Rate for Payer: Wellpoint Medicaid Managed Care	$4.44

CATH URETERAL OLIVE TIP 3FR

Facility

$213.80

Service Code	HCPCS C1758
Hospital Charge Code	270650800
Hospital Revenue Code	278
Min. Negotiated Rate	$32.07
Max. Negotiated Rate	$51.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$47.04
Rate for Payer: Qualcare PPO/HMO/WC	$32.07

CATH URETERAL OLIVE TIP 3FR

Facility

$213.80

Service Code	HCPCS C1758
Hospital Charge Code	270650800
Hospital Revenue Code	278
Min. Negotiated Rate	$5.15
Max. Negotiated Rate	$106.90
Rate for Payer: Aetna Commercial	$81.24
Rate for Payer: Aetna Medicare Advantage	$64.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.52
Rate for Payer: Cigna Commercial	$106.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$47.04
Rate for Payer: Qualcare PPO/HMO/WC	$32.07
Rate for Payer: UnitedHealthcare Community & State	$5.15
Rate for Payer: Wellpoint Medicaid Managed Care	$5.67

CATH URETERAL OLIVETIP 4FR

Facility

$190.55

Service Code	HCPCS C1758
Hospital Charge Code	270644065
Hospital Revenue Code	278
Min. Negotiated Rate	$28.58
Max. Negotiated Rate	$46.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$41.92
Rate for Payer: Qualcare PPO/HMO/WC	$28.58

CATH URETERAL OLIVETIP 4FR

Facility

$190.55

Service Code	HCPCS C1758
Hospital Charge Code	270644065
Hospital Revenue Code	278
Min. Negotiated Rate	$4.59
Max. Negotiated Rate	$95.28
Rate for Payer: Aetna Commercial	$72.41
Rate for Payer: Aetna Medicare Advantage	$57.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.59
Rate for Payer: Cigna Commercial	$95.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$41.92
Rate for Payer: Qualcare PPO/HMO/WC	$28.58
Rate for Payer: UnitedHealthcare Community & State	$4.59
Rate for Payer: Wellpoint Medicaid Managed Care	$5.05

CATH URETERAL OLIVETIP 5FR

Facility

$244.50

Hospital Charge Code	270646262
Hospital Revenue Code	278
Min. Negotiated Rate	$36.67
Max. Negotiated Rate	$59.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.79
Rate for Payer: Qualcare PPO/HMO/WC	$36.67

CATH URETERAL OLIVETIP 5FR

Facility

$244.50

Hospital Charge Code	270646262
Hospital Revenue Code	278
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$122.25
Rate for Payer: Aetna Commercial	$92.91
Rate for Payer: Aetna Medicare Advantage	$73.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.35
Rate for Payer: Cigna Commercial	$122.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.79
Rate for Payer: Qualcare PPO/HMO/WC	$36.67
Rate for Payer: UnitedHealthcare Community & State	$5.89
Rate for Payer: Wellpoint Medicaid Managed Care	$6.48

Know your out-of-pocket cost for care.

All Charges