Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH URETERAL OLIVE TIP 6FR

Facility

$373.20

Service Code	HCPCS C1758
Hospital Charge Code	270646263
Hospital Revenue Code	278
Min. Negotiated Rate	$55.98
Max. Negotiated Rate	$90.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.10
Rate for Payer: Qualcare PPO/HMO/WC	$55.98

CATH URETERAL OLIVE TIP 6FR

Facility

$373.20

Service Code	HCPCS C1758
Hospital Charge Code	270646263
Hospital Revenue Code	278
Min. Negotiated Rate	$8.99
Max. Negotiated Rate	$186.60
Rate for Payer: Aetna Commercial	$141.82
Rate for Payer: Aetna Medicare Advantage	$111.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.17
Rate for Payer: Cigna Commercial	$186.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.10
Rate for Payer: Qualcare PPO/HMO/WC	$55.98
Rate for Payer: UnitedHealthcare Community & State	$8.99
Rate for Payer: Wellpoint Medicaid Managed Care	$9.89

CATH URETERAL OP-END 5F 135005

Facility

$38.00

Hospital Charge Code	270618083
Hospital Revenue Code	272
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$5.70

CATH URETERAL OP-END 5F 135005

Facility

$38.00

Hospital Charge Code	270618083
Hospital Revenue Code	272
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$19.00
Rate for Payer: Aetna Commercial	$14.44
Rate for Payer: Aetna Medicare Advantage	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.69
Rate for Payer: Cigna Commercial	$19.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.40
Rate for Payer: Oxford Commercial	$7.60
Rate for Payer: Qualcare PPO/HMO/WC	$5.70
Rate for Payer: UnitedHealthcare Commercial	$7.60
Rate for Payer: UnitedHealthcare Community & State	$0.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1.01

CATH URETERAL POLY WHIS TIP

Facility

$32.65

Service Code	HCPCS C1729
Hospital Charge Code	270659735
Hospital Revenue Code	278
Min. Negotiated Rate	$4.90
Max. Negotiated Rate	$7.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7.18
Rate for Payer: Qualcare PPO/HMO/WC	$4.90

CATH URETERAL POLY WHIS TIP

Facility

$32.65

Service Code	HCPCS C1729
Hospital Charge Code	270659735
Hospital Revenue Code	278
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$16.32
Rate for Payer: Aetna Commercial	$12.41
Rate for Payer: Aetna Medicare Advantage	$9.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.33
Rate for Payer: Cigna Commercial	$16.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7.18
Rate for Payer: Qualcare PPO/HMO/WC	$4.90
Rate for Payer: UnitedHealthcare Community & State	$0.79
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

CATH URETERAL TIGERTAIL 5FR

Facility

$49.75

Service Code	HCPCS C1758
Hospital Charge Code	270660500
Hospital Revenue Code	278
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$24.88
Rate for Payer: Aetna Commercial	$18.91
Rate for Payer: Aetna Medicare Advantage	$14.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.69
Rate for Payer: Cigna Commercial	$24.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$10.95
Rate for Payer: Qualcare PPO/HMO/WC	$7.46
Rate for Payer: UnitedHealthcare Community & State	$1.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

CATH URETERAL TIGERTAIL 5FR

Facility

$49.75

Service Code	HCPCS C1758
Hospital Charge Code	270660500
Hospital Revenue Code	278
Min. Negotiated Rate	$7.46
Max. Negotiated Rate	$12.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$10.95
Rate for Payer: Qualcare PPO/HMO/WC	$7.46

CATH URETERAL TIP #5 WHISTLE

Facility

$214.95

Hospital Charge Code	270658470
Hospital Revenue Code	272
Min. Negotiated Rate	$32.24
Max. Negotiated Rate	$32.24
Rate for Payer: Qualcare PPO/HMO/WC	$32.24

CATH URETERAL TIP #5 WHISTLE

Facility

$214.95

Hospital Charge Code	270658470
Hospital Revenue Code	272
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$107.47
Rate for Payer: Aetna Commercial	$81.68
Rate for Payer: Aetna Medicare Advantage	$64.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.81
Rate for Payer: Cigna Commercial	$107.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.48
Rate for Payer: Oxford Commercial	$42.99
Rate for Payer: Qualcare PPO/HMO/WC	$32.24
Rate for Payer: UnitedHealthcare Commercial	$42.99
Rate for Payer: UnitedHealthcare Community & State	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$5.70

CATH URETH 2WAY 6 EYE 20FR

Facility

$53.81

Hospital Charge Code	270684822
Hospital Revenue Code	272
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.07

CATH URETH 2WAY 6 EYE 20FR

Facility

$53.81

Hospital Charge Code	270684822
Hospital Revenue Code	272
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$26.91
Rate for Payer: Aetna Commercial	$20.45
Rate for Payer: Aetna Medicare Advantage	$16.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.72
Rate for Payer: Cigna Commercial	$26.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.14
Rate for Payer: Oxford Commercial	$10.76
Rate for Payer: Qualcare PPO/HMO/WC	$8.07
Rate for Payer: UnitedHealthcare Commercial	$10.76
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.43

CATH URETH 2WAY 6 EYE 22FR

Facility

$53.81

Hospital Charge Code	270684823
Hospital Revenue Code	272
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.07

CATH URETH 2WAY 6 EYE 22FR

Facility

$53.81

Hospital Charge Code	270684823
Hospital Revenue Code	272
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$26.91
Rate for Payer: Aetna Commercial	$20.45
Rate for Payer: Aetna Medicare Advantage	$16.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.72
Rate for Payer: Cigna Commercial	$26.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.14
Rate for Payer: Oxford Commercial	$10.76
Rate for Payer: Qualcare PPO/HMO/WC	$8.07
Rate for Payer: UnitedHealthcare Commercial	$10.76
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.43

CATH URETH 2WAY 6 EYE 24FR

Facility

$53.81

Hospital Charge Code	270684824
Hospital Revenue Code	272
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.07

CATH URETH 2WAY 6 EYE 24FR

Facility

$53.81

Hospital Charge Code	270684824
Hospital Revenue Code	272
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$26.91
Rate for Payer: Aetna Commercial	$20.45
Rate for Payer: Aetna Medicare Advantage	$16.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.72
Rate for Payer: Cigna Commercial	$26.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.14
Rate for Payer: Oxford Commercial	$10.76
Rate for Payer: Qualcare PPO/HMO/WC	$8.07
Rate for Payer: UnitedHealthcare Commercial	$10.76
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.43

CATH URETH COUDE 3 WAY 22FR 30

Facility

$146.58

Hospital Charge Code	270633022
Hospital Revenue Code	272
Min. Negotiated Rate	$3.53
Max. Negotiated Rate	$73.29
Rate for Payer: Aetna Commercial	$55.70
Rate for Payer: Aetna Medicare Advantage	$43.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.38
Rate for Payer: Cigna Commercial	$73.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.97
Rate for Payer: Oxford Commercial	$29.32
Rate for Payer: Qualcare PPO/HMO/WC	$21.99
Rate for Payer: UnitedHealthcare Commercial	$29.32
Rate for Payer: UnitedHealthcare Community & State	$3.53
Rate for Payer: Wellpoint Medicaid Managed Care	$3.88

CATH URETH COUDE 3 WAY 22FR 30

Facility

$146.58

Hospital Charge Code	270633022
Hospital Revenue Code	272
Min. Negotiated Rate	$21.99
Max. Negotiated Rate	$21.99
Rate for Payer: Qualcare PPO/HMO/WC	$21.99

CATH URETH COUDE 3 WAY 24FR 30

Facility

$146.58

Hospital Charge Code	270684838
Hospital Revenue Code	272
Min. Negotiated Rate	$3.53
Max. Negotiated Rate	$73.29
Rate for Payer: Aetna Commercial	$55.70
Rate for Payer: Aetna Medicare Advantage	$43.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.38
Rate for Payer: Cigna Commercial	$73.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.97
Rate for Payer: Oxford Commercial	$29.32
Rate for Payer: Qualcare PPO/HMO/WC	$21.99
Rate for Payer: UnitedHealthcare Commercial	$29.32
Rate for Payer: UnitedHealthcare Community & State	$3.53
Rate for Payer: Wellpoint Medicaid Managed Care	$3.88

CATH URETH COUDE 3 WAY 24FR 30

Facility

$146.58

Hospital Charge Code	270684838
Hospital Revenue Code	272
Min. Negotiated Rate	$21.99
Max. Negotiated Rate	$21.99
Rate for Payer: Qualcare PPO/HMO/WC	$21.99

CATH URETH MEASUR BAL 72401446

Facility

$545.65

Hospital Charge Code	270625250
Hospital Revenue Code	278
Min. Negotiated Rate	$13.15
Max. Negotiated Rate	$272.82
Rate for Payer: Aetna Commercial	$207.35
Rate for Payer: Aetna Medicare Advantage	$163.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.14
Rate for Payer: Cigna Commercial	$272.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$120.04
Rate for Payer: Qualcare PPO/HMO/WC	$81.85
Rate for Payer: UnitedHealthcare Community & State	$13.15
Rate for Payer: Wellpoint Medicaid Managed Care	$14.46

CATH URETH MEASUR BAL 72401446

Facility

$545.65

Hospital Charge Code	270625250
Hospital Revenue Code	278
Min. Negotiated Rate	$81.85
Max. Negotiated Rate	$132.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$120.04
Rate for Payer: Qualcare PPO/HMO/WC	$81.85

CATH URETHRAL RED RUBBER 10FR

Facility

$4.43

Hospital Charge Code	270300515
Hospital Revenue Code	272
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.21
Rate for Payer: Aetna Commercial	$1.68
Rate for Payer: Aetna Medicare Advantage	$1.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.13
Rate for Payer: Cigna Commercial	$2.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.33
Rate for Payer: Oxford Commercial	$0.89
Rate for Payer: Qualcare PPO/HMO/WC	$0.66
Rate for Payer: UnitedHealthcare Commercial	$0.89
Rate for Payer: UnitedHealthcare Community & State	$0.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

CATH URETHRAL RED RUBBER 10FR

Facility

$4.43

Hospital Charge Code	270300515
Hospital Revenue Code	272
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$0.66
Rate for Payer: Qualcare PPO/HMO/WC	$0.66

CATH URET OLIVE TP 4FR

Facility

$511.25

Hospital Charge Code	270060420
Hospital Revenue Code	278
Min. Negotiated Rate	$76.69
Max. Negotiated Rate	$123.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$112.47
Rate for Payer: Qualcare PPO/HMO/WC	$76.69

Know your out-of-pocket cost for care.

All Charges