Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH U/THIN DIAMOND 135c 17638

Facility

$1,080.00

Hospital Charge Code	270632829V
Hospital Revenue Code	278
Min. Negotiated Rate	$162.00
Max. Negotiated Rate	$261.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$237.60
Rate for Payer: Qualcare PPO/HMO/WC	$162.00

CATH U/THIN DIAMOND 135c 17638

Facility

$1,071.45

Hospital Charge Code	270632829
Hospital Revenue Code	278
Min. Negotiated Rate	$25.82
Max. Negotiated Rate	$535.73
Rate for Payer: Aetna Commercial	$407.15
Rate for Payer: Aetna Medicare Advantage	$321.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$273.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$273.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$273.22
Rate for Payer: Cigna Commercial	$535.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.72
Rate for Payer: Qualcare PPO/HMO/WC	$160.72
Rate for Payer: UnitedHealthcare Community & State	$25.82
Rate for Payer: Wellpoint Medicaid Managed Care	$28.39

CATH U/THIN DIAMOND 135c 17638

Facility

$1,080.00

Hospital Charge Code	270632829V
Hospital Revenue Code	278
Min. Negotiated Rate	$26.03
Max. Negotiated Rate	$540.00
Rate for Payer: Aetna Commercial	$410.40
Rate for Payer: Aetna Medicare Advantage	$324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.40
Rate for Payer: Cigna Commercial	$540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$237.60
Rate for Payer: Qualcare PPO/HMO/WC	$162.00
Rate for Payer: UnitedHealthcare Community & State	$26.03
Rate for Payer: Wellpoint Medicaid Managed Care	$28.62

CATH U/THIN DIAMOND 135c 17638

Facility

$1,071.45

Hospital Charge Code	270632829
Hospital Revenue Code	278
Min. Negotiated Rate	$160.72
Max. Negotiated Rate	$259.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.72
Rate for Payer: Qualcare PPO/HMO/WC	$160.72

CATH U/THIN DIM 12x4x120 16534

Facility

$1,703.25

Hospital Charge Code	270627287
Hospital Revenue Code	278
Min. Negotiated Rate	$255.49
Max. Negotiated Rate	$412.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$412.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$374.71
Rate for Payer: Qualcare PPO/HMO/WC	$255.49

CATH U/THIN DIM 12x4x120 16534

Facility

$1,703.25

Hospital Charge Code	270627287V
Hospital Revenue Code	278
Min. Negotiated Rate	$255.49
Max. Negotiated Rate	$412.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$412.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$374.71
Rate for Payer: Qualcare PPO/HMO/WC	$255.49

CATH U/THIN DIM 12x4x120 16534

Facility

$1,703.25

Hospital Charge Code	270627287V
Hospital Revenue Code	278
Min. Negotiated Rate	$41.05
Max. Negotiated Rate	$851.62
Rate for Payer: Aetna Commercial	$647.24
Rate for Payer: Aetna Medicare Advantage	$510.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$434.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$434.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$434.33
Rate for Payer: Cigna Commercial	$851.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$412.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$374.71
Rate for Payer: Qualcare PPO/HMO/WC	$255.49
Rate for Payer: UnitedHealthcare Community & State	$41.05
Rate for Payer: Wellpoint Medicaid Managed Care	$45.14

CATH U/THIN DIM 12x4x120 16534

Facility

$1,703.25

Hospital Charge Code	270627287
Hospital Revenue Code	278
Min. Negotiated Rate	$41.05
Max. Negotiated Rate	$851.62
Rate for Payer: Aetna Commercial	$647.24
Rate for Payer: Aetna Medicare Advantage	$510.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$434.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$434.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$434.33
Rate for Payer: Cigna Commercial	$851.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$412.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$374.71
Rate for Payer: Qualcare PPO/HMO/WC	$255.49
Rate for Payer: UnitedHealthcare Community & State	$41.05
Rate for Payer: Wellpoint Medicaid Managed Care	$45.14

CATH U/THIN S 5F 4-8 135 17578

Facility

$1,071.45

Hospital Charge Code	270634116
Hospital Revenue Code	278
Min. Negotiated Rate	$25.82
Max. Negotiated Rate	$535.73
Rate for Payer: Aetna Commercial	$407.15
Rate for Payer: Aetna Medicare Advantage	$321.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$273.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$273.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$273.22
Rate for Payer: Cigna Commercial	$535.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.72
Rate for Payer: Qualcare PPO/HMO/WC	$160.72
Rate for Payer: UnitedHealthcare Community & State	$25.82
Rate for Payer: Wellpoint Medicaid Managed Care	$28.39

CATH U/THIN S 5F 4-8 135 17578

Facility

$1,071.45

Hospital Charge Code	270634116
Hospital Revenue Code	278
Min. Negotiated Rate	$160.72
Max. Negotiated Rate	$259.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.72
Rate for Payer: Qualcare PPO/HMO/WC	$160.72

CATH U/THIN SDS 5x4x135 17-598

Facility

$1,418.65

Hospital Charge Code	270632140
Hospital Revenue Code	278
Min. Negotiated Rate	$212.80
Max. Negotiated Rate	$343.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$283.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$343.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$312.10
Rate for Payer: Qualcare PPO/HMO/WC	$212.80

CATH U/THIN SDS 5x4x135 17-598

Facility

$1,418.65

Hospital Charge Code	270632140
Hospital Revenue Code	278
Min. Negotiated Rate	$34.19
Max. Negotiated Rate	$709.33
Rate for Payer: Aetna Commercial	$539.09
Rate for Payer: Aetna Medicare Advantage	$425.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$361.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$361.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$283.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$361.76
Rate for Payer: Cigna Commercial	$709.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$343.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$312.10
Rate for Payer: Qualcare PPO/HMO/WC	$212.80
Rate for Payer: UnitedHealthcare Community & State	$34.19
Rate for Payer: Wellpoint Medicaid Managed Care	$37.59

CATH UTHIN SDS 5x5-8x135 17608

Facility

$1,080.00

Hospital Charge Code	270632850V
Hospital Revenue Code	278
Min. Negotiated Rate	$26.03
Max. Negotiated Rate	$540.00
Rate for Payer: Aetna Commercial	$410.40
Rate for Payer: Aetna Medicare Advantage	$324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.40
Rate for Payer: Cigna Commercial	$540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$237.60
Rate for Payer: Qualcare PPO/HMO/WC	$162.00
Rate for Payer: UnitedHealthcare Community & State	$26.03
Rate for Payer: Wellpoint Medicaid Managed Care	$28.62

CATH UTHIN SDS 5x5-8x135 17608

Facility

$1,071.45

Hospital Charge Code	270632850
Hospital Revenue Code	278
Min. Negotiated Rate	$25.82
Max. Negotiated Rate	$535.73
Rate for Payer: Aetna Commercial	$407.15
Rate for Payer: Aetna Medicare Advantage	$321.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$273.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$273.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$273.22
Rate for Payer: Cigna Commercial	$535.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.72
Rate for Payer: Qualcare PPO/HMO/WC	$160.72
Rate for Payer: UnitedHealthcare Community & State	$25.82
Rate for Payer: Wellpoint Medicaid Managed Care	$28.39

CATH UTHIN SDS 5x5-8x135 17608

Facility

$1,071.45

Hospital Charge Code	270632850
Hospital Revenue Code	278
Min. Negotiated Rate	$160.72
Max. Negotiated Rate	$259.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.72
Rate for Payer: Qualcare PPO/HMO/WC	$160.72

CATH UTHIN SDS 5x5-8x135 17608

Facility

$1,080.00

Hospital Charge Code	270632850V
Hospital Revenue Code	278
Min. Negotiated Rate	$162.00
Max. Negotiated Rate	$261.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$237.60
Rate for Payer: Qualcare PPO/HMO/WC	$162.00

CATH U/TN DIM 10x2x75 16-521

Facility

$1,020.00

Hospital Charge Code	270629354V
Hospital Revenue Code	278
Min. Negotiated Rate	$153.00
Max. Negotiated Rate	$246.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$224.40
Rate for Payer: Qualcare PPO/HMO/WC	$153.00

CATH U/TN DIM 10x2x75 16-521

Facility

$1,020.00

Hospital Charge Code	270629354V
Hospital Revenue Code	278
Min. Negotiated Rate	$24.58
Max. Negotiated Rate	$510.00
Rate for Payer: Aetna Commercial	$387.60
Rate for Payer: Aetna Medicare Advantage	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.10
Rate for Payer: Cigna Commercial	$510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$224.40
Rate for Payer: Qualcare PPO/HMO/WC	$153.00
Rate for Payer: UnitedHealthcare Community & State	$24.58
Rate for Payer: Wellpoint Medicaid Managed Care	$27.03

CATH U/TN DIM 10x2x75 16-521

Facility

$1,011.90

Hospital Charge Code	270629354
Hospital Revenue Code	278
Min. Negotiated Rate	$151.78
Max. Negotiated Rate	$244.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$202.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$222.62
Rate for Payer: Qualcare PPO/HMO/WC	$151.78

CATH U/TN DIM 10x2x75 16-521

Facility

$1,011.90

Hospital Charge Code	270629354
Hospital Revenue Code	278
Min. Negotiated Rate	$24.39
Max. Negotiated Rate	$505.95
Rate for Payer: Aetna Commercial	$384.52
Rate for Payer: Aetna Medicare Advantage	$303.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$258.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$258.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$202.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$258.03
Rate for Payer: Cigna Commercial	$505.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$222.62
Rate for Payer: Qualcare PPO/HMO/WC	$151.78
Rate for Payer: UnitedHealthcare Community & State	$24.39
Rate for Payer: Wellpoint Medicaid Managed Care	$26.82

CATH VAN ANDEL BALLOON ERCP

Facility

$390.00

Hospital Charge Code	270651763
Hospital Revenue Code	272
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CATH VAN ANDEL BALLOON ERCP

Facility

$390.00

Hospital Charge Code	270651763
Hospital Revenue Code	272
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$78.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$78.00
Rate for Payer: UnitedHealthcare Community & State	$9.40
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CATH VASCEL PASV 5FR DUAL PICC

Facility

$1,025.00

Hospital Charge Code	270638411
Hospital Revenue Code	278
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$389.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$225.50
Rate for Payer: Qualcare PPO/HMO/WC	$153.75
Rate for Payer: UnitedHealthcare Community & State	$24.70
Rate for Payer: Wellpoint Medicaid Managed Care	$27.16

CATH VASCEL PASV 5FR DUAL PICC

Facility

$1,025.00

Hospital Charge Code	270638411
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$225.50
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

CATH VASCEL PASV 5FR SNGL PICC

Facility

$800.00

Hospital Charge Code	270638410
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

Know your out-of-pocket cost for care.

All Charges