Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH VASCEL PASV 5FR SNGL PICC

Facility

$800.00

Hospital Charge Code	270638410
Hospital Revenue Code	278
Min. Negotiated Rate	$19.28
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
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
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$21.20

CATH VASCULR NONSELECT SVC IVC

Facility

$331.55

Service Code	HCPCS 36010
Hospital Charge Code	5100190
Hospital Revenue Code	361
Min. Negotiated Rate	$7.99
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$125.99
Rate for Payer: Aetna Medicare Advantage	$99.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.55
Rate for Payer: Cigna Commercial	$165.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.47
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.73
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$7.99

CATH VASCULR NONSELECT SVC IVC

Facility

$331.55

Service Code	HCPCS 36010
Hospital Charge Code	5100190
Hospital Revenue Code	361
Min. Negotiated Rate	$49.73
Max. Negotiated Rate	$49.73
Rate for Payer: Qualcare PPO/HMO/WC	$49.73

CATH VAXCEL PASV 6F 45213

Facility

$1,800.00

Hospital Charge Code	270632597
Hospital Revenue Code	278
Min. Negotiated Rate	$43.38
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$684.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Community & State	$43.38
Rate for Payer: Wellpoint Medicaid Managed Care	$47.70

CATH VAXCEL PASV 6F 45213

Facility

$1,800.00

Hospital Charge Code	270632597
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$435.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

CATH VAXCEL PASV 6F 45213

Facility

$1,800.00

Hospital Charge Code	270632597V
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$435.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

CATH VAXCEL PASV 6F 45213

Facility

$1,800.00

Hospital Charge Code	270632597V
Hospital Revenue Code	278
Min. Negotiated Rate	$43.38
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$684.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Community & State	$43.38
Rate for Payer: Wellpoint Medicaid Managed Care	$47.70

CATH VAXEL DIALYSIS 19cm 45511

Facility

$1,800.00

Hospital Charge Code	270628311V
Hospital Revenue Code	278
Min. Negotiated Rate	$43.38
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$684.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Community & State	$43.38
Rate for Payer: Wellpoint Medicaid Managed Care	$47.70

CATH VAXEL DIALYSIS 19cm 45511

Facility

$1,800.00

Hospital Charge Code	270628311V
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$435.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

CATH VAXEL DIALYSIS 19cm 45511

Facility

$1,785.65

Hospital Charge Code	270628311
Hospital Revenue Code	278
Min. Negotiated Rate	$43.03
Max. Negotiated Rate	$892.83
Rate for Payer: Aetna Commercial	$678.55
Rate for Payer: Aetna Medicare Advantage	$535.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$455.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$455.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$357.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$455.34
Rate for Payer: Cigna Commercial	$892.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$432.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$392.84
Rate for Payer: Qualcare PPO/HMO/WC	$267.85
Rate for Payer: UnitedHealthcare Community & State	$43.03
Rate for Payer: Wellpoint Medicaid Managed Care	$47.32

CATH VAXEL DIALYSIS 19cm 45511

Facility

$1,785.65

Hospital Charge Code	270628311
Hospital Revenue Code	278
Min. Negotiated Rate	$267.85
Max. Negotiated Rate	$432.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$357.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$432.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$392.84
Rate for Payer: Qualcare PPO/HMO/WC	$267.85

CATH VAXEL DIALYSIS 23cm 45521

Facility

$1,800.00

Hospital Charge Code	270628312V
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$435.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

CATH VAXEL DIALYSIS 23cm 45521

Facility

$1,800.00

Hospital Charge Code	270628312V
Hospital Revenue Code	278
Min. Negotiated Rate	$43.38
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$684.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Community & State	$43.38
Rate for Payer: Wellpoint Medicaid Managed Care	$47.70

CATH VAXEL DIALYSIS 23cm 45521

Facility

$1,785.65

Hospital Charge Code	270628312
Hospital Revenue Code	278
Min. Negotiated Rate	$43.03
Max. Negotiated Rate	$892.83
Rate for Payer: Aetna Commercial	$678.55
Rate for Payer: Aetna Medicare Advantage	$535.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$455.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$455.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$357.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$455.34
Rate for Payer: Cigna Commercial	$892.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$432.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$392.84
Rate for Payer: Qualcare PPO/HMO/WC	$267.85
Rate for Payer: UnitedHealthcare Community & State	$43.03
Rate for Payer: Wellpoint Medicaid Managed Care	$47.32

CATH VAXEL DIALYSIS 23cm 45521

Facility

$1,785.65

Hospital Charge Code	270628312
Hospital Revenue Code	278
Min. Negotiated Rate	$267.85
Max. Negotiated Rate	$432.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$357.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$432.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$392.84
Rate for Payer: Qualcare PPO/HMO/WC	$267.85

CATH VAXEL DIALYSIS 28cm 45531

Facility

$1,800.00

Hospital Charge Code	270628313V
Hospital Revenue Code	278
Min. Negotiated Rate	$43.38
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$684.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Community & State	$43.38
Rate for Payer: Wellpoint Medicaid Managed Care	$47.70

CATH VAXEL DIALYSIS 28cm 45531

Facility

$1,800.00

Hospital Charge Code	270628313V
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$435.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

CATH VAXEL DIALYSIS 28cm 45531

Facility

$1,785.65

Hospital Charge Code	270628313
Hospital Revenue Code	278
Min. Negotiated Rate	$43.03
Max. Negotiated Rate	$892.83
Rate for Payer: Aetna Commercial	$678.55
Rate for Payer: Aetna Medicare Advantage	$535.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$455.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$455.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$357.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$455.34
Rate for Payer: Cigna Commercial	$892.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$432.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$392.84
Rate for Payer: Qualcare PPO/HMO/WC	$267.85
Rate for Payer: UnitedHealthcare Community & State	$43.03
Rate for Payer: Wellpoint Medicaid Managed Care	$47.32

CATH VAXEL DIALYSIS 28cm 45531

Facility

$1,785.65

Hospital Charge Code	270628313
Hospital Revenue Code	278
Min. Negotiated Rate	$267.85
Max. Negotiated Rate	$432.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$357.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$432.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$392.84
Rate for Payer: Qualcare PPO/HMO/WC	$267.85

CATH VAXL PICC 5x130 CLP 45432

Facility

$64.70

Hospital Charge Code	270623513
Hospital Revenue Code	278
Min. Negotiated Rate	$9.71
Max. Negotiated Rate	$15.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.23
Rate for Payer: Qualcare PPO/HMO/WC	$9.71

CATH VAXL PICC 5x130 CLP 45432

Facility

$64.70

Hospital Charge Code	270623513
Hospital Revenue Code	278
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$32.35
Rate for Payer: Aetna Commercial	$24.59
Rate for Payer: Aetna Medicare Advantage	$19.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.50
Rate for Payer: Cigna Commercial	$32.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.23
Rate for Payer: Qualcare PPO/HMO/WC	$9.71
Rate for Payer: UnitedHealthcare Community & State	$1.56
Rate for Payer: Wellpoint Medicaid Managed Care	$1.71

CATH VAX PICC 5F 130C CL 45432

Facility

$360.00

Hospital Charge Code	270623512V
Hospital Revenue Code	278
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$87.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$79.20
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

CATH VAX PICC 5F 130C CL 45432

Facility

$360.00

Hospital Charge Code	270623512V
Hospital Revenue Code	278
Min. Negotiated Rate	$8.68
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$136.80
Rate for Payer: Aetna Medicare Advantage	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.80
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$79.20
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Community & State	$8.68
Rate for Payer: Wellpoint Medicaid Managed Care	$9.54

CATH VAX PICC 5F 130C CL 45432

Facility

$360.00

Hospital Charge Code	270623512
Hospital Revenue Code	278
Min. Negotiated Rate	$8.68
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$136.80
Rate for Payer: Aetna Medicare Advantage	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.80
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$79.20
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Community & State	$8.68
Rate for Payer: Wellpoint Medicaid Managed Care	$9.54

CATH VAX PICC 5F 130C CL 45432

Facility

$360.00

Hospital Charge Code	270623512
Hospital Revenue Code	278
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$87.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$79.20
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

Know your out-of-pocket cost for care.

All Charges