Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DILATOR VESSEL 7FR .038 20cm

Facility

$36.70

Service Code	HCPCS C1725
Hospital Charge Code	270605470
Hospital Revenue Code	278
Min. Negotiated Rate	$5.50
Max. Negotiated Rate	$8.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$5.50

DILATOR VESSEL 7FR .038 20CM

Facility

$45.45

Service Code	HCPCS C1725
Hospital Charge Code	270605470S
Hospital Revenue Code	278
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$11.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.82

DILATOR VESSEL 7FR .038 20CM

Facility

$45.45

Service Code	HCPCS C1725
Hospital Charge Code	270605470S
Hospital Revenue Code	278
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$22.73
Rate for Payer: Aetna Commercial	$17.27
Rate for Payer: Aetna Medicare Advantage	$13.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.59
Rate for Payer: Cigna Commercial	$22.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.82
Rate for Payer: UnitedHealthcare Community & State	$1.10
Rate for Payer: Wellpoint Medicaid Managed Care	$1.20

DILATOR VESSEL 8FR .038 20cm

Facility

$36.70

Service Code	HCPCS C1725
Hospital Charge Code	270624074S
Hospital Revenue Code	278
Min. Negotiated Rate	$5.50
Max. Negotiated Rate	$8.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$5.50

DILATOR VESSEL 8FR .038 20cm

Facility

$36.70

Service Code	HCPCS C1725
Hospital Charge Code	270624074S
Hospital Revenue Code	278
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$18.35
Rate for Payer: Aetna Commercial	$13.95
Rate for Payer: Aetna Medicare Advantage	$11.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.36
Rate for Payer: Cigna Commercial	$18.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$5.50
Rate for Payer: UnitedHealthcare Community & State	$0.88
Rate for Payer: Wellpoint Medicaid Managed Care	$0.97

DILATOR VESSEL 8FR .038 20cm

Facility

$42.45

Hospital Charge Code	270624074
Hospital Revenue Code	278
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$21.23
Rate for Payer: Aetna Commercial	$16.13
Rate for Payer: Aetna Medicare Advantage	$12.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.82
Rate for Payer: Cigna Commercial	$21.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.34
Rate for Payer: Qualcare PPO/HMO/WC	$6.37
Rate for Payer: UnitedHealthcare Community & State	$1.02
Rate for Payer: Wellpoint Medicaid Managed Care	$1.12

DILATOR VESSEL 8FR .038 20cm

Facility

$42.45

Hospital Charge Code	270624074
Hospital Revenue Code	278
Min. Negotiated Rate	$6.37
Max. Negotiated Rate	$10.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.34
Rate for Payer: Qualcare PPO/HMO/WC	$6.37

DILATOR VESSEL 8FR.038 20CM

Facility

$45.45

Service Code	HCPCS C1725
Hospital Charge Code	270624074N
Hospital Revenue Code	278
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$11.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.82

DILATOR VESSEL 8FR.038 20CM

Facility

$45.45

Service Code	HCPCS C1725
Hospital Charge Code	270624074N
Hospital Revenue Code	278
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$22.73
Rate for Payer: Aetna Commercial	$17.27
Rate for Payer: Aetna Medicare Advantage	$13.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.59
Rate for Payer: Cigna Commercial	$22.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.82
Rate for Payer: UnitedHealthcare Community & State	$1.10
Rate for Payer: Wellpoint Medicaid Managed Care	$1.20

DILATOR VESSEL 8FR.038 20CM

Facility

$36.70

Hospital Charge Code	270624074C
Hospital Revenue Code	272
Min. Negotiated Rate	$5.50
Max. Negotiated Rate	$5.50
Rate for Payer: Qualcare PPO/HMO/WC	$5.50

DILATOR VESSEL 8FR.038 20CM

Facility

$36.70

Hospital Charge Code	270624074C
Hospital Revenue Code	272
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$18.35
Rate for Payer: Aetna Commercial	$13.95
Rate for Payer: Aetna Medicare Advantage	$11.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.36
Rate for Payer: Cigna Commercial	$18.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.01
Rate for Payer: Oxford Commercial	$7.34
Rate for Payer: Qualcare PPO/HMO/WC	$5.50
Rate for Payer: UnitedHealthcare Commercial	$7.34
Rate for Payer: UnitedHealthcare Community & State	$0.88
Rate for Payer: Wellpoint Medicaid Managed Care	$0.97

DILATOR VESSEL 9FR .038 20cm

Facility

$36.70

Service Code	HCPCS C1725
Hospital Charge Code	270601482
Hospital Revenue Code	278
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$18.35
Rate for Payer: Aetna Commercial	$13.95
Rate for Payer: Aetna Medicare Advantage	$11.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.36
Rate for Payer: Cigna Commercial	$18.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$5.50
Rate for Payer: UnitedHealthcare Community & State	$0.88
Rate for Payer: Wellpoint Medicaid Managed Care	$0.97

DILATOR VESSEL 9FR .038 20cm

Facility

$36.70

Service Code	HCPCS C1725
Hospital Charge Code	270601482
Hospital Revenue Code	278
Min. Negotiated Rate	$5.50
Max. Negotiated Rate	$8.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$5.50

DILATORVESSELHYDROCOATED JCD

Facility

$55.25

Hospital Charge Code	2709006349
Hospital Revenue Code	272
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$27.62
Rate for Payer: Aetna Commercial	$21.00
Rate for Payer: Aetna Medicare Advantage	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.09
Rate for Payer: Cigna Commercial	$27.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.57
Rate for Payer: Oxford Commercial	$11.05
Rate for Payer: Qualcare PPO/HMO/WC	$8.29
Rate for Payer: UnitedHealthcare Commercial	$11.05
Rate for Payer: UnitedHealthcare Community & State	$1.33
Rate for Payer: Wellpoint Medicaid Managed Care	$1.46

DILATORVESSELHYDROCOATED JCD

Facility

$55.25

Hospital Charge Code	2709006349
Hospital Revenue Code	272
Min. Negotiated Rate	$8.29
Max. Negotiated Rate	$8.29
Rate for Payer: Qualcare PPO/HMO/WC	$8.29

DILATOR VESSEL HYDROPHILIC

Facility

$154.60

Hospital Charge Code	270654375
Hospital Revenue Code	272
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$77.30
Rate for Payer: Aetna Commercial	$58.75
Rate for Payer: Aetna Medicare Advantage	$46.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.42
Rate for Payer: Cigna Commercial	$77.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.38
Rate for Payer: Oxford Commercial	$30.92
Rate for Payer: Qualcare PPO/HMO/WC	$23.19
Rate for Payer: UnitedHealthcare Commercial	$30.92
Rate for Payer: UnitedHealthcare Community & State	$3.73
Rate for Payer: Wellpoint Medicaid Managed Care	$4.10

DILATOR VESSEL HYDROPHILIC

Facility

$154.60

Hospital Charge Code	270654375
Hospital Revenue Code	272
Min. Negotiated Rate	$23.19
Max. Negotiated Rate	$23.19
Rate for Payer: Qualcare PPO/HMO/WC	$23.19

DILATOR VESSEL HYDROPHILIC COA

Facility

$55.60

Hospital Charge Code	270658317
Hospital Revenue Code	278
Min. Negotiated Rate	$1.34
Max. Negotiated Rate	$27.80
Rate for Payer: Aetna Commercial	$21.13
Rate for Payer: Aetna Medicare Advantage	$16.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.18
Rate for Payer: Cigna Commercial	$27.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.23
Rate for Payer: Qualcare PPO/HMO/WC	$8.34
Rate for Payer: UnitedHealthcare Community & State	$1.34
Rate for Payer: Wellpoint Medicaid Managed Care	$1.47

DILATOR VESSEL HYDROPHILIC COA

Facility

$55.60

Hospital Charge Code	270658317
Hospital Revenue Code	278
Min. Negotiated Rate	$8.34
Max. Negotiated Rate	$13.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.23
Rate for Payer: Qualcare PPO/HMO/WC	$8.34

DILATOR VESSEL JCD10.0-38-20

Facility

$33.80

Hospital Charge Code	2706000418
Hospital Revenue Code	272
Min. Negotiated Rate	$5.07
Max. Negotiated Rate	$5.07
Rate for Payer: Qualcare PPO/HMO/WC	$5.07

DILATOR VESSEL JCD10.0-38-20

Facility

$33.80

Hospital Charge Code	2706000418
Hospital Revenue Code	272
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$16.90
Rate for Payer: Aetna Commercial	$12.84
Rate for Payer: Aetna Medicare Advantage	$10.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.62
Rate for Payer: Cigna Commercial	$16.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.14
Rate for Payer: Oxford Commercial	$6.76
Rate for Payer: Qualcare PPO/HMO/WC	$5.07
Rate for Payer: UnitedHealthcare Commercial	$6.76
Rate for Payer: UnitedHealthcare Community & State	$0.81
Rate for Payer: Wellpoint Medicaid Managed Care	$0.90

DILATOR VESSEL JCD12.0-38-20

Facility

$33.80

Hospital Charge Code	2706000432
Hospital Revenue Code	272
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$16.90
Rate for Payer: Aetna Commercial	$12.84
Rate for Payer: Aetna Medicare Advantage	$10.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.62
Rate for Payer: Cigna Commercial	$16.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.14
Rate for Payer: Oxford Commercial	$6.76
Rate for Payer: Qualcare PPO/HMO/WC	$5.07
Rate for Payer: UnitedHealthcare Commercial	$6.76
Rate for Payer: UnitedHealthcare Community & State	$0.81
Rate for Payer: Wellpoint Medicaid Managed Care	$0.90

DILATOR VESSEL JCD12.0-38-20

Facility

$33.80

Hospital Charge Code	2706000432
Hospital Revenue Code	272
Min. Negotiated Rate	$5.07
Max. Negotiated Rate	$5.07
Rate for Payer: Qualcare PPO/HMO/WC	$5.07

DILATOR VESSEL JCD14.0-38-20

Facility

$36.15

Hospital Charge Code	2706000421
Hospital Revenue Code	272
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$5.42
Rate for Payer: Qualcare PPO/HMO/WC	$5.42

DILATOR VESSEL JCD14.0-38-20

Facility

$36.15

Hospital Charge Code	2706000421
Hospital Revenue Code	272
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$18.07
Rate for Payer: Aetna Commercial	$13.74
Rate for Payer: Aetna Medicare Advantage	$10.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.22
Rate for Payer: Cigna Commercial	$18.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.85
Rate for Payer: Oxford Commercial	$7.23
Rate for Payer: Qualcare PPO/HMO/WC	$5.42
Rate for Payer: UnitedHealthcare Commercial	$7.23
Rate for Payer: UnitedHealthcare Community & State	$0.87
Rate for Payer: Wellpoint Medicaid Managed Care	$0.96

Know your out-of-pocket cost for care.

All Charges