Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DILATOR VESSEL JCD16.0-38-20

Facility

$36.15

Hospital Charge Code	270635379
Hospital Revenue Code	278
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) NJ Health	$7.23
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	$8.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7.95
Rate for Payer: Qualcare PPO/HMO/WC	$5.42
Rate for Payer: UnitedHealthcare Community & State	$0.87
Rate for Payer: Wellpoint Medicaid Managed Care	$0.96

DILATOR VESSEL JCD16.0-38-20

Facility

$33.80

Hospital Charge Code	2706000433
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 JCD16.0-38-20

Facility

$33.80

Hospital Charge Code	2706000433
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 JCD16.0-38-20

Facility

$36.15

Hospital Charge Code	270635379
Hospital Revenue Code	278
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7.95
Rate for Payer: Qualcare PPO/HMO/WC	$5.42

DILATOR VESSEL JCD 6.0-38-20

Facility

$33.80

Hospital Charge Code	2709006350
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 JCD 6.0-38-20

Facility

$33.80

Hospital Charge Code	2709006350
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 JCD7.0-38-20

Facility

$33.80

Hospital Charge Code	2706000420
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 JCD7.0-38-20

Facility

$33.80

Hospital Charge Code	2706000420
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 JCD8.0-38-20

Facility

$33.80

Hospital Charge Code	2706000419
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 JCD8.0-38-20

Facility

$33.80

Hospital Charge Code	2706000419
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 JCD9.0-38-20

Facility

$33.80

Hospital Charge Code	2706000435
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 JCD9.0-38-20

Facility

$33.80

Hospital Charge Code	2706000435
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 NCD4.0-35-20

Facility

$45.35

Hospital Charge Code	2706000429
Hospital Revenue Code	272
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$22.68
Rate for Payer: Aetna Commercial	$17.23
Rate for Payer: Aetna Medicare Advantage	$13.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.56
Rate for Payer: Cigna Commercial	$22.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.61
Rate for Payer: Oxford Commercial	$9.07
Rate for Payer: Qualcare PPO/HMO/WC	$6.80
Rate for Payer: UnitedHealthcare Commercial	$9.07
Rate for Payer: UnitedHealthcare Community & State	$1.09
Rate for Payer: Wellpoint Medicaid Managed Care	$1.20

DILATOR VESSEL NCD4.0-35-20

Facility

$45.35

Hospital Charge Code	2706000429
Hospital Revenue Code	272
Min. Negotiated Rate	$6.80
Max. Negotiated Rate	$6.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.80

DILATOR VESSEL NCD4.0-35-20

Facility

$62.45

Hospital Charge Code	270632174
Hospital Revenue Code	278
Min. Negotiated Rate	$9.37
Max. Negotiated Rate	$15.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13.74
Rate for Payer: Qualcare PPO/HMO/WC	$9.37

DILATOR VESSEL NCD4.0-35-20

Facility

$62.45

Hospital Charge Code	270632174
Hospital Revenue Code	278
Min. Negotiated Rate	$1.51
Max. Negotiated Rate	$31.23
Rate for Payer: Aetna Commercial	$23.73
Rate for Payer: Aetna Medicare Advantage	$18.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.92
Rate for Payer: Cigna Commercial	$31.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13.74
Rate for Payer: Qualcare PPO/HMO/WC	$9.37
Rate for Payer: UnitedHealthcare Community & State	$1.51
Rate for Payer: Wellpoint Medicaid Managed Care	$1.65

DILATOR W/CANN 11MM VS101011

Facility

$361.65

Hospital Charge Code	270624152
Hospital Revenue Code	272
Min. Negotiated Rate	$8.72
Max. Negotiated Rate	$180.82
Rate for Payer: Aetna Commercial	$137.43
Rate for Payer: Aetna Medicare Advantage	$108.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.22
Rate for Payer: Cigna Commercial	$180.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.50
Rate for Payer: Oxford Commercial	$72.33
Rate for Payer: Qualcare PPO/HMO/WC	$54.25
Rate for Payer: UnitedHealthcare Commercial	$72.33
Rate for Payer: UnitedHealthcare Community & State	$8.72
Rate for Payer: Wellpoint Medicaid Managed Care	$9.58

DILATOR W/CANN 11MM VS101011

Facility

$361.65

Hospital Charge Code	270624152
Hospital Revenue Code	272
Min. Negotiated Rate	$54.25
Max. Negotiated Rate	$54.25
Rate for Payer: Qualcare PPO/HMO/WC	$54.25

DILATOR WC BALLN 42 8CM QD14X8

Facility

$396.85

Hospital Charge Code	270623505
Hospital Revenue Code	272
Min. Negotiated Rate	$59.53
Max. Negotiated Rate	$59.53
Rate for Payer: Qualcare PPO/HMO/WC	$59.53

DILATOR WC BALLN 42 8CM QD14X8

Facility

$396.85

Hospital Charge Code	270623505
Hospital Revenue Code	272
Min. Negotiated Rate	$9.56
Max. Negotiated Rate	$198.43
Rate for Payer: Aetna Commercial	$150.80
Rate for Payer: Aetna Medicare Advantage	$119.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.20
Rate for Payer: Cigna Commercial	$198.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.06
Rate for Payer: Oxford Commercial	$79.37
Rate for Payer: Qualcare PPO/HMO/WC	$59.53
Rate for Payer: UnitedHealthcare Commercial	$79.37
Rate for Payer: UnitedHealthcare Community & State	$9.56
Rate for Payer: Wellpoint Medicaid Managed Care	$10.52

DILATOR WC BALLN 48 8CM QD16X8

Facility

$396.85

Hospital Charge Code	270623506
Hospital Revenue Code	272
Min. Negotiated Rate	$59.53
Max. Negotiated Rate	$59.53
Rate for Payer: Qualcare PPO/HMO/WC	$59.53

DILATOR WC BALLN 48 8CM QD16X8

Facility

$396.85

Hospital Charge Code	270623506
Hospital Revenue Code	272
Min. Negotiated Rate	$9.56
Max. Negotiated Rate	$198.43
Rate for Payer: Aetna Commercial	$150.80
Rate for Payer: Aetna Medicare Advantage	$119.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.20
Rate for Payer: Cigna Commercial	$198.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.06
Rate for Payer: Oxford Commercial	$79.37
Rate for Payer: Qualcare PPO/HMO/WC	$59.53
Rate for Payer: UnitedHealthcare Commercial	$79.37
Rate for Payer: UnitedHealthcare Community & State	$9.56
Rate for Payer: Wellpoint Medicaid Managed Care	$10.52

DILATOR WC BALLN 54 8CM QD18X8

Facility

$420.00

Hospital Charge Code	270623507
Hospital Revenue Code	272
Min. Negotiated Rate	$10.12
Max. Negotiated Rate	$210.00
Rate for Payer: Aetna Commercial	$159.60
Rate for Payer: Aetna Medicare Advantage	$126.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.10
Rate for Payer: Cigna Commercial	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.00
Rate for Payer: Oxford Commercial	$84.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.00
Rate for Payer: UnitedHealthcare Commercial	$84.00
Rate for Payer: UnitedHealthcare Community & State	$10.12
Rate for Payer: Wellpoint Medicaid Managed Care	$11.13

DILATOR WC BALLN 54 8CM QD18X8

Facility

$420.00

Hospital Charge Code	270623507
Hospital Revenue Code	272
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$63.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.00

DILATOR WC COL BALLN QDC16X5.5

Facility

$396.85

Hospital Charge Code	270623618
Hospital Revenue Code	272
Min. Negotiated Rate	$9.56
Max. Negotiated Rate	$198.43
Rate for Payer: Aetna Commercial	$150.80
Rate for Payer: Aetna Medicare Advantage	$119.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.20
Rate for Payer: Cigna Commercial	$198.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.06
Rate for Payer: Oxford Commercial	$79.37
Rate for Payer: Qualcare PPO/HMO/WC	$59.53
Rate for Payer: UnitedHealthcare Commercial	$79.37
Rate for Payer: UnitedHealthcare Community & State	$9.56
Rate for Payer: Wellpoint Medicaid Managed Care	$10.52

Know your out-of-pocket cost for care.

All Charges