Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GLIDECATH 4FR-65CM STRAIGHT

Facility

$357.50

Hospital Charge Code	2709004130
Hospital Revenue Code	272
Min. Negotiated Rate	$53.62
Max. Negotiated Rate	$53.62
Rate for Payer: Qualcare PPO/HMO/WC	$53.62

GLIDECATH 4FR - C2 65 CM

Facility

$357.50

Hospital Charge Code	270CH0085
Hospital Revenue Code	272
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$178.75
Rate for Payer: Aetna Commercial	$135.85
Rate for Payer: Aetna Medicare Advantage	$107.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.16
Rate for Payer: Cigna Commercial	$178.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.25
Rate for Payer: Oxford Commercial	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$53.62
Rate for Payer: UnitedHealthcare Commercial	$71.50
Rate for Payer: UnitedHealthcare Community & State	$8.62
Rate for Payer: Wellpoint Medicaid Managed Care	$9.47

GLIDECATH 4FR - C2 65 CM

Facility

$357.50

Hospital Charge Code	270CH0085
Hospital Revenue Code	272
Min. Negotiated Rate	$53.62
Max. Negotiated Rate	$53.62
Rate for Payer: Qualcare PPO/HMO/WC	$53.62

GLIDECATH 4FR -C2 65 CM

Facility

$357.50

Hospital Charge Code	2709003411
Hospital Revenue Code	272
Min. Negotiated Rate	$53.62
Max. Negotiated Rate	$53.62
Rate for Payer: Qualcare PPO/HMO/WC	$53.62

GLIDECATH 4FR -C2 65 CM

Facility

$357.50

Hospital Charge Code	2709003411
Hospital Revenue Code	272
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$178.75
Rate for Payer: Aetna Commercial	$135.85
Rate for Payer: Aetna Medicare Advantage	$107.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.16
Rate for Payer: Cigna Commercial	$178.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.25
Rate for Payer: Oxford Commercial	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$53.62
Rate for Payer: UnitedHealthcare Commercial	$71.50
Rate for Payer: UnitedHealthcare Community & State	$8.62
Rate for Payer: Wellpoint Medicaid Managed Care	$9.47

Glidecath 5fr 100cm

Facility

$276.00

Service Code	HCPCS C1887
Hospital Charge Code	207658285S
Hospital Revenue Code	278
Min. Negotiated Rate	$41.40
Max. Negotiated Rate	$66.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.72
Rate for Payer: Qualcare PPO/HMO/WC	$41.40

Glidecath 5fr 100cm

Facility

$276.00

Service Code	HCPCS C1887
Hospital Charge Code	270658285N
Hospital Revenue Code	278
Min. Negotiated Rate	$6.65
Max. Negotiated Rate	$138.00
Rate for Payer: Aetna Commercial	$104.88
Rate for Payer: Aetna Medicare Advantage	$82.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.38
Rate for Payer: Cigna Commercial	$138.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.72
Rate for Payer: Qualcare PPO/HMO/WC	$41.40
Rate for Payer: UnitedHealthcare Community & State	$6.65
Rate for Payer: Wellpoint Medicaid Managed Care	$7.31

Glidecath 5fr 100cm

Facility

$276.00

Service Code	HCPCS C1887
Hospital Charge Code	270658285N
Hospital Revenue Code	278
Min. Negotiated Rate	$41.40
Max. Negotiated Rate	$66.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.72
Rate for Payer: Qualcare PPO/HMO/WC	$41.40

Glidecath 5fr 100cm

Facility

$276.00

Service Code	HCPCS C1887
Hospital Charge Code	207658285S
Hospital Revenue Code	278
Min. Negotiated Rate	$6.65
Max. Negotiated Rate	$138.00
Rate for Payer: Aetna Commercial	$104.88
Rate for Payer: Aetna Medicare Advantage	$82.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.38
Rate for Payer: Cigna Commercial	$138.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.72
Rate for Payer: Qualcare PPO/HMO/WC	$41.40
Rate for Payer: UnitedHealthcare Community & State	$6.65
Rate for Payer: Wellpoint Medicaid Managed Care	$7.31

GLIDECATH 5FR - 100 CM ANGLE

Facility

$357.50

Hospital Charge Code	270CH0093
Hospital Revenue Code	272
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$178.75
Rate for Payer: Aetna Commercial	$135.85
Rate for Payer: Aetna Medicare Advantage	$107.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.16
Rate for Payer: Cigna Commercial	$178.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.25
Rate for Payer: Oxford Commercial	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$53.62
Rate for Payer: UnitedHealthcare Commercial	$71.50
Rate for Payer: UnitedHealthcare Community & State	$8.62
Rate for Payer: Wellpoint Medicaid Managed Care	$9.47

GLIDECATH 5FR - 100 CM ANGLE

Facility

$357.50

Hospital Charge Code	270CH0093
Hospital Revenue Code	272
Min. Negotiated Rate	$53.62
Max. Negotiated Rate	$53.62
Rate for Payer: Qualcare PPO/HMO/WC	$53.62

GLIDECATH 5FR-100CM ANGLE

Facility

$357.50

Hospital Charge Code	2709004152
Hospital Revenue Code	272
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$178.75
Rate for Payer: Aetna Commercial	$135.85
Rate for Payer: Aetna Medicare Advantage	$107.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.16
Rate for Payer: Cigna Commercial	$178.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.25
Rate for Payer: Oxford Commercial	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$53.62
Rate for Payer: UnitedHealthcare Commercial	$71.50
Rate for Payer: UnitedHealthcare Community & State	$8.62
Rate for Payer: Wellpoint Medicaid Managed Care	$9.47

GLIDECATH 5FR-100CM ANGLE

Facility

$357.50

Hospital Charge Code	2709004152
Hospital Revenue Code	272
Min. Negotiated Rate	$53.62
Max. Negotiated Rate	$53.62
Rate for Payer: Qualcare PPO/HMO/WC	$53.62

GLIDECATH 5FR - 100 CM C2

Facility

$357.50

Service Code	HCPCS C1887
Hospital Charge Code	270659860
Hospital Revenue Code	278
Min. Negotiated Rate	$53.62
Max. Negotiated Rate	$86.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$78.65
Rate for Payer: Qualcare PPO/HMO/WC	$53.62

GLIDECATH 5FR - 100 CM C2

Facility

$357.50

Service Code	HCPCS C1887
Hospital Charge Code	270659860
Hospital Revenue Code	278
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$178.75
Rate for Payer: Aetna Commercial	$135.85
Rate for Payer: Aetna Medicare Advantage	$107.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.16
Rate for Payer: Cigna Commercial	$178.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$78.65
Rate for Payer: Qualcare PPO/HMO/WC	$53.62
Rate for Payer: UnitedHealthcare Community & State	$8.62
Rate for Payer: Wellpoint Medicaid Managed Care	$9.47

GLIDECATH 5FR - 100 CM C2

Facility

$357.50

Hospital Charge Code	270CH0094
Hospital Revenue Code	272
Min. Negotiated Rate	$53.62
Max. Negotiated Rate	$53.62
Rate for Payer: Qualcare PPO/HMO/WC	$53.62

GLIDECATH 5FR - 100 CM C2

Facility

$357.50

Hospital Charge Code	270CH0094
Hospital Revenue Code	272
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$178.75
Rate for Payer: Aetna Commercial	$135.85
Rate for Payer: Aetna Medicare Advantage	$107.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.16
Rate for Payer: Cigna Commercial	$178.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.25
Rate for Payer: Oxford Commercial	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$53.62
Rate for Payer: UnitedHealthcare Commercial	$71.50
Rate for Payer: UnitedHealthcare Community & State	$8.62
Rate for Payer: Wellpoint Medicaid Managed Care	$9.47

GLIDECATH 5FR-100CM C2

Facility

$357.50

Hospital Charge Code	2709004153
Hospital Revenue Code	272
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$178.75
Rate for Payer: Aetna Commercial	$135.85
Rate for Payer: Aetna Medicare Advantage	$107.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.16
Rate for Payer: Cigna Commercial	$178.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.25
Rate for Payer: Oxford Commercial	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$53.62
Rate for Payer: UnitedHealthcare Commercial	$71.50
Rate for Payer: UnitedHealthcare Community & State	$8.62
Rate for Payer: Wellpoint Medicaid Managed Care	$9.47

GLIDECATH 5FR-100CM C2

Facility

$357.50

Hospital Charge Code	2709004153
Hospital Revenue Code	272
Min. Negotiated Rate	$53.62
Max. Negotiated Rate	$53.62
Rate for Payer: Qualcare PPO/HMO/WC	$53.62

GLIDECATH 5FR - 100 CM H1

Facility

$357.50

Hospital Charge Code	270CH0098
Hospital Revenue Code	272
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$178.75
Rate for Payer: Aetna Commercial	$135.85
Rate for Payer: Aetna Medicare Advantage	$107.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.16
Rate for Payer: Cigna Commercial	$178.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.25
Rate for Payer: Oxford Commercial	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$53.62
Rate for Payer: UnitedHealthcare Commercial	$71.50
Rate for Payer: UnitedHealthcare Community & State	$8.62
Rate for Payer: Wellpoint Medicaid Managed Care	$9.47

GLIDECATH 5FR - 100 CM H1

Facility

$357.50

Hospital Charge Code	270CH0098
Hospital Revenue Code	272
Min. Negotiated Rate	$53.62
Max. Negotiated Rate	$53.62
Rate for Payer: Qualcare PPO/HMO/WC	$53.62

GLIDECATH 5FR-100CM H1

Facility

$357.50

Hospital Charge Code	2709004157
Hospital Revenue Code	272
Min. Negotiated Rate	$53.62
Max. Negotiated Rate	$53.62
Rate for Payer: Qualcare PPO/HMO/WC	$53.62

GLIDECATH 5FR-100CM H1

Facility

$357.50

Hospital Charge Code	2709004157
Hospital Revenue Code	272
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$178.75
Rate for Payer: Aetna Commercial	$135.85
Rate for Payer: Aetna Medicare Advantage	$107.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.16
Rate for Payer: Cigna Commercial	$178.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.25
Rate for Payer: Oxford Commercial	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$53.62
Rate for Payer: UnitedHealthcare Commercial	$71.50
Rate for Payer: UnitedHealthcare Community & State	$8.62
Rate for Payer: Wellpoint Medicaid Managed Care	$9.47

GLIDECATH 5FR - 100 CM SIM 1

Facility

$357.00

Hospital Charge Code	270CH0095
Hospital Revenue Code	272
Min. Negotiated Rate	$53.55
Max. Negotiated Rate	$53.55
Rate for Payer: Qualcare PPO/HMO/WC	$53.55

GLIDECATH 5FR - 100 CM SIM 1

Facility

$357.00

Hospital Charge Code	270CH0095
Hospital Revenue Code	272
Min. Negotiated Rate	$8.60
Max. Negotiated Rate	$178.50
Rate for Payer: Aetna Commercial	$135.66
Rate for Payer: Aetna Medicare Advantage	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.03
Rate for Payer: Cigna Commercial	$178.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.10
Rate for Payer: Oxford Commercial	$71.40
Rate for Payer: Qualcare PPO/HMO/WC	$53.55
Rate for Payer: UnitedHealthcare Commercial	$71.40
Rate for Payer: UnitedHealthcare Community & State	$8.60
Rate for Payer: Wellpoint Medicaid Managed Care	$9.46

Know your out-of-pocket cost for care.

All Charges