Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GLIDECATH 5FR-100CM SIM 1

Facility

$357.00

Hospital Charge Code	2709004154
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

GLIDECATH 5FR-100CM SIM 1

Facility

$357.00

Hospital Charge Code	2709004154
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 2

Facility

$357.00

Hospital Charge Code	270CH0097
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

GLIDECATH 5FR - 100 CM SIM 2

Facility

$357.00

Hospital Charge Code	270CH0097
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-100CM SIM 2

Facility

$357.00

Hospital Charge Code	2709004156
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-100CM SIM 2

Facility

$357.00

Hospital Charge Code	2709004156
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

GLIDECATH 5FR - 100 CM SIM 3

Facility

$357.50

Hospital Charge Code	270CH0096
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 3

Facility

$357.50

Hospital Charge Code	270CH0096
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 SIM 3

Facility

$357.50

Hospital Charge Code	2709004155
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 SIM 3

Facility

$357.50

Hospital Charge Code	2709004155
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 STRAIGH

Facility

$357.50

Hospital Charge Code	270CH0092
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 STRAIGH

Facility

$253.25

Service Code	HCPCS C1887
Hospital Charge Code	270658285S
Hospital Revenue Code	278
Min. Negotiated Rate	$37.99
Max. Negotiated Rate	$61.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.72
Rate for Payer: Qualcare PPO/HMO/WC	$37.99

GLIDECATH 5FR - 100 CM STRAIGH

Facility

$253.25

Service Code	HCPCS C1887
Hospital Charge Code	270658285S
Hospital Revenue Code	278
Min. Negotiated Rate	$6.10
Max. Negotiated Rate	$126.62
Rate for Payer: Aetna Commercial	$96.23
Rate for Payer: Aetna Medicare Advantage	$75.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.58
Rate for Payer: Cigna Commercial	$126.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.72
Rate for Payer: Qualcare PPO/HMO/WC	$37.99
Rate for Payer: UnitedHealthcare Community & State	$6.10
Rate for Payer: Wellpoint Medicaid Managed Care	$6.71

GLIDECATH 5FR - 100 CM STRAIGH

Facility

$357.50

Hospital Charge Code	270CH0092
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 STRAIGH

Facility

$253.25

Service Code	HCPCS C1887
Hospital Charge Code	270658285
Hospital Revenue Code	278
Min. Negotiated Rate	$6.10
Max. Negotiated Rate	$126.62
Rate for Payer: Aetna Commercial	$96.23
Rate for Payer: Aetna Medicare Advantage	$75.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.58
Rate for Payer: Cigna Commercial	$126.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.72
Rate for Payer: Qualcare PPO/HMO/WC	$37.99
Rate for Payer: UnitedHealthcare Community & State	$6.10
Rate for Payer: Wellpoint Medicaid Managed Care	$6.71

GLIDECATH 5FR - 100 CM STRAIGH

Facility

$253.25

Service Code	HCPCS C1887
Hospital Charge Code	270658285
Hospital Revenue Code	278
Min. Negotiated Rate	$37.99
Max. Negotiated Rate	$61.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.72
Rate for Payer: Qualcare PPO/HMO/WC	$37.99

GLIDECATH 5FR-100 CM STRAIGHT

Facility

$357.50

Hospital Charge Code	2709004151
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 STRAIGHT

Facility

$357.50

Hospital Charge Code	2709004151
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 - 65 CM ANGLE

Facility

$357.50

Hospital Charge Code	270CH0089
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 - 65 CM ANGLE

Facility

$357.50

Hospital Charge Code	270CH0089
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-65CM ANGLE

Facility

$357.50

Hospital Charge Code	2709004147
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-65CM ANGLE

Facility

$357.50

Hospital Charge Code	2709004147
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 - 65 CM C1

Facility

$357.50

Hospital Charge Code	270CH0090
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 - 65 CM C1

Facility

$357.50

Hospital Charge Code	270CH0090
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-65CM C1

Facility

$357.50

Hospital Charge Code	2709004148
Hospital Revenue Code	272
Min. Negotiated Rate	$53.62
Max. Negotiated Rate	$53.62
Rate for Payer: Qualcare PPO/HMO/WC	$53.62

Know your out-of-pocket cost for care.

All Charges