Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ANGIOMAT ILLUMENA CONTRAST SYR

Facility

$32.29

Hospital Charge Code	270667071
Hospital Revenue Code	270
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$16.14
Rate for Payer: Aetna Commercial	$12.27
Rate for Payer: Aetna Medicare Advantage	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.23
Rate for Payer: Cigna Commercial	$16.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.69
Rate for Payer: Oxford Commercial	$6.46
Rate for Payer: Qualcare PPO/HMO/WC	$4.84
Rate for Payer: UnitedHealthcare Commercial	$6.46
Rate for Payer: UnitedHealthcare Community & State	$0.78
Rate for Payer: Wellpoint Medicaid Managed Care	$0.86

ANGIOMAT ILLUMENA CONTRAST SYR

Facility

$25.00

Hospital Charge Code	270667071N
Hospital Revenue Code	270
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

ANGIOMAT ILLUMENA CONTRAST SYR

Facility

$25.00

Hospital Charge Code	270667071N
Hospital Revenue Code	270
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$9.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.50
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$5.00
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

ANGIOMAT ILLUMENA CONTRAST SYR

Facility

$32.29

Hospital Charge Code	270667071S
Hospital Revenue Code	270
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$16.14
Rate for Payer: Aetna Commercial	$12.27
Rate for Payer: Aetna Medicare Advantage	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.23
Rate for Payer: Cigna Commercial	$16.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.69
Rate for Payer: Oxford Commercial	$6.46
Rate for Payer: Qualcare PPO/HMO/WC	$4.84
Rate for Payer: UnitedHealthcare Commercial	$6.46
Rate for Payer: UnitedHealthcare Community & State	$0.78
Rate for Payer: Wellpoint Medicaid Managed Care	$0.86

ANGIOMAT ILLUMENA CONTRAST SYR

Facility

$25.00

Hospital Charge Code	270667072
Hospital Revenue Code	270
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$9.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.50
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$5.00
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

ANGIOMAT ILLUMENA CONTRAST SYR

Facility

$32.29

Hospital Charge Code	270667071S
Hospital Revenue Code	270
Min. Negotiated Rate	$4.84
Max. Negotiated Rate	$4.84
Rate for Payer: Qualcare PPO/HMO/WC	$4.84

ANGIO PELVIC

Facility

$6,122.00

Hospital Charge Code	2009075
Hospital Revenue Code	323
Min. Negotiated Rate	$147.54
Max. Negotiated Rate	$3,061.00
Rate for Payer: Aetna Commercial	$2,326.36
Rate for Payer: Aetna Medicare Advantage	$1,836.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,561.11
Rate for Payer: Cigna Commercial	$3,061.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,836.60
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$918.30
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$147.54
Rate for Payer: Wellpoint Medicaid Managed Care	$162.23

ANGIO PELVIC

Facility

$6,122.00

Hospital Charge Code	2009075
Hospital Revenue Code	323
Min. Negotiated Rate	$918.30
Max. Negotiated Rate	$918.30
Rate for Payer: Qualcare PPO/HMO/WC	$918.30

ANGIOPLASTY WITH STENT

Facility

$15,539.00

Service Code	HCPCS 31635
Hospital Charge Code	1600000519
Hospital Revenue Code	360
Min. Negotiated Rate	$2,330.85
Max. Negotiated Rate	$2,330.85
Rate for Payer: Qualcare PPO/HMO/WC	$2,330.85

ANGIOPLASTY WITH STENT

Facility

$15,539.00

Service Code	HCPCS 31635
Hospital Charge Code	1600000519
Hospital Revenue Code	360
Min. Negotiated Rate	$374.49
Max. Negotiated Rate	$7,632.96
Rate for Payer: Aetna Commercial	$5,751.63
Rate for Payer: Aetna Medicare Advantage	$6,851.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,114.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,632.96
Rate for Payer: Cigna Commercial	$4,238.63
Rate for Payer: Cigna Medicare Advantage	$2,114.57
Rate for Payer: Clover Medicare Advantage	$2,008.84
Rate for Payer: EmblemHealth Commercial	$6,343.71
Rate for Payer: Humana Medicare Advantage	$2,178.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,114.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,661.70
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,330.85
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$374.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare Medicare Advantage	$2,114.57
Rate for Payer: Wellpoint Medicaid Managed Care	$411.78

ANGIO SEAL HEMOSTATS 8F 610097

Facility

$1,116.00

Hospital Charge Code	270623508
Hospital Revenue Code	278
Min. Negotiated Rate	$167.40
Max. Negotiated Rate	$270.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$223.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$245.52
Rate for Payer: Qualcare PPO/HMO/WC	$167.40

ANGIO SEAL HEMOSTATS 8F 610097

Facility

$1,116.00

Hospital Charge Code	270623508
Hospital Revenue Code	278
Min. Negotiated Rate	$26.90
Max. Negotiated Rate	$558.00
Rate for Payer: Aetna Commercial	$424.08
Rate for Payer: Aetna Medicare Advantage	$334.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$284.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$284.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$223.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$284.58
Rate for Payer: Cigna Commercial	$558.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$245.52
Rate for Payer: Qualcare PPO/HMO/WC	$167.40
Rate for Payer: UnitedHealthcare Community & State	$26.90
Rate for Payer: Wellpoint Medicaid Managed Care	$29.57

ANGIO SEAL KITS 6FR 610119

Facility

$1,205.00

Hospital Charge Code	2707500021
Hospital Revenue Code	272
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$180.75
Rate for Payer: Qualcare PPO/HMO/WC	$180.75

ANGIO SEAL KITS 6FR 610119

Facility

$1,205.00

Hospital Charge Code	2707500021
Hospital Revenue Code	272
Min. Negotiated Rate	$29.04
Max. Negotiated Rate	$602.50
Rate for Payer: Aetna Commercial	$457.90
Rate for Payer: Aetna Medicare Advantage	$361.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.27
Rate for Payer: Cigna Commercial	$602.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.50
Rate for Payer: Oxford Commercial	$241.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.75
Rate for Payer: UnitedHealthcare Commercial	$241.00
Rate for Payer: UnitedHealthcare Community & State	$29.04
Rate for Payer: Wellpoint Medicaid Managed Care	$31.93

ANGIO SEAL STS 6FR 610119

Facility

$1,450.00

Service Code	HCPCS C1760
Hospital Charge Code	270632654
Hospital Revenue Code	278
Min. Negotiated Rate	$34.95
Max. Negotiated Rate	$725.00
Rate for Payer: Aetna Commercial	$551.00
Rate for Payer: Aetna Medicare Advantage	$435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$369.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$369.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$369.75
Rate for Payer: Cigna Commercial	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$319.00
Rate for Payer: Qualcare PPO/HMO/WC	$217.50
Rate for Payer: UnitedHealthcare Community & State	$34.95
Rate for Payer: Wellpoint Medicaid Managed Care	$38.42

ANGIO SEAL STS 6FR 610119

Facility

$1,450.00

Service Code	HCPCS C1760
Hospital Charge Code	270632654
Hospital Revenue Code	278
Min. Negotiated Rate	$217.50
Max. Negotiated Rate	$350.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$319.00
Rate for Payer: Qualcare PPO/HMO/WC	$217.50

ANGIOSEAL VIP 6FR

Facility

$241.00

Service Code	HCPCS C1760
Hospital Charge Code	270637740N
Hospital Revenue Code	278
Min. Negotiated Rate	$5.81
Max. Negotiated Rate	$120.50
Rate for Payer: Aetna Commercial	$91.58
Rate for Payer: Aetna Medicare Advantage	$72.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.45
Rate for Payer: Cigna Commercial	$120.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.02
Rate for Payer: Qualcare PPO/HMO/WC	$36.15
Rate for Payer: UnitedHealthcare Community & State	$5.81
Rate for Payer: Wellpoint Medicaid Managed Care	$6.39

ANGIOSEAL VIP 6FR

Facility

$12,000.00

Hospital Charge Code	270637740
Hospital Revenue Code	278
Min. Negotiated Rate	$289.20
Max. Negotiated Rate	$6,000.00
Rate for Payer: Aetna Commercial	$4,560.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,640.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Community & State	$289.20
Rate for Payer: Wellpoint Medicaid Managed Care	$318.00

ANGIOSEAL VIP 6FR

Facility

$241.00

Service Code	HCPCS C1760
Hospital Charge Code	270637740N
Hospital Revenue Code	278
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$58.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.02
Rate for Payer: Qualcare PPO/HMO/WC	$36.15

ANGIOSEAL VIP 6FR

Facility

$12,000.00

Hospital Charge Code	270637740
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$2,904.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,640.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

ANGIOSEAL VIP 6FR

Facility

$995.00

Service Code	HCPCS C1760
Hospital Charge Code	270637740S
Hospital Revenue Code	278
Min. Negotiated Rate	$149.25
Max. Negotiated Rate	$240.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$218.90
Rate for Payer: Qualcare PPO/HMO/WC	$149.25

ANGIOSEAL VIP 6FR

Facility

$995.00

Service Code	HCPCS C1760
Hospital Charge Code	270637740S
Hospital Revenue Code	278
Min. Negotiated Rate	$23.98
Max. Negotiated Rate	$497.50
Rate for Payer: Aetna Commercial	$378.10
Rate for Payer: Aetna Medicare Advantage	$298.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.72
Rate for Payer: Cigna Commercial	$497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$218.90
Rate for Payer: Qualcare PPO/HMO/WC	$149.25
Rate for Payer: UnitedHealthcare Community & State	$23.98
Rate for Payer: Wellpoint Medicaid Managed Care	$26.37

ANGIOSEAL VIP 6FR 610130

Facility

$995.00

Service Code	HCPCS C1760
Hospital Charge Code	270637740C
Hospital Revenue Code	278
Min. Negotiated Rate	$23.98
Max. Negotiated Rate	$497.50
Rate for Payer: Aetna Commercial	$378.10
Rate for Payer: Aetna Medicare Advantage	$298.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.72
Rate for Payer: Cigna Commercial	$497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$218.90
Rate for Payer: Qualcare PPO/HMO/WC	$149.25
Rate for Payer: UnitedHealthcare Community & State	$23.98
Rate for Payer: Wellpoint Medicaid Managed Care	$26.37

ANGIOSEAL VIP 6FR 610130

Facility

$995.00

Service Code	HCPCS C1760
Hospital Charge Code	270637740C
Hospital Revenue Code	278
Min. Negotiated Rate	$149.25
Max. Negotiated Rate	$240.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$218.90
Rate for Payer: Qualcare PPO/HMO/WC	$149.25

ANGIOSEAL VIP 8FR 610131

Facility

$12,000.00

Hospital Charge Code	270637741
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$2,904.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,640.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

Know your out-of-pocket cost for care.

All Charges