Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ANGIOSEAL VIP 8FR 610131

Facility

$1,150.00

Service Code	HCPCS C1760
Hospital Charge Code	270637741S
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$278.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$253.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

ANGIOSEAL VIP 8FR 610131

Facility

$1,150.00

Service Code	HCPCS C1760
Hospital Charge Code	270637741N
Hospital Revenue Code	278
Min. Negotiated Rate	$27.71
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$437.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$253.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Community & State	$27.71
Rate for Payer: Wellpoint Medicaid Managed Care	$30.48

ANGIOSEAL VIP 8FR 610131

Facility

$1,150.00

Service Code	HCPCS C1760
Hospital Charge Code	270637741N
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$278.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$253.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

ANGIOSEAL VIP 8FR 610131

Facility

$12,000.00

Hospital Charge Code	270637741
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 8FR 610131

Facility

$1,150.00

Service Code	HCPCS C1760
Hospital Charge Code	270637741S
Hospital Revenue Code	278
Min. Negotiated Rate	$27.71
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$437.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$253.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Community & State	$27.71
Rate for Payer: Wellpoint Medicaid Managed Care	$30.48

ANGIO SELECT RENAL BI S&L

Facility

$7,240.05

Hospital Charge Code	74110001
Hospital Revenue Code	323
Min. Negotiated Rate	$1,086.01
Max. Negotiated Rate	$1,086.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01

ANGIO SELECT RENAL BI S&L

Facility

$7,240.05

Hospital Charge Code	74110001
Hospital Revenue Code	323
Min. Negotiated Rate	$174.49
Max. Negotiated Rate	$3,620.03
Rate for Payer: Aetna Commercial	$2,751.22
Rate for Payer: Aetna Medicare Advantage	$2,172.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,846.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,846.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,846.21
Rate for Payer: Cigna Commercial	$3,620.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,172.01
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$174.49
Rate for Payer: Wellpoint Medicaid Managed Care	$191.86

ANGIO SELECT RENAL BI S&L

Facility

$7,240.05

Hospital Charge Code	5100012
Hospital Revenue Code	323
Min. Negotiated Rate	$174.49
Max. Negotiated Rate	$3,620.03
Rate for Payer: Aetna Commercial	$2,751.22
Rate for Payer: Aetna Medicare Advantage	$2,172.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,846.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,846.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,846.21
Rate for Payer: Cigna Commercial	$3,620.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,172.01
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$174.49
Rate for Payer: Wellpoint Medicaid Managed Care	$191.86

ANGIO SELECT RENAL BI S&L

Facility

$7,240.05

Hospital Charge Code	5100012
Hospital Revenue Code	323
Min. Negotiated Rate	$1,086.01
Max. Negotiated Rate	$1,086.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01

ANGIO SELECT RENAL UNI S&I

Facility

$7,240.05

Hospital Charge Code	74110002
Hospital Revenue Code	323
Min. Negotiated Rate	$1,086.01
Max. Negotiated Rate	$1,086.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01

ANGIO SELECT RENAL UNI S&I

Facility

$13,436.40

Hospital Charge Code	5100013
Hospital Revenue Code	323
Min. Negotiated Rate	$323.82
Max. Negotiated Rate	$6,718.20
Rate for Payer: Aetna Commercial	$5,105.83
Rate for Payer: Aetna Medicare Advantage	$4,030.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,426.28
Rate for Payer: Cigna Commercial	$6,718.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,030.92
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$323.82
Rate for Payer: Wellpoint Medicaid Managed Care	$356.06

ANGIO SELECT RENAL UNI S&I

Facility

$13,436.40

Hospital Charge Code	5100013
Hospital Revenue Code	323
Min. Negotiated Rate	$2,015.46
Max. Negotiated Rate	$2,015.46
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46

ANGIO SELECT RENAL UNI S&I

Facility

$7,240.05

Hospital Charge Code	74110002
Hospital Revenue Code	323
Min. Negotiated Rate	$174.49
Max. Negotiated Rate	$3,620.03
Rate for Payer: Aetna Commercial	$2,751.22
Rate for Payer: Aetna Medicare Advantage	$2,172.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,846.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,846.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,846.21
Rate for Payer: Cigna Commercial	$3,620.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,172.01
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$174.49
Rate for Payer: Wellpoint Medicaid Managed Care	$191.86

ANGIO SELECT VISCERAL S&I

Facility

$1,351.70

Service Code	HCPCS 75726
Hospital Charge Code	5100344
Hospital Revenue Code	323
Min. Negotiated Rate	$32.58
Max. Negotiated Rate	$23,862.86
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,862.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,862.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,862.86
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$4,627.53
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$405.51
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$202.75
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$32.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellpoint Medicaid Managed Care	$35.82

ANGIO SELECT VISCERAL S&I

Facility

$1,351.70

Service Code	HCPCS 75726
Hospital Charge Code	5100344
Hospital Revenue Code	323
Min. Negotiated Rate	$202.75
Max. Negotiated Rate	$202.75
Rate for Payer: Qualcare PPO/HMO/WC	$202.75

ANGIO SET IV CATH SYSTEM-20X1

Facility

$8.95

Hospital Charge Code	270612019
Hospital Revenue Code	270
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.47
Rate for Payer: Aetna Commercial	$3.40
Rate for Payer: Aetna Medicare Advantage	$2.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.28
Rate for Payer: Cigna Commercial	$4.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.69
Rate for Payer: Oxford Commercial	$1.79
Rate for Payer: Qualcare PPO/HMO/WC	$1.34
Rate for Payer: UnitedHealthcare Commercial	$1.79
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

ANGIO SET IV CATH SYSTEM-20X1

Facility

$8.95

Hospital Charge Code	270612019
Hospital Revenue Code	270
Min. Negotiated Rate	$1.34
Max. Negotiated Rate	$1.34
Rate for Payer: Qualcare PPO/HMO/WC	$1.34

ANGIOTENSIN CONV ENZY,CSF

Facility

$390.00

Service Code	HCPCS 82164
Hospital Charge Code	39900326
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ANGIOTENSIN CONV ENZY,CSF

Facility

$390.00

Service Code	HCPCS 82164
Hospital Charge Code	39900326
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$39.71
Rate for Payer: Aetna Medicare Advantage	$47.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.70
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$14.60
Rate for Payer: Clover Medicare Advantage	$13.87
Rate for Payer: EmblemHealth Commercial	$43.80
Rate for Payer: Humana Medicare Advantage	$15.04
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.60
Rate for Payer: Wellcare Medicare Advantage	$14.60
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

ANGIOTENSIN CONVERTING EN

Facility

$390.00

Service Code	HCPCS 82164
Hospital Charge Code	39900043
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ANGIOTENSIN CONVERTING EN

Facility

$390.00

Service Code	HCPCS 82164
Hospital Charge Code	39900043
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$39.71
Rate for Payer: Aetna Medicare Advantage	$47.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.70
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$14.60
Rate for Payer: Clover Medicare Advantage	$13.87
Rate for Payer: EmblemHealth Commercial	$43.80
Rate for Payer: Humana Medicare Advantage	$15.04
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.60
Rate for Payer: Wellcare Medicare Advantage	$14.60
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

ANGIOTENSIN CONVERTING ENZYME

Facility

$181.65

Service Code	HCPCS 82164
Hospital Charge Code	3004074
Hospital Revenue Code	301
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

ANGIOTENSIN CONVERTING ENZYME

Facility

$509.00

Service Code	HCPCS 82164
Hospital Charge Code	38472113
Hospital Revenue Code	301
Min. Negotiated Rate	$11.68
Max. Negotiated Rate	$254.50
Rate for Payer: Aetna Commercial	$39.71
Rate for Payer: Aetna Medicare Advantage	$47.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.70
Rate for Payer: Cigna Commercial	$254.50
Rate for Payer: Cigna Medicare Advantage	$14.60
Rate for Payer: Clover Medicare Advantage	$13.87
Rate for Payer: EmblemHealth Commercial	$43.80
Rate for Payer: Humana Medicare Advantage	$15.04
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$76.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.60
Rate for Payer: Wellcare Medicare Advantage	$14.60
Rate for Payer: Wellpoint Medicaid Managed Care	$13.49

ANGIOTENSIN CONVERTING ENZYME

Facility

$509.00

Service Code	HCPCS 82164
Hospital Charge Code	38472113
Hospital Revenue Code	301
Min. Negotiated Rate	$76.35
Max. Negotiated Rate	$76.35
Rate for Payer: Qualcare PPO/HMO/WC	$76.35

ANGIOTENSIN CONVERTING ENZYME

Facility

$181.65

Service Code	HCPCS 82164
Hospital Charge Code	3004074
Hospital Revenue Code	301
Min. Negotiated Rate	$4.81
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$39.71
Rate for Payer: Aetna Medicare Advantage	$47.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.70
Rate for Payer: Cigna Commercial	$90.83
Rate for Payer: Cigna Medicare Advantage	$14.60
Rate for Payer: Clover Medicare Advantage	$13.87
Rate for Payer: EmblemHealth Commercial	$43.80
Rate for Payer: Humana Medicare Advantage	$15.04
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.60
Rate for Payer: Wellcare Medicare Advantage	$14.60
Rate for Payer: Wellpoint Medicaid Managed Care	$4.81

Know your out-of-pocket cost for care.

All Charges