Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR PLACE CATH IN VEIN RIGHT

Facility

$2,919.00

Service Code	HCPCS 36012RT
Hospital Charge Code	2600144
Hospital Revenue Code	361
Min. Negotiated Rate	$70.35
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$1,109.22
Rate for Payer: Aetna Medicare Advantage	$875.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$744.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$744.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$744.35
Rate for Payer: Cigna Commercial	$1,459.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$875.70
Rate for Payer: Qualcare PPO/HMO/WC	$437.85
Rate for Payer: UnitedHealthcare Community & State	$70.35
Rate for Payer: Wellpoint Medicaid Managed Care	$77.35

IR PLACE CATH IN VEIN RIGHT

Facility

$2,918.60

Service Code	HCPCS 36012RT
Hospital Charge Code	7411900
Hospital Revenue Code	361
Min. Negotiated Rate	$437.79
Max. Negotiated Rate	$437.79
Rate for Payer: Qualcare PPO/HMO/WC	$437.79

IR PLACE CATH IN VEIN RIGHT

Facility

$2,919.00

Service Code	HCPCS 36012RT
Hospital Charge Code	321036012R
Hospital Revenue Code	361
Min. Negotiated Rate	$437.85
Max. Negotiated Rate	$437.85
Rate for Payer: Qualcare PPO/HMO/WC	$437.85

IR PLACE CATH IN VEIN RIGHT

Facility

$2,919.00

Service Code	HCPCS 36012RT
Hospital Charge Code	2600144
Hospital Revenue Code	361
Min. Negotiated Rate	$437.85
Max. Negotiated Rate	$437.85
Rate for Payer: Qualcare PPO/HMO/WC	$437.85

IR PLACE CATH IN VEIN RIGHT

Facility

$2,918.60

Service Code	HCPCS 36012RT
Hospital Charge Code	7411900
Hospital Revenue Code	361
Min. Negotiated Rate	$70.34
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$1,109.07
Rate for Payer: Aetna Medicare Advantage	$875.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$744.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$744.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$744.24
Rate for Payer: Cigna Commercial	$1,459.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$875.58
Rate for Payer: Qualcare PPO/HMO/WC	$437.79
Rate for Payer: UnitedHealthcare Community & State	$70.34
Rate for Payer: Wellpoint Medicaid Managed Care	$77.34

IR PLACE CATH IN VEIN RIGHT

Facility

$2,919.00

Service Code	HCPCS 36012RT
Hospital Charge Code	321036012R
Hospital Revenue Code	361
Min. Negotiated Rate	$70.35
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$1,109.22
Rate for Payer: Aetna Medicare Advantage	$875.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$744.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$744.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$744.35
Rate for Payer: Cigna Commercial	$1,459.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$875.70
Rate for Payer: Qualcare PPO/HMO/WC	$437.85
Rate for Payer: UnitedHealthcare Community & State	$70.35
Rate for Payer: Wellpoint Medicaid Managed Care	$77.35

IR-PLACE CATH PULM ART-BI

Facility

$230.00

Service Code	HCPCS 3601450
Hospital Charge Code	2690435
Hospital Revenue Code	361
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

IR-PLACE CATH PULM ART-BI

Facility

$230.00

Service Code	HCPCS 3601450
Hospital Charge Code	2690435
Hospital Revenue Code	361
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Community & State	$5.54
Rate for Payer: Wellpoint Medicaid Managed Care	$6.09

IR-PLACE CATH PULM ART-BI

Facility

$230.00

Service Code	HCPCS 3601450
Hospital Charge Code	7411792
Hospital Revenue Code	361
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

IR-PLACE CATH PULM ART-BI

Facility

$230.00

Service Code	HCPCS 3601450
Hospital Charge Code	7411792
Hospital Revenue Code	361
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Community & State	$5.54
Rate for Payer: Wellpoint Medicaid Managed Care	$6.09

IR-PLACE CATH PULM ART-LT

Facility

$230.00

Service Code	HCPCS 36014LT
Hospital Charge Code	2691170
Hospital Revenue Code	361
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Community & State	$5.54
Rate for Payer: Wellpoint Medicaid Managed Care	$6.09

IR-PLACE CATH PULM ART-LT

Facility

$230.00

Service Code	HCPCS 36014LT
Hospital Charge Code	2691170
Hospital Revenue Code	361
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

IR-PLACE CATH PULM ART-LT

Facility

$230.00

Service Code	HCPCS 36014LT
Hospital Charge Code	7411902
Hospital Revenue Code	361
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

IR-PLACE CATH PULM ART-LT

Facility

$230.00

Service Code	HCPCS 36014LT
Hospital Charge Code	7411902
Hospital Revenue Code	361
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Community & State	$5.54
Rate for Payer: Wellpoint Medicaid Managed Care	$6.09

IR-PLACE CATH PULM ART-LT

Facility

$230.00

Service Code	HCPCS 36014LT
Hospital Charge Code	321036014L
Hospital Revenue Code	361
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

IR-PLACE CATH PULM ART-LT

Facility

$230.00

Service Code	HCPCS 36014LT
Hospital Charge Code	321036014L
Hospital Revenue Code	361
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Community & State	$5.54
Rate for Payer: Wellpoint Medicaid Managed Care	$6.09

IR-PLACE CATH PULM ART-RT

Facility

$230.00

Service Code	HCPCS 36014RT
Hospital Charge Code	321036014R
Hospital Revenue Code	361
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

IR-PLACE CATH PULM ART-RT

Facility

$230.00

Service Code	HCPCS 36014RT
Hospital Charge Code	321036014R
Hospital Revenue Code	361
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Community & State	$5.54
Rate for Payer: Wellpoint Medicaid Managed Care	$6.09

IR-PLACE CATH PULM ART-RT

Facility

$230.00

Service Code	HCPCS 36014RT
Hospital Charge Code	7411903
Hospital Revenue Code	361
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Community & State	$5.54
Rate for Payer: Wellpoint Medicaid Managed Care	$6.09

IR-PLACE CATH PULM ART-RT

Facility

$230.00

Service Code	HCPCS 36014RT
Hospital Charge Code	7411903
Hospital Revenue Code	361
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

IR-PLACE CATH PULM ART-RT

Facility

$230.00

Service Code	HCPCS 36014RT
Hospital Charge Code	2691175
Hospital Revenue Code	361
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Community & State	$5.54
Rate for Payer: Wellpoint Medicaid Managed Care	$6.09

IR-PLACE CATH PULM ART-RT

Facility

$230.00

Service Code	HCPCS 36014RT
Hospital Charge Code	2691175
Hospital Revenue Code	361
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

IR-PLACE CATH SEGM ART-BI

Facility

$268.00

Service Code	HCPCS 3601550
Hospital Charge Code	2690440
Hospital Revenue Code	361
Min. Negotiated Rate	$40.20
Max. Negotiated Rate	$40.20
Rate for Payer: Qualcare PPO/HMO/WC	$40.20

IR-PLACE CATH SEGM ART-BI

Facility

$268.00

Service Code	HCPCS 3601550
Hospital Charge Code	2690440
Hospital Revenue Code	361
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$101.84
Rate for Payer: Aetna Medicare Advantage	$80.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.34
Rate for Payer: Cigna Commercial	$134.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.40
Rate for Payer: Qualcare PPO/HMO/WC	$40.20
Rate for Payer: UnitedHealthcare Community & State	$6.46
Rate for Payer: Wellpoint Medicaid Managed Care	$7.10

IR-PLACE CATH SEGM ART-BI

Facility

$268.00

Service Code	HCPCS 3601550
Hospital Charge Code	7411793
Hospital Revenue Code	361
Min. Negotiated Rate	$40.20
Max. Negotiated Rate	$40.20
Rate for Payer: Qualcare PPO/HMO/WC	$40.20

Know your out-of-pocket cost for care.

All Charges