Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KIT BRONCHIAL CHALLENGE

Facility

$127.25

Hospital Charge Code	270600614
Hospital Revenue Code	272
Min. Negotiated Rate	$19.09
Max. Negotiated Rate	$19.09
Rate for Payer: Qualcare PPO/HMO/WC	$19.09

KIT BRONCHIAL CHALLENGE

Facility

$127.25

Hospital Charge Code	270600614
Hospital Revenue Code	272
Min. Negotiated Rate	$3.07
Max. Negotiated Rate	$63.62
Rate for Payer: Aetna Commercial	$48.35
Rate for Payer: Aetna Medicare Advantage	$38.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.45
Rate for Payer: Cigna Commercial	$63.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.17
Rate for Payer: Oxford Commercial	$25.45
Rate for Payer: Qualcare PPO/HMO/WC	$19.09
Rate for Payer: UnitedHealthcare Commercial	$25.45
Rate for Payer: UnitedHealthcare Community & State	$3.07
Rate for Payer: Wellpoint Medicaid Managed Care	$3.37

KIT CANNULA IN OUT FLOW

Facility

$2,042.75

Hospital Charge Code	270688259
Hospital Revenue Code	272
Min. Negotiated Rate	$306.41
Max. Negotiated Rate	$306.41
Rate for Payer: Qualcare PPO/HMO/WC	$306.41

KIT CANNULA IN OUT FLOW

Facility

$2,042.75

Hospital Charge Code	270688259
Hospital Revenue Code	272
Min. Negotiated Rate	$49.23
Max. Negotiated Rate	$1,021.38
Rate for Payer: Aetna Commercial	$776.25
Rate for Payer: Aetna Medicare Advantage	$612.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$520.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$520.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$520.90
Rate for Payer: Cigna Commercial	$1,021.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$612.83
Rate for Payer: Oxford Commercial	$408.55
Rate for Payer: Qualcare PPO/HMO/WC	$306.41
Rate for Payer: UnitedHealthcare Commercial	$408.55
Rate for Payer: UnitedHealthcare Community & State	$49.23
Rate for Payer: Wellpoint Medicaid Managed Care	$54.13

KIT CANNULA UNIVERSAL

Facility

$800.00

Hospital Charge Code	270657831
Hospital Revenue Code	272
Min. Negotiated Rate	$19.28
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.00
Rate for Payer: Oxford Commercial	$160.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$160.00
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$21.20

KIT CANNULA UNIVERSAL

Facility

$800.00

Hospital Charge Code	270657831
Hospital Revenue Code	272
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

KIT CATARACT EYE CUSTOM AS9476

Facility

$1,214.45

Hospital Charge Code	270061148
Hospital Revenue Code	276
Min. Negotiated Rate	$182.17
Max. Negotiated Rate	$293.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$293.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$267.18
Rate for Payer: Qualcare PPO/HMO/WC	$182.17

KIT CATARACT EYE CUSTOM AS9476

Facility

$1,214.45

Hospital Charge Code	270061148
Hospital Revenue Code	276
Min. Negotiated Rate	$29.27
Max. Negotiated Rate	$607.23
Rate for Payer: Aetna Commercial	$461.49
Rate for Payer: Aetna Medicare Advantage	$364.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$309.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$309.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$309.68
Rate for Payer: Cigna Commercial	$607.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$293.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$267.18
Rate for Payer: Qualcare PPO/HMO/WC	$182.17
Rate for Payer: UnitedHealthcare Community & State	$29.27
Rate for Payer: Wellpoint Medicaid Managed Care	$32.18

KIT CATATACT EYE CUSTOM

Facility

$490.24

Hospital Charge Code	270604865
Hospital Revenue Code	272
Min. Negotiated Rate	$11.81
Max. Negotiated Rate	$245.12
Rate for Payer: Aetna Commercial	$186.29
Rate for Payer: Aetna Medicare Advantage	$147.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.01
Rate for Payer: Cigna Commercial	$245.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.07
Rate for Payer: Oxford Commercial	$98.05
Rate for Payer: Qualcare PPO/HMO/WC	$73.54
Rate for Payer: UnitedHealthcare Commercial	$98.05
Rate for Payer: UnitedHealthcare Community & State	$11.81
Rate for Payer: Wellpoint Medicaid Managed Care	$12.99

KIT CATATACT EYE CUSTOM

Facility

$490.24

Hospital Charge Code	270604865
Hospital Revenue Code	272
Min. Negotiated Rate	$73.54
Max. Negotiated Rate	$73.54
Rate for Payer: Qualcare PPO/HMO/WC	$73.54

KIT CATH BAXTER PERCUTANEOUS**

Facility

$95.00

Hospital Charge Code	8003121
Hospital Revenue Code	279
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$47.50
Rate for Payer: Aetna Commercial	$36.10
Rate for Payer: Aetna Medicare Advantage	$28.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.23
Rate for Payer: Cigna Commercial	$47.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.50
Rate for Payer: Oxford Commercial	$19.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.25
Rate for Payer: UnitedHealthcare Commercial	$19.00
Rate for Payer: UnitedHealthcare Community & State	$2.29
Rate for Payer: Wellpoint Medicaid Managed Care	$2.52

KIT CATH BAXTER PERCUTANEOUS**

Facility

$95.00

Hospital Charge Code	8003121
Hospital Revenue Code	279
Min. Negotiated Rate	$14.25
Max. Negotiated Rate	$14.25
Rate for Payer: Qualcare PPO/HMO/WC	$14.25

KIT CATHETER ACCESS PORT 5840

Facility

$138.95

Hospital Charge Code	270633467
Hospital Revenue Code	272
Min. Negotiated Rate	$3.35
Max. Negotiated Rate	$69.47
Rate for Payer: Aetna Commercial	$52.80
Rate for Payer: Aetna Medicare Advantage	$41.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.43
Rate for Payer: Cigna Commercial	$69.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.69
Rate for Payer: Oxford Commercial	$27.79
Rate for Payer: Qualcare PPO/HMO/WC	$20.84
Rate for Payer: UnitedHealthcare Commercial	$27.79
Rate for Payer: UnitedHealthcare Community & State	$3.35
Rate for Payer: Wellpoint Medicaid Managed Care	$3.68

KIT CATHETER ACCESS PORT 5840

Facility

$138.95

Hospital Charge Code	270633467
Hospital Revenue Code	272
Min. Negotiated Rate	$20.84
Max. Negotiated Rate	$20.84
Rate for Payer: Qualcare PPO/HMO/WC	$20.84

KIT CATHETER ASCENDA INTRA

Facility

$2,750.00

Hospital Charge Code	270691699
Hospital Revenue Code	272
Min. Negotiated Rate	$66.28
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.00
Rate for Payer: Oxford Commercial	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Commercial	$550.00
Rate for Payer: UnitedHealthcare Community & State	$66.28
Rate for Payer: Wellpoint Medicaid Managed Care	$72.88

KIT CATHETER ASCENDA INTRA

Facility

$2,750.00

Hospital Charge Code	270691699
Hospital Revenue Code	272
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

KIT CATHETER POWERMIDLINE 5F

Facility

$800.00

Service Code	HCPCS C1751
Hospital Charge Code	270682902
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

KIT CATHETER POWERMIDLINE 5F

Facility

$800.00

Service Code	HCPCS C1751
Hospital Charge Code	270682902
Hospital Revenue Code	278
Min. Negotiated Rate	$19.28
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$21.20

KIT CATHETER SILVERSOAKER ON-Q

Facility

$230.00

Hospital Charge Code	270650274
Hospital Revenue Code	271
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

KIT CATHETER SILVERSOAKER ON-Q

Facility

$230.00

Hospital Charge Code	270650274
Hospital Revenue Code	271
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$115.00
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) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.00
Rate for Payer: Oxford Commercial	$46.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Commercial	$46.00
Rate for Payer: UnitedHealthcare Community & State	$5.54
Rate for Payer: Wellpoint Medicaid Managed Care	$6.09

KIT CATH HEMOSPLIT 14.5 FR

Facility

$1,615.00

Service Code	HCPCS C1750
Hospital Charge Code	270637884
Hospital Revenue Code	278
Min. Negotiated Rate	$242.25
Max. Negotiated Rate	$390.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$323.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$355.30
Rate for Payer: Qualcare PPO/HMO/WC	$242.25

KIT CATH HEMOSPLIT 14.5 FR

Facility

$1,615.00

Service Code	HCPCS C1750
Hospital Charge Code	270637884
Hospital Revenue Code	278
Min. Negotiated Rate	$38.92
Max. Negotiated Rate	$807.50
Rate for Payer: Aetna Commercial	$613.70
Rate for Payer: Aetna Medicare Advantage	$484.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$411.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$411.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$323.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$411.82
Rate for Payer: Cigna Commercial	$807.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$355.30
Rate for Payer: Qualcare PPO/HMO/WC	$242.25
Rate for Payer: UnitedHealthcare Community & State	$38.92
Rate for Payer: Wellpoint Medicaid Managed Care	$42.80

KIT CATH HEMOSPLIT STRT STD 27

Facility

$1,750.00

Service Code	HCPCS C1750
Hospital Charge Code	270655799
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$385.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

KIT CATH HEMOSPLIT STRT STD 27

Facility

$1,750.00

Service Code	HCPCS C1750
Hospital Charge Code	270655799
Hospital Revenue Code	278
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$385.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Community & State	$42.17
Rate for Payer: Wellpoint Medicaid Managed Care	$46.38

KIT CATH INTRO 13.5 & 14FR****

Facility

$932.00

Hospital Charge Code	1604271
Hospital Revenue Code	278
Min. Negotiated Rate	$22.46
Max. Negotiated Rate	$466.00
Rate for Payer: Aetna Commercial	$354.16
Rate for Payer: Aetna Medicare Advantage	$279.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.66
Rate for Payer: Cigna Commercial	$466.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$205.04
Rate for Payer: Qualcare PPO/HMO/WC	$139.80
Rate for Payer: UnitedHealthcare Community & State	$22.46
Rate for Payer: Wellpoint Medicaid Managed Care	$24.70

Know your out-of-pocket cost for care.

All Charges