Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MICROCATHETER 135CM STR LANTER

Facility

$3,250.00

Hospital Charge Code	270683211
Hospital Revenue Code	272
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$487.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

MICROCATHETER HEADWAY 21 PLUS

Facility

$6,000.00

Service Code	HCPCS C1887
Hospital Charge Code	270699999S
Hospital Revenue Code	278
Min. Negotiated Rate	$144.60
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$159.00

MICROCATHETER HEADWAY 21 PLUS

Facility

$6,000.00

Service Code	HCPCS C1887
Hospital Charge Code	270699999S
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

MICROCATHETER RENEGADE HI-FLO

Facility

$2,624.00

Service Code	HCPCS C1887
Hospital Charge Code	270662978
Hospital Revenue Code	278
Min. Negotiated Rate	$63.24
Max. Negotiated Rate	$1,312.00
Rate for Payer: Aetna Commercial	$997.12
Rate for Payer: Aetna Medicare Advantage	$787.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$524.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.12
Rate for Payer: Cigna Commercial	$1,312.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$577.28
Rate for Payer: Qualcare PPO/HMO/WC	$393.60
Rate for Payer: UnitedHealthcare Community & State	$63.24
Rate for Payer: Wellpoint Medicaid Managed Care	$69.54

MICROCATHETER RENEGADE HI-FLO

Facility

$2,624.00

Service Code	HCPCS C1887
Hospital Charge Code	270662978
Hospital Revenue Code	278
Min. Negotiated Rate	$393.60
Max. Negotiated Rate	$635.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$524.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$577.28
Rate for Payer: Qualcare PPO/HMO/WC	$393.60

MICROCATHETER VELOCITY

Facility

$5,285.00

Service Code	HCPCS C1725
Hospital Charge Code	270682974
Hospital Revenue Code	278
Min. Negotiated Rate	$127.37
Max. Negotiated Rate	$2,642.50
Rate for Payer: Aetna Commercial	$2,008.30
Rate for Payer: Aetna Medicare Advantage	$1,585.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,347.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,347.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,347.67
Rate for Payer: Cigna Commercial	$2,642.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,278.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,162.70
Rate for Payer: Qualcare PPO/HMO/WC	$792.75
Rate for Payer: UnitedHealthcare Community & State	$127.37
Rate for Payer: Wellpoint Medicaid Managed Care	$140.05

MICROCATHETER VELOCITY

Facility

$5,285.00

Service Code	HCPCS C1725
Hospital Charge Code	270682974
Hospital Revenue Code	278
Min. Negotiated Rate	$792.75
Max. Negotiated Rate	$1,278.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,057.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,278.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,162.70
Rate for Payer: Qualcare PPO/HMO/WC	$792.75

MICROCATHETER VIA 17MM TIP

Facility

$6,750.00

Service Code	HCPCS C1887
Hospital Charge Code	270696910S
Hospital Revenue Code	278
Min. Negotiated Rate	$162.68
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$162.68
Rate for Payer: Wellpoint Medicaid Managed Care	$178.88

MICROCATHETER VIA 17MM TIP

Facility

$6,750.00

Service Code	HCPCS C1887
Hospital Charge Code	270696910S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

MICROCATHETER VIA 17 TI 45D

Facility

$6,750.00

Service Code	HCPCS C1887
Hospital Charge Code	270697715S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

MICROCATHETER VIA 17 TI 45D

Facility

$6,750.00

Service Code	HCPCS C1887
Hospital Charge Code	270697715S
Hospital Revenue Code	278
Min. Negotiated Rate	$162.68
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$162.68
Rate for Payer: Wellpoint Medicaid Managed Care	$178.88

MICROCATH VASC 2.4/1.7F 156CM

Facility

$4,650.00

Service Code	HCPCS C1887
Hospital Charge Code	270693915S
Hospital Revenue Code	278
Min. Negotiated Rate	$697.50
Max. Negotiated Rate	$1,125.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$930.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,125.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,023.00
Rate for Payer: Qualcare PPO/HMO/WC	$697.50

MICROCATH VASC 2.4/1.7F 156CM

Facility

$4,650.00

Service Code	HCPCS C1887
Hospital Charge Code	270693915S
Hospital Revenue Code	278
Min. Negotiated Rate	$112.06
Max. Negotiated Rate	$2,325.00
Rate for Payer: Aetna Commercial	$1,767.00
Rate for Payer: Aetna Medicare Advantage	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,185.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,185.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$930.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,185.75
Rate for Payer: Cigna Commercial	$2,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,125.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,023.00
Rate for Payer: Qualcare PPO/HMO/WC	$697.50
Rate for Payer: UnitedHealthcare Community & State	$112.06
Rate for Payer: Wellpoint Medicaid Managed Care	$123.22

MICROCLIPS TITANIUM HEMOSTATIC

Facility

$51.67

Hospital Charge Code	270663934
Hospital Revenue Code	270
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$25.84
Rate for Payer: Aetna Commercial	$19.63
Rate for Payer: Aetna Medicare Advantage	$15.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.18
Rate for Payer: Cigna Commercial	$25.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.50
Rate for Payer: Oxford Commercial	$10.33
Rate for Payer: Qualcare PPO/HMO/WC	$7.75
Rate for Payer: UnitedHealthcare Commercial	$10.33
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.37

MICROCLIPS TITANIUM HEMOSTATIC

Facility

$51.67

Hospital Charge Code	270663934
Hospital Revenue Code	270
Min. Negotiated Rate	$7.75
Max. Negotiated Rate	$7.75
Rate for Payer: Qualcare PPO/HMO/WC	$7.75

MICROCOIL HILAL EMBOL .018x1CM

Facility

$227.50

Hospital Charge Code	270668351
Hospital Revenue Code	278
Min. Negotiated Rate	$5.48
Max. Negotiated Rate	$113.75
Rate for Payer: Aetna Commercial	$86.45
Rate for Payer: Aetna Medicare Advantage	$68.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.01
Rate for Payer: Cigna Commercial	$113.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$50.05
Rate for Payer: Qualcare PPO/HMO/WC	$34.12
Rate for Payer: UnitedHealthcare Community & State	$5.48
Rate for Payer: Wellpoint Medicaid Managed Care	$6.03

MICROCOIL HILAL EMBOL .018x1CM

Facility

$227.50

Hospital Charge Code	270668351
Hospital Revenue Code	278
Min. Negotiated Rate	$34.12
Max. Negotiated Rate	$55.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$50.05
Rate for Payer: Qualcare PPO/HMO/WC	$34.12

MICROCOIL HILAL EMBOL.018x.5CM

Facility

$427.50

Hospital Charge Code	270676280
Hospital Revenue Code	278
Min. Negotiated Rate	$10.30
Max. Negotiated Rate	$213.75
Rate for Payer: Aetna Commercial	$162.45
Rate for Payer: Aetna Medicare Advantage	$128.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.01
Rate for Payer: Cigna Commercial	$213.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$94.05
Rate for Payer: Qualcare PPO/HMO/WC	$64.12
Rate for Payer: UnitedHealthcare Community & State	$10.30
Rate for Payer: Wellpoint Medicaid Managed Care	$11.33

MICROCOIL HILAL EMBOL.018x.5CM

Facility

$427.50

Hospital Charge Code	270676280
Hospital Revenue Code	278
Min. Negotiated Rate	$64.12
Max. Negotiated Rate	$103.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$94.05
Rate for Payer: Qualcare PPO/HMO/WC	$64.12

MICROCTHTER 2.9F 130CM STGHT

Facility

$375.00

Hospital Charge Code	270657613
Hospital Revenue Code	278
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

MICROCTHTER 2.9F 130CM STGHT

Facility

$375.00

Hospital Charge Code	270657610
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MICROCTHTER 2.9F 130CM STGHT

Facility

$375.00

Hospital Charge Code	270657613
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MICROCTHTER 2.9F 130CM STGHT

Facility

$375.00

Hospital Charge Code	270657610
Hospital Revenue Code	278
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

MICRODEBRIDER EZ IFF

Facility

$5,729.80

Hospital Charge Code	270677008
Hospital Revenue Code	272
Min. Negotiated Rate	$859.47
Max. Negotiated Rate	$859.47
Rate for Payer: Qualcare PPO/HMO/WC	$859.47

MICRODEBRIDER EZ IFF

Facility

$5,729.80

Hospital Charge Code	270677008
Hospital Revenue Code	272
Min. Negotiated Rate	$138.09
Max. Negotiated Rate	$2,864.90
Rate for Payer: Aetna Commercial	$2,177.32
Rate for Payer: Aetna Medicare Advantage	$1,718.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,461.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,461.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,461.10
Rate for Payer: Cigna Commercial	$2,864.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,718.94
Rate for Payer: Oxford Commercial	$1,145.96
Rate for Payer: Qualcare PPO/HMO/WC	$859.47
Rate for Payer: UnitedHealthcare Commercial	$1,145.96
Rate for Payer: UnitedHealthcare Community & State	$138.09
Rate for Payer: Wellpoint Medicaid Managed Care	$151.84

Know your out-of-pocket cost for care.

All Charges