Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BALLN CATH SD 7F 10x6 75 17741

Facility

$271.00

Hospital Charge Code	270639945
Hospital Revenue Code	278
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$135.50
Rate for Payer: Aetna Commercial	$102.98
Rate for Payer: Aetna Medicare Advantage	$81.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.11
Rate for Payer: Cigna Commercial	$135.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$59.62
Rate for Payer: Qualcare PPO/HMO/WC	$40.65
Rate for Payer: UnitedHealthcare Community & State	$6.53
Rate for Payer: Wellpoint Medicaid Managed Care	$7.18

BALLN CATH SD 7F 10x6 75 17741

Facility

$271.00

Hospital Charge Code	270639945
Hospital Revenue Code	278
Min. Negotiated Rate	$40.65
Max. Negotiated Rate	$65.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$59.62
Rate for Payer: Qualcare PPO/HMO/WC	$40.65

BALLN CATH TALN 4x4x135 11-605

Facility

$1,912.00

Hospital Charge Code	270632987
Hospital Revenue Code	278
Min. Negotiated Rate	$286.80
Max. Negotiated Rate	$462.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$382.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$462.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$420.64
Rate for Payer: Qualcare PPO/HMO/WC	$286.80

BALLN CATH TALN 4x4x135 11-605

Facility

$1,912.00

Hospital Charge Code	270632987
Hospital Revenue Code	278
Min. Negotiated Rate	$46.08
Max. Negotiated Rate	$956.00
Rate for Payer: Aetna Commercial	$726.56
Rate for Payer: Aetna Medicare Advantage	$573.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$487.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$487.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$382.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$487.56
Rate for Payer: Cigna Commercial	$956.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$462.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$420.64
Rate for Payer: Qualcare PPO/HMO/WC	$286.80
Rate for Payer: UnitedHealthcare Community & State	$46.08
Rate for Payer: Wellpoint Medicaid Managed Care	$50.67

BALLN CATH TALN 4x4x135 11-605

Facility

$1,927.40

Hospital Charge Code	270632987V
Hospital Revenue Code	278
Min. Negotiated Rate	$289.11
Max. Negotiated Rate	$466.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$385.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$466.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$424.03
Rate for Payer: Qualcare PPO/HMO/WC	$289.11

BALLN CATH TALN 4x4x135 11-605

Facility

$1,927.40

Hospital Charge Code	270632987V
Hospital Revenue Code	278
Min. Negotiated Rate	$46.45
Max. Negotiated Rate	$963.70
Rate for Payer: Aetna Commercial	$732.41
Rate for Payer: Aetna Medicare Advantage	$578.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$491.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$491.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$385.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$491.49
Rate for Payer: Cigna Commercial	$963.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$466.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$424.03
Rate for Payer: Qualcare PPO/HMO/WC	$289.11
Rate for Payer: UnitedHealthcare Community & State	$46.45
Rate for Payer: Wellpoint Medicaid Managed Care	$51.08

BALLN CUT PHRAL 6x20 PCB602090

Facility

$4,113.50

Hospital Charge Code	270633879V
Hospital Revenue Code	278
Min. Negotiated Rate	$617.02
Max. Negotiated Rate	$995.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$822.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$995.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$904.97
Rate for Payer: Qualcare PPO/HMO/WC	$617.02

BALLN CUT PHRAL 6x20 PCB602090

Facility

$4,113.50

Hospital Charge Code	270633879V
Hospital Revenue Code	278
Min. Negotiated Rate	$99.14
Max. Negotiated Rate	$2,056.75
Rate for Payer: Aetna Commercial	$1,563.13
Rate for Payer: Aetna Medicare Advantage	$1,234.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,048.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,048.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$822.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,048.94
Rate for Payer: Cigna Commercial	$2,056.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$995.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$904.97
Rate for Payer: Qualcare PPO/HMO/WC	$617.02
Rate for Payer: UnitedHealthcare Community & State	$99.14
Rate for Payer: Wellpoint Medicaid Managed Care	$109.01

BALLN EC 10x20mm AB35W10020080

Facility

$725.00

Hospital Charge Code	270644474C
Hospital Revenue Code	278
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Community & State	$17.47
Rate for Payer: Wellpoint Medicaid Managed Care	$19.21

BALLN EC 10x20mm AB35W10020080

Facility

$725.00

Hospital Charge Code	270644474C
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

BALLN EC 10x40mm AB35W10040080

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270644475C
Hospital Revenue Code	278
Min. Negotiated Rate	$102.17
Max. Negotiated Rate	$164.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$149.84
Rate for Payer: Qualcare PPO/HMO/WC	$102.17

BALLN EC 10x40mm AB35W10040080

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270644475C
Hospital Revenue Code	278
Min. Negotiated Rate	$16.41
Max. Negotiated Rate	$340.55
Rate for Payer: Aetna Commercial	$258.82
Rate for Payer: Aetna Medicare Advantage	$204.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.68
Rate for Payer: Cigna Commercial	$340.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$149.84
Rate for Payer: Qualcare PPO/HMO/WC	$102.17
Rate for Payer: UnitedHealthcare Community & State	$16.41
Rate for Payer: Wellpoint Medicaid Managed Care	$18.05

BALLN EC 12x20mm AB35W12020080

Facility

$725.00

Hospital Charge Code	270644476C
Hospital Revenue Code	278
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Community & State	$17.47
Rate for Payer: Wellpoint Medicaid Managed Care	$19.21

BALLN EC 12x20mm AB35W12020080

Facility

$725.00

Hospital Charge Code	270644476C
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

BALLN EC 5X100mm AB35W05100135

Facility

$725.00

Hospital Charge Code	270644463C
Hospital Revenue Code	278
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Community & State	$17.47
Rate for Payer: Wellpoint Medicaid Managed Care	$19.21

BALLN EC 5X100mm AB35W05100135

Facility

$725.00

Hospital Charge Code	270644463C
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

BALLN EC 5X120mm AB35W05120135

Facility

$857.50

Service Code	HCPCS C1725
Hospital Charge Code	270644464C
Hospital Revenue Code	278
Min. Negotiated Rate	$128.62
Max. Negotiated Rate	$207.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$188.65
Rate for Payer: Qualcare PPO/HMO/WC	$128.62

BALLN EC 5X120mm AB35W05120135

Facility

$857.50

Service Code	HCPCS C1725
Hospital Charge Code	270644464C
Hospital Revenue Code	278
Min. Negotiated Rate	$20.67
Max. Negotiated Rate	$428.75
Rate for Payer: Aetna Commercial	$325.85
Rate for Payer: Aetna Medicare Advantage	$257.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.66
Rate for Payer: Cigna Commercial	$428.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$188.65
Rate for Payer: Qualcare PPO/HMO/WC	$128.62
Rate for Payer: UnitedHealthcare Community & State	$20.67
Rate for Payer: Wellpoint Medicaid Managed Care	$22.72

BALLN EC 5x150mm AB35W05150135

Facility

$725.00

Hospital Charge Code	270642506V
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

BALLN EC 5x150mm AB35W05150135

Facility

$725.00

Hospital Charge Code	270642506V
Hospital Revenue Code	278
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Community & State	$17.47
Rate for Payer: Wellpoint Medicaid Managed Care	$19.21

BALLN EC 5X200mm AB35W05200135

Facility

$813.40

Service Code	HCPCS C1725
Hospital Charge Code	270644465C
Hospital Revenue Code	278
Min. Negotiated Rate	$122.01
Max. Negotiated Rate	$196.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$178.95
Rate for Payer: Qualcare PPO/HMO/WC	$122.01

BALLN EC 5X200mm AB35W05200135

Facility

$813.40

Service Code	HCPCS C1725
Hospital Charge Code	270644465C
Hospital Revenue Code	278
Min. Negotiated Rate	$19.60
Max. Negotiated Rate	$406.70
Rate for Payer: Aetna Commercial	$309.09
Rate for Payer: Aetna Medicare Advantage	$244.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.42
Rate for Payer: Cigna Commercial	$406.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$178.95
Rate for Payer: Qualcare PPO/HMO/WC	$122.01
Rate for Payer: UnitedHealthcare Community & State	$19.60
Rate for Payer: Wellpoint Medicaid Managed Care	$21.56

BALLN EC 5X30mm AB35W05030135

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270644460C
Hospital Revenue Code	278
Min. Negotiated Rate	$102.17
Max. Negotiated Rate	$164.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$149.84
Rate for Payer: Qualcare PPO/HMO/WC	$102.17

BALLN EC 5X30mm AB35W05030135

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270644460C
Hospital Revenue Code	278
Min. Negotiated Rate	$16.41
Max. Negotiated Rate	$340.55
Rate for Payer: Aetna Commercial	$258.82
Rate for Payer: Aetna Medicare Advantage	$204.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.68
Rate for Payer: Cigna Commercial	$340.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$149.84
Rate for Payer: Qualcare PPO/HMO/WC	$102.17
Rate for Payer: UnitedHealthcare Community & State	$16.41
Rate for Payer: Wellpoint Medicaid Managed Care	$18.05

BALLN EC 5X40mm AB35W05040135

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270644461C
Hospital Revenue Code	278
Min. Negotiated Rate	$102.17
Max. Negotiated Rate	$164.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$149.84
Rate for Payer: Qualcare PPO/HMO/WC	$102.17

Know your out-of-pocket cost for care.

All Charges