Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLACE CATHETER IN ARTERY

Facility

$486.00

Service Code	HCPCS 36217
Hospital Charge Code	366836217
Hospital Revenue Code	361
Min. Negotiated Rate	$72.90
Max. Negotiated Rate	$72.90
Rate for Payer: Qualcare PPO/HMO/WC	$72.90

PLACE CATHETER IN ARTERY

Facility

$403.00

Service Code	HCPCS 36216
Hospital Charge Code	366836216
Hospital Revenue Code	361
Min. Negotiated Rate	$60.45
Max. Negotiated Rate	$60.45
Rate for Payer: Qualcare PPO/HMO/WC	$60.45

PLACE CATHETER IN ARTERY

Facility

$486.00

Service Code	HCPCS 36217
Hospital Charge Code	366836217
Hospital Revenue Code	361
Min. Negotiated Rate	$11.71
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$184.68
Rate for Payer: Aetna Medicare Advantage	$145.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.93
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	$123.93
Rate for Payer: Cigna Commercial	$243.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.80
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.90
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$11.71
Rate for Payer: Wellpoint Medicaid Managed Care	$12.88

PLACE CATHETER IN ARTERY

Facility

$359.00

Service Code	HCPCS 36215
Hospital Charge Code	366836215
Hospital Revenue Code	361
Min. Negotiated Rate	$8.65
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$136.42
Rate for Payer: Aetna Medicare Advantage	$107.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.55
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	$91.55
Rate for Payer: Cigna Commercial	$179.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.70
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$53.85
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$8.65
Rate for Payer: Wellpoint Medicaid Managed Care	$9.51

PLACE CATHETER IN ARTERY

Facility

$359.00

Service Code	HCPCS 36215
Hospital Charge Code	366836215
Hospital Revenue Code	361
Min. Negotiated Rate	$53.85
Max. Negotiated Rate	$53.85
Rate for Payer: Qualcare PPO/HMO/WC	$53.85

PLACE CATHETER IN VEIN

Facility

$242.00

Service Code	HCPCS 36011
Hospital Charge Code	366836011
Hospital Revenue Code	361
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$91.96
Rate for Payer: Aetna Medicare Advantage	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.71
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	$61.71
Rate for Payer: Cigna Commercial	$121.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.30
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$5.83

PLACE CATHETER IN VEIN

Facility

$2,919.00

Service Code	HCPCS 36012
Hospital Charge Code	366836012
Hospital Revenue Code	361
Min. Negotiated Rate	$70.35
Max. Negotiated Rate	$2,220.00
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: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$437.85
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$70.35
Rate for Payer: Wellpoint Medicaid Managed Care	$77.35

PLACE CATHETER IN VEIN

Facility

$242.00

Service Code	HCPCS 36011
Hospital Charge Code	366836011
Hospital Revenue Code	361
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

PLACE CATHETER IN VEIN

Facility

$2,919.00

Service Code	HCPCS 36012
Hospital Charge Code	366836012
Hospital Revenue Code	361
Min. Negotiated Rate	$437.85
Max. Negotiated Rate	$437.85
Rate for Payer: Qualcare PPO/HMO/WC	$437.85

PLACE CATHETER IN VEIN

Facility

$2,919.00

Service Code	HCPCS 36012
Hospital Charge Code	411036012
Hospital Revenue Code	361
Min. Negotiated Rate	$70.35
Max. Negotiated Rate	$2,220.00
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: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$437.85
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$70.35
Rate for Payer: Wellpoint Medicaid Managed Care	$77.35

PLACE CATHETER IN VEIN

Facility

$242.00

Service Code	HCPCS 36011
Hospital Charge Code	411036011
Hospital Revenue Code	361
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$91.96
Rate for Payer: Aetna Medicare Advantage	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.71
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	$61.71
Rate for Payer: Cigna Commercial	$121.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.30
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$5.83

PLACE CATHETER IN VEIN

Facility

$2,919.00

Service Code	HCPCS 36012
Hospital Charge Code	411036012
Hospital Revenue Code	361
Min. Negotiated Rate	$437.85
Max. Negotiated Rate	$437.85
Rate for Payer: Qualcare PPO/HMO/WC	$437.85

PLACE CATHETER IN VEIN

Facility

$242.00

Service Code	HCPCS 36011
Hospital Charge Code	411036011
Hospital Revenue Code	361
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

PLACE CATH INIT 2ND ORDER THOR

Facility

$331.55

Service Code	HCPCS 36216
Hospital Charge Code	5100380
Hospital Revenue Code	761
Min. Negotiated Rate	$7.99
Max. Negotiated Rate	$165.78
Rate for Payer: Aetna Commercial	$125.99
Rate for Payer: Aetna Medicare Advantage	$99.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.55
Rate for Payer: Cigna Commercial	$165.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.47
Rate for Payer: Oxford Commercial	$66.31
Rate for Payer: Qualcare PPO/HMO/WC	$49.73
Rate for Payer: UnitedHealthcare Commercial	$66.31
Rate for Payer: UnitedHealthcare Community & State	$7.99
Rate for Payer: Wellpoint Medicaid Managed Care	$8.79

PLACE CATH INIT 2ND ORDER THOR

Facility

$331.55

Service Code	HCPCS 36216
Hospital Charge Code	5100380
Hospital Revenue Code	761
Min. Negotiated Rate	$49.73
Max. Negotiated Rate	$49.73
Rate for Payer: Qualcare PPO/HMO/WC	$49.73

PLACE CATH INTRACRANIAL ART

Facility

$2,919.00

Service Code	HCPCS 36228
Hospital Charge Code	411036228
Hospital Revenue Code	361
Min. Negotiated Rate	$70.35
Max. Negotiated Rate	$2,220.00
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: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$437.85
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$70.35
Rate for Payer: Wellpoint Medicaid Managed Care	$77.35

PLACE CATH INTRACRANIAL ART

Facility

$2,919.00

Service Code	HCPCS 36228
Hospital Charge Code	366836228
Hospital Revenue Code	361
Min. Negotiated Rate	$70.35
Max. Negotiated Rate	$2,220.00
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: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$437.85
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$70.35
Rate for Payer: Wellpoint Medicaid Managed Care	$77.35

PLACE CATH INTRACRANIAL ART

Facility

$2,919.00

Service Code	HCPCS 36228
Hospital Charge Code	366836228
Hospital Revenue Code	361
Min. Negotiated Rate	$437.85
Max. Negotiated Rate	$437.85
Rate for Payer: Qualcare PPO/HMO/WC	$437.85

PLACE CATH INTRACRANIAL ART

Facility

$2,919.00

Service Code	HCPCS 36228
Hospital Charge Code	411036228
Hospital Revenue Code	361
Min. Negotiated Rate	$437.85
Max. Negotiated Rate	$437.85
Rate for Payer: Qualcare PPO/HMO/WC	$437.85

PLACE CATH IN VEIN BILATRL

Facility

$5,837.20

Service Code	HCPCS 3601250
Hospital Charge Code	27009017
Hospital Revenue Code	361
Min. Negotiated Rate	$875.58
Max. Negotiated Rate	$875.58
Rate for Payer: Qualcare PPO/HMO/WC	$875.58

PLACE CATH IN VEIN BILATRL

Facility

$5,837.20

Service Code	HCPCS 3601250
Hospital Charge Code	7412047
Hospital Revenue Code	361
Min. Negotiated Rate	$140.68
Max. Negotiated Rate	$2,918.60
Rate for Payer: Aetna Commercial	$2,218.14
Rate for Payer: Aetna Medicare Advantage	$1,751.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,488.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,488.49
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	$1,488.49
Rate for Payer: Cigna Commercial	$2,918.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,751.16
Rate for Payer: Qualcare PPO/HMO/WC	$875.58
Rate for Payer: UnitedHealthcare Community & State	$140.68
Rate for Payer: Wellpoint Medicaid Managed Care	$154.69

PLACE CATH IN VEIN BILATRL

Facility

$5,837.20

Service Code	HCPCS 3601250
Hospital Charge Code	27009017
Hospital Revenue Code	361
Min. Negotiated Rate	$140.68
Max. Negotiated Rate	$2,918.60
Rate for Payer: Aetna Commercial	$2,218.14
Rate for Payer: Aetna Medicare Advantage	$1,751.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,488.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,488.49
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	$1,488.49
Rate for Payer: Cigna Commercial	$2,918.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,751.16
Rate for Payer: Qualcare PPO/HMO/WC	$875.58
Rate for Payer: UnitedHealthcare Community & State	$140.68
Rate for Payer: Wellpoint Medicaid Managed Care	$154.69

PLACE CATH IN VEIN BILATRL

Facility

$5,837.20

Service Code	HCPCS 3601250
Hospital Charge Code	2709017
Hospital Revenue Code	361
Min. Negotiated Rate	$140.68
Max. Negotiated Rate	$2,918.60
Rate for Payer: Aetna Commercial	$2,218.14
Rate for Payer: Aetna Medicare Advantage	$1,751.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,488.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,488.49
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	$1,488.49
Rate for Payer: Cigna Commercial	$2,918.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,751.16
Rate for Payer: Qualcare PPO/HMO/WC	$875.58
Rate for Payer: UnitedHealthcare Community & State	$140.68
Rate for Payer: Wellpoint Medicaid Managed Care	$154.69

PLACE CATH IN VEIN BILATRL

Facility

$5,837.20

Service Code	HCPCS 3601250
Hospital Charge Code	2709017
Hospital Revenue Code	361
Min. Negotiated Rate	$875.58
Max. Negotiated Rate	$875.58
Rate for Payer: Qualcare PPO/HMO/WC	$875.58

PLACE CATH IN VEIN BILATRL

Facility

$5,837.20

Service Code	HCPCS 3601250
Hospital Charge Code	7412047
Hospital Revenue Code	361
Min. Negotiated Rate	$875.58
Max. Negotiated Rate	$875.58
Rate for Payer: Qualcare PPO/HMO/WC	$875.58

Know your out-of-pocket cost for care.

All Charges