Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BALLOON ATTAIN CLARITY

Facility

$500.00

Hospital Charge Code	270675268
Hospital Revenue Code	272
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

BALLOON AVI 5x40 135 4225040X

Facility

$2,300.00

Hospital Charge Code	270634581V
Hospital Revenue Code	278
Min. Negotiated Rate	$55.43
Max. Negotiated Rate	$1,150.00
Rate for Payer: Aetna Commercial	$874.00
Rate for Payer: Aetna Medicare Advantage	$690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$586.50
Rate for Payer: Cigna Commercial	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$506.00
Rate for Payer: Qualcare PPO/HMO/WC	$345.00
Rate for Payer: UnitedHealthcare Community & State	$55.43
Rate for Payer: Wellpoint Medicaid Managed Care	$60.95

BALLOON AVI 5x40 135 4225040X

Facility

$2,300.00

Hospital Charge Code	270634581V
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$556.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$506.00
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

BALLOON AVIATOR 4224040X

Facility

$2,281.65

Hospital Charge Code	270633609
Hospital Revenue Code	278
Min. Negotiated Rate	$54.99
Max. Negotiated Rate	$1,140.83
Rate for Payer: Aetna Commercial	$867.03
Rate for Payer: Aetna Medicare Advantage	$684.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$581.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$581.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$581.82
Rate for Payer: Cigna Commercial	$1,140.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$501.96
Rate for Payer: Qualcare PPO/HMO/WC	$342.25
Rate for Payer: UnitedHealthcare Community & State	$54.99
Rate for Payer: Wellpoint Medicaid Managed Care	$60.46

BALLOON AVIATOR 4224040X

Facility

$2,281.65

Hospital Charge Code	270633609
Hospital Revenue Code	278
Min. Negotiated Rate	$342.25
Max. Negotiated Rate	$552.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$501.96
Rate for Payer: Qualcare PPO/HMO/WC	$342.25

BALLOON AVIATOR 4225040X

Facility

$2,281.65

Hospital Charge Code	270633610
Hospital Revenue Code	278
Min. Negotiated Rate	$342.25
Max. Negotiated Rate	$552.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$501.96
Rate for Payer: Qualcare PPO/HMO/WC	$342.25

BALLOON AVIATOR 4225040X

Facility

$2,281.65

Hospital Charge Code	270633610
Hospital Revenue Code	278
Min. Negotiated Rate	$54.99
Max. Negotiated Rate	$1,140.83
Rate for Payer: Aetna Commercial	$867.03
Rate for Payer: Aetna Medicare Advantage	$684.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$581.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$581.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$581.82
Rate for Payer: Cigna Commercial	$1,140.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$501.96
Rate for Payer: Qualcare PPO/HMO/WC	$342.25
Rate for Payer: UnitedHealthcare Community & State	$54.99
Rate for Payer: Wellpoint Medicaid Managed Care	$60.46

BALLOON AVIATOR 4226040X

Facility

$2,281.65

Hospital Charge Code	270633611
Hospital Revenue Code	278
Min. Negotiated Rate	$342.25
Max. Negotiated Rate	$552.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$501.96
Rate for Payer: Qualcare PPO/HMO/WC	$342.25

BALLOON AVIATOR 4226040X

Facility

$2,281.65

Hospital Charge Code	270633611
Hospital Revenue Code	278
Min. Negotiated Rate	$54.99
Max. Negotiated Rate	$1,140.83
Rate for Payer: Aetna Commercial	$867.03
Rate for Payer: Aetna Medicare Advantage	$684.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$581.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$581.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$581.82
Rate for Payer: Cigna Commercial	$1,140.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$501.96
Rate for Payer: Qualcare PPO/HMO/WC	$342.25
Rate for Payer: UnitedHealthcare Community & State	$54.99
Rate for Payer: Wellpoint Medicaid Managed Care	$60.46

BALLOON AVIATOR 6x40 142cm

Facility

$2,300.00

Hospital Charge Code	270639776
Hospital Revenue Code	272
Min. Negotiated Rate	$55.43
Max. Negotiated Rate	$1,150.00
Rate for Payer: Aetna Commercial	$874.00
Rate for Payer: Aetna Medicare Advantage	$690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$586.50
Rate for Payer: Cigna Commercial	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$690.00
Rate for Payer: Oxford Commercial	$460.00
Rate for Payer: Qualcare PPO/HMO/WC	$345.00
Rate for Payer: UnitedHealthcare Commercial	$460.00
Rate for Payer: UnitedHealthcare Community & State	$55.43
Rate for Payer: Wellpoint Medicaid Managed Care	$60.95

BALLOON AVIATOR 6x40 142cm

Facility

$2,300.00

Hospital Charge Code	270639776
Hospital Revenue Code	272
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$345.00
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

BALLOON BILIARY 4MM/4CM 6752

Facility

$2,863.25

Hospital Charge Code	270606232
Hospital Revenue Code	272
Min. Negotiated Rate	$69.00
Max. Negotiated Rate	$1,431.62
Rate for Payer: Aetna Commercial	$1,088.04
Rate for Payer: Aetna Medicare Advantage	$858.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$730.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$730.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$730.13
Rate for Payer: Cigna Commercial	$1,431.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$858.98
Rate for Payer: Oxford Commercial	$572.65
Rate for Payer: Qualcare PPO/HMO/WC	$429.49
Rate for Payer: UnitedHealthcare Commercial	$572.65
Rate for Payer: UnitedHealthcare Community & State	$69.00
Rate for Payer: Wellpoint Medicaid Managed Care	$75.88

BALLOON BILIARY 4MM/4CM 6752

Facility

$2,863.25

Hospital Charge Code	270606232
Hospital Revenue Code	272
Min. Negotiated Rate	$429.49
Max. Negotiated Rate	$429.49
Rate for Payer: Qualcare PPO/HMO/WC	$429.49

BALLOON BILIARY 5MM/4CM 6756

Facility

$2,860.85

Hospital Charge Code	270606234
Hospital Revenue Code	272
Min. Negotiated Rate	$68.95
Max. Negotiated Rate	$1,430.42
Rate for Payer: Aetna Commercial	$1,087.12
Rate for Payer: Aetna Medicare Advantage	$858.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$729.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$729.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$729.52
Rate for Payer: Cigna Commercial	$1,430.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$858.25
Rate for Payer: Oxford Commercial	$572.17
Rate for Payer: Qualcare PPO/HMO/WC	$429.13
Rate for Payer: UnitedHealthcare Commercial	$572.17
Rate for Payer: UnitedHealthcare Community & State	$68.95
Rate for Payer: Wellpoint Medicaid Managed Care	$75.81

BALLOON BILIARY 5MM/4CM 6756

Facility

$2,860.85

Hospital Charge Code	270606234
Hospital Revenue Code	272
Min. Negotiated Rate	$429.13
Max. Negotiated Rate	$429.13
Rate for Payer: Qualcare PPO/HMO/WC	$429.13

BALLOON BILIARY 6MM/4CM 6754

Facility

$2,863.25

Hospital Charge Code	270606233
Hospital Revenue Code	272
Min. Negotiated Rate	$69.00
Max. Negotiated Rate	$1,431.62
Rate for Payer: Aetna Commercial	$1,088.04
Rate for Payer: Aetna Medicare Advantage	$858.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$730.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$730.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$730.13
Rate for Payer: Cigna Commercial	$1,431.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$858.98
Rate for Payer: Oxford Commercial	$572.65
Rate for Payer: Qualcare PPO/HMO/WC	$429.49
Rate for Payer: UnitedHealthcare Commercial	$572.65
Rate for Payer: UnitedHealthcare Community & State	$69.00
Rate for Payer: Wellpoint Medicaid Managed Care	$75.88

BALLOON BILIARY 6MM/4CM 6754

Facility

$2,863.25

Hospital Charge Code	270606233
Hospital Revenue Code	272
Min. Negotiated Rate	$429.49
Max. Negotiated Rate	$429.49
Rate for Payer: Qualcare PPO/HMO/WC	$429.49

BALLOON BLUEMAX 10x4x75cm

Facility

$950.60

Hospital Charge Code	270623294
Hospital Revenue Code	278
Min. Negotiated Rate	$142.59
Max. Negotiated Rate	$230.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.13
Rate for Payer: Qualcare PPO/HMO/WC	$142.59

BALLOON BLUEMAX 10x4x75cm

Facility

$950.60

Hospital Charge Code	270623294
Hospital Revenue Code	278
Min. Negotiated Rate	$22.91
Max. Negotiated Rate	$475.30
Rate for Payer: Aetna Commercial	$361.23
Rate for Payer: Aetna Medicare Advantage	$285.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.40
Rate for Payer: Cigna Commercial	$475.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.13
Rate for Payer: Qualcare PPO/HMO/WC	$142.59
Rate for Payer: UnitedHealthcare Community & State	$22.91
Rate for Payer: Wellpoint Medicaid Managed Care	$25.19

BALLOON CATH ADMI 18 4x150x130

Facility

$8,550.00

Hospital Charge Code	270705324
Hospital Revenue Code	279
Min. Negotiated Rate	$206.06
Max. Negotiated Rate	$4,275.00
Rate for Payer: Aetna Commercial	$3,249.00
Rate for Payer: Aetna Medicare Advantage	$2,565.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,180.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,180.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,180.25
Rate for Payer: Cigna Commercial	$4,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,565.00
Rate for Payer: Oxford Commercial	$1,710.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.50
Rate for Payer: UnitedHealthcare Commercial	$1,710.00
Rate for Payer: UnitedHealthcare Community & State	$206.06
Rate for Payer: Wellpoint Medicaid Managed Care	$226.57

BALLOON CATH ADMI 18 4x150x130

Facility

$8,550.00

Hospital Charge Code	270705324
Hospital Revenue Code	279
Min. Negotiated Rate	$1,282.50
Max. Negotiated Rate	$1,282.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.50

BALLOON CATH ADMI 18 5x150x130

Facility

$8,550.00

Hospital Charge Code	270705325
Hospital Revenue Code	279
Min. Negotiated Rate	$1,282.50
Max. Negotiated Rate	$1,282.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.50

BALLOON CATH ADMI 18 5x150x130

Facility

$8,550.00

Hospital Charge Code	270705325
Hospital Revenue Code	279
Min. Negotiated Rate	$206.06
Max. Negotiated Rate	$4,275.00
Rate for Payer: Aetna Commercial	$3,249.00
Rate for Payer: Aetna Medicare Advantage	$2,565.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,180.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,180.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,180.25
Rate for Payer: Cigna Commercial	$4,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,565.00
Rate for Payer: Oxford Commercial	$1,710.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.50
Rate for Payer: UnitedHealthcare Commercial	$1,710.00
Rate for Payer: UnitedHealthcare Community & State	$206.06
Rate for Payer: Wellpoint Medicaid Managed Care	$226.57

BALLOON CATH ADMI 18 5x60x130

Facility

$7,050.00

Hospital Charge Code	270705315
Hospital Revenue Code	279
Min. Negotiated Rate	$169.91
Max. Negotiated Rate	$3,525.00
Rate for Payer: Aetna Commercial	$2,679.00
Rate for Payer: Aetna Medicare Advantage	$2,115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,797.75
Rate for Payer: Cigna Commercial	$3,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,115.00
Rate for Payer: Oxford Commercial	$1,410.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50
Rate for Payer: UnitedHealthcare Commercial	$1,410.00
Rate for Payer: UnitedHealthcare Community & State	$169.91
Rate for Payer: Wellpoint Medicaid Managed Care	$186.82

BALLOON CATH ADMI 18 5x60x130

Facility

$7,050.00

Hospital Charge Code	270705315
Hospital Revenue Code	279
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$1,057.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

Know your out-of-pocket cost for care.

All Charges