Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PORT A CATH POWER PORT 8F S

Facility

$3,215.00

Service Code	HCPCS C1788
Hospital Charge Code	270688735
Hospital Revenue Code	278
Min. Negotiated Rate	$77.48
Max. Negotiated Rate	$1,607.50
Rate for Payer: Aetna Commercial	$1,221.70
Rate for Payer: Aetna Medicare Advantage	$964.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$819.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$819.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$819.83
Rate for Payer: Cigna Commercial	$1,607.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$707.30
Rate for Payer: Qualcare PPO/HMO/WC	$482.25
Rate for Payer: UnitedHealthcare Community & State	$77.48
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

PORTACATH PRECON 10FR 0607100

Facility

$1,475.00

Service Code	HCPCS C1751
Hospital Charge Code	270614611
Hospital Revenue Code	278
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

PORTACATH PRECON 10FR 0607100

Facility

$1,475.00

Service Code	HCPCS C1751
Hospital Charge Code	270614611
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

PORT A CATH PRECON9.6F 0602610

Facility

$955.00

Service Code	HCPCS C1788
Hospital Charge Code	270614986
Hospital Revenue Code	278
Min. Negotiated Rate	$23.02
Max. Negotiated Rate	$477.50
Rate for Payer: Aetna Commercial	$362.90
Rate for Payer: Aetna Medicare Advantage	$286.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$243.53
Rate for Payer: Cigna Commercial	$477.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$210.10
Rate for Payer: Qualcare PPO/HMO/WC	$143.25
Rate for Payer: UnitedHealthcare Community & State	$23.02
Rate for Payer: Wellpoint Medicaid Managed Care	$25.31

PORT A CATH PRECON9.6F 0602610

Facility

$955.00

Service Code	HCPCS C1788
Hospital Charge Code	270614986
Hospital Revenue Code	278
Min. Negotiated Rate	$143.25
Max. Negotiated Rate	$231.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$210.10
Rate for Payer: Qualcare PPO/HMO/WC	$143.25

PORT ADAPTER Y FEEDING 20F

Facility

$35.88

Hospital Charge Code	270678363
Hospital Revenue Code	272
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$17.94
Rate for Payer: Aetna Commercial	$13.63
Rate for Payer: Aetna Medicare Advantage	$10.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.15
Rate for Payer: Cigna Commercial	$17.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.76
Rate for Payer: Oxford Commercial	$7.18
Rate for Payer: Qualcare PPO/HMO/WC	$5.38
Rate for Payer: UnitedHealthcare Commercial	$7.18
Rate for Payer: UnitedHealthcare Community & State	$0.86
Rate for Payer: Wellpoint Medicaid Managed Care	$0.95

PORT ADAPTER Y FEEDING 20F

Facility

$35.88

Hospital Charge Code	270678363
Hospital Revenue Code	272
Min. Negotiated Rate	$5.38
Max. Negotiated Rate	$5.38
Rate for Payer: Qualcare PPO/HMO/WC	$5.38

PORTAL SKID ENDO DIL

Facility

$225.00

Service Code	HCPCS A4649
Hospital Charge Code	270690982
Hospital Revenue Code	272
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

PORTAL SKID ENDO DIL

Facility

$225.00

Service Code	HCPCS A4649
Hospital Charge Code	270690982
Hospital Revenue Code	272
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.50
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$45.00
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

PORT BIOFLO 6FR PASV VALVED

Facility

$1,975.00

Service Code	HCPCS C1788
Hospital Charge Code	270673515
Hospital Revenue Code	278
Min. Negotiated Rate	$47.60
Max. Negotiated Rate	$987.50
Rate for Payer: Aetna Commercial	$750.50
Rate for Payer: Aetna Medicare Advantage	$592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.62
Rate for Payer: Cigna Commercial	$987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$477.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$434.50
Rate for Payer: Qualcare PPO/HMO/WC	$296.25
Rate for Payer: UnitedHealthcare Community & State	$47.60
Rate for Payer: Wellpoint Medicaid Managed Care	$52.34

PORT BIOFLO 6FR PASV VALVED

Facility

$1,975.00

Service Code	HCPCS C1788
Hospital Charge Code	270673515
Hospital Revenue Code	278
Min. Negotiated Rate	$296.25
Max. Negotiated Rate	$477.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$477.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$434.50
Rate for Payer: Qualcare PPO/HMO/WC	$296.25

PORT BIOFLO 8FR PASV VALVE

Facility

$1,375.00

Service Code	HCPCS C1889
Hospital Charge Code	270704983
Hospital Revenue Code	278
Min. Negotiated Rate	$33.14
Max. Negotiated Rate	$687.50
Rate for Payer: Aetna Commercial	$522.50
Rate for Payer: Aetna Medicare Advantage	$412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.62
Rate for Payer: Cigna Commercial	$687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$206.25
Rate for Payer: UnitedHealthcare Community & State	$33.14
Rate for Payer: Wellpoint Medicaid Managed Care	$36.44

PORT BIOFLO 8FR PASV VALVE

Facility

$1,375.00

Service Code	HCPCS C1889
Hospital Charge Code	270704983
Hospital Revenue Code	278
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$332.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

PORT BIOFLO 8FR PASV VALVED

Facility

$3,359.00

Hospital Charge Code	270673516
Hospital Revenue Code	279
Min. Negotiated Rate	$80.95
Max. Negotiated Rate	$1,679.50
Rate for Payer: Aetna Commercial	$1,276.42
Rate for Payer: Aetna Medicare Advantage	$1,007.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$856.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$856.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$856.54
Rate for Payer: Cigna Commercial	$1,679.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.70
Rate for Payer: Oxford Commercial	$671.80
Rate for Payer: Qualcare PPO/HMO/WC	$503.85
Rate for Payer: UnitedHealthcare Commercial	$671.80
Rate for Payer: UnitedHealthcare Community & State	$80.95
Rate for Payer: Wellpoint Medicaid Managed Care	$89.01

PORT BIOFLO 8FR PASV VALVED

Facility

$3,359.00

Hospital Charge Code	270673516
Hospital Revenue Code	279
Min. Negotiated Rate	$503.85
Max. Negotiated Rate	$503.85
Rate for Payer: Qualcare PPO/HMO/WC	$503.85

PORT,INDWELLING (IMPLANTABLE)

Facility

$21.40

Service Code	HCPCS C1751
Hospital Charge Code	4800885
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4.71
Rate for Payer: Qualcare PPO/HMO/WC	$3.21

PORT,INDWELLING (IMPLANTABLE)

Facility

$21.40

Service Code	HCPCS C1751
Hospital Charge Code	4800885
Hospital Revenue Code	278
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$10.70
Rate for Payer: Aetna Commercial	$8.13
Rate for Payer: Aetna Medicare Advantage	$6.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.46
Rate for Payer: Cigna Commercial	$10.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4.71
Rate for Payer: Qualcare PPO/HMO/WC	$3.21
Rate for Payer: UnitedHealthcare Community & State	$0.52
Rate for Payer: Wellpoint Medicaid Managed Care	$0.57

PORT INFUSEARTERIAL 0.6MM

Facility

$2,798.45

Hospital Charge Code	270601151
Hospital Revenue Code	270
Min. Negotiated Rate	$67.44
Max. Negotiated Rate	$1,399.22
Rate for Payer: Aetna Commercial	$1,063.41
Rate for Payer: Aetna Medicare Advantage	$839.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$713.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$713.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$713.60
Rate for Payer: Cigna Commercial	$1,399.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$839.53
Rate for Payer: Oxford Commercial	$559.69
Rate for Payer: Qualcare PPO/HMO/WC	$419.77
Rate for Payer: UnitedHealthcare Commercial	$559.69
Rate for Payer: UnitedHealthcare Community & State	$67.44
Rate for Payer: Wellpoint Medicaid Managed Care	$74.16

PORT INFUSEARTERIAL 0.6MM

Facility

$2,798.45

Hospital Charge Code	270601151
Hospital Revenue Code	270
Min. Negotiated Rate	$419.77
Max. Negotiated Rate	$419.77
Rate for Payer: Qualcare PPO/HMO/WC	$419.77

PORT INFUSOR ART 6.9fr 38940

Facility

$1,835.25

Hospital Charge Code	270634994
Hospital Revenue Code	272
Min. Negotiated Rate	$44.23
Max. Negotiated Rate	$917.62
Rate for Payer: Aetna Commercial	$697.39
Rate for Payer: Aetna Medicare Advantage	$550.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$467.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$467.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$467.99
Rate for Payer: Cigna Commercial	$917.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$550.58
Rate for Payer: Oxford Commercial	$367.05
Rate for Payer: Qualcare PPO/HMO/WC	$275.29
Rate for Payer: UnitedHealthcare Commercial	$367.05
Rate for Payer: UnitedHealthcare Community & State	$44.23
Rate for Payer: Wellpoint Medicaid Managed Care	$48.63

PORT INFUSOR ART 6.9fr 38940

Facility

$1,835.25

Hospital Charge Code	270634994
Hospital Revenue Code	272
Min. Negotiated Rate	$275.29
Max. Negotiated Rate	$275.29
Rate for Payer: Qualcare PPO/HMO/WC	$275.29

PORT MINI W/INTRO 2MM 171313

Facility

$272.85

Hospital Charge Code	270612742
Hospital Revenue Code	272
Min. Negotiated Rate	$6.58
Max. Negotiated Rate	$136.43
Rate for Payer: Aetna Commercial	$103.68
Rate for Payer: Aetna Medicare Advantage	$81.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.58
Rate for Payer: Cigna Commercial	$136.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.86
Rate for Payer: Oxford Commercial	$54.57
Rate for Payer: Qualcare PPO/HMO/WC	$40.93
Rate for Payer: UnitedHealthcare Commercial	$54.57
Rate for Payer: UnitedHealthcare Community & State	$6.58
Rate for Payer: Wellpoint Medicaid Managed Care	$7.23

PORT MINI W/INTRO 2MM 171313

Facility

$272.85

Hospital Charge Code	270612742
Hospital Revenue Code	272
Min. Negotiated Rate	$40.93
Max. Negotiated Rate	$40.93
Rate for Payer: Qualcare PPO/HMO/WC	$40.93

PORT MRI DUAL IMPLANT BARD 10F

Facility

$6,375.55

Hospital Charge Code	270662643
Hospital Revenue Code	278
Min. Negotiated Rate	$956.33
Max. Negotiated Rate	$1,542.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,402.62
Rate for Payer: Qualcare PPO/HMO/WC	$956.33

PORT MRI DUAL IMPLANT BARD 10F

Facility

$6,375.55

Hospital Charge Code	270662643
Hospital Revenue Code	278
Min. Negotiated Rate	$153.65
Max. Negotiated Rate	$3,187.78
Rate for Payer: Aetna Commercial	$2,422.71
Rate for Payer: Aetna Medicare Advantage	$1,912.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,625.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,625.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,625.77
Rate for Payer: Cigna Commercial	$3,187.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,402.62
Rate for Payer: Qualcare PPO/HMO/WC	$956.33
Rate for Payer: UnitedHealthcare Community & State	$153.65
Rate for Payer: Wellpoint Medicaid Managed Care	$168.95

Know your out-of-pocket cost for care.

All Charges