Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATECHOLAMINES, FRACT (PLASMA)

Facility

$332.85

Service Code	HCPCS 82384
Hospital Charge Code	3006137
Hospital Revenue Code	301
Min. Negotiated Rate	$49.93
Max. Negotiated Rate	$49.93
Rate for Payer: Qualcare PPO/HMO/WC	$49.93

CATECHOLAMINES,FRAC URINE

Facility

$506.00

Service Code	HCPCS 82384
Hospital Charge Code	38472176
Hospital Revenue Code	301
Min. Negotiated Rate	$75.90
Max. Negotiated Rate	$75.90
Rate for Payer: Qualcare PPO/HMO/WC	$75.90

CATECHOLAMINES,FRAC URINE

Facility

$506.00

Service Code	HCPCS 82384
Hospital Charge Code	38472176
Hospital Revenue Code	301
Min. Negotiated Rate	$13.41
Max. Negotiated Rate	$253.00
Rate for Payer: Aetna Commercial	$68.68
Rate for Payer: Aetna Medicare Advantage	$81.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.14
Rate for Payer: Cigna Commercial	$253.00
Rate for Payer: Cigna Medicare Advantage	$25.25
Rate for Payer: Clover Medicare Advantage	$23.99
Rate for Payer: EmblemHealth Commercial	$75.75
Rate for Payer: Humana Medicare Advantage	$26.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.90
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$20.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.25
Rate for Payer: Wellcare Medicare Advantage	$25.25
Rate for Payer: Wellpoint Medicaid Managed Care	$13.41

CATECHOLAMINES, URINE FREE

Facility

$332.85

Service Code	HCPCS 82384
Hospital Charge Code	3030921
Hospital Revenue Code	301
Min. Negotiated Rate	$8.82
Max. Negotiated Rate	$166.43
Rate for Payer: Aetna Commercial	$68.68
Rate for Payer: Aetna Medicare Advantage	$81.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.14
Rate for Payer: Cigna Commercial	$166.43
Rate for Payer: Cigna Medicare Advantage	$25.25
Rate for Payer: Clover Medicare Advantage	$23.99
Rate for Payer: EmblemHealth Commercial	$75.75
Rate for Payer: Humana Medicare Advantage	$26.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.93
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$20.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.25
Rate for Payer: Wellcare Medicare Advantage	$25.25
Rate for Payer: Wellpoint Medicaid Managed Care	$8.82

CATECHOLAMINES, URINE FREE

Facility

$332.85

Service Code	HCPCS 82384
Hospital Charge Code	3030921
Hospital Revenue Code	301
Min. Negotiated Rate	$49.93
Max. Negotiated Rate	$49.93
Rate for Payer: Qualcare PPO/HMO/WC	$49.93

CATH .018 CXI SUPPORT 150 CM

Facility

$1,132.45

Hospital Charge Code	270701472
Hospital Revenue Code	279
Min. Negotiated Rate	$169.87
Max. Negotiated Rate	$169.87
Rate for Payer: Qualcare PPO/HMO/WC	$169.87

CATH .018 CXI SUPPORT 150 CM

Facility

$1,132.45

Hospital Charge Code	270701472
Hospital Revenue Code	279
Min. Negotiated Rate	$27.29
Max. Negotiated Rate	$566.23
Rate for Payer: Aetna Commercial	$430.33
Rate for Payer: Aetna Medicare Advantage	$339.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$288.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$288.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$288.77
Rate for Payer: Cigna Commercial	$566.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.74
Rate for Payer: Oxford Commercial	$226.49
Rate for Payer: Qualcare PPO/HMO/WC	$169.87
Rate for Payer: UnitedHealthcare Commercial	$226.49
Rate for Payer: UnitedHealthcare Community & State	$27.29
Rate for Payer: Wellpoint Medicaid Managed Care	$30.01

CATH 11.5FRX19.5CM MAHURKAR

Facility

$626.68

Service Code	HCPCS C1752
Hospital Charge Code	278649890
Hospital Revenue Code	278
Min. Negotiated Rate	$94.00
Max. Negotiated Rate	$151.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.87
Rate for Payer: Qualcare PPO/HMO/WC	$94.00

CATH 11.5FRX19.5CM MAHURKAR

Facility

$626.68

Service Code	HCPCS C1752
Hospital Charge Code	278649890
Hospital Revenue Code	278
Min. Negotiated Rate	$15.10
Max. Negotiated Rate	$313.34
Rate for Payer: Aetna Commercial	$238.14
Rate for Payer: Aetna Medicare Advantage	$188.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.80
Rate for Payer: Cigna Commercial	$313.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.87
Rate for Payer: Qualcare PPO/HMO/WC	$94.00
Rate for Payer: UnitedHealthcare Community & State	$15.10
Rate for Payer: Wellpoint Medicaid Managed Care	$16.61

CATH 12 FR 605687*****

Facility

$33.76

Hospital Charge Code	270605687
Hospital Revenue Code	272
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$5.06
Rate for Payer: Qualcare PPO/HMO/WC	$5.06

CATH 12 FR 605687*****

Facility

$33.76

Hospital Charge Code	270605687
Hospital Revenue Code	272
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$16.88
Rate for Payer: Aetna Commercial	$12.83
Rate for Payer: Aetna Medicare Advantage	$10.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.61
Rate for Payer: Cigna Commercial	$16.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.13
Rate for Payer: Oxford Commercial	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$5.06
Rate for Payer: UnitedHealthcare Commercial	$6.75
Rate for Payer: UnitedHealthcare Community & State	$0.81
Rate for Payer: Wellpoint Medicaid Managed Care	$0.89

CATH 14 FR 605688*****

Facility

$33.76

Hospital Charge Code	270605688
Hospital Revenue Code	272
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$5.06
Rate for Payer: Qualcare PPO/HMO/WC	$5.06

CATH 14 FR 605688*****

Facility

$33.76

Hospital Charge Code	270605688
Hospital Revenue Code	272
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$16.88
Rate for Payer: Aetna Commercial	$12.83
Rate for Payer: Aetna Medicare Advantage	$10.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.61
Rate for Payer: Cigna Commercial	$16.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.13
Rate for Payer: Oxford Commercial	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$5.06
Rate for Payer: UnitedHealthcare Commercial	$6.75
Rate for Payer: UnitedHealthcare Community & State	$0.81
Rate for Payer: Wellpoint Medicaid Managed Care	$0.89

CATH 14FR SHEATH

Facility

$39.57

Hospital Charge Code	270644425
Hospital Revenue Code	270
Min. Negotiated Rate	$5.94
Max. Negotiated Rate	$5.94
Rate for Payer: Qualcare PPO/HMO/WC	$5.94

CATH 14FR SHEATH

Facility

$39.57

Hospital Charge Code	270644425
Hospital Revenue Code	270
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$19.79
Rate for Payer: Aetna Commercial	$15.04
Rate for Payer: Aetna Medicare Advantage	$11.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.09
Rate for Payer: Cigna Commercial	$19.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.87
Rate for Payer: Oxford Commercial	$7.91
Rate for Payer: Qualcare PPO/HMO/WC	$5.94
Rate for Payer: UnitedHealthcare Commercial	$7.91
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1.05

CATH 14PLUS 4x30 135 100818930

Facility

$1,425.00

Hospital Charge Code	270638381V
Hospital Revenue Code	278
Min. Negotiated Rate	$34.34
Max. Negotiated Rate	$712.50
Rate for Payer: Aetna Commercial	$541.50
Rate for Payer: Aetna Medicare Advantage	$427.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.38
Rate for Payer: Cigna Commercial	$712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$313.50
Rate for Payer: Qualcare PPO/HMO/WC	$213.75
Rate for Payer: UnitedHealthcare Community & State	$34.34
Rate for Payer: Wellpoint Medicaid Managed Care	$37.76

CATH 14PLUS 4x30 135 100818930

Facility

$1,425.00

Hospital Charge Code	270638381V
Hospital Revenue Code	278
Min. Negotiated Rate	$213.75
Max. Negotiated Rate	$344.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$285.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$313.50
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

CATH 16 FR 605685*****

Facility

$33.76

Hospital Charge Code	270605685
Hospital Revenue Code	272
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$16.88
Rate for Payer: Aetna Commercial	$12.83
Rate for Payer: Aetna Medicare Advantage	$10.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.61
Rate for Payer: Cigna Commercial	$16.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.13
Rate for Payer: Oxford Commercial	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$5.06
Rate for Payer: UnitedHealthcare Commercial	$6.75
Rate for Payer: UnitedHealthcare Community & State	$0.81
Rate for Payer: Wellpoint Medicaid Managed Care	$0.89

CATH 16 FR 605685*****

Facility

$33.76

Hospital Charge Code	270605685
Hospital Revenue Code	272
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$5.06
Rate for Payer: Qualcare PPO/HMO/WC	$5.06

CATH 18 FR****

Facility

$33.76

Hospital Charge Code	270605686
Hospital Revenue Code	272
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$16.88
Rate for Payer: Aetna Commercial	$12.83
Rate for Payer: Aetna Medicare Advantage	$10.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.61
Rate for Payer: Cigna Commercial	$16.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.13
Rate for Payer: Oxford Commercial	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$5.06
Rate for Payer: UnitedHealthcare Commercial	$6.75
Rate for Payer: UnitedHealthcare Community & State	$0.81
Rate for Payer: Wellpoint Medicaid Managed Care	$0.89

CATH 18 FR****

Facility

$33.76

Hospital Charge Code	706056862
Hospital Revenue Code	272
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$5.06
Rate for Payer: Qualcare PPO/HMO/WC	$5.06

CATH 18 FR****

Facility

$33.76

Hospital Charge Code	706056862
Hospital Revenue Code	272
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$16.88
Rate for Payer: Aetna Commercial	$12.83
Rate for Payer: Aetna Medicare Advantage	$10.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.61
Rate for Payer: Cigna Commercial	$16.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.13
Rate for Payer: Oxford Commercial	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$5.06
Rate for Payer: UnitedHealthcare Commercial	$6.75
Rate for Payer: UnitedHealthcare Community & State	$0.81
Rate for Payer: Wellpoint Medicaid Managed Care	$0.89

CATH 18 FR****

Facility

$33.76

Hospital Charge Code	270605686
Hospital Revenue Code	272
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$5.06
Rate for Payer: Qualcare PPO/HMO/WC	$5.06

CATH 2.00MM/30MICRO145CM

Facility

$16,975.00

Hospital Charge Code	2709007656
Hospital Revenue Code	272
Min. Negotiated Rate	$409.10
Max. Negotiated Rate	$8,487.50
Rate for Payer: Aetna Commercial	$6,450.50
Rate for Payer: Aetna Medicare Advantage	$5,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,328.62
Rate for Payer: Cigna Commercial	$8,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,092.50
Rate for Payer: Oxford Commercial	$3,395.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25
Rate for Payer: UnitedHealthcare Commercial	$3,395.00
Rate for Payer: UnitedHealthcare Community & State	$409.10
Rate for Payer: Wellpoint Medicaid Managed Care	$449.84

CATH 2.00MM/30MICRO145CM

Facility

$16,975.00

Hospital Charge Code	2709007656
Hospital Revenue Code	272
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$2,546.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

Know your out-of-pocket cost for care.

All Charges