Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH AD CARD BERENS 10722104

Facility

$94.45

Hospital Charge Code	270623315
Hospital Revenue Code	272
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$47.23
Rate for Payer: Aetna Commercial	$35.89
Rate for Payer: Aetna Medicare Advantage	$28.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.08
Rate for Payer: Cigna Commercial	$47.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.34
Rate for Payer: Oxford Commercial	$18.89
Rate for Payer: Qualcare PPO/HMO/WC	$14.17
Rate for Payer: UnitedHealthcare Commercial	$18.89
Rate for Payer: UnitedHealthcare Community & State	$2.28
Rate for Payer: Wellpoint Medicaid Managed Care	$2.50

CATH AD CARD BERENS 10722104

Facility

$94.45

Hospital Charge Code	270623315
Hospital Revenue Code	272
Min. Negotiated Rate	$14.17
Max. Negotiated Rate	$14.17
Rate for Payer: Qualcare PPO/HMO/WC	$14.17

CATH AD CARD COBRA 10719702

Facility

$94.45

Hospital Charge Code	270623314
Hospital Revenue Code	272
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$47.23
Rate for Payer: Aetna Commercial	$35.89
Rate for Payer: Aetna Medicare Advantage	$28.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.08
Rate for Payer: Cigna Commercial	$47.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.34
Rate for Payer: Oxford Commercial	$18.89
Rate for Payer: Qualcare PPO/HMO/WC	$14.17
Rate for Payer: UnitedHealthcare Commercial	$18.89
Rate for Payer: UnitedHealthcare Community & State	$2.28
Rate for Payer: Wellpoint Medicaid Managed Care	$2.50

CATH AD CARD COBRA 10719702

Facility

$94.45

Hospital Charge Code	270623314
Hospital Revenue Code	272
Min. Negotiated Rate	$14.17
Max. Negotiated Rate	$14.17
Rate for Payer: Qualcare PPO/HMO/WC	$14.17

CATH ADMIRAL XTREME 9x60x80

Facility

$700.00

Service Code	HCPCS C1725
Hospital Charge Code	270642305
Hospital Revenue Code	278
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

CATH ADMIRAL XTREME 9x60x80

Facility

$700.00

Service Code	HCPCS C1725
Hospital Charge Code	270642305
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

CATH AL 1.5 6F 67003800

Facility

$277.70

Service Code	HCPCS C1887
Hospital Charge Code	270636312
Hospital Revenue Code	278
Min. Negotiated Rate	$41.66
Max. Negotiated Rate	$67.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.09
Rate for Payer: Qualcare PPO/HMO/WC	$41.66

CATH AL 1.5 6F 67003800

Facility

$277.70

Service Code	HCPCS C1887
Hospital Charge Code	270636312
Hospital Revenue Code	278
Min. Negotiated Rate	$6.69
Max. Negotiated Rate	$138.85
Rate for Payer: Aetna Commercial	$105.53
Rate for Payer: Aetna Medicare Advantage	$83.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.81
Rate for Payer: Cigna Commercial	$138.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.09
Rate for Payer: Qualcare PPO/HMO/WC	$41.66
Rate for Payer: UnitedHealthcare Community & State	$6.69
Rate for Payer: Wellpoint Medicaid Managed Care	$7.36

CATH AL 1.5 7F 77803800

Facility

$277.70

Hospital Charge Code	270636367
Hospital Revenue Code	278
Min. Negotiated Rate	$41.66
Max. Negotiated Rate	$67.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.09
Rate for Payer: Qualcare PPO/HMO/WC	$41.66

CATH AL 1.5 7F 77803800

Facility

$277.70

Hospital Charge Code	270636367
Hospital Revenue Code	278
Min. Negotiated Rate	$6.69
Max. Negotiated Rate	$138.85
Rate for Payer: Aetna Commercial	$105.53
Rate for Payer: Aetna Medicare Advantage	$83.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.81
Rate for Payer: Cigna Commercial	$138.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.09
Rate for Payer: Qualcare PPO/HMO/WC	$41.66
Rate for Payer: UnitedHealthcare Community & State	$6.69
Rate for Payer: Wellpoint Medicaid Managed Care	$7.36

CATH AL 1.5 SH 7F 67004000

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636313
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATH AL 1.5 SH 7F 67004000

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636313S
Hospital Revenue Code	278
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Community & State	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$6.36

CATH AL 1.5 SH 7F 67004000

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636313S
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATH AL 1.5 SH 7F 67004000

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636313
Hospital Revenue Code	278
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Community & State	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$6.36

CATH AL 1.5 SH 7F 67004000

Facility

$277.70

Service Code	HCPCS C1887
Hospital Charge Code	270636313N
Hospital Revenue Code	278
Min. Negotiated Rate	$41.66
Max. Negotiated Rate	$67.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.09
Rate for Payer: Qualcare PPO/HMO/WC	$41.66

CATH AL 1.5 SH 7F 67004000

Facility

$277.70

Service Code	HCPCS C1887
Hospital Charge Code	270636313N
Hospital Revenue Code	278
Min. Negotiated Rate	$6.69
Max. Negotiated Rate	$138.85
Rate for Payer: Aetna Commercial	$105.53
Rate for Payer: Aetna Medicare Advantage	$83.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.81
Rate for Payer: Cigna Commercial	$138.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.09
Rate for Payer: Qualcare PPO/HMO/WC	$41.66
Rate for Payer: UnitedHealthcare Community & State	$6.69
Rate for Payer: Wellpoint Medicaid Managed Care	$7.36

CATH AL 1.5 SH 7F 77803900

Facility

$277.70

Hospital Charge Code	270636368
Hospital Revenue Code	278
Min. Negotiated Rate	$41.66
Max. Negotiated Rate	$67.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.09
Rate for Payer: Qualcare PPO/HMO/WC	$41.66

CATH AL 1.5 SH 7F 77803900

Facility

$277.70

Hospital Charge Code	270636368
Hospital Revenue Code	278
Min. Negotiated Rate	$6.69
Max. Negotiated Rate	$138.85
Rate for Payer: Aetna Commercial	$105.53
Rate for Payer: Aetna Medicare Advantage	$83.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.81
Rate for Payer: Cigna Commercial	$138.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.09
Rate for Payer: Qualcare PPO/HMO/WC	$41.66
Rate for Payer: UnitedHealthcare Community & State	$6.69
Rate for Payer: Wellpoint Medicaid Managed Care	$7.36

CATH AL 1 6F

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636308
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATH AL 1 6F

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636308
Hospital Revenue Code	278
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Community & State	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$6.36

CATH AL 1 SH 6F 67003700

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636309
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATH AL 1 SH 6F 67003700

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636309
Hospital Revenue Code	278
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Community & State	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$6.36

CATH AL 1 SH 6F 67003700

Facility

$277.70

Service Code	HCPCS C1887
Hospital Charge Code	270636309N
Hospital Revenue Code	278
Min. Negotiated Rate	$6.69
Max. Negotiated Rate	$138.85
Rate for Payer: Aetna Commercial	$105.53
Rate for Payer: Aetna Medicare Advantage	$83.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.81
Rate for Payer: Cigna Commercial	$138.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.09
Rate for Payer: Qualcare PPO/HMO/WC	$41.66
Rate for Payer: UnitedHealthcare Community & State	$6.69
Rate for Payer: Wellpoint Medicaid Managed Care	$7.36

CATH AL 1 SH 6F 67003700

Facility

$277.70

Service Code	HCPCS C1887
Hospital Charge Code	270636309N
Hospital Revenue Code	278
Min. Negotiated Rate	$41.66
Max. Negotiated Rate	$67.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.09
Rate for Payer: Qualcare PPO/HMO/WC	$41.66

CATH AL .75 6F 67003400

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636306
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

Know your out-of-pocket cost for care.

All Charges