Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH AL .75 6F 67003400

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636306
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 .75 6F 67003400

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636306N
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 .75 6F 67003400

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636306N
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 .75 7F 77803400

Facility

$277.70

Hospital Charge Code	270636363
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 7F 77803400

Facility

$277.70

Hospital Charge Code	270636363
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 75 7FR 77803400

Facility

$279.85

Hospital Charge Code	270636363C
Hospital Revenue Code	278
Min. Negotiated Rate	$41.98
Max. Negotiated Rate	$67.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.57
Rate for Payer: Qualcare PPO/HMO/WC	$41.98

CATH AL 75 7FR 77803400

Facility

$279.85

Hospital Charge Code	270636363C
Hospital Revenue Code	278
Min. Negotiated Rate	$6.74
Max. Negotiated Rate	$139.93
Rate for Payer: Aetna Commercial	$106.34
Rate for Payer: Aetna Medicare Advantage	$83.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.36
Rate for Payer: Cigna Commercial	$139.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.57
Rate for Payer: Qualcare PPO/HMO/WC	$41.98
Rate for Payer: UnitedHealthcare Community & State	$6.74
Rate for Payer: Wellpoint Medicaid Managed Care	$7.42

CATH AL .75 SH 6F

Facility

$54.95

Service Code	HCPCS C1887
Hospital Charge Code	270636307
Hospital Revenue Code	278
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$27.48
Rate for Payer: Aetna Commercial	$20.88
Rate for Payer: Aetna Medicare Advantage	$16.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.01
Rate for Payer: Cigna Commercial	$27.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.09
Rate for Payer: Qualcare PPO/HMO/WC	$8.24
Rate for Payer: UnitedHealthcare Community & State	$1.32
Rate for Payer: Wellpoint Medicaid Managed Care	$1.46

CATH AL .75 SH 6F

Facility

$54.95

Service Code	HCPCS C1887
Hospital Charge Code	270636307
Hospital Revenue Code	278
Min. Negotiated Rate	$8.24
Max. Negotiated Rate	$13.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.09
Rate for Payer: Qualcare PPO/HMO/WC	$8.24

CATH AL I 7FR 77803600

Facility

$277.70

Hospital Charge Code	270636364
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 I 7FR 77803600

Facility

$277.70

Hospital Charge Code	270636364
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 II 7FR 77804000

Facility

$277.70

Service Code	HCPCS C1887
Hospital Charge Code	270636369N
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 II 7FR 77804000

Facility

$277.70

Service Code	HCPCS C1887
Hospital Charge Code	270636369N
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 II 7FR 77804000

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636369
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 II 7FR 77804000

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636369
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 I SH 7F 77803700

Facility

$220.00

Service Code	HCPCS C1887
Hospital Charge Code	270636365
Hospital Revenue Code	278
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$53.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$48.40
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

CATH AL I SH 7F 77803700

Facility

$220.00

Service Code	HCPCS C1887
Hospital Charge Code	270636365
Hospital Revenue Code	278
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$83.60
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$48.40
Rate for Payer: Qualcare PPO/HMO/WC	$33.00
Rate for Payer: UnitedHealthcare Community & State	$5.30
Rate for Payer: Wellpoint Medicaid Managed Care	$5.83

CATH AL I ST 7F 77804400

Facility

$277.70

Hospital Charge Code	270636366
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 I ST 7F 77804400

Facility

$277.70

Hospital Charge Code	270636366
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 ST 6F 67004400

Facility

$277.70

Hospital Charge Code	270636311
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 ST 6F 67004400

Facility

$277.70

Hospital Charge Code	270636311
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 AMD EXPRESSO 28 XM23SH28

Facility

$1,482.45

Hospital Charge Code	270629055
Hospital Revenue Code	278
Min. Negotiated Rate	$35.73
Max. Negotiated Rate	$741.23
Rate for Payer: Aetna Commercial	$563.33
Rate for Payer: Aetna Medicare Advantage	$444.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$378.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$378.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$296.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$378.02
Rate for Payer: Cigna Commercial	$741.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$358.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$326.14
Rate for Payer: Qualcare PPO/HMO/WC	$222.37
Rate for Payer: UnitedHealthcare Community & State	$35.73
Rate for Payer: Wellpoint Medicaid Managed Care	$39.28

CATH AMD EXPRESSO 28 XM23SH28

Facility

$1,482.45

Hospital Charge Code	270629055
Hospital Revenue Code	278
Min. Negotiated Rate	$222.37
Max. Negotiated Rate	$358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$296.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$358.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$326.14
Rate for Payer: Qualcare PPO/HMO/WC	$222.37

CATH AMPLATZ 1 MOD 5FR 100cm

Facility

$44.50

Service Code	HCPCS C1887
Hospital Charge Code	270644620C
Hospital Revenue Code	278
Min. Negotiated Rate	$6.67
Max. Negotiated Rate	$10.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.79
Rate for Payer: Qualcare PPO/HMO/WC	$6.67

CATH AMPLATZ 1 MOD 5FR 100cm

Facility

$44.50

Service Code	HCPCS C1887
Hospital Charge Code	270644620C
Hospital Revenue Code	278
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$22.25
Rate for Payer: Aetna Commercial	$16.91
Rate for Payer: Aetna Medicare Advantage	$13.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.35
Rate for Payer: Cigna Commercial	$22.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.79
Rate for Payer: Qualcare PPO/HMO/WC	$6.67
Rate for Payer: UnitedHealthcare Community & State	$1.07
Rate for Payer: Wellpoint Medicaid Managed Care	$1.18

Know your out-of-pocket cost for care.

All Charges