Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH ASH SPLIT 14F 32 ASPC32-3

Facility

$3,057.65

Hospital Charge Code	270617290V
Hospital Revenue Code	761
Min. Negotiated Rate	$73.69
Max. Negotiated Rate	$1,528.83
Rate for Payer: Aetna Commercial	$1,161.91
Rate for Payer: Aetna Medicare Advantage	$917.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$779.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$779.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$779.70
Rate for Payer: Cigna Commercial	$1,528.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$917.29
Rate for Payer: Oxford Commercial	$611.53
Rate for Payer: Qualcare PPO/HMO/WC	$458.65
Rate for Payer: UnitedHealthcare Commercial	$611.53
Rate for Payer: UnitedHealthcare Community & State	$73.69
Rate for Payer: Wellpoint Medicaid Managed Care	$81.03

CATH ASH SPLIT 14F 32 ASPC32-3

Facility

$3,057.65

Hospital Charge Code	270617290V
Hospital Revenue Code	761
Min. Negotiated Rate	$458.65
Max. Negotiated Rate	$458.65
Rate for Payer: Qualcare PPO/HMO/WC	$458.65

CATH ASH SPLIT 14F 32 ASPC32-3

Facility

$3,057.65

Hospital Charge Code	270617290
Hospital Revenue Code	360
Min. Negotiated Rate	$73.69
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$1,161.91
Rate for Payer: Aetna Medicare Advantage	$917.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$779.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$779.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$779.70
Rate for Payer: Cigna Commercial	$1,528.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$917.29
Rate for Payer: Qualcare PPO/HMO/WC	$458.65
Rate for Payer: UnitedHealthcare Community & State	$73.69
Rate for Payer: Wellpoint Medicaid Managed Care	$81.03

CATH ASH SPLIT 14F 36 ASPC36

Facility

$1,976.00

Hospital Charge Code	270624360V
Hospital Revenue Code	761
Min. Negotiated Rate	$296.40
Max. Negotiated Rate	$296.40
Rate for Payer: Qualcare PPO/HMO/WC	$296.40

CATH ASH SPLIT 14F 36 ASPC36

Facility

$1,976.00

Hospital Charge Code	270624360V
Hospital Revenue Code	761
Min. Negotiated Rate	$47.62
Max. Negotiated Rate	$988.00
Rate for Payer: Aetna Commercial	$750.88
Rate for Payer: Aetna Medicare Advantage	$592.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.88
Rate for Payer: Cigna Commercial	$988.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.80
Rate for Payer: Oxford Commercial	$395.20
Rate for Payer: Qualcare PPO/HMO/WC	$296.40
Rate for Payer: UnitedHealthcare Commercial	$395.20
Rate for Payer: UnitedHealthcare Community & State	$47.62
Rate for Payer: Wellpoint Medicaid Managed Care	$52.36

CATH ASH SPLIT 14F 36 ASPC36-3

Facility

$1,976.00

Hospital Charge Code	270624360
Hospital Revenue Code	360
Min. Negotiated Rate	$47.62
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$750.88
Rate for Payer: Aetna Medicare Advantage	$592.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.88
Rate for Payer: Cigna Commercial	$988.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.80
Rate for Payer: Qualcare PPO/HMO/WC	$296.40
Rate for Payer: UnitedHealthcare Community & State	$47.62
Rate for Payer: Wellpoint Medicaid Managed Care	$52.36

CATH ASH SPLIT 14F 36 ASPC36-3

Facility

$1,976.00

Hospital Charge Code	270624360
Hospital Revenue Code	360
Min. Negotiated Rate	$296.40
Max. Negotiated Rate	$296.40
Rate for Payer: Qualcare PPO/HMO/WC	$296.40

CATH ASH SPLIT 14FR 28cm

Facility

$1,540.00

Service Code	HCPCS C1750
Hospital Charge Code	270617195
Hospital Revenue Code	278
Min. Negotiated Rate	$37.11
Max. Negotiated Rate	$770.00
Rate for Payer: Aetna Commercial	$585.20
Rate for Payer: Aetna Medicare Advantage	$462.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$392.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$392.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$308.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$392.70
Rate for Payer: Cigna Commercial	$770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$338.80
Rate for Payer: Qualcare PPO/HMO/WC	$231.00
Rate for Payer: UnitedHealthcare Community & State	$37.11
Rate for Payer: Wellpoint Medicaid Managed Care	$40.81

CATH ASH SPLIT 14FR 28cm

Facility

$1,540.00

Service Code	HCPCS C1750
Hospital Charge Code	270617195
Hospital Revenue Code	278
Min. Negotiated Rate	$231.00
Max. Negotiated Rate	$372.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$308.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$338.80
Rate for Payer: Qualcare PPO/HMO/WC	$231.00

CATH ASH SPLIT 14fx55cm ASPC55

Facility

$2,108.00

Hospital Charge Code	270624983
Hospital Revenue Code	272
Min. Negotiated Rate	$316.20
Max. Negotiated Rate	$316.20
Rate for Payer: Qualcare PPO/HMO/WC	$316.20

CATH ASH SPLIT 14fx55cm ASPC55

Facility

$2,108.00

Hospital Charge Code	270624983
Hospital Revenue Code	272
Min. Negotiated Rate	$50.80
Max. Negotiated Rate	$1,054.00
Rate for Payer: Aetna Commercial	$801.04
Rate for Payer: Aetna Medicare Advantage	$632.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$537.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$537.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$537.54
Rate for Payer: Cigna Commercial	$1,054.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$632.40
Rate for Payer: Oxford Commercial	$421.60
Rate for Payer: Qualcare PPO/HMO/WC	$316.20
Rate for Payer: UnitedHealthcare Commercial	$421.60
Rate for Payer: UnitedHealthcare Community & State	$50.80
Rate for Payer: Wellpoint Medicaid Managed Care	$55.86

CATH ASPIRATION NASOTRACH

Facility

$128.00

Service Code	HCPCS 31720
Hospital Charge Code	9500425
Hospital Revenue Code	410
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$707.61
Rate for Payer: Aetna Medicare Advantage	$842.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$939.06
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: Cigna Medicare Advantage	$260.15
Rate for Payer: Clover Medicare Advantage	$247.14
Rate for Payer: EmblemHealth Commercial	$780.45
Rate for Payer: Humana Medicare Advantage	$267.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$260.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.40
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$3.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$260.15
Rate for Payer: Wellcare Medicare Advantage	$260.15
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

CATH ASPIRATION NASOTRACH

Facility

$128.00

Service Code	HCPCS 31720
Hospital Charge Code	9500425
Hospital Revenue Code	410
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

CATH ASPIRAT ZOOM 088 LDP 110C

Facility

$12,425.00

Service Code	HCPCS C1887
Hospital Charge Code	270694790S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,863.75
Max. Negotiated Rate	$3,006.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,006.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,733.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.75

CATH ASPIRAT ZOOM 088 LDP 110C

Facility

$12,425.00

Service Code	HCPCS C1887
Hospital Charge Code	270694790S
Hospital Revenue Code	278
Min. Negotiated Rate	$299.44
Max. Negotiated Rate	$6,212.50
Rate for Payer: Aetna Commercial	$4,721.50
Rate for Payer: Aetna Medicare Advantage	$3,727.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,168.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,168.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,168.38
Rate for Payer: Cigna Commercial	$6,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,006.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,733.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.75
Rate for Payer: UnitedHealthcare Community & State	$299.44
Rate for Payer: Wellpoint Medicaid Managed Care	$329.26

CATH ATKIS 12x4 AT75124

Facility

$1,810.45

Hospital Charge Code	270634928
Hospital Revenue Code	278
Min. Negotiated Rate	$271.57
Max. Negotiated Rate	$438.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$362.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$438.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$398.30
Rate for Payer: Qualcare PPO/HMO/WC	$271.57

CATH ATKIS 12x4 AT75124

Facility

$1,810.45

Hospital Charge Code	270634928
Hospital Revenue Code	278
Min. Negotiated Rate	$43.63
Max. Negotiated Rate	$905.23
Rate for Payer: Aetna Commercial	$687.97
Rate for Payer: Aetna Medicare Advantage	$543.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$362.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.66
Rate for Payer: Cigna Commercial	$905.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$438.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$398.30
Rate for Payer: Qualcare PPO/HMO/WC	$271.57
Rate for Payer: UnitedHealthcare Community & State	$43.63
Rate for Payer: Wellpoint Medicaid Managed Care	$47.98

CATH ATTAIN COMMAND 50S

Facility

$1,175.00

Service Code	HCPCS C1887
Hospital Charge Code	270675266
Hospital Revenue Code	278
Min. Negotiated Rate	$28.32
Max. Negotiated Rate	$587.50
Rate for Payer: Aetna Commercial	$446.50
Rate for Payer: Aetna Medicare Advantage	$352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.62
Rate for Payer: Cigna Commercial	$587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$258.50
Rate for Payer: Qualcare PPO/HMO/WC	$176.25
Rate for Payer: UnitedHealthcare Community & State	$28.32
Rate for Payer: Wellpoint Medicaid Managed Care	$31.14

CATH ATTAIN COMMAND 50S

Facility

$1,175.00

Service Code	HCPCS C1887
Hospital Charge Code	270675266
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$284.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$258.50
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

CATH ATTAIN COMMAND MP

Facility

$1,175.00

Service Code	HCPCS C1887
Hospital Charge Code	270675267
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$284.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$258.50
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

CATH ATTAIN COMMAND MP

Facility

$1,175.00

Service Code	HCPCS C1887
Hospital Charge Code	270675267
Hospital Revenue Code	278
Min. Negotiated Rate	$28.32
Max. Negotiated Rate	$587.50
Rate for Payer: Aetna Commercial	$446.50
Rate for Payer: Aetna Medicare Advantage	$352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.62
Rate for Payer: Cigna Commercial	$587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$258.50
Rate for Payer: Qualcare PPO/HMO/WC	$176.25
Rate for Payer: UnitedHealthcare Community & State	$28.32
Rate for Payer: Wellpoint Medicaid Managed Care	$31.14

CATH AVIA PLU 4x20 142 424402W

Facility

$2,500.00

Hospital Charge Code	270639315C
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

CATH AVIA PLU 4x20 142 424402W

Facility

$2,500.00

Hospital Charge Code	270639315C
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$60.25
Rate for Payer: Wellpoint Medicaid Managed Care	$66.25

CATH AVIATOR PL .14 6X30 142CM

Facility

$1,710.00

Service Code	HCPCS C1725
Hospital Charge Code	270694130S
Hospital Revenue Code	278
Min. Negotiated Rate	$41.21
Max. Negotiated Rate	$855.00
Rate for Payer: Aetna Commercial	$649.80
Rate for Payer: Aetna Medicare Advantage	$513.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$436.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$436.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$342.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$436.05
Rate for Payer: Cigna Commercial	$855.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$376.20
Rate for Payer: Qualcare PPO/HMO/WC	$256.50
Rate for Payer: UnitedHealthcare Community & State	$41.21
Rate for Payer: Wellpoint Medicaid Managed Care	$45.31

CATH AVIATOR PL .14 6X30 142CM

Facility

$1,710.00

Service Code	HCPCS C1725
Hospital Charge Code	270694130S
Hospital Revenue Code	278
Min. Negotiated Rate	$256.50
Max. Negotiated Rate	$413.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$342.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$376.20
Rate for Payer: Qualcare PPO/HMO/WC	$256.50

Know your out-of-pocket cost for care.

All Charges