Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHBALLOONHIGHPRESS 7X40X120

Facility

$975.00

Hospital Charge Code	2709006519
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATHBALLOONHIGHPRESS 7X40X120

Facility

$975.00

Hospital Charge Code	2709006519
Hospital Revenue Code	272
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

CATHBALLOONHIGHPRESS 7X40X80

Facility

$975.00

Hospital Charge Code	2709006518
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATHBALLOONHIGHPRESS 7X40X80

Facility

$975.00

Hospital Charge Code	2709006518
Hospital Revenue Code	272
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

CATHBALLOONHIGHPRESS 7X60X80

Facility

$975.00

Hospital Charge Code	2709006520
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATHBALLOONHIGHPRESS 7X60X80

Facility

$975.00

Hospital Charge Code	2709006520
Hospital Revenue Code	272
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

CATHBALLOONHIGHPRESS 8X20X120

Facility

$975.00

Hospital Charge Code	2709006525
Hospital Revenue Code	272
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

CATHBALLOONHIGHPRESS 8X20X120

Facility

$975.00

Hospital Charge Code	2709006525
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATHBALLOONHIGHPRESS 8X40X120

Facility

$975.00

Hospital Charge Code	2709006527
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATHBALLOONHIGHPRESS 8X40X120

Facility

$975.00

Hospital Charge Code	2709006527
Hospital Revenue Code	272
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

CATHBALLOONHIGHPRESS 8X40X80

Facility

$975.00

Hospital Charge Code	2709006526
Hospital Revenue Code	272
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

CATHBALLOONHIGHPRESS 8X40X80

Facility

$975.00

Hospital Charge Code	2709006526
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATHBALLOONHIGHPRESS 8X60X120

Facility

$975.00

Hospital Charge Code	2709006529
Hospital Revenue Code	272
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

CATHBALLOONHIGHPRESS 8X60X120

Facility

$975.00

Hospital Charge Code	2709006529
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATHBALLOONHIGHPRESS 8X60X80

Facility

$975.00

Hospital Charge Code	2709006528
Hospital Revenue Code	272
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

CATHBALLOONHIGHPRESS 8X60X80

Facility

$975.00

Hospital Charge Code	2709006528
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATHBALLOONHIGHPRESS 8X80X120

Facility

$975.00

Hospital Charge Code	2709006531
Hospital Revenue Code	272
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

CATHBALLOONHIGHPRESS 8X80X120

Facility

$975.00

Hospital Charge Code	2709006531
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATH BALLOON INFLATION 7FR

Facility

$1,166.60

Hospital Charge Code	270661557
Hospital Revenue Code	278
Min. Negotiated Rate	$28.12
Max. Negotiated Rate	$583.30
Rate for Payer: Aetna Commercial	$443.31
Rate for Payer: Aetna Medicare Advantage	$349.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$297.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$297.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$233.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$297.48
Rate for Payer: Cigna Commercial	$583.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$282.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$256.65
Rate for Payer: Qualcare PPO/HMO/WC	$174.99
Rate for Payer: UnitedHealthcare Community & State	$28.12
Rate for Payer: Wellpoint Medicaid Managed Care	$30.91

CATH BALLOON INFLATION 7FR

Facility

$1,166.60

Hospital Charge Code	270661557
Hospital Revenue Code	278
Min. Negotiated Rate	$174.99
Max. Negotiated Rate	$282.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$233.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$282.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$256.65
Rate for Payer: Qualcare PPO/HMO/WC	$174.99

CATH BALLOON OCCLUSION SCEPTER

Facility

$16,975.00

Service Code	HCPCS C2628
Hospital Charge Code	270699202S
Hospital Revenue Code	278
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) NJ Health	$3,395.00
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	$4,107.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,734.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25
Rate for Payer: UnitedHealthcare Community & State	$409.10
Rate for Payer: Wellpoint Medicaid Managed Care	$449.84

CATH BALLOON OCCLUSION SCEPTER

Facility

$16,975.00

Service Code	HCPCS C2628
Hospital Charge Code	270699202S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,734.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATH BALLOON POLAR 4x60 120cm

Facility

$2,976.00

Hospital Charge Code	270634517
Hospital Revenue Code	278
Min. Negotiated Rate	$446.40
Max. Negotiated Rate	$720.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$720.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$654.72
Rate for Payer: Qualcare PPO/HMO/WC	$446.40

CATH BALLOON POLAR 4x60 120cm

Facility

$2,976.00

Hospital Charge Code	270634517
Hospital Revenue Code	278
Min. Negotiated Rate	$71.72
Max. Negotiated Rate	$1,488.00
Rate for Payer: Aetna Commercial	$1,130.88
Rate for Payer: Aetna Medicare Advantage	$892.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.88
Rate for Payer: Cigna Commercial	$1,488.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$720.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$654.72
Rate for Payer: Qualcare PPO/HMO/WC	$446.40
Rate for Payer: UnitedHealthcare Community & State	$71.72
Rate for Payer: Wellpoint Medicaid Managed Care	$78.86

CATH BALLOON POLAR 6x60 120cm

Facility

$2,976.00

Hospital Charge Code	270634519
Hospital Revenue Code	278
Min. Negotiated Rate	$71.72
Max. Negotiated Rate	$1,488.00
Rate for Payer: Aetna Commercial	$1,130.88
Rate for Payer: Aetna Medicare Advantage	$892.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.88
Rate for Payer: Cigna Commercial	$1,488.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$720.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$654.72
Rate for Payer: Qualcare PPO/HMO/WC	$446.40
Rate for Payer: UnitedHealthcare Community & State	$71.72
Rate for Payer: Wellpoint Medicaid Managed Care	$78.86

Know your out-of-pocket cost for care.

All Charges