Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH BALLOON POLAR 6x60 120cm

Facility

$2,976.00

Hospital Charge Code	270634519
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 SAVVY 3x2 110c

Facility

$1,810.45

Hospital Charge Code	270634860
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 BALLOON SAVVY 3x2 110c

Facility

$1,810.45

Hospital Charge Code	270634860
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 BALLOON SLALOM 4385020S

Facility

$1,237.65

Hospital Charge Code	270625415
Hospital Revenue Code	272
Min. Negotiated Rate	$185.65
Max. Negotiated Rate	$185.65
Rate for Payer: Qualcare PPO/HMO/WC	$185.65

CATH BALLOON SLALOM 4385020S

Facility

$1,900.00

Hospital Charge Code	270625415V
Hospital Revenue Code	278
Min. Negotiated Rate	$45.79
Max. Negotiated Rate	$950.00
Rate for Payer: Aetna Commercial	$722.00
Rate for Payer: Aetna Medicare Advantage	$570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$484.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$484.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$380.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$484.50
Rate for Payer: Cigna Commercial	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$418.00
Rate for Payer: Qualcare PPO/HMO/WC	$285.00
Rate for Payer: UnitedHealthcare Community & State	$45.79
Rate for Payer: Wellpoint Medicaid Managed Care	$50.35

CATH BALLOON SLALOM 4385020S

Facility

$1,237.65

Hospital Charge Code	270625415
Hospital Revenue Code	272
Min. Negotiated Rate	$29.83
Max. Negotiated Rate	$618.83
Rate for Payer: Aetna Commercial	$470.31
Rate for Payer: Aetna Medicare Advantage	$371.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$315.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$315.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$315.60
Rate for Payer: Cigna Commercial	$618.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$371.30
Rate for Payer: Oxford Commercial	$247.53
Rate for Payer: Qualcare PPO/HMO/WC	$185.65
Rate for Payer: UnitedHealthcare Commercial	$247.53
Rate for Payer: UnitedHealthcare Community & State	$29.83
Rate for Payer: Wellpoint Medicaid Managed Care	$32.80

CATH BALLOON SLALOM 4385020S

Facility

$1,900.00

Hospital Charge Code	270625415V
Hospital Revenue Code	278
Min. Negotiated Rate	$285.00
Max. Negotiated Rate	$459.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$380.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$418.00
Rate for Payer: Qualcare PPO/HMO/WC	$285.00

CATH BALLOON SLALOM 438-5040X

Facility

$1,884.85

Hospital Charge Code	270626422
Hospital Revenue Code	278
Min. Negotiated Rate	$282.73
Max. Negotiated Rate	$456.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$456.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$414.67
Rate for Payer: Qualcare PPO/HMO/WC	$282.73

CATH BALLOON SLALOM 438-5040X

Facility

$1,884.85

Hospital Charge Code	270626422
Hospital Revenue Code	278
Min. Negotiated Rate	$45.42
Max. Negotiated Rate	$942.42
Rate for Payer: Aetna Commercial	$716.24
Rate for Payer: Aetna Medicare Advantage	$565.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$480.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$480.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$480.64
Rate for Payer: Cigna Commercial	$942.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$456.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$414.67
Rate for Payer: Qualcare PPO/HMO/WC	$282.73
Rate for Payer: UnitedHealthcare Community & State	$45.42
Rate for Payer: Wellpoint Medicaid Managed Care	$49.95

CATH BALLOON SLALOM 438-5040X

Facility

$1,900.00

Hospital Charge Code	270626422V
Hospital Revenue Code	278
Min. Negotiated Rate	$45.79
Max. Negotiated Rate	$950.00
Rate for Payer: Aetna Commercial	$722.00
Rate for Payer: Aetna Medicare Advantage	$570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$484.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$484.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$380.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$484.50
Rate for Payer: Cigna Commercial	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$418.00
Rate for Payer: Qualcare PPO/HMO/WC	$285.00
Rate for Payer: UnitedHealthcare Community & State	$45.79
Rate for Payer: Wellpoint Medicaid Managed Care	$50.35

CATH BALLOON SLALOM 438-5040X

Facility

$1,900.00

Hospital Charge Code	270626422V
Hospital Revenue Code	278
Min. Negotiated Rate	$285.00
Max. Negotiated Rate	$459.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$380.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$418.00
Rate for Payer: Qualcare PPO/HMO/WC	$285.00

CATH BALLOON SLALOM 438-6040X

Facility

$1,884.85

Hospital Charge Code	270626423V
Hospital Revenue Code	278
Min. Negotiated Rate	$45.42
Max. Negotiated Rate	$942.42
Rate for Payer: Aetna Commercial	$716.24
Rate for Payer: Aetna Medicare Advantage	$565.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$480.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$480.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$480.64
Rate for Payer: Cigna Commercial	$942.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$456.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$414.67
Rate for Payer: Qualcare PPO/HMO/WC	$282.73
Rate for Payer: UnitedHealthcare Community & State	$45.42
Rate for Payer: Wellpoint Medicaid Managed Care	$49.95

CATH BALLOON SLALOM 438-6040X

Facility

$1,884.85

Hospital Charge Code	270626423V
Hospital Revenue Code	278
Min. Negotiated Rate	$282.73
Max. Negotiated Rate	$456.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$456.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$414.67
Rate for Payer: Qualcare PPO/HMO/WC	$282.73

CATH BALLOON SLALOM 438-6040X

Facility

$1,884.85

Hospital Charge Code	270626423
Hospital Revenue Code	278
Min. Negotiated Rate	$45.42
Max. Negotiated Rate	$942.42
Rate for Payer: Aetna Commercial	$716.24
Rate for Payer: Aetna Medicare Advantage	$565.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$480.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$480.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$480.64
Rate for Payer: Cigna Commercial	$942.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$456.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$414.67
Rate for Payer: Qualcare PPO/HMO/WC	$282.73
Rate for Payer: UnitedHealthcare Community & State	$45.42
Rate for Payer: Wellpoint Medicaid Managed Care	$49.95

CATH BALLOON SLALOM 438-6040X

Facility

$1,884.85

Hospital Charge Code	270626423
Hospital Revenue Code	278
Min. Negotiated Rate	$282.73
Max. Negotiated Rate	$456.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$456.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$414.67
Rate for Payer: Qualcare PPO/HMO/WC	$282.73

CATHBALLOONUT/SDS OTW10/2/75

Facility

$271.00

Hospital Charge Code	270653620
Hospital Revenue Code	278
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$135.50
Rate for Payer: Aetna Commercial	$102.98
Rate for Payer: Aetna Medicare Advantage	$81.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.11
Rate for Payer: Cigna Commercial	$135.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$59.62
Rate for Payer: Qualcare PPO/HMO/WC	$40.65
Rate for Payer: UnitedHealthcare Community & State	$6.53
Rate for Payer: Wellpoint Medicaid Managed Care	$7.18

CATHBALLOONUT/SDS OTW10/2/75

Facility

$271.00

Hospital Charge Code	270653620
Hospital Revenue Code	278
Min. Negotiated Rate	$40.65
Max. Negotiated Rate	$65.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$59.62
Rate for Payer: Qualcare PPO/HMO/WC	$40.65

CATH BALLOON UT/SDS OTW 6/8/75

Facility

$857.50

Hospital Charge Code	270653610
Hospital Revenue Code	278
Min. Negotiated Rate	$20.67
Max. Negotiated Rate	$428.75
Rate for Payer: Aetna Commercial	$325.85
Rate for Payer: Aetna Medicare Advantage	$257.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.66
Rate for Payer: Cigna Commercial	$428.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$188.65
Rate for Payer: Qualcare PPO/HMO/WC	$128.62
Rate for Payer: UnitedHealthcare Community & State	$20.67
Rate for Payer: Wellpoint Medicaid Managed Care	$22.72

CATH BALLOON UT/SDS OTW 6/8/75

Facility

$857.50

Hospital Charge Code	270653610
Hospital Revenue Code	278
Min. Negotiated Rate	$128.62
Max. Negotiated Rate	$207.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$188.65
Rate for Payer: Qualcare PPO/HMO/WC	$128.62

CATHBALLOONVOYAGERRXCOMP1.5X12

Facility

$850.00

Hospital Charge Code	2709001127
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

CATHBALLOONVOYAGERRXCOMP1.5X12

Facility

$850.00

Hospital Charge Code	2709001127
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.00
Rate for Payer: Oxford Commercial	$170.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$170.00
Rate for Payer: UnitedHealthcare Community & State	$20.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.52

CATHBALLOONVOYAGERRXCOMP3.0X20

Facility

$850.00

Hospital Charge Code	2709001134
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

CATHBALLOONVOYAGERRXCOMP3.0X20

Facility

$850.00

Hospital Charge Code	2709001134
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.00
Rate for Payer: Oxford Commercial	$170.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$170.00
Rate for Payer: UnitedHealthcare Community & State	$20.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.52

CATHBALLOONVOYAGERRXCOMP3.5X12

Facility

$1,275.00

Hospital Charge Code	2709001131
Hospital Revenue Code	272
Min. Negotiated Rate	$30.73
Max. Negotiated Rate	$637.50
Rate for Payer: Aetna Commercial	$484.50
Rate for Payer: Aetna Medicare Advantage	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.12
Rate for Payer: Cigna Commercial	$637.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$382.50
Rate for Payer: Oxford Commercial	$255.00
Rate for Payer: Qualcare PPO/HMO/WC	$191.25
Rate for Payer: UnitedHealthcare Commercial	$255.00
Rate for Payer: UnitedHealthcare Community & State	$30.73
Rate for Payer: Wellpoint Medicaid Managed Care	$33.79

CATHBALLOONVOYAGERRXCOMP3.5X12

Facility

$1,275.00

Hospital Charge Code	2709001131
Hospital Revenue Code	272
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$191.25
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

Know your out-of-pocket cost for care.

All Charges