Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH BALN DIAD 7x2x75 5F 16477

Facility

$1,020.00

Hospital Charge Code	270629351V
Hospital Revenue Code	278
Min. Negotiated Rate	$24.58
Max. Negotiated Rate	$510.00
Rate for Payer: Aetna Commercial	$387.60
Rate for Payer: Aetna Medicare Advantage	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.10
Rate for Payer: Cigna Commercial	$510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$224.40
Rate for Payer: Qualcare PPO/HMO/WC	$153.00
Rate for Payer: UnitedHealthcare Community & State	$24.58
Rate for Payer: Wellpoint Medicaid Managed Care	$27.03

CATH BALN DILA 3x4x135 10-537

Facility

$2,218.85

Service Code	HCPCS C1725
Hospital Charge Code	270
Hospital Revenue Code	272
Min. Negotiated Rate	$53.47
Max. Negotiated Rate	$1,109.42
Rate for Payer: Aetna Commercial	$843.16
Rate for Payer: Aetna Medicare Advantage	$665.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$565.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$565.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$565.81
Rate for Payer: Cigna Commercial	$1,109.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.65
Rate for Payer: Oxford Commercial	$443.77
Rate for Payer: Qualcare PPO/HMO/WC	$332.83
Rate for Payer: UnitedHealthcare Commercial	$443.77
Rate for Payer: UnitedHealthcare Community & State	$53.47
Rate for Payer: Wellpoint Medicaid Managed Care	$58.80

CATH BALN DILA 3x4x135 10-537

Facility

$2,218.85

Service Code	HCPCS C1725
Hospital Charge Code	270
Hospital Revenue Code	272
Min. Negotiated Rate	$332.83
Max. Negotiated Rate	$332.83
Rate for Payer: Qualcare PPO/HMO/WC	$332.83

CATH BALN POWER 10X4 4200040S

Facility

$1,264.00

Hospital Charge Code	270626106
Hospital Revenue Code	272
Min. Negotiated Rate	$189.60
Max. Negotiated Rate	$189.60
Rate for Payer: Qualcare PPO/HMO/WC	$189.60

CATH BALN POWER 10X4 4200040S

Facility

$1,264.00

Hospital Charge Code	270626106
Hospital Revenue Code	272
Min. Negotiated Rate	$30.46
Max. Negotiated Rate	$632.00
Rate for Payer: Aetna Commercial	$480.32
Rate for Payer: Aetna Medicare Advantage	$379.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$322.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$322.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$322.32
Rate for Payer: Cigna Commercial	$632.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$379.20
Rate for Payer: Oxford Commercial	$252.80
Rate for Payer: Qualcare PPO/HMO/WC	$189.60
Rate for Payer: UnitedHealthcare Commercial	$252.80
Rate for Payer: UnitedHealthcare Community & State	$30.46
Rate for Payer: Wellpoint Medicaid Managed Care	$33.50

CATH BALN SL 4x4 135c 4384040X

Facility

$1,884.85

Hospital Charge Code	270630842
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 BALN SL 4x4 135c 4384040X

Facility

$1,884.85

Hospital Charge Code	270630842
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 BALN SL 4x4 135c 4384040X

Facility

$1,900.00

Hospital Charge Code	270630842V
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 BALN SL 4x4 135c 4384040X

Facility

$1,900.00

Hospital Charge Code	270630842V
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 BALN SLAM 5x4 80 4385040S

Facility

$1,884.85

Hospital Charge Code	270630608
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 BALN SLAM 5x4 80 4385040S

Facility

$1,884.85

Hospital Charge Code	270630608
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 BALN SLAM 5x4 80 4385040S

Facility

$1,884.85

Hospital Charge Code	270630608V
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 BALN SLAM 5x4 80 4385040S

Facility

$1,884.85

Hospital Charge Code	270630608V
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 BALN SLM 8x4 135 4388040X

Facility

$1,900.00

Hospital Charge Code	270624764V
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 BALN SLM 8x4 135 4388040X

Facility

$1,900.00

Hospital Charge Code	270624764V
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 BALN SLM 8x4 135 4388040X

Facility

$1,884.85

Hospital Charge Code	270624764
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 BALN SLM 8x4 135 4388040X

Facility

$1,884.85

Hospital Charge Code	270624764
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 BALN SLOM 7x2 80 4387020S

Facility

$1,900.00

Hospital Charge Code	270631031V
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 BALN SLOM 7x2 80 4387020S

Facility

$1,884.85

Hospital Charge Code	270631031
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 BALN SLOM 7x2 80 4387020S

Facility

$1,884.85

Hospital Charge Code	270631031
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 BALN SLOM 7x2 80 4387020S

Facility

$1,900.00

Hospital Charge Code	270631031V
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 BALN TALON 5-2 135c 11612

Facility

$1,927.40

Hospital Charge Code	270623535V
Hospital Revenue Code	278
Min. Negotiated Rate	$46.45
Max. Negotiated Rate	$963.70
Rate for Payer: Aetna Commercial	$732.41
Rate for Payer: Aetna Medicare Advantage	$578.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$491.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$491.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$385.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$491.49
Rate for Payer: Cigna Commercial	$963.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$466.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$424.03
Rate for Payer: Qualcare PPO/HMO/WC	$289.11
Rate for Payer: UnitedHealthcare Community & State	$46.45
Rate for Payer: Wellpoint Medicaid Managed Care	$51.08

CATH BALN TALON 5-2 135c 11612

Facility

$1,912.00

Hospital Charge Code	270623535
Hospital Revenue Code	278
Min. Negotiated Rate	$286.80
Max. Negotiated Rate	$462.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$382.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$462.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$420.64
Rate for Payer: Qualcare PPO/HMO/WC	$286.80

CATH BALN TALON 5-2 135c 11612

Facility

$1,912.00

Hospital Charge Code	270623535
Hospital Revenue Code	278
Min. Negotiated Rate	$46.08
Max. Negotiated Rate	$956.00
Rate for Payer: Aetna Commercial	$726.56
Rate for Payer: Aetna Medicare Advantage	$573.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$487.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$487.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$382.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$487.56
Rate for Payer: Cigna Commercial	$956.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$462.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$420.64
Rate for Payer: Qualcare PPO/HMO/WC	$286.80
Rate for Payer: UnitedHealthcare Community & State	$46.08
Rate for Payer: Wellpoint Medicaid Managed Care	$50.67

CATH BALN TALON 5-2 135c 11612

Facility

$1,927.40

Hospital Charge Code	270623535V
Hospital Revenue Code	278
Min. Negotiated Rate	$289.11
Max. Negotiated Rate	$466.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$385.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$466.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$424.03
Rate for Payer: Qualcare PPO/HMO/WC	$289.11

Know your out-of-pocket cost for care.

All Charges