Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH BIOFLO PICC SNGL 145cm

Facility

$575.00

Service Code	HCPCS C1751
Hospital Charge Code	270673434
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$126.50
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

CATH BIOFLO PICC SNGL 145cm

Facility

$575.00

Service Code	HCPCS C1751
Hospital Charge Code	270673434
Hospital Revenue Code	278
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$218.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$126.50
Rate for Payer: Qualcare PPO/HMO/WC	$86.25
Rate for Payer: UnitedHealthcare Community & State	$13.86
Rate for Payer: Wellpoint Medicaid Managed Care	$15.24

CATH BIOFLOW DURAMAX 19CM

Facility

$1,250.00

Hospital Charge Code	270676455
Hospital Revenue Code	272
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

CATH BIOFLOW DURAMAX 19CM

Facility

$1,250.00

Hospital Charge Code	270676455
Hospital Revenue Code	272
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$250.00
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

CATH BIOFLOW DURAMAX 23CM

Facility

$1,250.00

Hospital Charge Code	270676456
Hospital Revenue Code	272
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$250.00
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

CATH BIOFLOW DURAMAX 23CM

Facility

$1,250.00

Hospital Charge Code	270676456
Hospital Revenue Code	272
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

CATH BIOFLOW DURAMAX 27CM

Facility

$1,250.00

Hospital Charge Code	270676457
Hospital Revenue Code	272
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$250.00
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

CATH BIOFLOW DURAMAX 27CM

Facility

$1,250.00

Hospital Charge Code	270676457
Hospital Revenue Code	272
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

CATH BLN ADM XTRM.035/4/40/130

Facility

$900.00

Hospital Charge Code	2700900359
Hospital Revenue Code	272
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.00
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Commercial	$180.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

CATH BLN ADM XTRM.035/4/40/130

Facility

$900.00

Hospital Charge Code	2700900359
Hospital Revenue Code	272
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

CATH BLN DIAD 7x2x75 5.8 16497

Facility

$1,020.00

Hospital Charge Code	270629352V
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 BLN DIAD 7x2x75 5.8 16497

Facility

$653.25

Hospital Charge Code	270629352
Hospital Revenue Code	278
Min. Negotiated Rate	$15.74
Max. Negotiated Rate	$326.62
Rate for Payer: Aetna Commercial	$248.24
Rate for Payer: Aetna Medicare Advantage	$195.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.58
Rate for Payer: Cigna Commercial	$326.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.72
Rate for Payer: Qualcare PPO/HMO/WC	$97.99
Rate for Payer: UnitedHealthcare Community & State	$15.74
Rate for Payer: Wellpoint Medicaid Managed Care	$17.31

CATH BLN DIAD 7x2x75 5.8 16497

Facility

$1,020.00

Hospital Charge Code	270629352V
Hospital Revenue Code	278
Min. Negotiated Rate	$153.00
Max. Negotiated Rate	$246.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
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

CATH BLN DIAD 7x2x75 5.8 16497

Facility

$653.25

Hospital Charge Code	270629352
Hospital Revenue Code	278
Min. Negotiated Rate	$97.99
Max. Negotiated Rate	$158.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.72
Rate for Payer: Qualcare PPO/HMO/WC	$97.99

CATH BLN DIL SYM 3x4x135 10537

Facility

$1,789.40

Hospital Charge Code	270628772V
Hospital Revenue Code	278
Min. Negotiated Rate	$43.12
Max. Negotiated Rate	$894.70
Rate for Payer: Aetna Commercial	$679.97
Rate for Payer: Aetna Medicare Advantage	$536.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$456.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$456.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$357.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$456.30
Rate for Payer: Cigna Commercial	$894.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$393.67
Rate for Payer: Qualcare PPO/HMO/WC	$268.41
Rate for Payer: UnitedHealthcare Community & State	$43.12
Rate for Payer: Wellpoint Medicaid Managed Care	$47.42

CATH BLN DIL SYM 3x4x135 10537

Facility

$1,789.40

Hospital Charge Code	270628772V
Hospital Revenue Code	278
Min. Negotiated Rate	$268.41
Max. Negotiated Rate	$433.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$357.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$393.67
Rate for Payer: Qualcare PPO/HMO/WC	$268.41

CATH BLN DIL SYM 5x4x135 10548

Facility

$1,775.10

Hospital Charge Code	270628773
Hospital Revenue Code	278
Min. Negotiated Rate	$266.26
Max. Negotiated Rate	$429.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$355.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$390.52
Rate for Payer: Qualcare PPO/HMO/WC	$266.26

CATH BLN DIL SYM 5x4x135 10548

Facility

$1,789.40

Hospital Charge Code	270628773V
Hospital Revenue Code	278
Min. Negotiated Rate	$43.12
Max. Negotiated Rate	$894.70
Rate for Payer: Aetna Commercial	$679.97
Rate for Payer: Aetna Medicare Advantage	$536.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$456.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$456.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$357.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$456.30
Rate for Payer: Cigna Commercial	$894.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$393.67
Rate for Payer: Qualcare PPO/HMO/WC	$268.41
Rate for Payer: UnitedHealthcare Community & State	$43.12
Rate for Payer: Wellpoint Medicaid Managed Care	$47.42

CATH BLN DIL SYM 5x4x135 10548

Facility

$1,775.10

Hospital Charge Code	270628773
Hospital Revenue Code	278
Min. Negotiated Rate	$42.78
Max. Negotiated Rate	$887.55
Rate for Payer: Aetna Commercial	$674.54
Rate for Payer: Aetna Medicare Advantage	$532.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$452.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$452.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$355.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$452.65
Rate for Payer: Cigna Commercial	$887.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$390.52
Rate for Payer: Qualcare PPO/HMO/WC	$266.26
Rate for Payer: UnitedHealthcare Community & State	$42.78
Rate for Payer: Wellpoint Medicaid Managed Care	$47.04

CATH BLN DIL SYM 5x4x135 10548

Facility

$1,789.40

Hospital Charge Code	270628773V
Hospital Revenue Code	278
Min. Negotiated Rate	$268.41
Max. Negotiated Rate	$433.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$357.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$393.67
Rate for Payer: Qualcare PPO/HMO/WC	$268.41

CATH BLN OP P5 2x135c 4195020X

Facility

$1,264.00

Hospital Charge Code	270624402
Hospital Revenue Code	272
Min. Negotiated Rate	$189.60
Max. Negotiated Rate	$189.60
Rate for Payer: Qualcare PPO/HMO/WC	$189.60

CATH BLN OP P5 2x135c 4195020X

Facility

$1,264.00

Hospital Charge Code	270624402
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 BLN POWFLEX 9x4 4209040S

Facility

$1,325.00

Hospital Charge Code	270630174V
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

CATH BLN POWFLEX 9x4 4209040S

Facility

$1,325.00

Hospital Charge Code	270630174V
Hospital Revenue Code	278
Min. Negotiated Rate	$31.93
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$31.93
Rate for Payer: Wellpoint Medicaid Managed Care	$35.11

CATH BLN POWFLEX 9x4 4209040S

Facility

$1,314.45

Hospital Charge Code	270630174
Hospital Revenue Code	278
Min. Negotiated Rate	$197.17
Max. Negotiated Rate	$318.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$262.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$289.18
Rate for Payer: Qualcare PPO/HMO/WC	$197.17

Know your out-of-pocket cost for care.

All Charges