Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH CANON II 15FR 32c CS15322

Facility

$1,587.10

Service Code	HCPCS C1752
Hospital Charge Code	270631856
Hospital Revenue Code	278
Min. Negotiated Rate	$238.06
Max. Negotiated Rate	$384.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$317.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$384.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$349.16
Rate for Payer: Qualcare PPO/HMO/WC	$238.06

CATH CANON II 15FR 32c CS15322

Facility

$1,587.10

Service Code	HCPCS C1752
Hospital Charge Code	270631856
Hospital Revenue Code	278
Min. Negotiated Rate	$38.25
Max. Negotiated Rate	$793.55
Rate for Payer: Aetna Commercial	$603.10
Rate for Payer: Aetna Medicare Advantage	$476.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$404.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$404.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$317.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$404.71
Rate for Payer: Cigna Commercial	$793.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$384.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$349.16
Rate for Payer: Qualcare PPO/HMO/WC	$238.06
Rate for Payer: UnitedHealthcare Community & State	$38.25
Rate for Payer: Wellpoint Medicaid Managed Care	$42.06

CATH CANON II 15FR 32c CS15322

Facility

$1,936.15

Hospital Charge Code	270631856V
Hospital Revenue Code	278
Min. Negotiated Rate	$290.42
Max. Negotiated Rate	$468.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$387.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$468.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$425.95
Rate for Payer: Qualcare PPO/HMO/WC	$290.42

CATH CANON II 15FR 32c CS15322

Facility

$1,936.15

Hospital Charge Code	270631856V
Hospital Revenue Code	278
Min. Negotiated Rate	$46.66
Max. Negotiated Rate	$968.08
Rate for Payer: Aetna Commercial	$735.74
Rate for Payer: Aetna Medicare Advantage	$580.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$493.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$493.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$387.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$493.72
Rate for Payer: Cigna Commercial	$968.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$468.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$425.95
Rate for Payer: Qualcare PPO/HMO/WC	$290.42
Rate for Payer: UnitedHealthcare Community & State	$46.66
Rate for Payer: Wellpoint Medicaid Managed Care	$51.31

CATH CENTERCROSS ANCHOR DEVIC

Facility

$7,475.00

Hospital Charge Code	270683237
Hospital Revenue Code	272
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,121.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

CATH CENTERCROSS ANCHOR DEVIC

Facility

$7,475.00

Hospital Charge Code	270683237N
Hospital Revenue Code	272
Min. Negotiated Rate	$180.15
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,242.50
Rate for Payer: Oxford Commercial	$1,495.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Commercial	$1,495.00
Rate for Payer: UnitedHealthcare Community & State	$180.15
Rate for Payer: Wellpoint Medicaid Managed Care	$198.09

CATH CENTERCROSS ANCHOR DEVIC

Facility

$7,475.00

Hospital Charge Code	270683237
Hospital Revenue Code	272
Min. Negotiated Rate	$180.15
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,242.50
Rate for Payer: Oxford Commercial	$1,495.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Commercial	$1,495.00
Rate for Payer: UnitedHealthcare Community & State	$180.15
Rate for Payer: Wellpoint Medicaid Managed Care	$198.09

CATH CENTERCROSS ANCHOR DEVIC

Facility

$7,475.00

Hospital Charge Code	270683237N
Hospital Revenue Code	272
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,121.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

CATH CENTRAL VENOUS OXIMETRY

Facility

$2,750.00

Service Code	HCPCS C1751
Hospital Charge Code	270689001
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

CATH CENTRAL VENOUS OXIMETRY

Facility

$2,750.00

Service Code	HCPCS C1751
Hospital Charge Code	270689001
Hospital Revenue Code	278
Min. Negotiated Rate	$66.28
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Community & State	$66.28
Rate for Payer: Wellpoint Medicaid Managed Care	$72.88

CATH CHEMO SITE 10.5FR 120110

Facility

$2,684.85

Hospital Charge Code	270605597
Hospital Revenue Code	278
Min. Negotiated Rate	$402.73
Max. Negotiated Rate	$649.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$536.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$649.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$590.67
Rate for Payer: Qualcare PPO/HMO/WC	$402.73

CATH CHEMO SITE 10.5FR 120110

Facility

$2,684.85

Hospital Charge Code	270605597
Hospital Revenue Code	278
Min. Negotiated Rate	$64.70
Max. Negotiated Rate	$1,342.42
Rate for Payer: Aetna Commercial	$1,020.24
Rate for Payer: Aetna Medicare Advantage	$805.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$684.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$684.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$536.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$684.64
Rate for Payer: Cigna Commercial	$1,342.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$649.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$590.67
Rate for Payer: Qualcare PPO/HMO/WC	$402.73
Rate for Payer: UnitedHealthcare Community & State	$64.70
Rate for Payer: Wellpoint Medicaid Managed Care	$71.15

CATH CHOCOLATE 4.0X40CM

Facility

$5,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270684604
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,155.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

CATH CHOCOLATE 4.0X40CM

Facility

$5,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270684604
Hospital Revenue Code	278
Min. Negotiated Rate	$126.53
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,995.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,155.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Community & State	$126.53
Rate for Payer: Wellpoint Medicaid Managed Care	$139.12

CATH CHOCOLATE 5.0X120CM

Facility

$5,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270687524
Hospital Revenue Code	278
Min. Negotiated Rate	$126.53
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,995.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,155.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Community & State	$126.53
Rate for Payer: Wellpoint Medicaid Managed Care	$139.12

CATH CHOCOLATE 5.0X120CM

Facility

$5,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270687524
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,155.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

CATH CHOLANGIOGRAPH 4 & 6FR***

Facility

$93.00

Hospital Charge Code	1600550
Hospital Revenue Code	272
Min. Negotiated Rate	$13.95
Max. Negotiated Rate	$13.95
Rate for Payer: Qualcare PPO/HMO/WC	$13.95

CATH CHOLANGIOGRAPH 4 & 6FR***

Facility

$93.00

Hospital Charge Code	1600550
Hospital Revenue Code	272
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$46.50
Rate for Payer: Aetna Commercial	$35.34
Rate for Payer: Aetna Medicare Advantage	$27.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.71
Rate for Payer: Cigna Commercial	$46.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.90
Rate for Payer: Oxford Commercial	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$13.95
Rate for Payer: UnitedHealthcare Commercial	$18.60
Rate for Payer: UnitedHealthcare Community & State	$2.24
Rate for Payer: Wellpoint Medicaid Managed Care	$2.46

CATH CHOLANGIOGRAPH 4FR

Facility

$300.00

Hospital Charge Code	270600380
Hospital Revenue Code	272
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.00
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$60.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

CATH CHOLANGIOGRAPH 4FR

Facility

$300.00

Hospital Charge Code	270600380
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

CATH CHOLANGIOGRAPH 6FR

Facility

$300.00

Hospital Charge Code	270600381
Hospital Revenue Code	272
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.00
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$60.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

CATH CHOLANGIOGRAPH 6FR

Facility

$300.00

Hospital Charge Code	270600381
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

CATH CK ANGIOGRAPH SZNG 250686

Facility

$973.65

Hospital Charge Code	270621637
Hospital Revenue Code	270
Min. Negotiated Rate	$146.05
Max. Negotiated Rate	$146.05
Rate for Payer: Qualcare PPO/HMO/WC	$146.05

CATH CK ANGIOGRAPH SZNG 250686

Facility

$973.65

Hospital Charge Code	270621637
Hospital Revenue Code	270
Min. Negotiated Rate	$23.46
Max. Negotiated Rate	$486.82
Rate for Payer: Aetna Commercial	$369.99
Rate for Payer: Aetna Medicare Advantage	$292.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.28
Rate for Payer: Cigna Commercial	$486.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.10
Rate for Payer: Oxford Commercial	$194.73
Rate for Payer: Qualcare PPO/HMO/WC	$146.05
Rate for Payer: UnitedHealthcare Commercial	$194.73
Rate for Payer: UnitedHealthcare Community & State	$23.46
Rate for Payer: Wellpoint Medicaid Managed Care	$25.80

CATH CK BALN DIL 7FR 200621

Facility

$1,382.45

Hospital Charge Code	270600990
Hospital Revenue Code	272
Min. Negotiated Rate	$207.37
Max. Negotiated Rate	$207.37
Rate for Payer: Qualcare PPO/HMO/WC	$207.37

Know your out-of-pocket cost for care.

All Charges