Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH CK TORCON 5F 220420

Facility

$80.00

Hospital Charge Code	270624344
Hospital Revenue Code	272
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00

CATH CK TORCON 5F 220420

Facility

$80.00

Hospital Charge Code	270624344
Hospital Revenue Code	272
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$40.00
Rate for Payer: Aetna Commercial	$30.40
Rate for Payer: Aetna Medicare Advantage	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.40
Rate for Payer: Cigna Commercial	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.00
Rate for Payer: Oxford Commercial	$16.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00
Rate for Payer: UnitedHealthcare Commercial	$16.00
Rate for Payer: UnitedHealthcare Community & State	$1.93
Rate for Payer: Wellpoint Medicaid Managed Care	$2.12

CATH CK URET 5 70 020040CS

Facility

$51.15

Service Code	HCPCS C1758
Hospital Charge Code	270624358
Hospital Revenue Code	278
Min. Negotiated Rate	$7.67
Max. Negotiated Rate	$12.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$7.67

CATH CK URET 5 70 020040CS

Facility

$51.15

Service Code	HCPCS C1758
Hospital Charge Code	270624358
Hospital Revenue Code	278
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$25.57
Rate for Payer: Aetna Commercial	$19.44
Rate for Payer: Aetna Medicare Advantage	$15.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.04
Rate for Payer: Cigna Commercial	$25.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$7.67
Rate for Payer: UnitedHealthcare Community & State	$1.23
Rate for Payer: Wellpoint Medicaid Managed Care	$1.36

CATH CK URET 6 70 020040C6

Facility

$51.15

Service Code	HCPCS C1758
Hospital Charge Code	270624727
Hospital Revenue Code	278
Min. Negotiated Rate	$7.67
Max. Negotiated Rate	$12.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$7.67

CATH CK URET 6 70 020040C6

Facility

$51.15

Service Code	HCPCS C1758
Hospital Charge Code	270624727
Hospital Revenue Code	278
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$25.57
Rate for Payer: Aetna Commercial	$19.44
Rate for Payer: Aetna Medicare Advantage	$15.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.04
Rate for Payer: Cigna Commercial	$25.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$7.67
Rate for Payer: UnitedHealthcare Community & State	$1.23
Rate for Payer: Wellpoint Medicaid Managed Care	$1.36

CATH CK URET 7 70 020047-C7

Facility

$32.85

Hospital Charge Code	270624432
Hospital Revenue Code	272
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$16.43
Rate for Payer: Aetna Commercial	$12.48
Rate for Payer: Aetna Medicare Advantage	$9.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.38
Rate for Payer: Cigna Commercial	$16.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.86
Rate for Payer: Oxford Commercial	$6.57
Rate for Payer: Qualcare PPO/HMO/WC	$4.93
Rate for Payer: UnitedHealthcare Commercial	$6.57
Rate for Payer: UnitedHealthcare Community & State	$0.79
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

CATH CK URET 7 70 020047-C7

Facility

$32.85

Hospital Charge Code	270624432
Hospital Revenue Code	272
Min. Negotiated Rate	$4.93
Max. Negotiated Rate	$4.93
Rate for Payer: Qualcare PPO/HMO/WC	$4.93

CATH CK URET BAL 5/65 010005**

Facility

$436.00

Hospital Charge Code	1604503
Hospital Revenue Code	272
Min. Negotiated Rate	$10.51
Max. Negotiated Rate	$218.00
Rate for Payer: Aetna Commercial	$165.68
Rate for Payer: Aetna Medicare Advantage	$130.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.18
Rate for Payer: Cigna Commercial	$218.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.80
Rate for Payer: Oxford Commercial	$87.20
Rate for Payer: Qualcare PPO/HMO/WC	$65.40
Rate for Payer: UnitedHealthcare Commercial	$87.20
Rate for Payer: UnitedHealthcare Community & State	$10.51
Rate for Payer: Wellpoint Medicaid Managed Care	$11.55

CATH CK URET BAL 5/65 010005**

Facility

$436.00

Hospital Charge Code	1604503
Hospital Revenue Code	272
Min. Negotiated Rate	$65.40
Max. Negotiated Rate	$65.40
Rate for Payer: Qualcare PPO/HMO/WC	$65.40

CATH CK URET BAL 7/65 010004**

Facility

$436.00

Hospital Charge Code	1604511
Hospital Revenue Code	272
Min. Negotiated Rate	$10.51
Max. Negotiated Rate	$218.00
Rate for Payer: Aetna Commercial	$165.68
Rate for Payer: Aetna Medicare Advantage	$130.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.18
Rate for Payer: Cigna Commercial	$218.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.80
Rate for Payer: Oxford Commercial	$87.20
Rate for Payer: Qualcare PPO/HMO/WC	$65.40
Rate for Payer: UnitedHealthcare Commercial	$87.20
Rate for Payer: UnitedHealthcare Community & State	$10.51
Rate for Payer: Wellpoint Medicaid Managed Care	$11.55

CATH CK URET BAL 7/65 010004**

Facility

$436.00

Hospital Charge Code	1604511
Hospital Revenue Code	272
Min. Negotiated Rate	$65.40
Max. Negotiated Rate	$65.40
Rate for Payer: Qualcare PPO/HMO/WC	$65.40

CATH CK URET BALN 5/65 010005

Facility

$703.50

Service Code	HCPCS C1726
Hospital Charge Code	270601087
Hospital Revenue Code	278
Min. Negotiated Rate	$105.53
Max. Negotiated Rate	$170.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.77
Rate for Payer: Qualcare PPO/HMO/WC	$105.53

CATH CK URET BALN 5/65 010005

Facility

$703.50

Service Code	HCPCS C1726
Hospital Charge Code	270601087
Hospital Revenue Code	278
Min. Negotiated Rate	$16.95
Max. Negotiated Rate	$351.75
Rate for Payer: Aetna Commercial	$267.33
Rate for Payer: Aetna Medicare Advantage	$211.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.39
Rate for Payer: Cigna Commercial	$351.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.77
Rate for Payer: Qualcare PPO/HMO/WC	$105.53
Rate for Payer: UnitedHealthcare Community & State	$16.95
Rate for Payer: Wellpoint Medicaid Managed Care	$18.64

CATH CK URET BALN 7/65 010004

Facility

$703.50

Service Code	HCPCS C1758
Hospital Charge Code	270605616
Hospital Revenue Code	278
Min. Negotiated Rate	$16.95
Max. Negotiated Rate	$351.75
Rate for Payer: Aetna Commercial	$267.33
Rate for Payer: Aetna Medicare Advantage	$211.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.39
Rate for Payer: Cigna Commercial	$351.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.77
Rate for Payer: Qualcare PPO/HMO/WC	$105.53
Rate for Payer: UnitedHealthcare Community & State	$16.95
Rate for Payer: Wellpoint Medicaid Managed Care	$18.64

CATH CK URET BALN 7/65 010004

Facility

$703.50

Service Code	HCPCS C1758
Hospital Charge Code	270605616
Hospital Revenue Code	278
Min. Negotiated Rate	$105.53
Max. Negotiated Rate	$170.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.77
Rate for Payer: Qualcare PPO/HMO/WC	$105.53

CATH CK URET CONE TP 5F 024605

Facility

$60.45

Service Code	HCPCS C1758
Hospital Charge Code	270601096
Hospital Revenue Code	278
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$30.23
Rate for Payer: Aetna Commercial	$22.97
Rate for Payer: Aetna Medicare Advantage	$18.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.41
Rate for Payer: Cigna Commercial	$30.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13.30
Rate for Payer: Qualcare PPO/HMO/WC	$9.07
Rate for Payer: UnitedHealthcare Community & State	$1.46
Rate for Payer: Wellpoint Medicaid Managed Care	$1.60

CATH CK URET CONE TP 5F 024605

Facility

$60.45

Service Code	HCPCS C1758
Hospital Charge Code	270601096
Hospital Revenue Code	278
Min. Negotiated Rate	$9.07
Max. Negotiated Rate	$14.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13.30
Rate for Payer: Qualcare PPO/HMO/WC	$9.07

CATH CK URET CONE TP 8F 024608

Facility

$83.25

Hospital Charge Code	270605388
Hospital Revenue Code	278
Min. Negotiated Rate	$12.49
Max. Negotiated Rate	$20.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.32
Rate for Payer: Qualcare PPO/HMO/WC	$12.49

CATH CK URET CONE TP 8F 024608

Facility

$83.25

Hospital Charge Code	270605388
Hospital Revenue Code	278
Min. Negotiated Rate	$2.01
Max. Negotiated Rate	$41.62
Rate for Payer: Aetna Commercial	$31.64
Rate for Payer: Aetna Medicare Advantage	$24.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.23
Rate for Payer: Cigna Commercial	$41.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.32
Rate for Payer: Qualcare PPO/HMO/WC	$12.49
Rate for Payer: UnitedHealthcare Community & State	$2.01
Rate for Payer: Wellpoint Medicaid Managed Care	$2.21

CATH CK URET PIGTL 5F 025305

Facility

$360.85

Hospital Charge Code	270601077
Hospital Revenue Code	278
Min. Negotiated Rate	$54.13
Max. Negotiated Rate	$87.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$79.39
Rate for Payer: Qualcare PPO/HMO/WC	$54.13

CATH CK URET PIGTL 5F 025305

Facility

$360.85

Hospital Charge Code	270601077
Hospital Revenue Code	278
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$180.43
Rate for Payer: Aetna Commercial	$137.12
Rate for Payer: Aetna Medicare Advantage	$108.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.02
Rate for Payer: Cigna Commercial	$180.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$79.39
Rate for Payer: Qualcare PPO/HMO/WC	$54.13
Rate for Payer: UnitedHealthcare Community & State	$8.70
Rate for Payer: Wellpoint Medicaid Managed Care	$9.56

CATH CK URET PIGTL 5F 025305**

Facility

$157.00

Hospital Charge Code	1604578
Hospital Revenue Code	272
Min. Negotiated Rate	$3.78
Max. Negotiated Rate	$78.50
Rate for Payer: Aetna Commercial	$59.66
Rate for Payer: Aetna Medicare Advantage	$47.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.03
Rate for Payer: Cigna Commercial	$78.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.10
Rate for Payer: Oxford Commercial	$31.40
Rate for Payer: Qualcare PPO/HMO/WC	$23.55
Rate for Payer: UnitedHealthcare Commercial	$31.40
Rate for Payer: UnitedHealthcare Community & State	$3.78
Rate for Payer: Wellpoint Medicaid Managed Care	$4.16

CATH CK URET PIGTL 5F 025305**

Facility

$157.00

Hospital Charge Code	1604578
Hospital Revenue Code	272
Min. Negotiated Rate	$23.55
Max. Negotiated Rate	$23.55
Rate for Payer: Qualcare PPO/HMO/WC	$23.55

CATH CK URET PIGTL 5F 036500

Facility

$923.25

Hospital Charge Code	270605599
Hospital Revenue Code	278
Min. Negotiated Rate	$22.25
Max. Negotiated Rate	$461.62
Rate for Payer: Aetna Commercial	$350.83
Rate for Payer: Aetna Medicare Advantage	$276.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.43
Rate for Payer: Cigna Commercial	$461.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$203.12
Rate for Payer: Qualcare PPO/HMO/WC	$138.49
Rate for Payer: UnitedHealthcare Community & State	$22.25
Rate for Payer: Wellpoint Medicaid Managed Care	$24.47

Know your out-of-pocket cost for care.

All Charges