Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH CK URET PIGTL 5F 036500

Facility

$923.25

Hospital Charge Code	270605599
Hospital Revenue Code	278
Min. Negotiated Rate	$138.49
Max. Negotiated Rate	$223.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.65
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

CATH CK URET RTNR 5F 026205

Facility

$83.25

Hospital Charge Code	270602963
Hospital Revenue Code	272
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) PPO	$21.23
Rate for Payer: Cigna Commercial	$41.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.98
Rate for Payer: Oxford Commercial	$16.65
Rate for Payer: Qualcare PPO/HMO/WC	$12.49
Rate for Payer: UnitedHealthcare Commercial	$16.65
Rate for Payer: UnitedHealthcare Community & State	$2.01
Rate for Payer: Wellpoint Medicaid Managed Care	$2.21

CATH CK URET RTNR 5F 026205

Facility

$83.25

Hospital Charge Code	270602963
Hospital Revenue Code	272
Min. Negotiated Rate	$12.49
Max. Negotiated Rate	$12.49
Rate for Payer: Qualcare PPO/HMO/WC	$12.49

CATH CK URET RTNR 5X70 ******

Facility

$34.00

Hospital Charge Code	1604586
Hospital Revenue Code	272
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$5.10
Rate for Payer: Qualcare PPO/HMO/WC	$5.10

CATH CK URET RTNR 5X70 ******

Facility

$34.00

Hospital Charge Code	1604586
Hospital Revenue Code	272
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$17.00
Rate for Payer: Aetna Commercial	$12.92
Rate for Payer: Aetna Medicare Advantage	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.67
Rate for Payer: Cigna Commercial	$17.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.20
Rate for Payer: Oxford Commercial	$6.80
Rate for Payer: Qualcare PPO/HMO/WC	$5.10
Rate for Payer: UnitedHealthcare Commercial	$6.80
Rate for Payer: UnitedHealthcare Community & State	$0.82
Rate for Payer: Wellpoint Medicaid Managed Care	$0.90

CATH CK URET SPRL TP 5F 024405

Facility

$83.25

Hospital Charge Code	270601094
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 SPRL TP 5F 024405

Facility

$83.25

Hospital Charge Code	270601094
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 CLASS CROWN 2.0MM 145CM

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270681113
Hospital Revenue Code	278
Min. Negotiated Rate	$409.10
Max. Negotiated Rate	$8,487.50
Rate for Payer: Aetna Commercial	$6,450.50
Rate for Payer: Aetna Medicare Advantage	$5,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,328.62
Rate for Payer: Cigna Commercial	$8,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,734.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25
Rate for Payer: UnitedHealthcare Community & State	$409.10
Rate for Payer: Wellpoint Medicaid Managed Care	$449.84

CATH CLASS CROWN 2.0MM 145CM

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270681113
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,734.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATH CLASSIC CROWN 1.25mm

Facility

$15,975.00

Hospital Charge Code	270642639C
Hospital Revenue Code	278
Min. Negotiated Rate	$385.00
Max. Negotiated Rate	$7,987.50
Rate for Payer: Aetna Commercial	$6,070.50
Rate for Payer: Aetna Medicare Advantage	$4,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,073.62
Rate for Payer: Cigna Commercial	$7,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,865.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,514.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25
Rate for Payer: UnitedHealthcare Community & State	$385.00
Rate for Payer: Wellpoint Medicaid Managed Care	$423.34

CATH CLASSIC CROWN 1.25mm

Facility

$15,975.00

Hospital Charge Code	270642639C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,396.25
Max. Negotiated Rate	$3,865.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,865.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,514.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25

CATH CLASSIC CROWN 1.50mm

Facility

$15,975.00

Hospital Charge Code	270642011C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,396.25
Max. Negotiated Rate	$3,865.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,865.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,514.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25

CATH CLASSIC CROWN 1.50mm

Facility

$15,975.00

Hospital Charge Code	270642011C
Hospital Revenue Code	278
Min. Negotiated Rate	$385.00
Max. Negotiated Rate	$7,987.50
Rate for Payer: Aetna Commercial	$6,070.50
Rate for Payer: Aetna Medicare Advantage	$4,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,073.62
Rate for Payer: Cigna Commercial	$7,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,865.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,514.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25
Rate for Payer: UnitedHealthcare Community & State	$385.00
Rate for Payer: Wellpoint Medicaid Managed Care	$423.34

CATH CLASSIC CROWN 1.75 DB175L

Facility

$15,975.00

Hospital Charge Code	270642012V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,396.25
Max. Negotiated Rate	$3,865.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,865.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,514.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25

CATH CLASSIC CROWN 1.75 DB175L

Facility

$15,975.00

Hospital Charge Code	270642012V
Hospital Revenue Code	278
Min. Negotiated Rate	$385.00
Max. Negotiated Rate	$7,987.50
Rate for Payer: Aetna Commercial	$6,070.50
Rate for Payer: Aetna Medicare Advantage	$4,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,073.62
Rate for Payer: Cigna Commercial	$7,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,865.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,514.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25
Rate for Payer: UnitedHealthcare Community & State	$385.00
Rate for Payer: Wellpoint Medicaid Managed Care	$423.34

CATH CLASSIC CROWN 2.00mm

Facility

$15,975.00

Hospital Charge Code	270642013C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,396.25
Max. Negotiated Rate	$3,865.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,865.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,514.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25

CATH CLASSIC CROWN 2.00mm

Facility

$15,975.00

Hospital Charge Code	270642013C
Hospital Revenue Code	278
Min. Negotiated Rate	$385.00
Max. Negotiated Rate	$7,987.50
Rate for Payer: Aetna Commercial	$6,070.50
Rate for Payer: Aetna Medicare Advantage	$4,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,073.62
Rate for Payer: Cigna Commercial	$7,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,865.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,514.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25
Rate for Payer: UnitedHealthcare Community & State	$385.00
Rate for Payer: Wellpoint Medicaid Managed Care	$423.34

CATH CLSD SUCT TRACH DBL 14FR

Facility

$54.07

Hospital Charge Code	270650303
Hospital Revenue Code	272
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$27.04
Rate for Payer: Aetna Commercial	$20.55
Rate for Payer: Aetna Medicare Advantage	$16.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.79
Rate for Payer: Cigna Commercial	$27.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.22
Rate for Payer: Oxford Commercial	$10.81
Rate for Payer: Qualcare PPO/HMO/WC	$8.11
Rate for Payer: UnitedHealthcare Commercial	$10.81
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.43

CATH CLSD SUCT TRACH DBL 14FR

Facility

$54.07

Hospital Charge Code	270650303
Hospital Revenue Code	272
Min. Negotiated Rate	$8.11
Max. Negotiated Rate	$8.11
Rate for Payer: Qualcare PPO/HMO/WC	$8.11

CATH CLSSC CRWN 1.75mm DB-175L

Facility

$15,975.00

Hospital Charge Code	270642012C
Hospital Revenue Code	278
Min. Negotiated Rate	$385.00
Max. Negotiated Rate	$7,987.50
Rate for Payer: Aetna Commercial	$6,070.50
Rate for Payer: Aetna Medicare Advantage	$4,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,073.62
Rate for Payer: Cigna Commercial	$7,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,865.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,514.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25
Rate for Payer: UnitedHealthcare Community & State	$385.00
Rate for Payer: Wellpoint Medicaid Managed Care	$423.34

CATH CLSSC CRWN 1.75mm DB-175L

Facility

$15,975.00

Hospital Charge Code	270642012C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,396.25
Max. Negotiated Rate	$3,865.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,865.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,514.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25

CATH CLSSCRWN ORB ARTHR 1.50mm

Facility

$15,975.00

Hospital Charge Code	2709003736
Hospital Revenue Code	272
Min. Negotiated Rate	$2,396.25
Max. Negotiated Rate	$2,396.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25

CATH CLSSCRWN ORB ARTHR 1.50mm

Facility

$15,975.00

Hospital Charge Code	2709003736
Hospital Revenue Code	272
Min. Negotiated Rate	$385.00
Max. Negotiated Rate	$7,987.50
Rate for Payer: Aetna Commercial	$6,070.50
Rate for Payer: Aetna Medicare Advantage	$4,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,073.62
Rate for Payer: Cigna Commercial	$7,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,792.50
Rate for Payer: Oxford Commercial	$3,195.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25
Rate for Payer: UnitedHealthcare Commercial	$3,195.00
Rate for Payer: UnitedHealthcare Community & State	$385.00
Rate for Payer: Wellpoint Medicaid Managed Care	$423.34

CATH COATED GLIDEX 10FR 25CM

Facility

$233.45

Hospital Charge Code	270675447
Hospital Revenue Code	278
Min. Negotiated Rate	$5.63
Max. Negotiated Rate	$116.72
Rate for Payer: Aetna Commercial	$88.71
Rate for Payer: Aetna Medicare Advantage	$70.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.53
Rate for Payer: Cigna Commercial	$116.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$51.36
Rate for Payer: Qualcare PPO/HMO/WC	$35.02
Rate for Payer: UnitedHealthcare Community & State	$5.63
Rate for Payer: Wellpoint Medicaid Managed Care	$6.19

CATH COATED GLIDEX 10FR 25CM

Facility

$233.45

Hospital Charge Code	270675447
Hospital Revenue Code	278
Min. Negotiated Rate	$35.02
Max. Negotiated Rate	$56.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$51.36
Rate for Payer: Qualcare PPO/HMO/WC	$35.02

Know your out-of-pocket cost for care.

All Charges