Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH COUDE 2W 20FR 30CC

Facility

$48.80

Hospital Charge Code	270303265
Hospital Revenue Code	272
Min. Negotiated Rate	$7.32
Max. Negotiated Rate	$7.32
Rate for Payer: Qualcare PPO/HMO/WC	$7.32

CATH COUDE 2W 22FR 30CC

Facility

$48.33

Hospital Charge Code	270303270
Hospital Revenue Code	272
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$24.16
Rate for Payer: Aetna Commercial	$18.37
Rate for Payer: Aetna Medicare Advantage	$14.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.32
Rate for Payer: Cigna Commercial	$24.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.50
Rate for Payer: Oxford Commercial	$9.67
Rate for Payer: Qualcare PPO/HMO/WC	$7.25
Rate for Payer: UnitedHealthcare Commercial	$9.67
Rate for Payer: UnitedHealthcare Community & State	$1.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.28

CATH COUDE 2W 22FR 30CC

Facility

$48.33

Hospital Charge Code	270303270
Hospital Revenue Code	272
Min. Negotiated Rate	$7.25
Max. Negotiated Rate	$7.25
Rate for Payer: Qualcare PPO/HMO/WC	$7.25

CATH COUDE 2W 24FR 30CC

Facility

$128.00

Hospital Charge Code	270303275
Hospital Revenue Code	272
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

CATH COUDE 2W 24FR 30CC

Facility

$128.00

Hospital Charge Code	270303275
Hospital Revenue Code	272
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$64.00
Rate for Payer: Aetna Commercial	$48.64
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.40
Rate for Payer: Oxford Commercial	$25.60
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$25.60
Rate for Payer: UnitedHealthcare Community & State	$3.08
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

CATH COUDE 2W 26FR 30CC

Facility

$128.00

Hospital Charge Code	270303280
Hospital Revenue Code	272
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$64.00
Rate for Payer: Aetna Commercial	$48.64
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.40
Rate for Payer: Oxford Commercial	$25.60
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$25.60
Rate for Payer: UnitedHealthcare Community & State	$3.08
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

CATH COUDE 2W 26FR 30CC

Facility

$128.00

Hospital Charge Code	270303280
Hospital Revenue Code	272
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

CATH COUDE 30 CC****

Facility

$64.00

Hospital Charge Code	8002768
Hospital Revenue Code	279
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$32.00
Rate for Payer: Aetna Commercial	$24.32
Rate for Payer: Aetna Medicare Advantage	$19.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.32
Rate for Payer: Cigna Commercial	$32.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.20
Rate for Payer: Oxford Commercial	$12.80
Rate for Payer: Qualcare PPO/HMO/WC	$9.60
Rate for Payer: UnitedHealthcare Commercial	$12.80
Rate for Payer: UnitedHealthcare Community & State	$1.54
Rate for Payer: Wellpoint Medicaid Managed Care	$1.70

CATH COUDE 30 CC****

Facility

$64.00

Hospital Charge Code	8002768
Hospital Revenue Code	279
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

CATH COUDE 3W 22FR

Facility

$137.14

Hospital Charge Code	27064778
Hospital Revenue Code	272
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$68.57
Rate for Payer: Aetna Commercial	$52.11
Rate for Payer: Aetna Medicare Advantage	$41.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.97
Rate for Payer: Cigna Commercial	$68.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.14
Rate for Payer: Oxford Commercial	$27.43
Rate for Payer: Qualcare PPO/HMO/WC	$20.57
Rate for Payer: UnitedHealthcare Commercial	$27.43
Rate for Payer: UnitedHealthcare Community & State	$3.31
Rate for Payer: Wellpoint Medicaid Managed Care	$3.63

CATH COUDE 3W 22FR

Facility

$137.14

Hospital Charge Code	27064778
Hospital Revenue Code	272
Min. Negotiated Rate	$20.57
Max. Negotiated Rate	$20.57
Rate for Payer: Qualcare PPO/HMO/WC	$20.57

CATH COUDE ALL SIZES ******

Facility

$38.00

Hospital Charge Code	8000358
Hospital Revenue Code	279
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$19.00
Rate for Payer: Aetna Commercial	$14.44
Rate for Payer: Aetna Medicare Advantage	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.69
Rate for Payer: Cigna Commercial	$19.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.40
Rate for Payer: Oxford Commercial	$7.60
Rate for Payer: Qualcare PPO/HMO/WC	$5.70
Rate for Payer: UnitedHealthcare Commercial	$7.60
Rate for Payer: UnitedHealthcare Community & State	$0.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1.01

CATH COUDE ALL SIZES ******

Facility

$38.00

Hospital Charge Code	8000358
Hospital Revenue Code	279
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$5.70

CATH COUNCIL 2WAY 18FR 5cc

Facility

$147.50

Hospital Charge Code	270651012
Hospital Revenue Code	272
Min. Negotiated Rate	$22.12
Max. Negotiated Rate	$22.12
Rate for Payer: Qualcare PPO/HMO/WC	$22.12

CATH COUNCIL 2WAY 18FR 5cc

Facility

$147.50

Hospital Charge Code	270651012
Hospital Revenue Code	272
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$73.75
Rate for Payer: Aetna Commercial	$56.05
Rate for Payer: Aetna Medicare Advantage	$44.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.61
Rate for Payer: Cigna Commercial	$73.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.25
Rate for Payer: Oxford Commercial	$29.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.12
Rate for Payer: UnitedHealthcare Commercial	$29.50
Rate for Payer: UnitedHealthcare Community & State	$3.55
Rate for Payer: Wellpoint Medicaid Managed Care	$3.91

CATH COUNCIL TIP 2WAY 16FR 5CC

Facility

$61.76

Hospital Charge Code	270625258
Hospital Revenue Code	272
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$30.88
Rate for Payer: Aetna Commercial	$23.47
Rate for Payer: Aetna Medicare Advantage	$18.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.75
Rate for Payer: Cigna Commercial	$30.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.53
Rate for Payer: Oxford Commercial	$12.35
Rate for Payer: Qualcare PPO/HMO/WC	$9.26
Rate for Payer: UnitedHealthcare Commercial	$12.35
Rate for Payer: UnitedHealthcare Community & State	$1.49
Rate for Payer: Wellpoint Medicaid Managed Care	$1.64

CATH COUNCIL TIP 2WAY 16FR 5CC

Facility

$61.76

Hospital Charge Code	270625258
Hospital Revenue Code	272
Min. Negotiated Rate	$9.26
Max. Negotiated Rate	$9.26
Rate for Payer: Qualcare PPO/HMO/WC	$9.26

CATH COUNCL TIP 20 5 200196L20

Facility

$61.76

Hospital Charge Code	270633135
Hospital Revenue Code	272
Min. Negotiated Rate	$9.26
Max. Negotiated Rate	$9.26
Rate for Payer: Qualcare PPO/HMO/WC	$9.26

CATH COUNCL TIP 20 5 200196L20

Facility

$61.76

Hospital Charge Code	270633135
Hospital Revenue Code	272
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$30.88
Rate for Payer: Aetna Commercial	$23.47
Rate for Payer: Aetna Medicare Advantage	$18.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.75
Rate for Payer: Cigna Commercial	$30.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.53
Rate for Payer: Oxford Commercial	$12.35
Rate for Payer: Qualcare PPO/HMO/WC	$9.26
Rate for Payer: UnitedHealthcare Commercial	$12.35
Rate for Payer: UnitedHealthcare Community & State	$1.49
Rate for Payer: Wellpoint Medicaid Managed Care	$1.64

CATH COYOTE 3x150MM 150CM

Facility

$1,866.90

Hospital Charge Code	270676336
Hospital Revenue Code	278
Min. Negotiated Rate	$280.04
Max. Negotiated Rate	$451.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$373.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$451.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$410.72
Rate for Payer: Qualcare PPO/HMO/WC	$280.04

CATH COYOTE 3x150MM 150CM

Facility

$1,866.90

Hospital Charge Code	270676336
Hospital Revenue Code	278
Min. Negotiated Rate	$44.99
Max. Negotiated Rate	$933.45
Rate for Payer: Aetna Commercial	$709.42
Rate for Payer: Aetna Medicare Advantage	$560.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$476.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$476.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$373.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$476.06
Rate for Payer: Cigna Commercial	$933.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$451.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$410.72
Rate for Payer: Qualcare PPO/HMO/WC	$280.04
Rate for Payer: UnitedHealthcare Community & State	$44.99
Rate for Payer: Wellpoint Medicaid Managed Care	$49.47

CATH COYOTE OTW 2.5x120MM

Facility

$1,866.90

Service Code	HCPCS C1725
Hospital Charge Code	270673987
Hospital Revenue Code	278
Min. Negotiated Rate	$280.04
Max. Negotiated Rate	$451.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$373.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$451.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$410.72
Rate for Payer: Qualcare PPO/HMO/WC	$280.04

CATH COYOTE OTW 2.5x120MM

Facility

$1,866.90

Service Code	HCPCS C1725
Hospital Charge Code	270673987
Hospital Revenue Code	278
Min. Negotiated Rate	$44.99
Max. Negotiated Rate	$933.45
Rate for Payer: Aetna Commercial	$709.42
Rate for Payer: Aetna Medicare Advantage	$560.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$476.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$476.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$373.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$476.06
Rate for Payer: Cigna Commercial	$933.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$451.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$410.72
Rate for Payer: Qualcare PPO/HMO/WC	$280.04
Rate for Payer: UnitedHealthcare Community & State	$44.99
Rate for Payer: Wellpoint Medicaid Managed Care	$49.47

CATH CRAGG MCN 100x20cm4105101

Facility

$525.00

Hospital Charge Code	270637237V
Hospital Revenue Code	278
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

CATH CRAGG MCN 100x20cm4105101

Facility

$525.00

Hospital Charge Code	270637237V
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

Know your out-of-pocket cost for care.

All Charges