Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH CRAGG MCNAMARA 100x20

Facility

$490.00

Service Code	HCPCS C1887
Hospital Charge Code	270637237
Hospital Revenue Code	278
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$118.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$107.80
Rate for Payer: Qualcare PPO/HMO/WC	$73.50

CATH CRAGG MCNAMARA 100x20

Facility

$490.00

Service Code	HCPCS C1887
Hospital Charge Code	270637237
Hospital Revenue Code	278
Min. Negotiated Rate	$11.81
Max. Negotiated Rate	$245.00
Rate for Payer: Aetna Commercial	$186.20
Rate for Payer: Aetna Medicare Advantage	$147.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.95
Rate for Payer: Cigna Commercial	$245.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$107.80
Rate for Payer: Qualcare PPO/HMO/WC	$73.50
Rate for Payer: UnitedHealthcare Community & State	$11.81
Rate for Payer: Wellpoint Medicaid Managed Care	$12.98

CATH CRAGG MCNAMARA 100x30cm

Facility

$800.00

Service Code	HCPCS C1887
Hospital Charge Code	270631254O
Hospital Revenue Code	278
Min. Negotiated Rate	$19.28
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$21.20

CATH CRAGG MCNAMARA 100x30cm

Facility

$490.00

Service Code	HCPCS C1887
Hospital Charge Code	270631254
Hospital Revenue Code	278
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$118.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$107.80
Rate for Payer: Qualcare PPO/HMO/WC	$73.50

CATH CRAGG MCNAMARA 100x30cm

Facility

$800.00

Service Code	HCPCS C1887
Hospital Charge Code	270631254O
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

CATH CRAGG MCNAMARA 100x30cm

Facility

$490.00

Service Code	HCPCS C1887
Hospital Charge Code	270631254
Hospital Revenue Code	278
Min. Negotiated Rate	$11.81
Max. Negotiated Rate	$245.00
Rate for Payer: Aetna Commercial	$186.20
Rate for Payer: Aetna Medicare Advantage	$147.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.95
Rate for Payer: Cigna Commercial	$245.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$107.80
Rate for Payer: Qualcare PPO/HMO/WC	$73.50
Rate for Payer: UnitedHealthcare Community & State	$11.81
Rate for Payer: Wellpoint Medicaid Managed Care	$12.98

CATH CRAGG MCNAMARA 4106001

Facility

$775.00

Hospital Charge Code	270657473
Hospital Revenue Code	278
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25
Rate for Payer: UnitedHealthcare Community & State	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$20.54

CATH CRAGG MCNAMARA 4106001

Facility

$775.00

Hospital Charge Code	270657473
Hospital Revenue Code	278
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$187.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

CATH CRAG MCN 100x40cm 4105301

Facility

$759.50

Service Code	HCPCS C1887
Hospital Charge Code	270637238
Hospital Revenue Code	278
Min. Negotiated Rate	$18.30
Max. Negotiated Rate	$379.75
Rate for Payer: Aetna Commercial	$288.61
Rate for Payer: Aetna Medicare Advantage	$227.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$193.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$193.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$151.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$193.67
Rate for Payer: Cigna Commercial	$379.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$167.09
Rate for Payer: Qualcare PPO/HMO/WC	$113.92
Rate for Payer: UnitedHealthcare Community & State	$18.30
Rate for Payer: Wellpoint Medicaid Managed Care	$20.13

CATH CRAG MCN 100x40cm 4105301

Facility

$759.50

Service Code	HCPCS C1887
Hospital Charge Code	270637238
Hospital Revenue Code	278
Min. Negotiated Rate	$113.92
Max. Negotiated Rate	$183.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$151.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$167.09
Rate for Payer: Qualcare PPO/HMO/WC	$113.92

CATH CRD BALLN 4CM 4127040S

Facility

$892.00

Hospital Charge Code	270623560
Hospital Revenue Code	278
Min. Negotiated Rate	$133.80
Max. Negotiated Rate	$215.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$196.24
Rate for Payer: Qualcare PPO/HMO/WC	$133.80

CATH CRD BALLN 4CM 4127040S

Facility

$892.00

Hospital Charge Code	270623560
Hospital Revenue Code	278
Min. Negotiated Rate	$21.50
Max. Negotiated Rate	$446.00
Rate for Payer: Aetna Commercial	$338.96
Rate for Payer: Aetna Medicare Advantage	$267.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.46
Rate for Payer: Cigna Commercial	$446.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$196.24
Rate for Payer: Qualcare PPO/HMO/WC	$133.80
Rate for Payer: UnitedHealthcare Community & State	$21.50
Rate for Payer: Wellpoint Medicaid Managed Care	$23.64

CATH CRD BALLN 5F 8 4208040S

Facility

$1,325.00

Hospital Charge Code	270625226V
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 CRD BALLN 5F 8 4208040S

Facility

$1,325.00

Hospital Charge Code	270625226V
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 CRD BALLN 5F 8 4208040S

Facility

$1,312.00

Hospital Charge Code	270625226
Hospital Revenue Code	278
Min. Negotiated Rate	$196.80
Max. Negotiated Rate	$317.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$262.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$317.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$288.64
Rate for Payer: Qualcare PPO/HMO/WC	$196.80

CATH CRD BALLN 5F 8 4208040S

Facility

$1,312.00

Hospital Charge Code	270625226
Hospital Revenue Code	278
Min. Negotiated Rate	$31.62
Max. Negotiated Rate	$656.00
Rate for Payer: Aetna Commercial	$498.56
Rate for Payer: Aetna Medicare Advantage	$393.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$334.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$334.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$262.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$334.56
Rate for Payer: Cigna Commercial	$656.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$317.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$288.64
Rate for Payer: Qualcare PPO/HMO/WC	$196.80
Rate for Payer: UnitedHealthcare Community & State	$31.62
Rate for Payer: Wellpoint Medicaid Managed Care	$34.77

CATH CRD BERENSTN 5F 451513V0

Facility

$92.85

Hospital Charge Code	270623528
Hospital Revenue Code	272
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$46.42
Rate for Payer: Aetna Commercial	$35.28
Rate for Payer: Aetna Medicare Advantage	$27.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.68
Rate for Payer: Cigna Commercial	$46.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.86
Rate for Payer: Oxford Commercial	$18.57
Rate for Payer: Qualcare PPO/HMO/WC	$13.93
Rate for Payer: UnitedHealthcare Commercial	$18.57
Rate for Payer: UnitedHealthcare Community & State	$2.24
Rate for Payer: Wellpoint Medicaid Managed Care	$2.46

CATH CRD BERENSTN 5F 451513V0

Facility

$92.85

Hospital Charge Code	270623528
Hospital Revenue Code	272
Min. Negotiated Rate	$13.93
Max. Negotiated Rate	$13.93
Rate for Payer: Qualcare PPO/HMO/WC	$13.93

CATH CRD CARD 3DRC 6F

Facility

$292.85

Hospital Charge Code	270600704
Hospital Revenue Code	272
Min. Negotiated Rate	$7.06
Max. Negotiated Rate	$146.43
Rate for Payer: Aetna Commercial	$111.28
Rate for Payer: Aetna Medicare Advantage	$87.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.68
Rate for Payer: Cigna Commercial	$146.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.86
Rate for Payer: Oxford Commercial	$58.57
Rate for Payer: Qualcare PPO/HMO/WC	$43.93
Rate for Payer: UnitedHealthcare Commercial	$58.57
Rate for Payer: UnitedHealthcare Community & State	$7.06
Rate for Payer: Wellpoint Medicaid Managed Care	$7.76

CATH CRD CARD 3DRC 6F

Facility

$292.85

Hospital Charge Code	270600704
Hospital Revenue Code	272
Min. Negotiated Rate	$43.93
Max. Negotiated Rate	$43.93
Rate for Payer: Qualcare PPO/HMO/WC	$43.93

CATH CRD CARD 6F+TL 533614T

Facility

$136.85

Hospital Charge Code	270607620
Hospital Revenue Code	272
Min. Negotiated Rate	$20.53
Max. Negotiated Rate	$20.53
Rate for Payer: Qualcare PPO/HMO/WC	$20.53

CATH CRD CARD 6F+TL 533614T

Facility

$136.85

Hospital Charge Code	270607620
Hospital Revenue Code	272
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$68.42
Rate for Payer: Aetna Commercial	$52.00
Rate for Payer: Aetna Medicare Advantage	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.90
Rate for Payer: Cigna Commercial	$68.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.05
Rate for Payer: Oxford Commercial	$27.37
Rate for Payer: Qualcare PPO/HMO/WC	$20.53
Rate for Payer: UnitedHealthcare Commercial	$27.37
Rate for Payer: UnitedHealthcare Community & State	$3.30
Rate for Payer: Wellpoint Medicaid Managed Care	$3.63

CATH CRD CARD AL111 524-844

Facility

$131.25

Hospital Charge Code	270607618
Hospital Revenue Code	272
Min. Negotiated Rate	$19.69
Max. Negotiated Rate	$19.69
Rate for Payer: Qualcare PPO/HMO/WC	$19.69

CATH CRD CARD AL111 524-844

Facility

$131.25

Hospital Charge Code	270607618
Hospital Revenue Code	272
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$65.62
Rate for Payer: Aetna Commercial	$49.88
Rate for Payer: Aetna Medicare Advantage	$39.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.47
Rate for Payer: Cigna Commercial	$65.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.38
Rate for Payer: Oxford Commercial	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$19.69
Rate for Payer: UnitedHealthcare Commercial	$26.25
Rate for Payer: UnitedHealthcare Community & State	$3.16
Rate for Payer: Wellpoint Medicaid Managed Care	$3.48

CATH CRD CARD AL111 7F 533647T

Facility

$42.25

Hospital Charge Code	270614269
Hospital Revenue Code	272
Min. Negotiated Rate	$6.34
Max. Negotiated Rate	$6.34
Rate for Payer: Qualcare PPO/HMO/WC	$6.34

Know your out-of-pocket cost for care.

All Charges