Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH CRD PTA BALLN 419-9040L

Facility

$1,180.00

Hospital Charge Code	270623885
Hospital Revenue Code	272
Min. Negotiated Rate	$177.00
Max. Negotiated Rate	$177.00
Rate for Payer: Qualcare PPO/HMO/WC	$177.00

CATH CRD PTA BLN 4 80 4198040S

Facility

$1,337.65

Hospital Charge Code	270622621
Hospital Revenue Code	278
Min. Negotiated Rate	$200.65
Max. Negotiated Rate	$323.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$267.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$323.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$294.28
Rate for Payer: Qualcare PPO/HMO/WC	$200.65

CATH CRD PTA BLN 4 80 4198040S

Facility

$1,337.65

Hospital Charge Code	270622621
Hospital Revenue Code	278
Min. Negotiated Rate	$32.24
Max. Negotiated Rate	$668.83
Rate for Payer: Aetna Commercial	$508.31
Rate for Payer: Aetna Medicare Advantage	$401.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$341.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$341.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$267.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$341.10
Rate for Payer: Cigna Commercial	$668.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$323.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$294.28
Rate for Payer: Qualcare PPO/HMO/WC	$200.65
Rate for Payer: UnitedHealthcare Community & State	$32.24
Rate for Payer: Wellpoint Medicaid Managed Care	$35.45

CATH CROSSTELLA RX 5F 4X100MM

Facility

$1,891.05

Service Code	HCPCS C1725
Hospital Charge Code	270698328S
Hospital Revenue Code	278
Min. Negotiated Rate	$283.66
Max. Negotiated Rate	$457.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$378.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$416.03
Rate for Payer: Qualcare PPO/HMO/WC	$283.66

CATH CROSSTELLA RX 5F 4X100MM

Facility

$1,891.05

Service Code	HCPCS C1725
Hospital Charge Code	270698328S
Hospital Revenue Code	278
Min. Negotiated Rate	$45.57
Max. Negotiated Rate	$945.52
Rate for Payer: Aetna Commercial	$718.60
Rate for Payer: Aetna Medicare Advantage	$567.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$482.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$482.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$378.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$482.22
Rate for Payer: Cigna Commercial	$945.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$416.03
Rate for Payer: Qualcare PPO/HMO/WC	$283.66
Rate for Payer: UnitedHealthcare Community & State	$45.57
Rate for Payer: Wellpoint Medicaid Managed Care	$50.11

CATH CROSSTELLA RX 5F 4X150MM

Facility

$1,891.05

Service Code	HCPCS C1725
Hospital Charge Code	270698330S
Hospital Revenue Code	278
Min. Negotiated Rate	$45.57
Max. Negotiated Rate	$945.52
Rate for Payer: Aetna Commercial	$718.60
Rate for Payer: Aetna Medicare Advantage	$567.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$482.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$482.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$378.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$482.22
Rate for Payer: Cigna Commercial	$945.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$416.03
Rate for Payer: Qualcare PPO/HMO/WC	$283.66
Rate for Payer: UnitedHealthcare Community & State	$45.57
Rate for Payer: Wellpoint Medicaid Managed Care	$50.11

CATH CROSSTELLA RX 5F 4X150MM

Facility

$1,891.05

Service Code	HCPCS C1725
Hospital Charge Code	270698330S
Hospital Revenue Code	278
Min. Negotiated Rate	$283.66
Max. Negotiated Rate	$457.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$378.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$416.03
Rate for Payer: Qualcare PPO/HMO/WC	$283.66

CATH CROSSTELLA RX 5F 6X200MM

Facility

$1,891.05

Service Code	HCPCS C1725
Hospital Charge Code	270698329S
Hospital Revenue Code	278
Min. Negotiated Rate	$283.66
Max. Negotiated Rate	$457.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$378.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$416.03
Rate for Payer: Qualcare PPO/HMO/WC	$283.66

CATH CROSSTELLA RX 5F 6X200MM

Facility

$1,891.05

Service Code	HCPCS C1725
Hospital Charge Code	270698329S
Hospital Revenue Code	278
Min. Negotiated Rate	$45.57
Max. Negotiated Rate	$945.52
Rate for Payer: Aetna Commercial	$718.60
Rate for Payer: Aetna Medicare Advantage	$567.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$482.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$482.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$378.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$482.22
Rate for Payer: Cigna Commercial	$945.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$416.03
Rate for Payer: Qualcare PPO/HMO/WC	$283.66
Rate for Payer: UnitedHealthcare Community & State	$45.57
Rate for Payer: Wellpoint Medicaid Managed Care	$50.11

CATH CRYO 2X40X150

Facility

$891.00

Hospital Charge Code	270642197
Hospital Revenue Code	278
Min. Negotiated Rate	$133.65
Max. Negotiated Rate	$215.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$196.02
Rate for Payer: Qualcare PPO/HMO/WC	$133.65

CATH CRYO 2X40X150

Facility

$891.00

Hospital Charge Code	270642197
Hospital Revenue Code	278
Min. Negotiated Rate	$21.47
Max. Negotiated Rate	$445.50
Rate for Payer: Aetna Commercial	$338.58
Rate for Payer: Aetna Medicare Advantage	$267.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.21
Rate for Payer: Cigna Commercial	$445.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$196.02
Rate for Payer: Qualcare PPO/HMO/WC	$133.65
Rate for Payer: UnitedHealthcare Community & State	$21.47
Rate for Payer: Wellpoint Medicaid Managed Care	$23.61

CATH CT PICC S/LUM 5F 12102811

Facility

$520.85

Hospital Charge Code	270635355
Hospital Revenue Code	278
Min. Negotiated Rate	$78.13
Max. Negotiated Rate	$126.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.59
Rate for Payer: Qualcare PPO/HMO/WC	$78.13

CATH CT PICC S/LUM 5F 12102811

Facility

$520.85

Hospital Charge Code	270635355
Hospital Revenue Code	278
Min. Negotiated Rate	$12.55
Max. Negotiated Rate	$260.43
Rate for Payer: Aetna Commercial	$197.92
Rate for Payer: Aetna Medicare Advantage	$156.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.82
Rate for Payer: Cigna Commercial	$260.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.59
Rate for Payer: Qualcare PPO/HMO/WC	$78.13
Rate for Payer: UnitedHealthcare Community & State	$12.55
Rate for Payer: Wellpoint Medicaid Managed Care	$13.80

CATH CT PICC S/LUMEN 5F

Facility

$520.85

Hospital Charge Code	270635355V
Hospital Revenue Code	278
Min. Negotiated Rate	$78.13
Max. Negotiated Rate	$126.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.59
Rate for Payer: Qualcare PPO/HMO/WC	$78.13

CATH CT PICC S/LUMEN 5F

Facility

$520.85

Hospital Charge Code	270635355V
Hospital Revenue Code	278
Min. Negotiated Rate	$12.55
Max. Negotiated Rate	$260.43
Rate for Payer: Aetna Commercial	$197.92
Rate for Payer: Aetna Medicare Advantage	$156.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.82
Rate for Payer: Cigna Commercial	$260.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.59
Rate for Payer: Qualcare PPO/HMO/WC	$78.13
Rate for Payer: UnitedHealthcare Community & State	$12.55
Rate for Payer: Wellpoint Medicaid Managed Care	$13.80

CATH CURL PERIL 57C 8811313015

Facility

$455.00

Hospital Charge Code	270644734
Hospital Revenue Code	278
Min. Negotiated Rate	$10.97
Max. Negotiated Rate	$227.50
Rate for Payer: Aetna Commercial	$172.90
Rate for Payer: Aetna Medicare Advantage	$136.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.03
Rate for Payer: Cigna Commercial	$227.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$100.10
Rate for Payer: Qualcare PPO/HMO/WC	$68.25
Rate for Payer: UnitedHealthcare Community & State	$10.97
Rate for Payer: Wellpoint Medicaid Managed Care	$12.06

CATH CURL PERIL 57C 8811313015

Facility

$455.00

Hospital Charge Code	270644734
Hospital Revenue Code	278
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$110.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$100.10
Rate for Payer: Qualcare PPO/HMO/WC	$68.25

CATH CURL PERIL 57C 8811313015

Facility

$455.40

Hospital Charge Code	270644734C
Hospital Revenue Code	278
Min. Negotiated Rate	$10.98
Max. Negotiated Rate	$227.70
Rate for Payer: Aetna Commercial	$173.05
Rate for Payer: Aetna Medicare Advantage	$136.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.13
Rate for Payer: Cigna Commercial	$227.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$100.19
Rate for Payer: Qualcare PPO/HMO/WC	$68.31
Rate for Payer: UnitedHealthcare Community & State	$10.98
Rate for Payer: Wellpoint Medicaid Managed Care	$12.07

CATH CURL PERIL 57C 8811313015

Facility

$455.40

Hospital Charge Code	270644734C
Hospital Revenue Code	278
Min. Negotiated Rate	$68.31
Max. Negotiated Rate	$110.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$100.19
Rate for Payer: Qualcare PPO/HMO/WC	$68.31

CATH CXI SPPT 2.6FR 018x65 ANG

Facility

$1,132.45

Hospital Charge Code	270705309
Hospital Revenue Code	279
Min. Negotiated Rate	$27.29
Max. Negotiated Rate	$566.23
Rate for Payer: Aetna Commercial	$430.33
Rate for Payer: Aetna Medicare Advantage	$339.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$288.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$288.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$288.77
Rate for Payer: Cigna Commercial	$566.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.74
Rate for Payer: Oxford Commercial	$226.49
Rate for Payer: Qualcare PPO/HMO/WC	$169.87
Rate for Payer: UnitedHealthcare Commercial	$226.49
Rate for Payer: UnitedHealthcare Community & State	$27.29
Rate for Payer: Wellpoint Medicaid Managed Care	$30.01

CATH CXI SPPT 2.6FR 018x65 ANG

Facility

$1,132.45

Hospital Charge Code	270705309
Hospital Revenue Code	279
Min. Negotiated Rate	$169.87
Max. Negotiated Rate	$169.87
Rate for Payer: Qualcare PPO/HMO/WC	$169.87

CATH CXI SPPT 2.6FR 18X035x150

Facility

$1,132.45

Hospital Charge Code	270705310
Hospital Revenue Code	279
Min. Negotiated Rate	$27.29
Max. Negotiated Rate	$566.23
Rate for Payer: Aetna Commercial	$430.33
Rate for Payer: Aetna Medicare Advantage	$339.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$288.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$288.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$288.77
Rate for Payer: Cigna Commercial	$566.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.74
Rate for Payer: Oxford Commercial	$226.49
Rate for Payer: Qualcare PPO/HMO/WC	$169.87
Rate for Payer: UnitedHealthcare Commercial	$226.49
Rate for Payer: UnitedHealthcare Community & State	$27.29
Rate for Payer: Wellpoint Medicaid Managed Care	$30.01

CATH CXI SPPT 2.6FR 18X035x150

Facility

$1,132.45

Hospital Charge Code	270705310
Hospital Revenue Code	279
Min. Negotiated Rate	$169.87
Max. Negotiated Rate	$169.87
Rate for Payer: Qualcare PPO/HMO/WC	$169.87

CATH CXI SPPT 4FR

Facility

$925.00

Service Code	HCPCS C1887
Hospital Charge Code	270677154S
Hospital Revenue Code	278
Min. Negotiated Rate	$22.29
Max. Negotiated Rate	$462.50
Rate for Payer: Aetna Commercial	$351.50
Rate for Payer: Aetna Medicare Advantage	$277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$203.50
Rate for Payer: Qualcare PPO/HMO/WC	$138.75
Rate for Payer: UnitedHealthcare Community & State	$22.29
Rate for Payer: Wellpoint Medicaid Managed Care	$24.51

CATH CXI SPPT 4FR

Facility

$925.00

Service Code	HCPCS C1887
Hospital Charge Code	270677154N
Hospital Revenue Code	278
Min. Negotiated Rate	$22.29
Max. Negotiated Rate	$462.50
Rate for Payer: Aetna Commercial	$351.50
Rate for Payer: Aetna Medicare Advantage	$277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$203.50
Rate for Payer: Qualcare PPO/HMO/WC	$138.75
Rate for Payer: UnitedHealthcare Community & State	$22.29
Rate for Payer: Wellpoint Medicaid Managed Care	$24.51

Know your out-of-pocket cost for care.

All Charges