Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH CXI SPPT 4FR

Facility

$925.00

Service Code	HCPCS C1887
Hospital Charge Code	270677154N
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$223.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
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

CATH CXI SPPT 4FR

Facility

$925.00

Service Code	HCPCS C1887
Hospital Charge Code	270677154S
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$223.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
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

CATH CXI SPPT 4FR .035x135CM

Facility

$925.00

Hospital Charge Code	270677153
Hospital Revenue Code	272
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) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.50
Rate for Payer: Oxford Commercial	$185.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.75
Rate for Payer: UnitedHealthcare Commercial	$185.00
Rate for Payer: UnitedHealthcare Community & State	$22.29
Rate for Payer: Wellpoint Medicaid Managed Care	$24.51

CATH CXI SPPT 4FR .035x135CM

Facility

$925.00

Hospital Charge Code	270677153
Hospital Revenue Code	272
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$138.75
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

CATH CXI SPPT 4FR .035x150

Facility

$1,024.95

Hospital Charge Code	270677154
Hospital Revenue Code	278
Min. Negotiated Rate	$153.74
Max. Negotiated Rate	$248.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$225.49
Rate for Payer: Qualcare PPO/HMO/WC	$153.74

CATH CXI SPPT 4FR .035x150

Facility

$1,024.95

Hospital Charge Code	270677154
Hospital Revenue Code	278
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$512.48
Rate for Payer: Aetna Commercial	$389.48
Rate for Payer: Aetna Medicare Advantage	$307.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.36
Rate for Payer: Cigna Commercial	$512.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$225.49
Rate for Payer: Qualcare PPO/HMO/WC	$153.74
Rate for Payer: UnitedHealthcare Community & State	$24.70
Rate for Payer: Wellpoint Medicaid Managed Care	$27.16

CATH CXI SPPT 4FR .035x90 DAV

Facility

$1,024.95

Hospital Charge Code	270705311
Hospital Revenue Code	279
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$512.48
Rate for Payer: Aetna Commercial	$389.48
Rate for Payer: Aetna Medicare Advantage	$307.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.36
Rate for Payer: Cigna Commercial	$512.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.49
Rate for Payer: Oxford Commercial	$204.99
Rate for Payer: Qualcare PPO/HMO/WC	$153.74
Rate for Payer: UnitedHealthcare Commercial	$204.99
Rate for Payer: UnitedHealthcare Community & State	$24.70
Rate for Payer: Wellpoint Medicaid Managed Care	$27.16

CATH CXI SPPT 4FR .035x90 DAV

Facility

$1,024.95

Hospital Charge Code	270705311
Hospital Revenue Code	279
Min. Negotiated Rate	$153.74
Max. Negotiated Rate	$153.74
Rate for Payer: Qualcare PPO/HMO/WC	$153.74

CATH CXI SPPT 4FR .035x90 STR

Facility

$1,024.95

Hospital Charge Code	270705312
Hospital Revenue Code	279
Min. Negotiated Rate	$153.74
Max. Negotiated Rate	$153.74
Rate for Payer: Qualcare PPO/HMO/WC	$153.74

CATH CXI SPPT 4FR .035x90 STR

Facility

$1,024.95

Hospital Charge Code	270705312
Hospital Revenue Code	279
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$512.48
Rate for Payer: Aetna Commercial	$389.48
Rate for Payer: Aetna Medicare Advantage	$307.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.36
Rate for Payer: Cigna Commercial	$512.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.49
Rate for Payer: Oxford Commercial	$204.99
Rate for Payer: Qualcare PPO/HMO/WC	$153.74
Rate for Payer: UnitedHealthcare Commercial	$204.99
Rate for Payer: UnitedHealthcare Community & State	$24.70
Rate for Payer: Wellpoint Medicaid Managed Care	$27.16

CATH CXI SUPP .014 2.3x135 STR

Facility

$1,024.95

Hospital Charge Code	270705307
Hospital Revenue Code	279
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$512.48
Rate for Payer: Aetna Commercial	$389.48
Rate for Payer: Aetna Medicare Advantage	$307.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.36
Rate for Payer: Cigna Commercial	$512.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.49
Rate for Payer: Oxford Commercial	$204.99
Rate for Payer: Qualcare PPO/HMO/WC	$153.74
Rate for Payer: UnitedHealthcare Commercial	$204.99
Rate for Payer: UnitedHealthcare Community & State	$24.70
Rate for Payer: Wellpoint Medicaid Managed Care	$27.16

CATH CXI SUPP .014 2.3x135 STR

Facility

$1,024.95

Hospital Charge Code	270705307
Hospital Revenue Code	279
Min. Negotiated Rate	$153.74
Max. Negotiated Rate	$153.74
Rate for Payer: Qualcare PPO/HMO/WC	$153.74

CATH CXI SUPP .018 2.6x150 ANG

Facility

$1,132.45

Hospital Charge Code	270705308
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 SUPP .018 2.6x150 ANG

Facility

$1,132.45

Hospital Charge Code	270705308
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 SUPP 2.3 FR 135CM ANG

Facility

$1,024.95

Hospital Charge Code	270673502
Hospital Revenue Code	272
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$512.48
Rate for Payer: Aetna Commercial	$389.48
Rate for Payer: Aetna Medicare Advantage	$307.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.36
Rate for Payer: Cigna Commercial	$512.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.49
Rate for Payer: Oxford Commercial	$204.99
Rate for Payer: Qualcare PPO/HMO/WC	$153.74
Rate for Payer: UnitedHealthcare Commercial	$204.99
Rate for Payer: UnitedHealthcare Community & State	$24.70
Rate for Payer: Wellpoint Medicaid Managed Care	$27.16

CATH CXI SUPP 2.3 FR 135CM ANG

Facility

$1,024.95

Hospital Charge Code	270673502
Hospital Revenue Code	272
Min. Negotiated Rate	$153.74
Max. Negotiated Rate	$153.74
Rate for Payer: Qualcare PPO/HMO/WC	$153.74

CATH CXI SUPP 2.3 FR 135CM ANG

Facility

$925.00

Hospital Charge Code	270673502S
Hospital Revenue Code	272
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$138.75
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

CATH CXI SUPP 2.3 FR 135CM ANG

Facility

$925.00

Hospital Charge Code	270673502S
Hospital Revenue Code	272
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) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.50
Rate for Payer: Oxford Commercial	$185.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.75
Rate for Payer: UnitedHealthcare Commercial	$185.00
Rate for Payer: UnitedHealthcare Community & State	$22.29
Rate for Payer: Wellpoint Medicaid Managed Care	$24.51

CATH CXI SUPP 2.3FR 135CM ANG2

Facility

$975.00

Hospital Charge Code	270673503
Hospital Revenue Code	272
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

CATH CXI SUPP 2.3FR 135CM ANG2

Facility

$975.00

Hospital Charge Code	270673503
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATH CXI SUPP 2.3 FR 150CM ANG

Facility

$1,024.95

Hospital Charge Code	270673504
Hospital Revenue Code	272
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$512.48
Rate for Payer: Aetna Commercial	$389.48
Rate for Payer: Aetna Medicare Advantage	$307.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.36
Rate for Payer: Cigna Commercial	$512.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.49
Rate for Payer: Oxford Commercial	$204.99
Rate for Payer: Qualcare PPO/HMO/WC	$153.74
Rate for Payer: UnitedHealthcare Commercial	$204.99
Rate for Payer: UnitedHealthcare Community & State	$24.70
Rate for Payer: Wellpoint Medicaid Managed Care	$27.16

CATH CXI SUPP 2.3 FR 150CM ANG

Facility

$1,024.95

Hospital Charge Code	270673504
Hospital Revenue Code	272
Min. Negotiated Rate	$153.74
Max. Negotiated Rate	$153.74
Rate for Payer: Qualcare PPO/HMO/WC	$153.74

CATH CXI SUPP 2.3FR 150CM ANG

Facility

$975.00

Hospital Charge Code	270673504S
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATH CXI SUPP 2.3FR 150CM ANG

Facility

$975.00

Hospital Charge Code	270673504S
Hospital Revenue Code	272
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

CATH CXI SUPP 2.3FR 150CM ANG2

Facility

$975.00

Hospital Charge Code	270673505
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

Know your out-of-pocket cost for care.

All Charges