Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH CXI SUPP 2.6 FR 90CM ANG

Facility

$925.00

Hospital Charge Code	270673508S
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 2.6 FR 90CM ANG

Facility

$925.00

Hospital Charge Code	270673508
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 2.6 FR 90CM STR

Facility

$925.00

Hospital Charge Code	270673510
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 2.6 FR 90CM STR

Facility

$925.00

Hospital Charge Code	270673510
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 4 FR 135CM ANG

Facility

$925.00

Hospital Charge Code	270662850
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 4 FR 135CM ANG

Facility

$925.00

Hospital Charge Code	270662850
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 4 FR 150CM ANG

Facility

$1,024.95

Hospital Charge Code	270673512
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 SUPP 4 FR 150CM ANG

Facility

$925.00

Service Code	HCPCS C1887
Hospital Charge Code	270673512S
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 SUPP 4 FR 150CM ANG

Facility

$925.00

Service Code	HCPCS C1887
Hospital Charge Code	270673512S
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 SUPP 4 FR 150CM ANG

Facility

$1,024.95

Hospital Charge Code	270673512
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 CYSTO BALN DBL 20FR******

Facility

$249.00

Hospital Charge Code	1604529
Hospital Revenue Code	272
Min. Negotiated Rate	$37.35
Max. Negotiated Rate	$37.35
Rate for Payer: Qualcare PPO/HMO/WC	$37.35

CATH CYSTO BALN DBL 20FR******

Facility

$249.00

Hospital Charge Code	1604529
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$124.50
Rate for Payer: Aetna Commercial	$94.62
Rate for Payer: Aetna Medicare Advantage	$74.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.49
Rate for Payer: Cigna Commercial	$124.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.70
Rate for Payer: Oxford Commercial	$49.80
Rate for Payer: Qualcare PPO/HMO/WC	$37.35
Rate for Payer: UnitedHealthcare Commercial	$49.80
Rate for Payer: UnitedHealthcare Community & State	$6.00
Rate for Payer: Wellpoint Medicaid Managed Care	$6.60

CATH DAVIS 5FR

Facility

$74.30

Service Code	HCPCS C1887
Hospital Charge Code	270677004
Hospital Revenue Code	272
Min. Negotiated Rate	$11.14
Max. Negotiated Rate	$11.14
Rate for Payer: Qualcare PPO/HMO/WC	$11.14

CATH DAVIS 5FR

Facility

$74.30

Service Code	HCPCS C1887
Hospital Charge Code	270677004
Hospital Revenue Code	272
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$37.15
Rate for Payer: Aetna Commercial	$28.23
Rate for Payer: Aetna Medicare Advantage	$22.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.95
Rate for Payer: Cigna Commercial	$37.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.29
Rate for Payer: Oxford Commercial	$14.86
Rate for Payer: Qualcare PPO/HMO/WC	$11.14
Rate for Payer: UnitedHealthcare Commercial	$14.86
Rate for Payer: UnitedHealthcare Community & State	$1.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1.97

CATH DEVICE CTO CROSS FLEX 150

Facility

$10,975.00

Service Code	HCPCS C1887
Hospital Charge Code	270661755
Hospital Revenue Code	278
Min. Negotiated Rate	$1,646.25
Max. Negotiated Rate	$2,655.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,655.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,414.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,646.25

CATH DEVICE CTO CROSS FLEX 150

Facility

$10,975.00

Service Code	HCPCS C1887
Hospital Charge Code	270661755
Hospital Revenue Code	278
Min. Negotiated Rate	$264.50
Max. Negotiated Rate	$5,487.50
Rate for Payer: Aetna Commercial	$4,170.50
Rate for Payer: Aetna Medicare Advantage	$3,292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,798.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,798.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,798.62
Rate for Payer: Cigna Commercial	$5,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,655.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,414.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,646.25
Rate for Payer: UnitedHealthcare Community & State	$264.50
Rate for Payer: Wellpoint Medicaid Managed Care	$290.84

CATH DIAMONDBK 1.25MICRO145CM

Facility

$18,475.00

Service Code	HCPCS C1724
Hospital Charge Code	270693011
Hospital Revenue Code	278
Min. Negotiated Rate	$2,771.25
Max. Negotiated Rate	$4,470.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,470.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,064.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,771.25

CATH DIAMONDBK 1.25MICRO145CM

Facility

$18,475.00

Service Code	HCPCS C1724
Hospital Charge Code	270693011
Hospital Revenue Code	278
Min. Negotiated Rate	$445.25
Max. Negotiated Rate	$9,237.50
Rate for Payer: Aetna Commercial	$7,020.50
Rate for Payer: Aetna Medicare Advantage	$5,542.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,711.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,711.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,711.12
Rate for Payer: Cigna Commercial	$9,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,470.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,064.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,771.25
Rate for Payer: UnitedHealthcare Community & State	$445.25
Rate for Payer: Wellpoint Medicaid Managed Care	$489.59

CATH DIAMOND BK CL CROWN 2.25

Facility

$15,975.00

Hospital Charge Code	270642391V
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 DIAMOND BK CL CROWN 2.25

Facility

$15,975.00

Hospital Charge Code	270642391V
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 DIL GUIDE FUBUKI 6FR 80CM

Facility

$2,745.00

Service Code	HCPCS C1887
Hospital Charge Code	270699484S
Hospital Revenue Code	278
Min. Negotiated Rate	$411.75
Max. Negotiated Rate	$664.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$549.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$664.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$603.90
Rate for Payer: Qualcare PPO/HMO/WC	$411.75

CATH DIL GUIDE FUBUKI 6FR 80CM

Facility

$2,745.00

Service Code	HCPCS C1887
Hospital Charge Code	270699484S
Hospital Revenue Code	278
Min. Negotiated Rate	$66.15
Max. Negotiated Rate	$1,372.50
Rate for Payer: Aetna Commercial	$1,043.10
Rate for Payer: Aetna Medicare Advantage	$823.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$699.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$699.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$549.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$699.98
Rate for Payer: Cigna Commercial	$1,372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$664.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$603.90
Rate for Payer: Qualcare PPO/HMO/WC	$411.75
Rate for Payer: UnitedHealthcare Community & State	$66.15
Rate for Payer: Wellpoint Medicaid Managed Care	$72.74

CATH DRAINAGE 16FR 40CM 0.038

Facility

$457.60

Hospital Charge Code	270648117
Hospital Revenue Code	272
Min. Negotiated Rate	$68.64
Max. Negotiated Rate	$68.64
Rate for Payer: Qualcare PPO/HMO/WC	$68.64

CATH DRAINAGE 16FR 40CM 0.038

Facility

$457.60

Hospital Charge Code	270648117
Hospital Revenue Code	272
Min. Negotiated Rate	$11.03
Max. Negotiated Rate	$228.80
Rate for Payer: Aetna Commercial	$173.89
Rate for Payer: Aetna Medicare Advantage	$137.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.69
Rate for Payer: Cigna Commercial	$228.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.28
Rate for Payer: Oxford Commercial	$91.52
Rate for Payer: Qualcare PPO/HMO/WC	$68.64
Rate for Payer: UnitedHealthcare Commercial	$91.52
Rate for Payer: UnitedHealthcare Community & State	$11.03
Rate for Payer: Wellpoint Medicaid Managed Care	$12.13

CATH DRAINAGE APD GLIDEX 8FR

Facility

$466.90

Hospital Charge Code	270651754
Hospital Revenue Code	272
Min. Negotiated Rate	$70.03
Max. Negotiated Rate	$70.03
Rate for Payer: Qualcare PPO/HMO/WC	$70.03

Know your out-of-pocket cost for care.

All Charges