Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH DRAINAGE APD GLIDEX 8FR

Facility

$466.90

Hospital Charge Code	270651754
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$233.45
Rate for Payer: Aetna Commercial	$177.42
Rate for Payer: Aetna Medicare Advantage	$140.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.06
Rate for Payer: Cigna Commercial	$233.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.07
Rate for Payer: Oxford Commercial	$93.38
Rate for Payer: Qualcare PPO/HMO/WC	$70.03
Rate for Payer: UnitedHealthcare Commercial	$93.38
Rate for Payer: UnitedHealthcare Community & State	$11.25
Rate for Payer: Wellpoint Medicaid Managed Care	$12.37

CATH DRAINAGE THAL-QUICK 16FR

Facility

$694.40

Hospital Charge Code	270624607
Hospital Revenue Code	272
Min. Negotiated Rate	$16.74
Max. Negotiated Rate	$347.20
Rate for Payer: Aetna Commercial	$263.87
Rate for Payer: Aetna Medicare Advantage	$208.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.07
Rate for Payer: Cigna Commercial	$347.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.32
Rate for Payer: Oxford Commercial	$138.88
Rate for Payer: Qualcare PPO/HMO/WC	$104.16
Rate for Payer: UnitedHealthcare Commercial	$138.88
Rate for Payer: UnitedHealthcare Community & State	$16.74
Rate for Payer: Wellpoint Medicaid Managed Care	$18.40

CATH DRAINAGE THAL-QUICK 16FR

Facility

$694.40

Hospital Charge Code	270624607
Hospital Revenue Code	272
Min. Negotiated Rate	$104.16
Max. Negotiated Rate	$104.16
Rate for Payer: Qualcare PPO/HMO/WC	$104.16

CATH DRAINGE BILIAR 12F G09499

Facility

$443.00

Hospital Charge Code	270637472C
Hospital Revenue Code	278
Min. Negotiated Rate	$66.45
Max. Negotiated Rate	$107.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$97.46
Rate for Payer: Qualcare PPO/HMO/WC	$66.45

CATH DRAINGE BILIAR 12F G09499

Facility

$443.00

Hospital Charge Code	270637472C
Hospital Revenue Code	278
Min. Negotiated Rate	$10.68
Max. Negotiated Rate	$221.50
Rate for Payer: Aetna Commercial	$168.34
Rate for Payer: Aetna Medicare Advantage	$132.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.97
Rate for Payer: Cigna Commercial	$221.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$97.46
Rate for Payer: Qualcare PPO/HMO/WC	$66.45
Rate for Payer: UnitedHealthcare Community & State	$10.68
Rate for Payer: Wellpoint Medicaid Managed Care	$11.74

CATH DRAINGE BILIARY 12FR

Facility

$595.15

Hospital Charge Code	270637472
Hospital Revenue Code	272
Min. Negotiated Rate	$14.34
Max. Negotiated Rate	$297.57
Rate for Payer: Aetna Commercial	$226.16
Rate for Payer: Aetna Medicare Advantage	$178.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.76
Rate for Payer: Cigna Commercial	$297.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.54
Rate for Payer: Oxford Commercial	$119.03
Rate for Payer: Qualcare PPO/HMO/WC	$89.27
Rate for Payer: UnitedHealthcare Commercial	$119.03
Rate for Payer: UnitedHealthcare Community & State	$14.34
Rate for Payer: Wellpoint Medicaid Managed Care	$15.77

CATH DRAINGE BILIARY 12FR

Facility

$595.15

Hospital Charge Code	270637472
Hospital Revenue Code	272
Min. Negotiated Rate	$89.27
Max. Negotiated Rate	$89.27
Rate for Payer: Qualcare PPO/HMO/WC	$89.27

CATH DRC 3 SH 67013100

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636345
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATH DRC 3 SH 67013100

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636345
Hospital Revenue Code	278
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Community & State	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$6.36

CATH DRN DAW MEUL MAC8.5FX25CM

Facility

$464.65

Service Code	HCPCS C1727
Hospital Charge Code	270700818
Hospital Revenue Code	272
Min. Negotiated Rate	$11.20
Max. Negotiated Rate	$232.32
Rate for Payer: Aetna Commercial	$176.57
Rate for Payer: Aetna Medicare Advantage	$139.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.49
Rate for Payer: Cigna Commercial	$232.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.40
Rate for Payer: Oxford Commercial	$92.93
Rate for Payer: Qualcare PPO/HMO/WC	$69.70
Rate for Payer: UnitedHealthcare Commercial	$92.93
Rate for Payer: UnitedHealthcare Community & State	$11.20
Rate for Payer: Wellpoint Medicaid Managed Care	$12.31

CATH DRN DAW MEUL MAC8.5FX25CM

Facility

$464.65

Service Code	HCPCS C1727
Hospital Charge Code	270700818
Hospital Revenue Code	272
Min. Negotiated Rate	$69.70
Max. Negotiated Rate	$69.70
Rate for Payer: Qualcare PPO/HMO/WC	$69.70

CATH DUAL LMN & 10FR INTRO****

Facility

$885.00

Hospital Charge Code	1604297
Hospital Revenue Code	278
Min. Negotiated Rate	$21.33
Max. Negotiated Rate	$442.50
Rate for Payer: Aetna Commercial	$336.30
Rate for Payer: Aetna Medicare Advantage	$265.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$225.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$225.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$225.68
Rate for Payer: Cigna Commercial	$442.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$194.70
Rate for Payer: Qualcare PPO/HMO/WC	$132.75
Rate for Payer: UnitedHealthcare Community & State	$21.33
Rate for Payer: Wellpoint Medicaid Managed Care	$23.45

CATH DUAL LMN & 10FR INTRO****

Facility

$885.00

Hospital Charge Code	1604297
Hospital Revenue Code	278
Min. Negotiated Rate	$132.75
Max. Negotiated Rate	$214.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$194.70
Rate for Payer: Qualcare PPO/HMO/WC	$132.75

CATH DUAL LMN HEM 13.5 AC190KC

Facility

$1,310.45

Hospital Charge Code	270608767
Hospital Revenue Code	272
Min. Negotiated Rate	$196.57
Max. Negotiated Rate	$196.57
Rate for Payer: Qualcare PPO/HMO/WC	$196.57

CATH DUAL LMN HEM 13.5 AC190KC

Facility

$1,310.45

Hospital Charge Code	270608767
Hospital Revenue Code	272
Min. Negotiated Rate	$31.58
Max. Negotiated Rate	$655.23
Rate for Payer: Aetna Commercial	$497.97
Rate for Payer: Aetna Medicare Advantage	$393.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$334.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$334.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$334.16
Rate for Payer: Cigna Commercial	$655.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.13
Rate for Payer: Oxford Commercial	$262.09
Rate for Payer: Qualcare PPO/HMO/WC	$196.57
Rate for Payer: UnitedHealthcare Commercial	$262.09
Rate for Payer: UnitedHealthcare Community & State	$31.58
Rate for Payer: Wellpoint Medicaid Managed Care	$34.73

CATH DUAL LMN HEM 13.5 AC230KC

Facility

$1,702.45

Hospital Charge Code	270608809
Hospital Revenue Code	272
Min. Negotiated Rate	$255.37
Max. Negotiated Rate	$255.37
Rate for Payer: Qualcare PPO/HMO/WC	$255.37

CATH DUAL LMN HEM 13.5 AC230KC

Facility

$1,702.45

Hospital Charge Code	270608809
Hospital Revenue Code	272
Min. Negotiated Rate	$41.03
Max. Negotiated Rate	$851.23
Rate for Payer: Aetna Commercial	$646.93
Rate for Payer: Aetna Medicare Advantage	$510.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$434.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$434.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$434.12
Rate for Payer: Cigna Commercial	$851.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$510.74
Rate for Payer: Oxford Commercial	$340.49
Rate for Payer: Qualcare PPO/HMO/WC	$255.37
Rate for Payer: UnitedHealthcare Commercial	$340.49
Rate for Payer: UnitedHealthcare Community & State	$41.03
Rate for Payer: Wellpoint Medicaid Managed Care	$45.11

CATH DUAL LMN HEM 13.5 AC280KC

Facility

$1,702.45

Hospital Charge Code	270608769
Hospital Revenue Code	278
Min. Negotiated Rate	$255.37
Max. Negotiated Rate	$411.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$374.54
Rate for Payer: Qualcare PPO/HMO/WC	$255.37

CATH DUAL LMN HEM 13.5 AC280KC

Facility

$1,702.45

Hospital Charge Code	270608769
Hospital Revenue Code	278
Min. Negotiated Rate	$41.03
Max. Negotiated Rate	$851.23
Rate for Payer: Aetna Commercial	$646.93
Rate for Payer: Aetna Medicare Advantage	$510.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$434.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$434.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$434.12
Rate for Payer: Cigna Commercial	$851.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$374.54
Rate for Payer: Qualcare PPO/HMO/WC	$255.37
Rate for Payer: UnitedHealthcare Community & State	$41.03
Rate for Payer: Wellpoint Medicaid Managed Care	$45.11

CATH DUAL LMN HEM 6 AK22122-F

Facility

$984.85

Hospital Charge Code	270606876
Hospital Revenue Code	278
Min. Negotiated Rate	$147.73
Max. Negotiated Rate	$238.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$216.67
Rate for Payer: Qualcare PPO/HMO/WC	$147.73

CATH DUAL LMN HEM 6 AK22122-F

Facility

$984.85

Hospital Charge Code	270606876
Hospital Revenue Code	278
Min. Negotiated Rate	$23.73
Max. Negotiated Rate	$492.43
Rate for Payer: Aetna Commercial	$374.24
Rate for Payer: Aetna Medicare Advantage	$295.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.14
Rate for Payer: Cigna Commercial	$492.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$216.67
Rate for Payer: Qualcare PPO/HMO/WC	$147.73
Rate for Payer: UnitedHealthcare Community & State	$23.73
Rate for Payer: Wellpoint Medicaid Managed Care	$26.10

CATH DUAL LMN HEM 6 DLC600-EC

Facility

$480.00

Hospital Charge Code	270607582
Hospital Revenue Code	278
Min. Negotiated Rate	$72.00
Max. Negotiated Rate	$116.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$105.60
Rate for Payer: Qualcare PPO/HMO/WC	$72.00

CATH DUAL LMN HEM 6 DLC600-EC

Facility

$480.00

Hospital Charge Code	270607582
Hospital Revenue Code	278
Min. Negotiated Rate	$11.57
Max. Negotiated Rate	$240.00
Rate for Payer: Aetna Commercial	$182.40
Rate for Payer: Aetna Medicare Advantage	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.40
Rate for Payer: Cigna Commercial	$240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$105.60
Rate for Payer: Qualcare PPO/HMO/WC	$72.00
Rate for Payer: UnitedHealthcare Community & State	$11.57
Rate for Payer: Wellpoint Medicaid Managed Care	$12.72

CATH DUAL LMN MAHURKAR UDALL

Facility

$716.00

Hospital Charge Code	270300576
Hospital Revenue Code	272
Min. Negotiated Rate	$17.26
Max. Negotiated Rate	$358.00
Rate for Payer: Aetna Commercial	$272.08
Rate for Payer: Aetna Medicare Advantage	$214.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.58
Rate for Payer: Cigna Commercial	$358.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.80
Rate for Payer: Oxford Commercial	$143.20
Rate for Payer: Qualcare PPO/HMO/WC	$107.40
Rate for Payer: UnitedHealthcare Commercial	$143.20
Rate for Payer: UnitedHealthcare Community & State	$17.26
Rate for Payer: Wellpoint Medicaid Managed Care	$18.97

CATH DUAL LMN MAHURKAR UDALL

Facility

$716.00

Hospital Charge Code	270300576
Hospital Revenue Code	272
Min. Negotiated Rate	$107.40
Max. Negotiated Rate	$107.40
Rate for Payer: Qualcare PPO/HMO/WC	$107.40

Know your out-of-pocket cost for care.

All Charges