Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHER BALLON ADM. 60.40.130

Facility

$900.00

Hospital Charge Code	2709003822
Hospital Revenue Code	272
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.00
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Commercial	$180.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

CATHER BALLON AMPH 3.5.80.150

Facility

$1,825.00

Hospital Charge Code	2709003770
Hospital Revenue Code	272
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$273.75
Rate for Payer: Qualcare PPO/HMO/WC	$273.75

CATHER BALLON AMPH 3.5.80.150

Facility

$1,825.00

Hospital Charge Code	2709003770
Hospital Revenue Code	272
Min. Negotiated Rate	$43.98
Max. Negotiated Rate	$912.50
Rate for Payer: Aetna Commercial	$693.50
Rate for Payer: Aetna Medicare Advantage	$547.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.38
Rate for Payer: Cigna Commercial	$912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$547.50
Rate for Payer: Oxford Commercial	$365.00
Rate for Payer: Qualcare PPO/HMO/WC	$273.75
Rate for Payer: UnitedHealthcare Commercial	$365.00
Rate for Payer: UnitedHealthcare Community & State	$43.98
Rate for Payer: Wellpoint Medicaid Managed Care	$48.36

CATH ERCP***

Facility

$110.00

Hospital Charge Code	2300762
Hospital Revenue Code	279
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

CATH ERCP***

Facility

$110.00

Hospital Charge Code	2300762
Hospital Revenue Code	279
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.00
Rate for Payer: Oxford Commercial	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$22.00
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

CATH ERCP1-LT 0.21

Facility

$412.85

Hospital Charge Code	270600975
Hospital Revenue Code	272
Min. Negotiated Rate	$61.93
Max. Negotiated Rate	$61.93
Rate for Payer: Qualcare PPO/HMO/WC	$61.93

CATH ERCP1-LT 0.21

Facility

$412.85

Hospital Charge Code	270600975
Hospital Revenue Code	272
Min. Negotiated Rate	$9.95
Max. Negotiated Rate	$206.43
Rate for Payer: Aetna Commercial	$156.88
Rate for Payer: Aetna Medicare Advantage	$123.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.28
Rate for Payer: Cigna Commercial	$206.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.86
Rate for Payer: Oxford Commercial	$82.57
Rate for Payer: Qualcare PPO/HMO/WC	$61.93
Rate for Payer: UnitedHealthcare Commercial	$82.57
Rate for Payer: UnitedHealthcare Community & State	$9.95
Rate for Payer: Wellpoint Medicaid Managed Care	$10.94

CATHERER PERFUSION RED43

Facility

$11,950.00

Service Code	HCPCS C1887
Hospital Charge Code	270699564S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,792.50
Max. Negotiated Rate	$2,891.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,891.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,629.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,792.50

CATHERER PERFUSION RED43

Facility

$11,950.00

Service Code	HCPCS C1887
Hospital Charge Code	270699564S
Hospital Revenue Code	278
Min. Negotiated Rate	$288.00
Max. Negotiated Rate	$5,975.00
Rate for Payer: Aetna Commercial	$4,541.00
Rate for Payer: Aetna Medicare Advantage	$3,585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,047.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,047.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,047.25
Rate for Payer: Cigna Commercial	$5,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,891.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,629.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,792.50
Rate for Payer: UnitedHealthcare Community & State	$288.00
Rate for Payer: Wellpoint Medicaid Managed Care	$316.68

CATHERTER BALLOON 4 X 20 X 80

Facility

$975.00

Service Code	HCPCS C1725
Hospital Charge Code	270658395
Hospital Revenue Code	278
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) NJ Health	$195.00
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	$235.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

CATHERTER BALLOON 4 X 20 X 80

Facility

$975.00

Service Code	HCPCS C1725
Hospital Charge Code	270658395
Hospital Revenue Code	278
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$235.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATHERTER BALLOON 6 X 40 X 120

Facility

$195.00

Hospital Charge Code	270658397
Hospital Revenue Code	278
Min. Negotiated Rate	$4.70
Max. Negotiated Rate	$97.50
Rate for Payer: Aetna Commercial	$74.10
Rate for Payer: Aetna Medicare Advantage	$58.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.73
Rate for Payer: Cigna Commercial	$97.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$42.90
Rate for Payer: Qualcare PPO/HMO/WC	$29.25
Rate for Payer: UnitedHealthcare Community & State	$4.70
Rate for Payer: Wellpoint Medicaid Managed Care	$5.17

CATHERTER BALLOON 6 X 40 X 120

Facility

$195.00

Hospital Charge Code	270658397
Hospital Revenue Code	278
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$42.90
Rate for Payer: Qualcare PPO/HMO/WC	$29.25

CATHERTER BALLOON ADMIRAL XTRE

Facility

$900.00

Hospital Charge Code	2709002299
Hospital Revenue Code	272
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

CATHERTER BALLOON ADMIRAL XTRE

Facility

$900.00

Hospital Charge Code	2709002299
Hospital Revenue Code	272
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.00
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Commercial	$180.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

CATH ESOPH DIL 10-12M 5835

Facility

$939.05

Service Code	HCPCS C1726
Hospital Charge Code	270608028
Hospital Revenue Code	278
Min. Negotiated Rate	$22.63
Max. Negotiated Rate	$469.52
Rate for Payer: Aetna Commercial	$356.84
Rate for Payer: Aetna Medicare Advantage	$281.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$239.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$239.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$239.46
Rate for Payer: Cigna Commercial	$469.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$206.59
Rate for Payer: Qualcare PPO/HMO/WC	$140.86
Rate for Payer: UnitedHealthcare Community & State	$22.63
Rate for Payer: Wellpoint Medicaid Managed Care	$24.88

CATH ESOPH DIL 10-12M 5835

Facility

$939.05

Service Code	HCPCS C1726
Hospital Charge Code	270608028
Hospital Revenue Code	278
Min. Negotiated Rate	$140.86
Max. Negotiated Rate	$227.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$206.59
Rate for Payer: Qualcare PPO/HMO/WC	$140.86

CATH ESOPH DIL BAL 12-15M 5836

Facility

$4,201.00

Service Code	HCPCS C1726
Hospital Charge Code	270608025
Hospital Revenue Code	278
Min. Negotiated Rate	$101.24
Max. Negotiated Rate	$2,100.50
Rate for Payer: Aetna Commercial	$1,596.38
Rate for Payer: Aetna Medicare Advantage	$1,260.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,071.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,071.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$840.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,071.26
Rate for Payer: Cigna Commercial	$2,100.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,016.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$924.22
Rate for Payer: Qualcare PPO/HMO/WC	$630.15
Rate for Payer: UnitedHealthcare Community & State	$101.24
Rate for Payer: Wellpoint Medicaid Managed Care	$111.33

CATH ESOPH DIL BAL 12-15M 5836

Facility

$4,201.00

Service Code	HCPCS C1726
Hospital Charge Code	270608025
Hospital Revenue Code	278
Min. Negotiated Rate	$630.15
Max. Negotiated Rate	$1,016.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$840.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,016.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$924.22
Rate for Payer: Qualcare PPO/HMO/WC	$630.15

CATH ESOPH DIL BAL 15-18M 5837

Facility

$1,995.25

Service Code	HCPCS C1726
Hospital Charge Code	270608026
Hospital Revenue Code	278
Min. Negotiated Rate	$299.29
Max. Negotiated Rate	$482.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$399.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$482.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$438.95
Rate for Payer: Qualcare PPO/HMO/WC	$299.29

CATH ESOPH DIL BAL 15-18M 5837

Facility

$1,995.25

Service Code	HCPCS C1726
Hospital Charge Code	270608026
Hospital Revenue Code	278
Min. Negotiated Rate	$48.09
Max. Negotiated Rate	$997.62
Rate for Payer: Aetna Commercial	$758.20
Rate for Payer: Aetna Medicare Advantage	$598.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$508.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$508.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$399.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$508.79
Rate for Payer: Cigna Commercial	$997.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$482.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$438.95
Rate for Payer: Qualcare PPO/HMO/WC	$299.29
Rate for Payer: UnitedHealthcare Community & State	$48.09
Rate for Payer: Wellpoint Medicaid Managed Care	$52.87

CATH ESOPH DIL ITE 8-10MM 5834

Facility

$1,995.25

Hospital Charge Code	270608027
Hospital Revenue Code	278
Min. Negotiated Rate	$48.09
Max. Negotiated Rate	$997.62
Rate for Payer: Aetna Commercial	$758.20
Rate for Payer: Aetna Medicare Advantage	$598.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$508.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$508.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$399.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$508.79
Rate for Payer: Cigna Commercial	$997.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$482.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$438.95
Rate for Payer: Qualcare PPO/HMO/WC	$299.29
Rate for Payer: UnitedHealthcare Community & State	$48.09
Rate for Payer: Wellpoint Medicaid Managed Care	$52.87

CATH ESOPH DIL ITE 8-10MM 5834

Facility

$1,995.25

Hospital Charge Code	270608027
Hospital Revenue Code	278
Min. Negotiated Rate	$299.29
Max. Negotiated Rate	$482.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$399.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$482.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$438.95
Rate for Payer: Qualcare PPO/HMO/WC	$299.29

CATHET BALLN ADMIRAL XTREM

Facility

$200.00

Service Code	HCPCS C1725
Hospital Charge Code	270655027
Hospital Revenue Code	278
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Community & State	$4.82
Rate for Payer: Wellpoint Medicaid Managed Care	$5.30

CATHET BALLN ADMIRAL XTREM

Facility

$200.00

Service Code	HCPCS C1725
Hospital Charge Code	270655027
Hospital Revenue Code	278
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$48.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

Know your out-of-pocket cost for care.

All Charges