Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER 10FR. FELXIMA NEPHROS

Facility

$359.45

Hospital Charge Code	2706000661
Hospital Revenue Code	272
Min. Negotiated Rate	$8.66
Max. Negotiated Rate	$179.72
Rate for Payer: Aetna Commercial	$136.59
Rate for Payer: Aetna Medicare Advantage	$107.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.66
Rate for Payer: Cigna Commercial	$179.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.83
Rate for Payer: Oxford Commercial	$71.89
Rate for Payer: Qualcare PPO/HMO/WC	$53.92
Rate for Payer: UnitedHealthcare Commercial	$71.89
Rate for Payer: UnitedHealthcare Community & State	$8.66
Rate for Payer: Wellpoint Medicaid Managed Care	$9.53

CATHETER 10FR. FELXIMA NEPHROS

Facility

$359.45

Hospital Charge Code	2706000661
Hospital Revenue Code	272
Min. Negotiated Rate	$53.92
Max. Negotiated Rate	$53.92
Rate for Payer: Qualcare PPO/HMO/WC	$53.92

CATHETER 120CM 5F SIM

Facility

$625.00

Service Code	HCPCS C1725
Hospital Charge Code	270695065S
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

CATHETER 120CM 5F SIM

Facility

$625.00

Service Code	HCPCS C1725
Hospital Charge Code	270695065S
Hospital Revenue Code	278
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

CATHETER 125 CM SIMS

Facility

$625.00

Service Code	HCPCS C1887
Hospital Charge Code	270690857
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

CATHETER 125 CM SIMS

Facility

$625.00

Service Code	HCPCS C1887
Hospital Charge Code	270690857
Hospital Revenue Code	278
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

CATHETER 12FR. FLEXIMA NEPHROS

Facility

$359.45

Hospital Charge Code	2706000660
Hospital Revenue Code	272
Min. Negotiated Rate	$8.66
Max. Negotiated Rate	$179.72
Rate for Payer: Aetna Commercial	$136.59
Rate for Payer: Aetna Medicare Advantage	$107.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.66
Rate for Payer: Cigna Commercial	$179.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.83
Rate for Payer: Oxford Commercial	$71.89
Rate for Payer: Qualcare PPO/HMO/WC	$53.92
Rate for Payer: UnitedHealthcare Commercial	$71.89
Rate for Payer: UnitedHealthcare Community & State	$8.66
Rate for Payer: Wellpoint Medicaid Managed Care	$9.53

CATHETER 12FR. FLEXIMA NEPHROS

Facility

$359.45

Hospital Charge Code	2706000660
Hospital Revenue Code	272
Min. Negotiated Rate	$53.92
Max. Negotiated Rate	$53.92
Rate for Payer: Qualcare PPO/HMO/WC	$53.92

CATHETER 12 FR HIGH 20 CM

Facility

$2,647.60

Hospital Charge Code	270700834
Hospital Revenue Code	278
Min. Negotiated Rate	$397.14
Max. Negotiated Rate	$640.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$529.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$640.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$582.47
Rate for Payer: Qualcare PPO/HMO/WC	$397.14

CATHETER 12 FR HIGH 20 CM

Facility

$2,647.60

Hospital Charge Code	270700834
Hospital Revenue Code	278
Min. Negotiated Rate	$63.81
Max. Negotiated Rate	$1,323.80
Rate for Payer: Aetna Commercial	$1,006.09
Rate for Payer: Aetna Medicare Advantage	$794.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$675.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$675.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$529.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$675.14
Rate for Payer: Cigna Commercial	$1,323.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$640.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$582.47
Rate for Payer: Qualcare PPO/HMO/WC	$397.14
Rate for Payer: UnitedHealthcare Community & State	$63.81
Rate for Payer: Wellpoint Medicaid Managed Care	$70.16

CATHETER 130CM 5F SIMMON

Facility

$625.00

Service Code	HCPCS C1725
Hospital Charge Code	270695066S
Hospital Revenue Code	278
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

CATHETER 130CM 5F SIMMON

Facility

$625.00

Service Code	HCPCS C1725
Hospital Charge Code	270695066S
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

CATHETER 130 CM TO CAT 7

Facility

$40,100.00

Hospital Charge Code	270700669
Hospital Revenue Code	272
Min. Negotiated Rate	$966.41
Max. Negotiated Rate	$20,050.00
Rate for Payer: Aetna Commercial	$15,238.00
Rate for Payer: Aetna Medicare Advantage	$12,030.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,225.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,225.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,225.50
Rate for Payer: Cigna Commercial	$20,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,030.00
Rate for Payer: Oxford Commercial	$8,020.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,015.00
Rate for Payer: UnitedHealthcare Commercial	$8,020.00
Rate for Payer: UnitedHealthcare Community & State	$966.41
Rate for Payer: Wellpoint Medicaid Managed Care	$1,062.65

CATHETER 130 CM TO CAT 7

Facility

$40,100.00

Hospital Charge Code	270700669
Hospital Revenue Code	272
Min. Negotiated Rate	$6,015.00
Max. Negotiated Rate	$6,015.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,015.00

CATHETER 14FR CLOSED TRACH

Facility

$35.00

Hospital Charge Code	270689128
Hospital Revenue Code	272
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

CATHETER 14FR CLOSED TRACH

Facility

$35.00

Hospital Charge Code	270689128
Hospital Revenue Code	272
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$17.50
Rate for Payer: Aetna Commercial	$13.30
Rate for Payer: Aetna Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.93
Rate for Payer: Cigna Commercial	$17.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.50
Rate for Payer: Oxford Commercial	$7.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$7.00
Rate for Payer: UnitedHealthcare Community & State	$0.84
Rate for Payer: Wellpoint Medicaid Managed Care	$0.93

CATHETER 14FX15CM SLX DOUBLE L

Facility

$465.00

Hospital Charge Code	270CH0065
Hospital Revenue Code	278
Min. Negotiated Rate	$69.75
Max. Negotiated Rate	$112.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$102.30
Rate for Payer: Qualcare PPO/HMO/WC	$69.75

CATHETER 14FX15CM SLX DOUBLE L

Facility

$465.00

Hospital Charge Code	270CH0065
Hospital Revenue Code	278
Min. Negotiated Rate	$11.21
Max. Negotiated Rate	$232.50
Rate for Payer: Aetna Commercial	$176.70
Rate for Payer: Aetna Medicare Advantage	$139.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.58
Rate for Payer: Cigna Commercial	$232.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$102.30
Rate for Payer: Qualcare PPO/HMO/WC	$69.75
Rate for Payer: UnitedHealthcare Community & State	$11.21
Rate for Payer: Wellpoint Medicaid Managed Care	$12.32

CATHETER 14F X20CM SLX DOUBLE

Facility

$425.00

Hospital Charge Code	270CH0066
Hospital Revenue Code	278
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

CATHETER 14F X20CM SLX DOUBLE

Facility

$425.00

Hospital Charge Code	270CH0066
Hospital Revenue Code	278
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

CATHETER 16FR 20 IN 4 EYE

Facility

$33.60

Hospital Charge Code	270697328
Hospital Revenue Code	272
Min. Negotiated Rate	$5.04
Max. Negotiated Rate	$5.04
Rate for Payer: Qualcare PPO/HMO/WC	$5.04

CATHETER 16FR 20 IN 4 EYE

Facility

$33.60

Hospital Charge Code	270697328
Hospital Revenue Code	272
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$16.80
Rate for Payer: Aetna Commercial	$12.77
Rate for Payer: Aetna Medicare Advantage	$10.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.57
Rate for Payer: Cigna Commercial	$16.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.08
Rate for Payer: Oxford Commercial	$6.72
Rate for Payer: Qualcare PPO/HMO/WC	$5.04
Rate for Payer: UnitedHealthcare Commercial	$6.72
Rate for Payer: UnitedHealthcare Community & State	$0.81
Rate for Payer: Wellpoint Medicaid Managed Care	$0.89

CATHETER 20FR 5CC 3WAY FOLEY

Facility

$191.00

Hospital Charge Code	270331252
Hospital Revenue Code	272
Min. Negotiated Rate	$28.65
Max. Negotiated Rate	$28.65
Rate for Payer: Qualcare PPO/HMO/WC	$28.65

CATHETER 20FR 5CC 3WAY FOLEY

Facility

$191.00

Hospital Charge Code	270331252
Hospital Revenue Code	272
Min. Negotiated Rate	$4.60
Max. Negotiated Rate	$95.50
Rate for Payer: Aetna Commercial	$72.58
Rate for Payer: Aetna Medicare Advantage	$57.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.70
Rate for Payer: Cigna Commercial	$95.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.30
Rate for Payer: Oxford Commercial	$38.20
Rate for Payer: Qualcare PPO/HMO/WC	$28.65
Rate for Payer: UnitedHealthcare Commercial	$38.20
Rate for Payer: UnitedHealthcare Community & State	$4.60
Rate for Payer: Wellpoint Medicaid Managed Care	$5.06

CATHETER 26FR 30CC/ML RIBBED

Facility

$60.60

Hospital Charge Code	270664341
Hospital Revenue Code	272
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$30.30
Rate for Payer: Aetna Commercial	$23.03
Rate for Payer: Aetna Medicare Advantage	$18.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.45
Rate for Payer: Cigna Commercial	$30.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.18
Rate for Payer: Oxford Commercial	$12.12
Rate for Payer: Qualcare PPO/HMO/WC	$9.09
Rate for Payer: UnitedHealthcare Commercial	$12.12
Rate for Payer: UnitedHealthcare Community & State	$1.46
Rate for Payer: Wellpoint Medicaid Managed Care	$1.61

Know your out-of-pocket cost for care.

All Charges