Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER 5F ANGLED PIGTAIL

Facility

$47.50

Service Code	HCPCS C1758
Hospital Charge Code	270658269N
Hospital Revenue Code	278
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$11.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$10.45
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

CATHETER 5F ANGLED PIGTAIL

Facility

$47.50

Hospital Charge Code	2709000314
Hospital Revenue Code	272
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$23.75
Rate for Payer: Aetna Commercial	$18.05
Rate for Payer: Aetna Medicare Advantage	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.11
Rate for Payer: Cigna Commercial	$23.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.25
Rate for Payer: Oxford Commercial	$9.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.12
Rate for Payer: UnitedHealthcare Commercial	$9.50
Rate for Payer: UnitedHealthcare Community & State	$1.14
Rate for Payer: Wellpoint Medicaid Managed Care	$1.26

CATHETER 5F ANGLED PIGTAIL

Facility

$47.50

Hospital Charge Code	2709000314
Hospital Revenue Code	272
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$7.12
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

CATHETER 5F ANGLED PIGTAIL

Facility

$37.35

Service Code	HCPCS C1758
Hospital Charge Code	270658269S
Hospital Revenue Code	278
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$18.68
Rate for Payer: Aetna Commercial	$14.19
Rate for Payer: Aetna Medicare Advantage	$11.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.52
Rate for Payer: Cigna Commercial	$18.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.22
Rate for Payer: Qualcare PPO/HMO/WC	$5.60
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

CATHETER 5F ANGLED PIGTAIL

Facility

$37.35

Service Code	HCPCS C1758
Hospital Charge Code	270658269
Hospital Revenue Code	278
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$9.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.22
Rate for Payer: Qualcare PPO/HMO/WC	$5.60

CATHETER 5F ANGLED PIGTAIL

Facility

$37.35

Service Code	HCPCS C1758
Hospital Charge Code	270658269
Hospital Revenue Code	278
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$18.68
Rate for Payer: Aetna Commercial	$14.19
Rate for Payer: Aetna Medicare Advantage	$11.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.52
Rate for Payer: Cigna Commercial	$18.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.22
Rate for Payer: Qualcare PPO/HMO/WC	$5.60
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

CATHETER 5F ANGLED PIGTAIL

Facility

$47.50

Service Code	HCPCS C1758
Hospital Charge Code	270658269N
Hospital Revenue Code	278
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$23.75
Rate for Payer: Aetna Commercial	$18.05
Rate for Payer: Aetna Medicare Advantage	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.11
Rate for Payer: Cigna Commercial	$23.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$10.45
Rate for Payer: Qualcare PPO/HMO/WC	$7.12
Rate for Payer: UnitedHealthcare Community & State	$1.14
Rate for Payer: Wellpoint Medicaid Managed Care	$1.26

CATHETER 5F ANGLED PIGTAIL

Facility

$37.35

Service Code	HCPCS C1758
Hospital Charge Code	270658269S
Hospital Revenue Code	278
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$9.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.22
Rate for Payer: Qualcare PPO/HMO/WC	$5.60

CATHETER 5F AR1

Facility

$37.35

Hospital Charge Code	270658172S
Hospital Revenue Code	270
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$18.68
Rate for Payer: Aetna Commercial	$14.19
Rate for Payer: Aetna Medicare Advantage	$11.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.52
Rate for Payer: Cigna Commercial	$18.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.21
Rate for Payer: Oxford Commercial	$7.47
Rate for Payer: Qualcare PPO/HMO/WC	$5.60
Rate for Payer: UnitedHealthcare Commercial	$7.47
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

CATHETER 5F AR1

Facility

$37.35

Hospital Charge Code	270658172
Hospital Revenue Code	270
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$5.60

CATHETER 5F AR1

Facility

$47.50

Hospital Charge Code	2709000308
Hospital Revenue Code	272
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$23.75
Rate for Payer: Aetna Commercial	$18.05
Rate for Payer: Aetna Medicare Advantage	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.11
Rate for Payer: Cigna Commercial	$23.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.25
Rate for Payer: Oxford Commercial	$9.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.12
Rate for Payer: UnitedHealthcare Commercial	$9.50
Rate for Payer: UnitedHealthcare Community & State	$1.14
Rate for Payer: Wellpoint Medicaid Managed Care	$1.26

CATHETER 5F AR1

Facility

$37.35

Hospital Charge Code	270658172
Hospital Revenue Code	270
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$18.68
Rate for Payer: Aetna Commercial	$14.19
Rate for Payer: Aetna Medicare Advantage	$11.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.52
Rate for Payer: Cigna Commercial	$18.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.21
Rate for Payer: Oxford Commercial	$7.47
Rate for Payer: Qualcare PPO/HMO/WC	$5.60
Rate for Payer: UnitedHealthcare Commercial	$7.47
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

CATHETER 5F AR1

Facility

$37.35

Hospital Charge Code	270658172S
Hospital Revenue Code	270
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$5.60

CATHETER 5F AR1

Facility

$47.50

Hospital Charge Code	2709000308
Hospital Revenue Code	272
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$7.12
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

CATHETER 5F AR2

Facility

$47.50

Hospital Charge Code	2709000309
Hospital Revenue Code	272
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$23.75
Rate for Payer: Aetna Commercial	$18.05
Rate for Payer: Aetna Medicare Advantage	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.11
Rate for Payer: Cigna Commercial	$23.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.25
Rate for Payer: Oxford Commercial	$9.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.12
Rate for Payer: UnitedHealthcare Commercial	$9.50
Rate for Payer: UnitedHealthcare Community & State	$1.14
Rate for Payer: Wellpoint Medicaid Managed Care	$1.26

CATHETER 5F AR2

Facility

$47.50

Hospital Charge Code	2709000309
Hospital Revenue Code	272
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$7.12
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

CATHETER 5F AR2

Facility

$37.35

Service Code	HCPCS C1887
Hospital Charge Code	270658173
Hospital Revenue Code	278
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$9.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.22
Rate for Payer: Qualcare PPO/HMO/WC	$5.60

CATHETER 5F AR2

Facility

$37.35

Service Code	HCPCS C1887
Hospital Charge Code	270658173
Hospital Revenue Code	278
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$18.68
Rate for Payer: Aetna Commercial	$14.19
Rate for Payer: Aetna Medicare Advantage	$11.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.52
Rate for Payer: Cigna Commercial	$18.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.22
Rate for Payer: Qualcare PPO/HMO/WC	$5.60
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

CATHETER 5F IMA

Facility

$40.00

Hospital Charge Code	2709000312
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.00
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$8.00
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

CATHETER 5F IMA

Facility

$37.35

Service Code	HCPCS C1887
Hospital Charge Code	270658174
Hospital Revenue Code	278
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$9.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.22
Rate for Payer: Qualcare PPO/HMO/WC	$5.60

CATHETER 5F IMA

Facility

$40.00

Hospital Charge Code	2709000312
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CATHETER 5F IMA

Facility

$40.00

Service Code	HCPCS C1887
Hospital Charge Code	270658174N
Hospital Revenue Code	278
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$9.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CATHETER 5F IMA

Facility

$40.00

Service Code	HCPCS C1887
Hospital Charge Code	270658174N
Hospital Revenue Code	278
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

CATHETER 5F IMA

Facility

$37.35

Service Code	HCPCS C1887
Hospital Charge Code	270658174
Hospital Revenue Code	278
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$18.68
Rate for Payer: Aetna Commercial	$14.19
Rate for Payer: Aetna Medicare Advantage	$11.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.52
Rate for Payer: Cigna Commercial	$18.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.22
Rate for Payer: Qualcare PPO/HMO/WC	$5.60
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

CATHETER 5F IMA

Facility

$37.35

Service Code	HCPCS C1887
Hospital Charge Code	270658174S
Hospital Revenue Code	278
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$9.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.22
Rate for Payer: Qualcare PPO/HMO/WC	$5.60

Know your out-of-pocket cost for care.

All Charges