Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER 5FR CTR FLUSH 65CM

Facility

$27.91

Hospital Charge Code	270651795N
Hospital Revenue Code	272
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$4.19
Rate for Payer: Qualcare PPO/HMO/WC	$4.19

CATHETER 5FR JR 3.5

Facility

$47.50

Service Code	HCPCS C1887
Hospital Charge Code	270658168N
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 5FR JR 3.5

Facility

$37.35

Service Code	HCPCS C1887
Hospital Charge Code	270658168S
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 5FR JR 3.5

Facility

$47.50

Hospital Charge Code	2707400147
Hospital Revenue Code	272
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$7.12
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

CATHETER 5FR JR 3.5

Facility

$47.50

Hospital Charge Code	2707400147
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 5FR JR 3.5

Facility

$37.35

Service Code	HCPCS C1887
Hospital Charge Code	270658168
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 5FR JR 3.5

Facility

$47.50

Service Code	HCPCS C1887
Hospital Charge Code	270658168N
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 5FR JR 3.5

Facility

$37.35

Service Code	HCPCS C1887
Hospital Charge Code	270658168
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 5FR JR 3.5

Facility

$37.35

Service Code	HCPCS C1887
Hospital Charge Code	270658168S
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 5FR JR4

Facility

$37.90

Service Code	HCPCS C1887
Hospital Charge Code	270654458
Hospital Revenue Code	278
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$9.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.34
Rate for Payer: Qualcare PPO/HMO/WC	$5.68

CATHETER 5FR JR4

Facility

$40.00

Hospital Charge Code	2707400148
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 5FR JR4

Facility

$37.90

Service Code	HCPCS C1887
Hospital Charge Code	270654458
Hospital Revenue Code	278
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$18.95
Rate for Payer: Aetna Commercial	$14.40
Rate for Payer: Aetna Medicare Advantage	$11.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.66
Rate for Payer: Cigna Commercial	$18.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.34
Rate for Payer: Qualcare PPO/HMO/WC	$5.68
Rate for Payer: UnitedHealthcare Community & State	$0.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

CATHETER 5FR JR4

Facility

$40.00

Hospital Charge Code	2707400148
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CATHETER 5FR JR4

Facility

$37.90

Service Code	HCPCS C1887
Hospital Charge Code	270654458S
Hospital Revenue Code	278
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$18.95
Rate for Payer: Aetna Commercial	$14.40
Rate for Payer: Aetna Medicare Advantage	$11.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.66
Rate for Payer: Cigna Commercial	$18.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.34
Rate for Payer: Qualcare PPO/HMO/WC	$5.68
Rate for Payer: UnitedHealthcare Community & State	$0.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

CATHETER 5FR JR4

Facility

$18.68

Service Code	HCPCS C1887
Hospital Charge Code	270654458N
Hospital Revenue Code	278
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$4.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4.11
Rate for Payer: Qualcare PPO/HMO/WC	$2.80

CATHETER 5FR JR4

Facility

$37.90

Service Code	HCPCS C1887
Hospital Charge Code	270654458S
Hospital Revenue Code	278
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$9.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.34
Rate for Payer: Qualcare PPO/HMO/WC	$5.68

CATHETER 5FR JR4

Facility

$18.68

Service Code	HCPCS C1887
Hospital Charge Code	270654458N
Hospital Revenue Code	278
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$9.34
Rate for Payer: Aetna Commercial	$7.10
Rate for Payer: Aetna Medicare Advantage	$5.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.76
Rate for Payer: Cigna Commercial	$9.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4.11
Rate for Payer: Qualcare PPO/HMO/WC	$2.80
Rate for Payer: UnitedHealthcare Community & State	$0.45
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

CATHETER 5FR PIG TAIL 65CM

Facility

$56.65

Hospital Charge Code	270663792
Hospital Revenue Code	272
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$8.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.50

CATHETER 5FR PIG TAIL 65CM

Facility

$56.65

Hospital Charge Code	270663792
Hospital Revenue Code	272
Min. Negotiated Rate	$1.37
Max. Negotiated Rate	$28.32
Rate for Payer: Aetna Commercial	$21.53
Rate for Payer: Aetna Medicare Advantage	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.45
Rate for Payer: Cigna Commercial	$28.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.00
Rate for Payer: Oxford Commercial	$11.33
Rate for Payer: Qualcare PPO/HMO/WC	$8.50
Rate for Payer: UnitedHealthcare Commercial	$11.33
Rate for Payer: UnitedHealthcare Community & State	$1.37
Rate for Payer: Wellpoint Medicaid Managed Care	$1.50

CATHETER 5FR SOFT-VU 65CM X.03

Facility

$166.50

Hospital Charge Code	270672223N
Hospital Revenue Code	272
Min. Negotiated Rate	$24.98
Max. Negotiated Rate	$24.98
Rate for Payer: Qualcare PPO/HMO/WC	$24.98

CATHETER 5FR SOFT-VU 65CM X.03

Facility

$166.50

Hospital Charge Code	270672223
Hospital Revenue Code	272
Min. Negotiated Rate	$24.98
Max. Negotiated Rate	$24.98
Rate for Payer: Qualcare PPO/HMO/WC	$24.98

CATHETER 5FR SOFT-VU 65CM X.03

Facility

$166.50

Hospital Charge Code	270672223
Hospital Revenue Code	272
Min. Negotiated Rate	$4.01
Max. Negotiated Rate	$83.25
Rate for Payer: Aetna Commercial	$63.27
Rate for Payer: Aetna Medicare Advantage	$49.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.46
Rate for Payer: Cigna Commercial	$83.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.95
Rate for Payer: Oxford Commercial	$33.30
Rate for Payer: Qualcare PPO/HMO/WC	$24.98
Rate for Payer: UnitedHealthcare Commercial	$33.30
Rate for Payer: UnitedHealthcare Community & State	$4.01
Rate for Payer: Wellpoint Medicaid Managed Care	$4.41

CATHETER 5FR SOFT-VU 65CM X.03

Facility

$166.50

Hospital Charge Code	270672223N
Hospital Revenue Code	272
Min. Negotiated Rate	$4.01
Max. Negotiated Rate	$83.25
Rate for Payer: Aetna Commercial	$63.27
Rate for Payer: Aetna Medicare Advantage	$49.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.46
Rate for Payer: Cigna Commercial	$83.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.95
Rate for Payer: Oxford Commercial	$33.30
Rate for Payer: Qualcare PPO/HMO/WC	$24.98
Rate for Payer: UnitedHealthcare Commercial	$33.30
Rate for Payer: UnitedHealthcare Community & State	$4.01
Rate for Payer: Wellpoint Medicaid Managed Care	$4.41

CATHETER 5 FR URETHANE UMB

Facility

$659.20

Hospital Charge Code	270663692
Hospital Revenue Code	278
Min. Negotiated Rate	$15.89
Max. Negotiated Rate	$329.60
Rate for Payer: Aetna Commercial	$250.50
Rate for Payer: Aetna Medicare Advantage	$197.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.10
Rate for Payer: Cigna Commercial	$329.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.02
Rate for Payer: Qualcare PPO/HMO/WC	$98.88
Rate for Payer: UnitedHealthcare Community & State	$15.89
Rate for Payer: Wellpoint Medicaid Managed Care	$17.47

CATHETER 5 FR URETHANE UMB

Facility

$659.20

Hospital Charge Code	270663692
Hospital Revenue Code	278
Min. Negotiated Rate	$98.88
Max. Negotiated Rate	$159.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.02
Rate for Payer: Qualcare PPO/HMO/WC	$98.88

Know your out-of-pocket cost for care.

All Charges