Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER 6FR JL5

Facility

$56.41

Service Code	HCPCS C1887
Hospital Charge Code	270655419N
Hospital Revenue Code	278
Min. Negotiated Rate	$8.46
Max. Negotiated Rate	$13.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.41
Rate for Payer: Qualcare PPO/HMO/WC	$8.46

CATHETER 6FR JL5

Facility

$56.41

Hospital Charge Code	2707400246
Hospital Revenue Code	272
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$28.20
Rate for Payer: Aetna Commercial	$21.44
Rate for Payer: Aetna Medicare Advantage	$16.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.38
Rate for Payer: Cigna Commercial	$28.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.92
Rate for Payer: Oxford Commercial	$11.28
Rate for Payer: Qualcare PPO/HMO/WC	$8.46
Rate for Payer: UnitedHealthcare Commercial	$11.28
Rate for Payer: UnitedHealthcare Community & State	$1.36
Rate for Payer: Wellpoint Medicaid Managed Care	$1.49

CATHETER 6FR JL5

Facility

$37.35

Service Code	HCPCS C1887
Hospital Charge Code	270655419
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 6FR JL5

Facility

$37.35

Service Code	HCPCS C1887
Hospital Charge Code	270655419S
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 6FR JL5 100CM

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636296S
Hospital Revenue Code	272
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATHETER 6FR JL5 100CM

Facility

$240.00

Hospital Charge Code	270636296
Hospital Revenue Code	272
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATHETER 6FR JL5 100CM

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636296S
Hospital Revenue Code	272
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) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.00
Rate for Payer: Oxford Commercial	$48.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Commercial	$48.00
Rate for Payer: UnitedHealthcare Community & State	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$6.36

CATHETER 6FR JL5 100CM

Facility

$240.00

Hospital Charge Code	270636296
Hospital Revenue Code	272
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) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.00
Rate for Payer: Oxford Commercial	$48.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Commercial	$48.00
Rate for Payer: UnitedHealthcare Community & State	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$6.36

CATHETER 6FR JR4

Facility

$40.00

Hospital Charge Code	2707400256
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 6FR JR4

Facility

$40.00

Hospital Charge Code	2707400256
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CATHETER 6FR MP A 1

Facility

$37.35

Service Code	HCPCS C1887
Hospital Charge Code	270658145
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 6FR MP A 1

Facility

$47.50

Hospital Charge Code	2707400274
Hospital Revenue Code	272
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$7.12
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

CATHETER 6FR MP A 1

Facility

$37.35

Service Code	HCPCS C1887
Hospital Charge Code	270658145
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 6FR MP A 1

Facility

$47.50

Hospital Charge Code	2707400274
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 6FR MPA 1 SH 100CM

Facility

$220.00

Hospital Charge Code	270636332
Hospital Revenue Code	272
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$83.60
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.00
Rate for Payer: Oxford Commercial	$44.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.00
Rate for Payer: UnitedHealthcare Commercial	$44.00
Rate for Payer: UnitedHealthcare Community & State	$5.30
Rate for Payer: Wellpoint Medicaid Managed Care	$5.83

CATHETER 6FR MPA 1 SH 100CM

Facility

$220.00

Hospital Charge Code	270636332
Hospital Revenue Code	272
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

CATHETER 6FR OPEN END URETERAL

Facility

$95.03

Service Code	HCPCS C1758
Hospital Charge Code	270664750
Hospital Revenue Code	278
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$47.52
Rate for Payer: Aetna Commercial	$36.11
Rate for Payer: Aetna Medicare Advantage	$28.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.23
Rate for Payer: Cigna Commercial	$47.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$20.91
Rate for Payer: Qualcare PPO/HMO/WC	$14.25
Rate for Payer: UnitedHealthcare Community & State	$2.29
Rate for Payer: Wellpoint Medicaid Managed Care	$2.52

CATHETER 6FR OPEN END URETERAL

Facility

$95.03

Service Code	HCPCS C1758
Hospital Charge Code	270664750
Hospital Revenue Code	278
Min. Negotiated Rate	$14.25
Max. Negotiated Rate	$23.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$20.91
Rate for Payer: Qualcare PPO/HMO/WC	$14.25

CATHETER 6FR PIGTAIL STR 145

Facility

$45.25

Service Code	HCPCS C1887
Hospital Charge Code	270675013
Hospital Revenue Code	278
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$22.62
Rate for Payer: Aetna Commercial	$17.20
Rate for Payer: Aetna Medicare Advantage	$13.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.54
Rate for Payer: Cigna Commercial	$22.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.96
Rate for Payer: Qualcare PPO/HMO/WC	$6.79
Rate for Payer: UnitedHealthcare Community & State	$1.09
Rate for Payer: Wellpoint Medicaid Managed Care	$1.20

CATHETER 6FR PIGTAIL STR 145

Facility

$45.25

Service Code	HCPCS C1887
Hospital Charge Code	270675013
Hospital Revenue Code	278
Min. Negotiated Rate	$6.79
Max. Negotiated Rate	$10.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.96
Rate for Payer: Qualcare PPO/HMO/WC	$6.79

CATHETER 6FR PIGTAIL STRAIGHT

Facility

$37.35

Hospital Charge Code	270658044N
Hospital Revenue Code	272
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 6FR PIGTAIL STRAIGHT

Facility

$37.35

Hospital Charge Code	270658044S
Hospital Revenue Code	272
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$5.60

CATHETER 6FR PIGTAIL STRAIGHT

Facility

$37.35

Hospital Charge Code	270658044N
Hospital Revenue Code	272
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$5.60

CATHETER 6FR PIGTAIL STRAIGHT

Facility

$37.35

Hospital Charge Code	270658044
Hospital Revenue Code	272
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 6FR PIGTAIL STRAIGHT

Facility

$37.35

Hospital Charge Code	270658044
Hospital Revenue Code	272
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$5.60

Know your out-of-pocket cost for care.

All Charges