Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER ACE60 REFERFUSION W/T

Facility

$12,125.00

Service Code	HCPCS C1725
Hospital Charge Code	270682965
Hospital Revenue Code	278
Min. Negotiated Rate	$292.21
Max. Negotiated Rate	$6,062.50
Rate for Payer: Aetna Commercial	$4,607.50
Rate for Payer: Aetna Medicare Advantage	$3,637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,091.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,091.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,091.88
Rate for Payer: Cigna Commercial	$6,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,934.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,667.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,818.75
Rate for Payer: UnitedHealthcare Community & State	$292.21
Rate for Payer: Wellpoint Medicaid Managed Care	$321.31

CATHETER ACE60 REFERFUSION W/T

Facility

$12,125.00

Service Code	HCPCS C1725
Hospital Charge Code	270682965N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,818.75
Max. Negotiated Rate	$2,934.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,934.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,667.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,818.75

CATHETER ACE60 REFERFUSION W/T

Facility

$12,125.00

Service Code	HCPCS C1725
Hospital Charge Code	270682965S
Hospital Revenue Code	278
Min. Negotiated Rate	$292.21
Max. Negotiated Rate	$6,062.50
Rate for Payer: Aetna Commercial	$4,607.50
Rate for Payer: Aetna Medicare Advantage	$3,637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,091.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,091.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,091.88
Rate for Payer: Cigna Commercial	$6,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,934.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,667.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,818.75
Rate for Payer: UnitedHealthcare Community & State	$292.21
Rate for Payer: Wellpoint Medicaid Managed Care	$321.31

CATHETER ACE60 REFERFUSION W/T

Facility

$12,125.00

Service Code	HCPCS C1725
Hospital Charge Code	270682965N
Hospital Revenue Code	278
Min. Negotiated Rate	$292.21
Max. Negotiated Rate	$6,062.50
Rate for Payer: Aetna Commercial	$4,607.50
Rate for Payer: Aetna Medicare Advantage	$3,637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,091.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,091.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,091.88
Rate for Payer: Cigna Commercial	$6,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,934.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,667.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,818.75
Rate for Payer: UnitedHealthcare Community & State	$292.21
Rate for Payer: Wellpoint Medicaid Managed Care	$321.31

CATHETER ACE60 REFERFUSION W/T

Facility

$12,125.00

Service Code	HCPCS C1725
Hospital Charge Code	270682965S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,818.75
Max. Negotiated Rate	$2,934.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,934.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,667.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,818.75

CATHETER ACE60 REFERFUSION W/T

Facility

$12,125.00

Service Code	HCPCS C1725
Hospital Charge Code	270682965
Hospital Revenue Code	278
Min. Negotiated Rate	$1,818.75
Max. Negotiated Rate	$2,934.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,934.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,667.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,818.75

CATHETER ACE64 REFERFUSION W/T

Facility

$13,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270682964
Hospital Revenue Code	278
Min. Negotiated Rate	$331.38
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$5,225.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50
Rate for Payer: UnitedHealthcare Community & State	$331.38
Rate for Payer: Wellpoint Medicaid Managed Care	$364.38

CATHETER ACE64 REFERFUSION W/T

Facility

$13,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270682964
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$3,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

CATHETER ACE68 REFERFUSION W/T

Facility

$13,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270682963N
Hospital Revenue Code	278
Min. Negotiated Rate	$331.38
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$5,225.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50
Rate for Payer: UnitedHealthcare Community & State	$331.38
Rate for Payer: Wellpoint Medicaid Managed Care	$364.38

CATHETER ACE68 REFERFUSION W/T

Facility

$13,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270682963N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$3,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

CATHETER ACE68 REFERFUSION W/T

Facility

$13,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270682963
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$3,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

CATHETER ACE68 REFERFUSION W/T

Facility

$13,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270682963
Hospital Revenue Code	278
Min. Negotiated Rate	$331.38
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$5,225.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50
Rate for Payer: UnitedHealthcare Community & State	$331.38
Rate for Payer: Wellpoint Medicaid Managed Care	$364.38

CATHETER ADAPTER STRL 403250

Facility

$3.12

Hospital Charge Code	270650508
Hospital Revenue Code	272
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$0.47
Rate for Payer: Qualcare PPO/HMO/WC	$0.47

CATHETER ADAPTER STRL 403250

Facility

$3.12

Hospital Charge Code	270650508
Hospital Revenue Code	272
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$1.56
Rate for Payer: Aetna Commercial	$1.19
Rate for Payer: Aetna Medicare Advantage	$0.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.80
Rate for Payer: Cigna Commercial	$1.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.94
Rate for Payer: Oxford Commercial	$0.62
Rate for Payer: Qualcare PPO/HMO/WC	$0.47
Rate for Payer: UnitedHealthcare Commercial	$0.62
Rate for Payer: UnitedHealthcare Community & State	$0.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

CATHETER ADULT PRESTERNAL CRVD

Facility

$2,375.00

Hospital Charge Code	270674113
Hospital Revenue Code	272
Min. Negotiated Rate	$356.25
Max. Negotiated Rate	$356.25
Rate for Payer: Qualcare PPO/HMO/WC	$356.25

CATHETER ADULT PRESTERNAL CRVD

Facility

$2,375.00

Hospital Charge Code	270674113
Hospital Revenue Code	272
Min. Negotiated Rate	$57.24
Max. Negotiated Rate	$1,187.50
Rate for Payer: Aetna Commercial	$902.50
Rate for Payer: Aetna Medicare Advantage	$712.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$605.62
Rate for Payer: Cigna Commercial	$1,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$712.50
Rate for Payer: Oxford Commercial	$475.00
Rate for Payer: Qualcare PPO/HMO/WC	$356.25
Rate for Payer: UnitedHealthcare Commercial	$475.00
Rate for Payer: UnitedHealthcare Community & State	$57.24
Rate for Payer: Wellpoint Medicaid Managed Care	$62.94

CATHETER ALL PURPOSE 12 FR 16

Facility

$42.00

Hospital Charge Code	270332306
Hospital Revenue Code	278
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$10.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.24
Rate for Payer: Qualcare PPO/HMO/WC	$6.30

CATHETER ALL PURPOSE 12 FR 16

Facility

$42.00

Hospital Charge Code	270332306
Hospital Revenue Code	278
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$21.00
Rate for Payer: Aetna Commercial	$15.96
Rate for Payer: Aetna Medicare Advantage	$12.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.71
Rate for Payer: Cigna Commercial	$21.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.24
Rate for Payer: Qualcare PPO/HMO/WC	$6.30
Rate for Payer: UnitedHealthcare Community & State	$1.01
Rate for Payer: Wellpoint Medicaid Managed Care	$1.11

CATHETER, ANGIO

Facility

$219.00

Hospital Charge Code	2008090
Hospital Revenue Code	272
Min. Negotiated Rate	$5.28
Max. Negotiated Rate	$109.50
Rate for Payer: Aetna Commercial	$83.22
Rate for Payer: Aetna Medicare Advantage	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.84
Rate for Payer: Cigna Commercial	$109.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.70
Rate for Payer: Oxford Commercial	$43.80
Rate for Payer: Qualcare PPO/HMO/WC	$32.85
Rate for Payer: UnitedHealthcare Commercial	$43.80
Rate for Payer: UnitedHealthcare Community & State	$5.28
Rate for Payer: Wellpoint Medicaid Managed Care	$5.80

CATHETER, ANGIO

Facility

$219.00

Hospital Charge Code	2008090
Hospital Revenue Code	272
Min. Negotiated Rate	$32.85
Max. Negotiated Rate	$32.85
Rate for Payer: Qualcare PPO/HMO/WC	$32.85

CATHETER ANGIOGRAPHIC 5FR. 65C

Facility

$146.00

Hospital Charge Code	270331798
Hospital Revenue Code	272
Min. Negotiated Rate	$21.90
Max. Negotiated Rate	$21.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.90

CATHETER ANGIOGRAPHIC 5FR. 65C

Facility

$146.00

Hospital Charge Code	270331798
Hospital Revenue Code	272
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$73.00
Rate for Payer: Aetna Commercial	$55.48
Rate for Payer: Aetna Medicare Advantage	$43.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.23
Rate for Payer: Cigna Commercial	$73.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.80
Rate for Payer: Oxford Commercial	$29.20
Rate for Payer: Qualcare PPO/HMO/WC	$21.90
Rate for Payer: UnitedHealthcare Commercial	$29.20
Rate for Payer: UnitedHealthcare Community & State	$3.52
Rate for Payer: Wellpoint Medicaid Managed Care	$3.87

CATHETER ANGIOPLASTY 14x60x75

Facility

$925.00

Hospital Charge Code	270705349
Hospital Revenue Code	279
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$138.75
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

CATHETER ANGIOPLASTY 14x60x75

Facility

$925.00

Hospital Charge Code	270705349
Hospital Revenue Code	279
Min. Negotiated Rate	$22.29
Max. Negotiated Rate	$462.50
Rate for Payer: Aetna Commercial	$351.50
Rate for Payer: Aetna Medicare Advantage	$277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.50
Rate for Payer: Oxford Commercial	$185.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.75
Rate for Payer: UnitedHealthcare Commercial	$185.00
Rate for Payer: UnitedHealthcare Community & State	$22.29
Rate for Payer: Wellpoint Medicaid Managed Care	$24.51

CATHETER APEX MONO 8X2 50

Facility

$1,225.00

Hospital Charge Code	270653666
Hospital Revenue Code	272
Min. Negotiated Rate	$183.75
Max. Negotiated Rate	$183.75
Rate for Payer: Qualcare PPO/HMO/WC	$183.75

Know your out-of-pocket cost for care.

All Charges