Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER CENTEZE 5FR 7 CM

Facility

$80.00

Hospital Charge Code	270685419
Hospital Revenue Code	272
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00

CATHETER CENTEZE 5FR 7 CM

Facility

$80.00

Hospital Charge Code	270685419
Hospital Revenue Code	272
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$40.00
Rate for Payer: Aetna Commercial	$30.40
Rate for Payer: Aetna Medicare Advantage	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.40
Rate for Payer: Cigna Commercial	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.00
Rate for Payer: Oxford Commercial	$16.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00
Rate for Payer: UnitedHealthcare Commercial	$16.00
Rate for Payer: UnitedHealthcare Community & State	$1.93
Rate for Payer: Wellpoint Medicaid Managed Care	$2.12

CATHETER CENT HEMO 15Fr X 50cm

Facility

$1,975.00

Service Code	HCPCS C1752
Hospital Charge Code	270680765
Hospital Revenue Code	278
Min. Negotiated Rate	$296.25
Max. Negotiated Rate	$477.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$477.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$434.50
Rate for Payer: Qualcare PPO/HMO/WC	$296.25

CATHETER CENT HEMO 15Fr X 50cm

Facility

$1,975.00

Service Code	HCPCS C1752
Hospital Charge Code	270680765
Hospital Revenue Code	278
Min. Negotiated Rate	$47.60
Max. Negotiated Rate	$987.50
Rate for Payer: Aetna Commercial	$750.50
Rate for Payer: Aetna Medicare Advantage	$592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.62
Rate for Payer: Cigna Commercial	$987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$477.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$434.50
Rate for Payer: Qualcare PPO/HMO/WC	$296.25
Rate for Payer: UnitedHealthcare Community & State	$47.60
Rate for Payer: Wellpoint Medicaid Managed Care	$52.34

CATHETER CHIKAI BLACK 18 200 M

Facility

$2,745.00

Service Code	HCPCS C1769
Hospital Charge Code	270698018
Hospital Revenue Code	278
Min. Negotiated Rate	$411.75
Max. Negotiated Rate	$664.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$549.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$664.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$603.90
Rate for Payer: Qualcare PPO/HMO/WC	$411.75

CATHETER CHIKAI BLACK 18 200 M

Facility

$2,745.00

Service Code	HCPCS C1769
Hospital Charge Code	270698018
Hospital Revenue Code	278
Min. Negotiated Rate	$66.15
Max. Negotiated Rate	$1,372.50
Rate for Payer: Aetna Commercial	$1,043.10
Rate for Payer: Aetna Medicare Advantage	$823.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$699.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$699.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$549.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$699.98
Rate for Payer: Cigna Commercial	$1,372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$664.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$603.90
Rate for Payer: Qualcare PPO/HMO/WC	$411.75
Rate for Payer: UnitedHealthcare Community & State	$66.15
Rate for Payer: Wellpoint Medicaid Managed Care	$72.74

CATHETER CHOCOLATE 2.5 X 120 C

Facility

$5,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270684606
Hospital Revenue Code	278
Min. Negotiated Rate	$138.57
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$2,185.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,265.00
Rate for Payer: Qualcare PPO/HMO/WC	$862.50
Rate for Payer: UnitedHealthcare Community & State	$138.57
Rate for Payer: Wellpoint Medicaid Managed Care	$152.38

CATHETER CHOCOLATE 2.5 X 120 C

Facility

$5,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270684606
Hospital Revenue Code	278
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$1,391.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,265.00
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

CATHETER CHOCOLATE 2.5X40CM

Facility

$3,825.00

Service Code	HCPCS C1725
Hospital Charge Code	4046687518
Hospital Revenue Code	278
Min. Negotiated Rate	$92.18
Max. Negotiated Rate	$1,912.50
Rate for Payer: Aetna Commercial	$1,453.50
Rate for Payer: Aetna Medicare Advantage	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$975.38
Rate for Payer: Cigna Commercial	$1,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$925.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$841.50
Rate for Payer: Qualcare PPO/HMO/WC	$573.75
Rate for Payer: UnitedHealthcare Community & State	$92.18
Rate for Payer: Wellpoint Medicaid Managed Care	$101.36

CATHETER CHOCOLATE 2.5X40CM

Facility

$3,825.00

Service Code	HCPCS C1725
Hospital Charge Code	270687518V
Hospital Revenue Code	278
Min. Negotiated Rate	$573.75
Max. Negotiated Rate	$925.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$925.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$841.50
Rate for Payer: Qualcare PPO/HMO/WC	$573.75

CATHETER CHOCOLATE 2.5X40CM

Facility

$3,825.00

Service Code	HCPCS C1725
Hospital Charge Code	4046687518
Hospital Revenue Code	278
Min. Negotiated Rate	$573.75
Max. Negotiated Rate	$925.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$925.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$841.50
Rate for Payer: Qualcare PPO/HMO/WC	$573.75

CATHETER CHOCOLATE 2.5X40CM

Facility

$3,825.00

Service Code	HCPCS C1725
Hospital Charge Code	270687518V
Hospital Revenue Code	278
Min. Negotiated Rate	$92.18
Max. Negotiated Rate	$1,912.50
Rate for Payer: Aetna Commercial	$1,453.50
Rate for Payer: Aetna Medicare Advantage	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$975.38
Rate for Payer: Cigna Commercial	$1,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$925.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$841.50
Rate for Payer: Qualcare PPO/HMO/WC	$573.75
Rate for Payer: UnitedHealthcare Community & State	$92.18
Rate for Payer: Wellpoint Medicaid Managed Care	$101.36

CATHETER CHOCOLATE 3.0X120CM

Facility

$3,825.00

Service Code	HCPCS C1725
Hospital Charge Code	270684603
Hospital Revenue Code	278
Min. Negotiated Rate	$573.75
Max. Negotiated Rate	$925.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$925.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$841.50
Rate for Payer: Qualcare PPO/HMO/WC	$573.75

CATHETER CHOCOLATE 3.0X120CM

Facility

$3,825.00

Service Code	HCPCS C1725
Hospital Charge Code	270684603
Hospital Revenue Code	278
Min. Negotiated Rate	$92.18
Max. Negotiated Rate	$1,912.50
Rate for Payer: Aetna Commercial	$1,453.50
Rate for Payer: Aetna Medicare Advantage	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$975.38
Rate for Payer: Cigna Commercial	$1,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$925.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$841.50
Rate for Payer: Qualcare PPO/HMO/WC	$573.75
Rate for Payer: UnitedHealthcare Community & State	$92.18
Rate for Payer: Wellpoint Medicaid Managed Care	$101.36

CATHETER CHOCOLATE 3.0X120CM

Facility

$3,825.00

Service Code	HCPCS C1725
Hospital Charge Code	270684603V
Hospital Revenue Code	278
Min. Negotiated Rate	$92.18
Max. Negotiated Rate	$1,912.50
Rate for Payer: Aetna Commercial	$1,453.50
Rate for Payer: Aetna Medicare Advantage	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$975.38
Rate for Payer: Cigna Commercial	$1,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$925.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$841.50
Rate for Payer: Qualcare PPO/HMO/WC	$573.75
Rate for Payer: UnitedHealthcare Community & State	$92.18
Rate for Payer: Wellpoint Medicaid Managed Care	$101.36

CATHETER CHOCOLATE 3.0X120CM

Facility

$3,825.00

Service Code	HCPCS C1725
Hospital Charge Code	4046684603
Hospital Revenue Code	278
Min. Negotiated Rate	$573.75
Max. Negotiated Rate	$925.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$925.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$841.50
Rate for Payer: Qualcare PPO/HMO/WC	$573.75

CATHETER CHOCOLATE 3.0X120CM

Facility

$3,825.00

Service Code	HCPCS C1725
Hospital Charge Code	4046684603
Hospital Revenue Code	278
Min. Negotiated Rate	$92.18
Max. Negotiated Rate	$1,912.50
Rate for Payer: Aetna Commercial	$1,453.50
Rate for Payer: Aetna Medicare Advantage	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$975.38
Rate for Payer: Cigna Commercial	$1,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$925.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$841.50
Rate for Payer: Qualcare PPO/HMO/WC	$573.75
Rate for Payer: UnitedHealthcare Community & State	$92.18
Rate for Payer: Wellpoint Medicaid Managed Care	$101.36

CATHETER CHOCOLATE 3.0X120CM

Facility

$3,825.00

Service Code	HCPCS C1725
Hospital Charge Code	270684603V
Hospital Revenue Code	278
Min. Negotiated Rate	$573.75
Max. Negotiated Rate	$925.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$925.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$841.50
Rate for Payer: Qualcare PPO/HMO/WC	$573.75

CATHETER CHOCOLATE 3.5 X 80 CM

Facility

$5,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270687517
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,155.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

CATHETER CHOCOLATE 3.5 X 80 CM

Facility

$5,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270687517
Hospital Revenue Code	278
Min. Negotiated Rate	$126.53
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,995.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,155.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Community & State	$126.53
Rate for Payer: Wellpoint Medicaid Managed Care	$139.12

CATHETER CHOCOLATE 4.0X120CM

Facility

$5,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270694640
Hospital Revenue Code	278
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$1,391.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,265.00
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

CATHETER CHOCOLATE 4.0X120CM

Facility

$5,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270694640
Hospital Revenue Code	278
Min. Negotiated Rate	$138.57
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$2,185.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,265.00
Rate for Payer: Qualcare PPO/HMO/WC	$862.50
Rate for Payer: UnitedHealthcare Community & State	$138.57
Rate for Payer: Wellpoint Medicaid Managed Care	$152.38

CATHETER CHOCOLATE 5.0X40CM

Facility

$5,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270687522S
Hospital Revenue Code	278
Min. Negotiated Rate	$126.53
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,995.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,155.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Community & State	$126.53
Rate for Payer: Wellpoint Medicaid Managed Care	$139.12

CATHETER CHOCOLATE 5.0X40CM

Facility

$5,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270687522S
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,155.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

CATHETER CHOCOLATE 5.0X80CM

Facility

$5,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270687523C
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,155.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

Know your out-of-pocket cost for care.

All Charges