Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER CRYO 2 X 40 X 150

Facility

$4,455.00

Hospital Charge Code	2709006441
Hospital Revenue Code	272
Min. Negotiated Rate	$668.25
Max. Negotiated Rate	$668.25
Rate for Payer: Qualcare PPO/HMO/WC	$668.25

CATHETER CRYO 6 x 40 x 120

Facility

$3,350.00

Hospital Charge Code	270CH0008
Hospital Revenue Code	272
Min. Negotiated Rate	$80.73
Max. Negotiated Rate	$1,675.00
Rate for Payer: Aetna Commercial	$1,273.00
Rate for Payer: Aetna Medicare Advantage	$1,005.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$854.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$854.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$854.25
Rate for Payer: Cigna Commercial	$1,675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,005.00
Rate for Payer: Oxford Commercial	$670.00
Rate for Payer: Qualcare PPO/HMO/WC	$502.50
Rate for Payer: UnitedHealthcare Commercial	$670.00
Rate for Payer: UnitedHealthcare Community & State	$80.73
Rate for Payer: Wellpoint Medicaid Managed Care	$88.78

CATHETER CRYO 6 x 40 x 120

Facility

$3,350.00

Hospital Charge Code	270CH0008
Hospital Revenue Code	272
Min. Negotiated Rate	$502.50
Max. Negotiated Rate	$502.50
Rate for Payer: Qualcare PPO/HMO/WC	$502.50

CATHETER CRYO 6 X 40 X 120

Facility

$3,350.00

Hospital Charge Code	2709006444
Hospital Revenue Code	272
Min. Negotiated Rate	$80.73
Max. Negotiated Rate	$1,675.00
Rate for Payer: Aetna Commercial	$1,273.00
Rate for Payer: Aetna Medicare Advantage	$1,005.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$854.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$854.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$854.25
Rate for Payer: Cigna Commercial	$1,675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,005.00
Rate for Payer: Oxford Commercial	$670.00
Rate for Payer: Qualcare PPO/HMO/WC	$502.50
Rate for Payer: UnitedHealthcare Commercial	$670.00
Rate for Payer: UnitedHealthcare Community & State	$80.73
Rate for Payer: Wellpoint Medicaid Managed Care	$88.78

CATHETER CRYO 6 X 40 X 120

Facility

$3,350.00

Hospital Charge Code	2709006444
Hospital Revenue Code	272
Min. Negotiated Rate	$502.50
Max. Negotiated Rate	$502.50
Rate for Payer: Qualcare PPO/HMO/WC	$502.50

CATHETER CRYO FOCAL ABLATION

Facility

$5,500.00

Service Code	HCPCS C1886
Hospital Charge Code	270679445
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

CATHETER CRYO FOCAL ABLATION

Facility

$5,500.00

Service Code	HCPCS C1886
Hospital Charge Code	270679445
Hospital Revenue Code	278
Min. Negotiated Rate	$132.55
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$132.55
Rate for Payer: Wellpoint Medicaid Managed Care	$145.75

CATHETER CRYO FOCAL ABLATION

Facility

$5,500.00

Hospital Charge Code	270679455
Hospital Revenue Code	272
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

CATHETER CRYO FOCAL ABLATION

Facility

$5,500.00

Hospital Charge Code	270679455
Hospital Revenue Code	272
Min. Negotiated Rate	$132.55
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,650.00
Rate for Payer: Oxford Commercial	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Commercial	$1,100.00
Rate for Payer: UnitedHealthcare Community & State	$132.55
Rate for Payer: Wellpoint Medicaid Managed Care	$145.75

CATHETER CXI SUPPORT 2 6F

Facility

$994.50

Service Code	HCPCS C1887
Hospital Charge Code	270679800N
Hospital Revenue Code	278
Min. Negotiated Rate	$149.18
Max. Negotiated Rate	$240.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$218.79
Rate for Payer: Qualcare PPO/HMO/WC	$149.18

CATHETER CXI SUPPORT 2 6F

Facility

$994.50

Service Code	HCPCS C1887
Hospital Charge Code	270679800N
Hospital Revenue Code	278
Min. Negotiated Rate	$23.97
Max. Negotiated Rate	$497.25
Rate for Payer: Aetna Commercial	$377.91
Rate for Payer: Aetna Medicare Advantage	$298.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.60
Rate for Payer: Cigna Commercial	$497.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$218.79
Rate for Payer: Qualcare PPO/HMO/WC	$149.18
Rate for Payer: UnitedHealthcare Community & State	$23.97
Rate for Payer: Wellpoint Medicaid Managed Care	$26.35

CATHETER CXI SUPPORT 2 6F

Facility

$994.50

Service Code	HCPCS C1887
Hospital Charge Code	270679800
Hospital Revenue Code	278
Min. Negotiated Rate	$23.97
Max. Negotiated Rate	$497.25
Rate for Payer: Aetna Commercial	$377.91
Rate for Payer: Aetna Medicare Advantage	$298.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.60
Rate for Payer: Cigna Commercial	$497.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$218.79
Rate for Payer: Qualcare PPO/HMO/WC	$149.18
Rate for Payer: UnitedHealthcare Community & State	$23.97
Rate for Payer: Wellpoint Medicaid Managed Care	$26.35

CATHETER CXI SUPPORT 2 6F

Facility

$994.50

Service Code	HCPCS C1887
Hospital Charge Code	270679800S
Hospital Revenue Code	278
Min. Negotiated Rate	$149.18
Max. Negotiated Rate	$240.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$218.79
Rate for Payer: Qualcare PPO/HMO/WC	$149.18

CATHETER CXI SUPPORT 2 6F

Facility

$994.50

Service Code	HCPCS C1887
Hospital Charge Code	270679800S
Hospital Revenue Code	278
Min. Negotiated Rate	$23.97
Max. Negotiated Rate	$497.25
Rate for Payer: Aetna Commercial	$377.91
Rate for Payer: Aetna Medicare Advantage	$298.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.60
Rate for Payer: Cigna Commercial	$497.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$218.79
Rate for Payer: Qualcare PPO/HMO/WC	$149.18
Rate for Payer: UnitedHealthcare Community & State	$23.97
Rate for Payer: Wellpoint Medicaid Managed Care	$26.35

CATHETER CXI SUPPORT 2 6F

Facility

$994.50

Service Code	HCPCS C1887
Hospital Charge Code	270679800
Hospital Revenue Code	278
Min. Negotiated Rate	$149.18
Max. Negotiated Rate	$240.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$218.79
Rate for Payer: Qualcare PPO/HMO/WC	$149.18

CATHETER DAV 125 CM

Facility

$625.00

Service Code	HCPCS C1887
Hospital Charge Code	270690858
Hospital Revenue Code	278
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

CATHETER DAV 125 CM

Facility

$625.00

Service Code	HCPCS C1887
Hospital Charge Code	270690858
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

CATHETER (DAVIS MODEL) 14FR

Facility

$339.00

Hospital Charge Code	270332134
Hospital Revenue Code	272
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$169.50
Rate for Payer: Aetna Commercial	$128.82
Rate for Payer: Aetna Medicare Advantage	$101.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.44
Rate for Payer: Cigna Commercial	$169.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.70
Rate for Payer: Oxford Commercial	$67.80
Rate for Payer: Qualcare PPO/HMO/WC	$50.85
Rate for Payer: UnitedHealthcare Commercial	$67.80
Rate for Payer: UnitedHealthcare Community & State	$8.17
Rate for Payer: Wellpoint Medicaid Managed Care	$8.98

CATHETER (DAVIS MODEL) 14FR

Facility

$339.00

Hospital Charge Code	270332134
Hospital Revenue Code	272
Min. Negotiated Rate	$50.85
Max. Negotiated Rate	$50.85
Rate for Payer: Qualcare PPO/HMO/WC	$50.85

CATHETER DILUMEN 130 CM EA

Facility

$10,000.00

Hospital Charge Code	270695193
Hospital Revenue Code	272
Min. Negotiated Rate	$241.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,000.00
Rate for Payer: Oxford Commercial	$2,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Commercial	$2,000.00
Rate for Payer: UnitedHealthcare Community & State	$241.00
Rate for Payer: Wellpoint Medicaid Managed Care	$265.00

CATHETER DILUMEN 130 CM EA

Facility

$10,000.00

Hospital Charge Code	270695193
Hospital Revenue Code	272
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

CATHETER DOVERTER FRED X 21

Facility

$86,600.00

Service Code	HCPCS C1876
Hospital Charge Code	270700000S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,087.06
Max. Negotiated Rate	$43,300.00
Rate for Payer: Aetna Commercial	$32,908.00
Rate for Payer: Aetna Medicare Advantage	$25,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,083.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,083.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,083.00
Rate for Payer: Cigna Commercial	$43,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20,957.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19,052.00
Rate for Payer: Qualcare PPO/HMO/WC	$12,990.00
Rate for Payer: UnitedHealthcare Community & State	$2,087.06
Rate for Payer: Wellpoint Medicaid Managed Care	$2,294.90

CATHETER DOVERTER FRED X 21

Facility

$86,600.00

Service Code	HCPCS C1876
Hospital Charge Code	270700000S
Hospital Revenue Code	278
Min. Negotiated Rate	$12,990.00
Max. Negotiated Rate	$20,957.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20,957.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19,052.00
Rate for Payer: Qualcare PPO/HMO/WC	$12,990.00

CATHETER DRAINAGE 14FR

Facility

$401.25

Hospital Charge Code	270666823
Hospital Revenue Code	278
Min. Negotiated Rate	$60.19
Max. Negotiated Rate	$97.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.28
Rate for Payer: Qualcare PPO/HMO/WC	$60.19

CATHETER DRAINAGE 14FR

Facility

$401.25

Hospital Charge Code	270666823
Hospital Revenue Code	278
Min. Negotiated Rate	$9.67
Max. Negotiated Rate	$200.62
Rate for Payer: Aetna Commercial	$152.47
Rate for Payer: Aetna Medicare Advantage	$120.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.32
Rate for Payer: Cigna Commercial	$200.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.28
Rate for Payer: Qualcare PPO/HMO/WC	$60.19
Rate for Payer: UnitedHealthcare Community & State	$9.67
Rate for Payer: Wellpoint Medicaid Managed Care	$10.63

Know your out-of-pocket cost for care.

All Charges