Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER,DRAINAGE,BILIARY

Facility

$21.40

Service Code	HCPCS C1729
Hospital Charge Code	4800930
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4.71
Rate for Payer: Qualcare PPO/HMO/WC	$3.21

CATHETER,DRAINAGE,BILIARY

Facility

$21.40

Service Code	HCPCS C1729
Hospital Charge Code	4800930
Hospital Revenue Code	278
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$10.70
Rate for Payer: Aetna Commercial	$8.13
Rate for Payer: Aetna Medicare Advantage	$6.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.46
Rate for Payer: Cigna Commercial	$10.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4.71
Rate for Payer: Qualcare PPO/HMO/WC	$3.21
Rate for Payer: UnitedHealthcare Community & State	$0.52
Rate for Payer: Wellpoint Medicaid Managed Care	$0.57

CATHETER, DRAIN/MULTIPURPOSE

Facility

$545.00

Service Code	HCPCS C1729
Hospital Charge Code	2008115
Hospital Revenue Code	278
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$131.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.90
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

CATHETER, DRAIN/MULTIPURPOSE

Facility

$545.00

Service Code	HCPCS C1729
Hospital Charge Code	2008115
Hospital Revenue Code	278
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$272.50
Rate for Payer: Aetna Commercial	$207.10
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.97
Rate for Payer: Cigna Commercial	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.90
Rate for Payer: Qualcare PPO/HMO/WC	$81.75
Rate for Payer: UnitedHealthcare Community & State	$13.13
Rate for Payer: Wellpoint Medicaid Managed Care	$14.44

CATHETER DXTERITY 6F 100CM

Facility

$41.25

Hospital Charge Code	270698803S
Hospital Revenue Code	272
Min. Negotiated Rate	$6.19
Max. Negotiated Rate	$6.19
Rate for Payer: Qualcare PPO/HMO/WC	$6.19

CATHETER DXTERITY 6F 100CM

Facility

$41.25

Hospital Charge Code	270698803S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$20.62
Rate for Payer: Aetna Commercial	$15.68
Rate for Payer: Aetna Medicare Advantage	$12.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.52
Rate for Payer: Cigna Commercial	$20.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.38
Rate for Payer: Oxford Commercial	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$6.19
Rate for Payer: UnitedHealthcare Commercial	$8.25
Rate for Payer: UnitedHealthcare Community & State	$0.99
Rate for Payer: Wellpoint Medicaid Managed Care	$1.09

CATHETER ECHELON 10 MICRO 45 D

Facility

$4,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685191
Hospital Revenue Code	278
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

CATHETER ECHELON 10 MICRO 45 D

Facility

$4,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685191
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

CATHETER ECHELON 10 MICRO 45 D

Facility

$4,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685191S
Hospital Revenue Code	278
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

CATHETER ECHELON 10 MICRO 45 D

Facility

$4,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685191S
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

CATHETER ECHELON 10 MICRO 45D

Facility

$4,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685191C
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

CATHETER ECHELON 10 MICRO 45D

Facility

$4,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685191C
Hospital Revenue Code	278
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

CATHETER EMBOLECTOMY OW 3FR

Facility

$900.00

Service Code	HCPCS C1757
Hospital Charge Code	270685900
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

CATHETER EMBOLECTOMY OW 3FR

Facility

$900.00

Service Code	HCPCS C1757
Hospital Charge Code	270685900
Hospital Revenue Code	278
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

CATHETER EMBOLECTOMY OW 4FR

Facility

$900.00

Service Code	HCPCS C1757
Hospital Charge Code	270685911
Hospital Revenue Code	278
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

CATHETER EMBOLECTOMY OW 4FR

Facility

$900.00

Service Code	HCPCS C1757
Hospital Charge Code	270685911
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

CATHETER EMBOLECTOMY OW 5FR

Facility

$900.00

Service Code	HCPCS C1757
Hospital Charge Code	270685912
Hospital Revenue Code	278
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

CATHETER EMBOLECTOMY OW 5FR

Facility

$900.00

Service Code	HCPCS C1757
Hospital Charge Code	270685912
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

CATHETER EMBOLECTOMY OW 6FR

Facility

$900.00

Service Code	HCPCS C1757
Hospital Charge Code	270685913
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

CATHETER EMBOLECTOMY OW 6FR

Facility

$900.00

Service Code	HCPCS C1757
Hospital Charge Code	270685913
Hospital Revenue Code	278
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

CATHETER EMBOLECTOMY OW 7FR

Facility

$900.00

Service Code	HCPCS C1757
Hospital Charge Code	270685914
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

CATHETER EMBOLECTOMY OW 7FR

Facility

$900.00

Service Code	HCPCS C1757
Hospital Charge Code	270685914
Hospital Revenue Code	278
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

CATHETER ENDOTRACHEAL 35FR

Facility

$586.00

Hospital Charge Code	270331066
Hospital Revenue Code	272
Min. Negotiated Rate	$87.90
Max. Negotiated Rate	$87.90
Rate for Payer: Qualcare PPO/HMO/WC	$87.90

CATHETER ENDOTRACHEAL 35FR

Facility

$586.00

Hospital Charge Code	270331066
Hospital Revenue Code	272
Min. Negotiated Rate	$14.12
Max. Negotiated Rate	$293.00
Rate for Payer: Aetna Commercial	$222.68
Rate for Payer: Aetna Medicare Advantage	$175.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.43
Rate for Payer: Cigna Commercial	$293.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.80
Rate for Payer: Oxford Commercial	$117.20
Rate for Payer: Qualcare PPO/HMO/WC	$87.90
Rate for Payer: UnitedHealthcare Commercial	$117.20
Rate for Payer: UnitedHealthcare Community & State	$14.12
Rate for Payer: Wellpoint Medicaid Managed Care	$15.53

CATHETER ENDOTRACHEAL 37 FR

Facility

$501.00

Hospital Charge Code	270330818
Hospital Revenue Code	272
Min. Negotiated Rate	$12.07
Max. Negotiated Rate	$250.50
Rate for Payer: Aetna Commercial	$190.38
Rate for Payer: Aetna Medicare Advantage	$150.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.75
Rate for Payer: Cigna Commercial	$250.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.30
Rate for Payer: Oxford Commercial	$100.20
Rate for Payer: Qualcare PPO/HMO/WC	$75.15
Rate for Payer: UnitedHealthcare Commercial	$100.20
Rate for Payer: UnitedHealthcare Community & State	$12.07
Rate for Payer: Wellpoint Medicaid Managed Care	$13.28

Know your out-of-pocket cost for care.

All Charges