Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER ENDOTRACHEAL 37 FR

Facility

$501.00

Hospital Charge Code	270330818
Hospital Revenue Code	272
Min. Negotiated Rate	$75.15
Max. Negotiated Rate	$75.15
Rate for Payer: Qualcare PPO/HMO/WC	$75.15

CATHETER ENDOTRACHEAL 39FR

Facility

$501.00

Hospital Charge Code	270331109
Hospital Revenue Code	272
Min. Negotiated Rate	$75.15
Max. Negotiated Rate	$75.15
Rate for Payer: Qualcare PPO/HMO/WC	$75.15

CATHETER ENDOTRACHEAL 39FR

Facility

$501.00

Hospital Charge Code	270331109
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

CATHETER ENVOY 5F 90CM

Facility

$0.01

Service Code	HCPCS C1887
Hospital Charge Code	270697878S
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

CATHETER ENVOY 5F 90CM

Facility

$0.01

Service Code	HCPCS C1887
Hospital Charge Code	270697878S
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

CATHETER EQUISTREAM 14.5 X 23C

Facility

$1,925.00

Service Code	HCPCS C1750
Hospital Charge Code	270660249
Hospital Revenue Code	278
Min. Negotiated Rate	$46.39
Max. Negotiated Rate	$962.50
Rate for Payer: Aetna Commercial	$731.50
Rate for Payer: Aetna Medicare Advantage	$577.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$385.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$490.88
Rate for Payer: Cigna Commercial	$962.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$465.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$288.75
Rate for Payer: UnitedHealthcare Community & State	$46.39
Rate for Payer: Wellpoint Medicaid Managed Care	$51.01

CATHETER EQUISTREAM 14.5 X 23C

Facility

$1,925.00

Service Code	HCPCS C1750
Hospital Charge Code	270660249
Hospital Revenue Code	278
Min. Negotiated Rate	$288.75
Max. Negotiated Rate	$465.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$465.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$288.75

CATHETER EVD ANTIBIOTIC

Facility

$1,390.50

Service Code	HCPCS C1729
Hospital Charge Code	270670472
Hospital Revenue Code	278
Min. Negotiated Rate	$208.57
Max. Negotiated Rate	$336.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$278.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$336.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$305.91
Rate for Payer: Qualcare PPO/HMO/WC	$208.57

CATHETER EVD ANTIBIOTIC

Facility

$1,390.50

Service Code	HCPCS C1729
Hospital Charge Code	270670472
Hospital Revenue Code	278
Min. Negotiated Rate	$33.51
Max. Negotiated Rate	$695.25
Rate for Payer: Aetna Commercial	$528.39
Rate for Payer: Aetna Medicare Advantage	$417.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$354.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$354.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$278.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$354.58
Rate for Payer: Cigna Commercial	$695.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$336.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$305.91
Rate for Payer: Qualcare PPO/HMO/WC	$208.57
Rate for Payer: UnitedHealthcare Community & State	$33.51
Rate for Payer: Wellpoint Medicaid Managed Care	$36.85

CATHETER EXCELSIOR SL-10

Facility

$5,027.25

Service Code	HCPCS C1887
Hospital Charge Code	270695286S
Hospital Revenue Code	278
Min. Negotiated Rate	$121.16
Max. Negotiated Rate	$2,513.62
Rate for Payer: Aetna Commercial	$1,910.36
Rate for Payer: Aetna Medicare Advantage	$1,508.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,281.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,281.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,005.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,281.95
Rate for Payer: Cigna Commercial	$2,513.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,216.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,105.99
Rate for Payer: Qualcare PPO/HMO/WC	$754.09
Rate for Payer: UnitedHealthcare Community & State	$121.16
Rate for Payer: Wellpoint Medicaid Managed Care	$133.22

CATHETER EXCELSIOR SL-10

Facility

$5,027.25

Service Code	HCPCS C1887
Hospital Charge Code	270695286S
Hospital Revenue Code	278
Min. Negotiated Rate	$754.09
Max. Negotiated Rate	$1,216.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,005.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,216.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,105.99
Rate for Payer: Qualcare PPO/HMO/WC	$754.09

CATHETER EXCELSIOR SL 10 PS J

Facility

$5,027.25

Service Code	HCPCS C1887
Hospital Charge Code	270695284S
Hospital Revenue Code	278
Min. Negotiated Rate	$121.16
Max. Negotiated Rate	$2,513.62
Rate for Payer: Aetna Commercial	$1,910.36
Rate for Payer: Aetna Medicare Advantage	$1,508.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,281.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,281.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,005.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,281.95
Rate for Payer: Cigna Commercial	$2,513.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,216.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,105.99
Rate for Payer: Qualcare PPO/HMO/WC	$754.09
Rate for Payer: UnitedHealthcare Community & State	$121.16
Rate for Payer: Wellpoint Medicaid Managed Care	$133.22

CATHETER EXCELSIOR SL 10 PS J

Facility

$5,463.75

Service Code	HCPCS C1887
Hospital Charge Code	270695284
Hospital Revenue Code	278
Min. Negotiated Rate	$819.56
Max. Negotiated Rate	$1,322.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,092.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,322.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,202.03
Rate for Payer: Qualcare PPO/HMO/WC	$819.56

CATHETER EXCELSIOR SL 10 PS J

Facility

$5,027.25

Service Code	HCPCS C1887
Hospital Charge Code	270695284S
Hospital Revenue Code	278
Min. Negotiated Rate	$754.09
Max. Negotiated Rate	$1,216.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,005.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,216.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,105.99
Rate for Payer: Qualcare PPO/HMO/WC	$754.09

CATHETER EXCELSIOR SL 10 PS J

Facility

$5,463.75

Service Code	HCPCS C1887
Hospital Charge Code	270695284
Hospital Revenue Code	278
Min. Negotiated Rate	$131.68
Max. Negotiated Rate	$2,731.88
Rate for Payer: Aetna Commercial	$2,076.22
Rate for Payer: Aetna Medicare Advantage	$1,639.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,393.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,393.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,092.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,393.26
Rate for Payer: Cigna Commercial	$2,731.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,322.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,202.03
Rate for Payer: Qualcare PPO/HMO/WC	$819.56
Rate for Payer: UnitedHealthcare Community & State	$131.68
Rate for Payer: Wellpoint Medicaid Managed Care	$144.79

CATHETER EXCELSIOR XT17 PS45

Facility

$5,463.75

Service Code	HCPCS C1887
Hospital Charge Code	270695288
Hospital Revenue Code	278
Min. Negotiated Rate	$131.68
Max. Negotiated Rate	$2,731.88
Rate for Payer: Aetna Commercial	$2,076.22
Rate for Payer: Aetna Medicare Advantage	$1,639.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,393.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,393.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,092.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,393.26
Rate for Payer: Cigna Commercial	$2,731.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,322.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,202.03
Rate for Payer: Qualcare PPO/HMO/WC	$819.56
Rate for Payer: UnitedHealthcare Community & State	$131.68
Rate for Payer: Wellpoint Medicaid Managed Care	$144.79

CATHETER EXCELSIOR XT17 PS45

Facility

$5,463.75

Service Code	HCPCS C1887
Hospital Charge Code	270695288
Hospital Revenue Code	278
Min. Negotiated Rate	$819.56
Max. Negotiated Rate	$1,322.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,092.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,322.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,202.03
Rate for Payer: Qualcare PPO/HMO/WC	$819.56

CATHETER EXCELSIOR XT-17 STD

Facility

$5,463.75

Service Code	HCPCS C1887
Hospital Charge Code	270695289
Hospital Revenue Code	278
Min. Negotiated Rate	$131.68
Max. Negotiated Rate	$2,731.88
Rate for Payer: Aetna Commercial	$2,076.22
Rate for Payer: Aetna Medicare Advantage	$1,639.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,393.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,393.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,092.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,393.26
Rate for Payer: Cigna Commercial	$2,731.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,322.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,202.03
Rate for Payer: Qualcare PPO/HMO/WC	$819.56
Rate for Payer: UnitedHealthcare Community & State	$131.68
Rate for Payer: Wellpoint Medicaid Managed Care	$144.79

CATHETER EXCELSIOR XT-17 STD

Facility

$5,463.75

Service Code	HCPCS C1887
Hospital Charge Code	270695289
Hospital Revenue Code	278
Min. Negotiated Rate	$819.56
Max. Negotiated Rate	$1,322.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,092.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,322.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,202.03
Rate for Payer: Qualcare PPO/HMO/WC	$819.56

CATHETER FEMORAL AORTIC FLUSH

Facility

$115.00

Hospital Charge Code	270331514
Hospital Revenue Code	272
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$17.25
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

CATHETER FEMORAL AORTIC FLUSH

Facility

$115.00

Hospital Charge Code	270331514
Hospital Revenue Code	272
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$57.50
Rate for Payer: Aetna Commercial	$43.70
Rate for Payer: Aetna Medicare Advantage	$34.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.32
Rate for Payer: Cigna Commercial	$57.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.50
Rate for Payer: Oxford Commercial	$23.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.25
Rate for Payer: UnitedHealthcare Commercial	$23.00
Rate for Payer: UnitedHealthcare Community & State	$2.77
Rate for Payer: Wellpoint Medicaid Managed Care	$3.05

CATHETER FLOWGATE 8F 85CM

Facility

$6,151.25

Service Code	HCPCS C2628
Hospital Charge Code	270685309S
Hospital Revenue Code	278
Min. Negotiated Rate	$148.25
Max. Negotiated Rate	$3,075.62
Rate for Payer: Aetna Commercial	$2,337.47
Rate for Payer: Aetna Medicare Advantage	$1,845.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,568.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,568.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,230.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,568.57
Rate for Payer: Cigna Commercial	$3,075.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,488.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,353.28
Rate for Payer: Qualcare PPO/HMO/WC	$922.69
Rate for Payer: UnitedHealthcare Community & State	$148.25
Rate for Payer: Wellpoint Medicaid Managed Care	$163.01

CATHETER FLOWGATE 8F 85CM

Facility

$6,151.25

Service Code	HCPCS C2628
Hospital Charge Code	270685309S
Hospital Revenue Code	278
Min. Negotiated Rate	$922.69
Max. Negotiated Rate	$1,488.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,230.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,488.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,353.28
Rate for Payer: Qualcare PPO/HMO/WC	$922.69

Catheter FlowGate 8F 95cm

Facility

$6,475.00

Hospital Charge Code	270685066S
Hospital Revenue Code	272
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$971.25
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

Catheter FlowGate 8F 95cm

Facility

$6,475.00

Hospital Charge Code	270685066S
Hospital Revenue Code	272
Min. Negotiated Rate	$156.05
Max. Negotiated Rate	$3,237.50
Rate for Payer: Aetna Commercial	$2,460.50
Rate for Payer: Aetna Medicare Advantage	$1,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.12
Rate for Payer: Cigna Commercial	$3,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,942.50
Rate for Payer: Oxford Commercial	$1,295.00
Rate for Payer: Qualcare PPO/HMO/WC	$971.25
Rate for Payer: UnitedHealthcare Commercial	$1,295.00
Rate for Payer: UnitedHealthcare Community & State	$156.05
Rate for Payer: Wellpoint Medicaid Managed Care	$171.59

Know your out-of-pocket cost for care.

All Charges