Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER FOLEY 30CC

Facility

$398.95

Hospital Charge Code	270663718
Hospital Revenue Code	272
Min. Negotiated Rate	$59.84
Max. Negotiated Rate	$59.84
Rate for Payer: Qualcare PPO/HMO/WC	$59.84

CATHETER FOLEY 30FR 5CC 2 WAY

Facility

$94.00

Hospital Charge Code	270331626
Hospital Revenue Code	272
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$47.00
Rate for Payer: Aetna Commercial	$35.72
Rate for Payer: Aetna Medicare Advantage	$28.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.97
Rate for Payer: Cigna Commercial	$47.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.20
Rate for Payer: Oxford Commercial	$18.80
Rate for Payer: Qualcare PPO/HMO/WC	$14.10
Rate for Payer: UnitedHealthcare Commercial	$18.80
Rate for Payer: UnitedHealthcare Community & State	$2.27
Rate for Payer: Wellpoint Medicaid Managed Care	$2.49

CATHETER FOLEY 30FR 5CC 2 WAY

Facility

$94.00

Hospital Charge Code	270331626
Hospital Revenue Code	272
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$14.10
Rate for Payer: Qualcare PPO/HMO/WC	$14.10

CATHETER FOLEY 3 WAY 28FR 30CC

Facility

$120.00

Hospital Charge Code	270331251
Hospital Revenue Code	272
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$60.00
Rate for Payer: Aetna Commercial	$45.60
Rate for Payer: Aetna Medicare Advantage	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.60
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.00
Rate for Payer: Oxford Commercial	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$24.00
Rate for Payer: UnitedHealthcare Community & State	$2.89
Rate for Payer: Wellpoint Medicaid Managed Care	$3.18

CATHETER FOLEY 3 WAY 28FR 30CC

Facility

$120.00

Hospital Charge Code	270331251
Hospital Revenue Code	272
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

CATHETER FOLEY 5CC 24FR SILIC.

Facility

$103.00

Hospital Charge Code	270331548
Hospital Revenue Code	272
Min. Negotiated Rate	$15.45
Max. Negotiated Rate	$15.45
Rate for Payer: Qualcare PPO/HMO/WC	$15.45

CATHETER FOLEY 5CC 24FR SILIC.

Facility

$103.00

Hospital Charge Code	270331548
Hospital Revenue Code	272
Min. Negotiated Rate	$2.48
Max. Negotiated Rate	$51.50
Rate for Payer: Aetna Commercial	$39.14
Rate for Payer: Aetna Medicare Advantage	$30.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.27
Rate for Payer: Cigna Commercial	$51.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.90
Rate for Payer: Oxford Commercial	$20.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.45
Rate for Payer: UnitedHealthcare Commercial	$20.60
Rate for Payer: UnitedHealthcare Community & State	$2.48
Rate for Payer: Wellpoint Medicaid Managed Care	$2.73

CATHETER FOLEY COUNCIL 16FR5CC

Facility

$85.59

Hospital Charge Code	270653419
Hospital Revenue Code	272
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$42.80
Rate for Payer: Aetna Commercial	$32.52
Rate for Payer: Aetna Medicare Advantage	$25.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.83
Rate for Payer: Cigna Commercial	$42.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.68
Rate for Payer: Oxford Commercial	$17.12
Rate for Payer: Qualcare PPO/HMO/WC	$12.84
Rate for Payer: UnitedHealthcare Commercial	$17.12
Rate for Payer: UnitedHealthcare Community & State	$2.06
Rate for Payer: Wellpoint Medicaid Managed Care	$2.27

CATHETER FOLEY COUNCIL 16FR5CC

Facility

$85.59

Hospital Charge Code	270653419
Hospital Revenue Code	272
Min. Negotiated Rate	$12.84
Max. Negotiated Rate	$12.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.84

CATHETER FOLEY COUNCIL 18FR5CC

Facility

$85.59

Hospital Charge Code	270653421
Hospital Revenue Code	272
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$42.80
Rate for Payer: Aetna Commercial	$32.52
Rate for Payer: Aetna Medicare Advantage	$25.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.83
Rate for Payer: Cigna Commercial	$42.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.68
Rate for Payer: Oxford Commercial	$17.12
Rate for Payer: Qualcare PPO/HMO/WC	$12.84
Rate for Payer: UnitedHealthcare Commercial	$17.12
Rate for Payer: UnitedHealthcare Community & State	$2.06
Rate for Payer: Wellpoint Medicaid Managed Care	$2.27

CATHETER FOLEY COUNCIL 18FR5CC

Facility

$85.59

Hospital Charge Code	270653421
Hospital Revenue Code	272
Min. Negotiated Rate	$12.84
Max. Negotiated Rate	$12.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.84

CATHETER FOLEY COUNCIL 20FR5CC

Facility

$83.95

Hospital Charge Code	270653422
Hospital Revenue Code	272
Min. Negotiated Rate	$12.59
Max. Negotiated Rate	$12.59
Rate for Payer: Qualcare PPO/HMO/WC	$12.59

CATHETER FOLEY COUNCIL 20FR5CC

Facility

$83.95

Hospital Charge Code	270653422
Hospital Revenue Code	272
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$41.98
Rate for Payer: Aetna Commercial	$31.90
Rate for Payer: Aetna Medicare Advantage	$25.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.41
Rate for Payer: Cigna Commercial	$41.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.18
Rate for Payer: Oxford Commercial	$16.79
Rate for Payer: Qualcare PPO/HMO/WC	$12.59
Rate for Payer: UnitedHealthcare Commercial	$16.79
Rate for Payer: UnitedHealthcare Community & State	$2.02
Rate for Payer: Wellpoint Medicaid Managed Care	$2.22

CATHETER FOR HYSTEROGRAPHY

Facility

$793.24

Service Code	HCPCS 58340
Hospital Charge Code	1600000549
Hospital Revenue Code	360
Min. Negotiated Rate	$19.12
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$301.43
Rate for Payer: Aetna Medicare Advantage	$237.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$202.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$202.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$202.28
Rate for Payer: Cigna Commercial	$396.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.97
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.99
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$19.12
Rate for Payer: Wellpoint Medicaid Managed Care	$21.02

CATHETER FOR HYSTEROGRAPHY

Facility

$793.24

Service Code	HCPCS 58340
Hospital Charge Code	1600000549
Hospital Revenue Code	360
Min. Negotiated Rate	$118.99
Max. Negotiated Rate	$118.99
Rate for Payer: Qualcare PPO/HMO/WC	$118.99

CATHETER FR TELESCOPE 6FR

Facility

$370.00

Service Code	HCPCS C1887
Hospital Charge Code	270689340
Hospital Revenue Code	278
Min. Negotiated Rate	$8.92
Max. Negotiated Rate	$185.00
Rate for Payer: Aetna Commercial	$140.60
Rate for Payer: Aetna Medicare Advantage	$111.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.35
Rate for Payer: Cigna Commercial	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$81.40
Rate for Payer: Qualcare PPO/HMO/WC	$55.50
Rate for Payer: UnitedHealthcare Community & State	$8.92
Rate for Payer: Wellpoint Medicaid Managed Care	$9.80

CATHETER FR TELESCOPE 6FR

Facility

$370.00

Service Code	HCPCS C1887
Hospital Charge Code	270689340
Hospital Revenue Code	278
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$89.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$81.40
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

CATHETER FUBUKI XF 6F 100CM

Facility

$2,745.00

Service Code	HCPCS C1887
Hospital Charge Code	270699393S
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 FUBUKI XF 6F 100CM

Facility

$2,745.00

Service Code	HCPCS C1887
Hospital Charge Code	270699393S
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 FUBUKI XF 6F 90CM

Facility

$2,745.00

Service Code	HCPCS C1887
Hospital Charge Code	270699392S
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 FUBUKI XF 6F 90CM

Facility

$2,745.00

Service Code	HCPCS C1887
Hospital Charge Code	270699392S
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 GC 7FR 078 HOCKEY STI

Facility

$290.00

Hospital Charge Code	270667183
Hospital Revenue Code	272
Min. Negotiated Rate	$43.50
Max. Negotiated Rate	$43.50
Rate for Payer: Qualcare PPO/HMO/WC	$43.50

CATHETER GC 7FR 078 HOCKEY STI

Facility

$290.00

Hospital Charge Code	270667183
Hospital Revenue Code	272
Min. Negotiated Rate	$6.99
Max. Negotiated Rate	$145.00
Rate for Payer: Aetna Commercial	$110.20
Rate for Payer: Aetna Medicare Advantage	$87.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.95
Rate for Payer: Cigna Commercial	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.00
Rate for Payer: Oxford Commercial	$58.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.50
Rate for Payer: UnitedHealthcare Commercial	$58.00
Rate for Payer: UnitedHealthcare Community & State	$6.99
Rate for Payer: Wellpoint Medicaid Managed Care	$7.68

CATHETER GLIDE 4FR C1 65CM

Facility

$360.00

Hospital Charge Code	270663773N
Hospital Revenue Code	272
Min. Negotiated Rate	$8.68
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$136.80
Rate for Payer: Aetna Medicare Advantage	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.80
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.00
Rate for Payer: Oxford Commercial	$72.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Commercial	$72.00
Rate for Payer: UnitedHealthcare Community & State	$8.68
Rate for Payer: Wellpoint Medicaid Managed Care	$9.54

CATHETER GLIDE 4FR C1 65CM

Facility

$253.25

Hospital Charge Code	270663773
Hospital Revenue Code	272
Min. Negotiated Rate	$6.10
Max. Negotiated Rate	$126.62
Rate for Payer: Aetna Commercial	$96.23
Rate for Payer: Aetna Medicare Advantage	$75.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.58
Rate for Payer: Cigna Commercial	$126.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.97
Rate for Payer: Oxford Commercial	$50.65
Rate for Payer: Qualcare PPO/HMO/WC	$37.99
Rate for Payer: UnitedHealthcare Commercial	$50.65
Rate for Payer: UnitedHealthcare Community & State	$6.10
Rate for Payer: Wellpoint Medicaid Managed Care	$6.71

Know your out-of-pocket cost for care.

All Charges