Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER GLIDE 4FR C1 65CM

Facility

$253.25

Hospital Charge Code	270663773
Hospital Revenue Code	272
Min. Negotiated Rate	$37.99
Max. Negotiated Rate	$37.99
Rate for Payer: Qualcare PPO/HMO/WC	$37.99

CATHETER GLIDE 4FR C1 65CM

Facility

$360.00

Hospital Charge Code	270663773N
Hospital Revenue Code	272
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

CATHETER GLIDE 4FR C2 65CM

Facility

$360.00

Hospital Charge Code	270669518N
Hospital Revenue Code	272
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

CATHETER GLIDE 4FR C2 65CM

Facility

$360.00

Hospital Charge Code	270669518N
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 C2 65CM

Facility

$1,775.00

Hospital Charge Code	270669518
Hospital Revenue Code	272
Min. Negotiated Rate	$42.78
Max. Negotiated Rate	$887.50
Rate for Payer: Aetna Commercial	$674.50
Rate for Payer: Aetna Medicare Advantage	$532.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$452.62
Rate for Payer: Cigna Commercial	$887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.50
Rate for Payer: Oxford Commercial	$355.00
Rate for Payer: Qualcare PPO/HMO/WC	$266.25
Rate for Payer: UnitedHealthcare Commercial	$355.00
Rate for Payer: UnitedHealthcare Community & State	$42.78
Rate for Payer: Wellpoint Medicaid Managed Care	$47.04

CATHETER GLIDE 4FR C2 65CM

Facility

$1,775.00

Hospital Charge Code	270669518
Hospital Revenue Code	272
Min. Negotiated Rate	$266.25
Max. Negotiated Rate	$266.25
Rate for Payer: Qualcare PPO/HMO/WC	$266.25

CATHETER GLIDECATH SIM1 5F40CM

Facility

$1,590.00

Service Code	HCPCS C1887
Hospital Charge Code	270696678S
Hospital Revenue Code	278
Min. Negotiated Rate	$238.50
Max. Negotiated Rate	$384.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$318.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$384.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$349.80
Rate for Payer: Qualcare PPO/HMO/WC	$238.50

CATHETER GLIDECATH SIM1 5F40CM

Facility

$1,590.00

Service Code	HCPCS C1887
Hospital Charge Code	270696678S
Hospital Revenue Code	278
Min. Negotiated Rate	$38.32
Max. Negotiated Rate	$795.00
Rate for Payer: Aetna Commercial	$604.20
Rate for Payer: Aetna Medicare Advantage	$477.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$405.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$405.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$318.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$405.45
Rate for Payer: Cigna Commercial	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$384.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$349.80
Rate for Payer: Qualcare PPO/HMO/WC	$238.50
Rate for Payer: UnitedHealthcare Community & State	$38.32
Rate for Payer: Wellpoint Medicaid Managed Care	$42.13

CATHETER GLIDECATH SIM2 5F40CM

Facility

$1,570.00

Service Code	HCPCS C1887
Hospital Charge Code	270696679S
Hospital Revenue Code	278
Min. Negotiated Rate	$37.84
Max. Negotiated Rate	$785.00
Rate for Payer: Aetna Commercial	$596.60
Rate for Payer: Aetna Medicare Advantage	$471.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$400.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$400.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$314.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$400.35
Rate for Payer: Cigna Commercial	$785.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$379.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$345.40
Rate for Payer: Qualcare PPO/HMO/WC	$235.50
Rate for Payer: UnitedHealthcare Community & State	$37.84
Rate for Payer: Wellpoint Medicaid Managed Care	$41.60

CATHETER GLIDECATH SIM2 5F40CM

Facility

$1,570.00

Service Code	HCPCS C1887
Hospital Charge Code	270696679S
Hospital Revenue Code	278
Min. Negotiated Rate	$235.50
Max. Negotiated Rate	$379.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$314.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$379.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$345.40
Rate for Payer: Qualcare PPO/HMO/WC	$235.50

CATHETER GLIDECATH SIM3 5F40CM

Facility

$1,590.00

Service Code	HCPCS C1887
Hospital Charge Code	270696680S
Hospital Revenue Code	278
Min. Negotiated Rate	$38.32
Max. Negotiated Rate	$795.00
Rate for Payer: Aetna Commercial	$604.20
Rate for Payer: Aetna Medicare Advantage	$477.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$405.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$405.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$318.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$405.45
Rate for Payer: Cigna Commercial	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$384.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$349.80
Rate for Payer: Qualcare PPO/HMO/WC	$238.50
Rate for Payer: UnitedHealthcare Community & State	$38.32
Rate for Payer: Wellpoint Medicaid Managed Care	$42.13

CATHETER GLIDECATH SIM3 5F40CM

Facility

$1,590.00

Service Code	HCPCS C1887
Hospital Charge Code	270696680S
Hospital Revenue Code	278
Min. Negotiated Rate	$238.50
Max. Negotiated Rate	$384.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$318.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$384.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$349.80
Rate for Payer: Qualcare PPO/HMO/WC	$238.50

CATHETER GLIDEX 8FR 25CM

Facility

$436.50

Service Code	HCPCS C1729
Hospital Charge Code	270673021
Hospital Revenue Code	278
Min. Negotiated Rate	$10.52
Max. Negotiated Rate	$218.25
Rate for Payer: Aetna Commercial	$165.87
Rate for Payer: Aetna Medicare Advantage	$130.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.31
Rate for Payer: Cigna Commercial	$218.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.03
Rate for Payer: Qualcare PPO/HMO/WC	$65.47
Rate for Payer: UnitedHealthcare Community & State	$10.52
Rate for Payer: Wellpoint Medicaid Managed Care	$11.57

CATHETER GLIDEX 8FR 25CM

Facility

$436.50

Service Code	HCPCS C1729
Hospital Charge Code	270673021
Hospital Revenue Code	278
Min. Negotiated Rate	$65.47
Max. Negotiated Rate	$105.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.03
Rate for Payer: Qualcare PPO/HMO/WC	$65.47

CATHETER GPC 5FR .038X100

Facility

$550.00

Hospital Charge Code	270658316
Hospital Revenue Code	272
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

CATHETER GPC 5FR .038X100

Facility

$550.00

Hospital Charge Code	270658316
Hospital Revenue Code	272
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.00
Rate for Payer: Oxford Commercial	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$110.00
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

CATHETER GUIDE 6FR XB 4.5

Facility

$217.50

Hospital Charge Code	270675271
Hospital Revenue Code	272
Min. Negotiated Rate	$5.24
Max. Negotiated Rate	$108.75
Rate for Payer: Aetna Commercial	$82.65
Rate for Payer: Aetna Medicare Advantage	$65.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.46
Rate for Payer: Cigna Commercial	$108.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.25
Rate for Payer: Oxford Commercial	$43.50
Rate for Payer: Qualcare PPO/HMO/WC	$32.62
Rate for Payer: UnitedHealthcare Commercial	$43.50
Rate for Payer: UnitedHealthcare Community & State	$5.24
Rate for Payer: Wellpoint Medicaid Managed Care	$5.76

CATHETER GUIDE 6FR XB 4.5

Facility

$217.50

Hospital Charge Code	270675271
Hospital Revenue Code	272
Min. Negotiated Rate	$32.62
Max. Negotiated Rate	$32.62
Rate for Payer: Qualcare PPO/HMO/WC	$32.62

CATHETER GUIDE 6FR XBLAD 3 SH

Facility

$240.00

Hospital Charge Code	270675270
Hospital Revenue Code	272
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATHETER GUIDE 6FR XBLAD 3 SH

Facility

$240.00

Hospital Charge Code	270675270S
Hospital Revenue Code	272
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATHETER GUIDE 6FR XBLAD 3 SH

Facility

$240.00

Hospital Charge Code	270675270S
Hospital Revenue Code	272
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.00
Rate for Payer: Oxford Commercial	$48.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Commercial	$48.00
Rate for Payer: UnitedHealthcare Community & State	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$6.36

CATHETER GUIDE 6FR XBLAD 3 SH

Facility

$240.00

Hospital Charge Code	270675270
Hospital Revenue Code	272
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.00
Rate for Payer: Oxford Commercial	$48.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Commercial	$48.00
Rate for Payer: UnitedHealthcare Community & State	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$6.36

CATHETER GUIDE 6FR XBLAD 3 SH

Facility

$220.00

Hospital Charge Code	270675270N
Hospital Revenue Code	272
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$83.60
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.00
Rate for Payer: Oxford Commercial	$44.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.00
Rate for Payer: UnitedHealthcare Commercial	$44.00
Rate for Payer: UnitedHealthcare Community & State	$5.30
Rate for Payer: Wellpoint Medicaid Managed Care	$5.83

CATHETER GUIDE 6FR XBLAD 3 SH

Facility

$220.00

Hospital Charge Code	270675270N
Hospital Revenue Code	272
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

CATHETER,GUIDING

Facility

$899.00

Service Code	HCPCS C1769
Hospital Charge Code	4800935
Hospital Revenue Code	278
Min. Negotiated Rate	$21.67
Max. Negotiated Rate	$449.50
Rate for Payer: Aetna Commercial	$341.62
Rate for Payer: Aetna Medicare Advantage	$269.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.25
Rate for Payer: Cigna Commercial	$449.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$197.78
Rate for Payer: Qualcare PPO/HMO/WC	$134.85
Rate for Payer: UnitedHealthcare Community & State	$21.67
Rate for Payer: Wellpoint Medicaid Managed Care	$23.82

Know your out-of-pocket cost for care.

All Charges