Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER HEMOSTAR DUAL 42 CM

Facility

$1,495.00

Service Code	HCPCS C1750
Hospital Charge Code	270684237
Hospital Revenue Code	278
Min. Negotiated Rate	$36.03
Max. Negotiated Rate	$747.50
Rate for Payer: Aetna Commercial	$568.10
Rate for Payer: Aetna Medicare Advantage	$448.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$381.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$381.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$299.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$381.23
Rate for Payer: Cigna Commercial	$747.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$328.90
Rate for Payer: Qualcare PPO/HMO/WC	$224.25
Rate for Payer: UnitedHealthcare Community & State	$36.03
Rate for Payer: Wellpoint Medicaid Managed Care	$39.62

CATHETER HEMOSTAR DUAL 42 CM

Facility

$1,495.00

Service Code	HCPCS C1750
Hospital Charge Code	270684237
Hospital Revenue Code	278
Min. Negotiated Rate	$224.25
Max. Negotiated Rate	$361.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$299.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$328.90
Rate for Payer: Qualcare PPO/HMO/WC	$224.25

CATHETER HICKAMN 9.6FR

Facility

$874.00

Hospital Charge Code	270651791
Hospital Revenue Code	272
Min. Negotiated Rate	$21.06
Max. Negotiated Rate	$437.00
Rate for Payer: Aetna Commercial	$332.12
Rate for Payer: Aetna Medicare Advantage	$262.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$222.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$222.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$222.87
Rate for Payer: Cigna Commercial	$437.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.20
Rate for Payer: Oxford Commercial	$174.80
Rate for Payer: Qualcare PPO/HMO/WC	$131.10
Rate for Payer: UnitedHealthcare Commercial	$174.80
Rate for Payer: UnitedHealthcare Community & State	$21.06
Rate for Payer: Wellpoint Medicaid Managed Care	$23.16

CATHETER HICKAMN 9.6FR

Facility

$874.00

Hospital Charge Code	270651791
Hospital Revenue Code	272
Min. Negotiated Rate	$131.10
Max. Negotiated Rate	$131.10
Rate for Payer: Qualcare PPO/HMO/WC	$131.10

CATHETER HYDROPHILIC 4F 100cm

Facility

$235.00

Hospital Charge Code	270657615
Hospital Revenue Code	278
Min. Negotiated Rate	$35.25
Max. Negotiated Rate	$56.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$51.70
Rate for Payer: Qualcare PPO/HMO/WC	$35.25

CATHETER HYDROPHILIC 4F 100cm

Facility

$235.00

Hospital Charge Code	270657615
Hospital Revenue Code	278
Min. Negotiated Rate	$5.66
Max. Negotiated Rate	$117.50
Rate for Payer: Aetna Commercial	$89.30
Rate for Payer: Aetna Medicare Advantage	$70.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.92
Rate for Payer: Cigna Commercial	$117.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$51.70
Rate for Payer: Qualcare PPO/HMO/WC	$35.25
Rate for Payer: UnitedHealthcare Community & State	$5.66
Rate for Payer: Wellpoint Medicaid Managed Care	$6.23

CATHETER, HYSTERO

Facility

$192.00

Hospital Charge Code	2008110
Hospital Revenue Code	272
Min. Negotiated Rate	$4.63
Max. Negotiated Rate	$96.00
Rate for Payer: Aetna Commercial	$72.96
Rate for Payer: Aetna Medicare Advantage	$57.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.96
Rate for Payer: Cigna Commercial	$96.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.60
Rate for Payer: Oxford Commercial	$38.40
Rate for Payer: Qualcare PPO/HMO/WC	$28.80
Rate for Payer: UnitedHealthcare Commercial	$38.40
Rate for Payer: UnitedHealthcare Community & State	$4.63
Rate for Payer: Wellpoint Medicaid Managed Care	$5.09

CATHETER, HYSTERO

Facility

$192.00

Hospital Charge Code	2008110
Hospital Revenue Code	272
Min. Negotiated Rate	$28.80
Max. Negotiated Rate	$28.80
Rate for Payer: Qualcare PPO/HMO/WC	$28.80

CATHETER IMA 6FR

Facility

$8.00

Service Code	HCPCS C1887
Hospital Charge Code	270658054N
Hospital Revenue Code	278
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1.76
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

CATHETER IMA 6FR

Facility

$8.00

Service Code	HCPCS C1887
Hospital Charge Code	270658054N
Hospital Revenue Code	278
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$3.04
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1.76
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

CATHETER IMA 6FR

Facility

$37.35

Hospital Charge Code	270658054S
Hospital Revenue Code	278
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$18.68
Rate for Payer: Aetna Commercial	$14.19
Rate for Payer: Aetna Medicare Advantage	$11.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.52
Rate for Payer: Cigna Commercial	$18.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.22
Rate for Payer: Qualcare PPO/HMO/WC	$5.60
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

CATHETER IMA 6FR

Facility

$37.35

Hospital Charge Code	270658054S
Hospital Revenue Code	278
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$9.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.22
Rate for Payer: Qualcare PPO/HMO/WC	$5.60

CATHETER IMA 6FR

Facility

$37.35

Service Code	HCPCS C1887
Hospital Charge Code	270658054
Hospital Revenue Code	278
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$18.68
Rate for Payer: Aetna Commercial	$14.19
Rate for Payer: Aetna Medicare Advantage	$11.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.52
Rate for Payer: Cigna Commercial	$18.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.22
Rate for Payer: Qualcare PPO/HMO/WC	$5.60
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

CATHETER IMA 6FR

Facility

$37.35

Service Code	HCPCS C1887
Hospital Charge Code	270658054
Hospital Revenue Code	278
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$9.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.22
Rate for Payer: Qualcare PPO/HMO/WC	$5.60

CATHETER IMAGER II FLUSH 4FR

Facility

$27.91

Hospital Charge Code	270653627N
Hospital Revenue Code	272
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$13.96
Rate for Payer: Aetna Commercial	$10.61
Rate for Payer: Aetna Medicare Advantage	$8.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.12
Rate for Payer: Cigna Commercial	$13.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.37
Rate for Payer: Oxford Commercial	$5.58
Rate for Payer: Qualcare PPO/HMO/WC	$4.19
Rate for Payer: UnitedHealthcare Commercial	$5.58
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

CATHETER IMAGER II FLUSH 4FR

Facility

$53.65

Hospital Charge Code	270653627S
Hospital Revenue Code	272
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$26.82
Rate for Payer: Aetna Commercial	$20.39
Rate for Payer: Aetna Medicare Advantage	$16.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.68
Rate for Payer: Cigna Commercial	$26.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.09
Rate for Payer: Oxford Commercial	$10.73
Rate for Payer: Qualcare PPO/HMO/WC	$8.05
Rate for Payer: UnitedHealthcare Commercial	$10.73
Rate for Payer: UnitedHealthcare Community & State	$1.29
Rate for Payer: Wellpoint Medicaid Managed Care	$1.42

CATHETER IMAGER II FLUSH 4FR

Facility

$27.91

Hospital Charge Code	270653627N
Hospital Revenue Code	272
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$4.19
Rate for Payer: Qualcare PPO/HMO/WC	$4.19

CATHETER IMAGER II FLUSH 4FR

Facility

$53.65

Hospital Charge Code	270653627S
Hospital Revenue Code	272
Min. Negotiated Rate	$8.05
Max. Negotiated Rate	$8.05
Rate for Payer: Qualcare PPO/HMO/WC	$8.05

CATHETER IMAGER II FLUSH 4FR

Facility

$53.65

Hospital Charge Code	270653627
Hospital Revenue Code	272
Min. Negotiated Rate	$8.05
Max. Negotiated Rate	$8.05
Rate for Payer: Qualcare PPO/HMO/WC	$8.05

CATHETER IMAGER II FLUSH 4FR

Facility

$53.65

Hospital Charge Code	270653627
Hospital Revenue Code	272
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$26.82
Rate for Payer: Aetna Commercial	$20.39
Rate for Payer: Aetna Medicare Advantage	$16.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.68
Rate for Payer: Cigna Commercial	$26.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.09
Rate for Payer: Oxford Commercial	$10.73
Rate for Payer: Qualcare PPO/HMO/WC	$8.05
Rate for Payer: UnitedHealthcare Commercial	$10.73
Rate for Payer: UnitedHealthcare Community & State	$1.29
Rate for Payer: Wellpoint Medicaid Managed Care	$1.42

CATHETER IMAGER II FLUSH 5FR

Facility

$27.91

Hospital Charge Code	270653623
Hospital Revenue Code	272
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$4.19
Rate for Payer: Qualcare PPO/HMO/WC	$4.19

CATHETER IMAGER II FLUSH 5FR

Facility

$27.91

Hospital Charge Code	270653623
Hospital Revenue Code	272
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$13.96
Rate for Payer: Aetna Commercial	$10.61
Rate for Payer: Aetna Medicare Advantage	$8.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.12
Rate for Payer: Cigna Commercial	$13.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.37
Rate for Payer: Oxford Commercial	$5.58
Rate for Payer: Qualcare PPO/HMO/WC	$4.19
Rate for Payer: UnitedHealthcare Commercial	$5.58
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

CATHETER IMAGER II FLUSH 5FR

Facility

$27.91

Hospital Charge Code	270653626N
Hospital Revenue Code	272
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$4.19
Rate for Payer: Qualcare PPO/HMO/WC	$4.19

CATHETER IMAGER II FLUSH 5FR

Facility

$27.91

Hospital Charge Code	270653626
Hospital Revenue Code	272
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$13.96
Rate for Payer: Aetna Commercial	$10.61
Rate for Payer: Aetna Medicare Advantage	$8.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.12
Rate for Payer: Cigna Commercial	$13.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.37
Rate for Payer: Oxford Commercial	$5.58
Rate for Payer: Qualcare PPO/HMO/WC	$4.19
Rate for Payer: UnitedHealthcare Commercial	$5.58
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

CATHETER IMAGER II FLUSH 5FR

Facility

$27.91

Hospital Charge Code	270653626
Hospital Revenue Code	272
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$4.19
Rate for Payer: Qualcare PPO/HMO/WC	$4.19

Know your out-of-pocket cost for care.

All Charges