Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER IMPRESS KA2 FR5

Facility

$66.00

Service Code	HCPCS C1887
Hospital Charge Code	270658004S
Hospital Revenue Code	278
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$15.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.52
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

CATHETER IMPRESS KA2 FR5

Facility

$66.00

Service Code	HCPCS C1887
Hospital Charge Code	270658004S
Hospital Revenue Code	278
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$33.00
Rate for Payer: Aetna Commercial	$25.08
Rate for Payer: Aetna Medicare Advantage	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.83
Rate for Payer: Cigna Commercial	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.52
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Community & State	$1.59
Rate for Payer: Wellpoint Medicaid Managed Care	$1.75

CATHETER IMPRESS KA2 FR5

Facility

$51.79

Service Code	HCPCS C1725
Hospital Charge Code	270652004
Hospital Revenue Code	278
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$25.89
Rate for Payer: Aetna Commercial	$19.68
Rate for Payer: Aetna Medicare Advantage	$15.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.21
Rate for Payer: Cigna Commercial	$25.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.39
Rate for Payer: Qualcare PPO/HMO/WC	$7.77
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.37

CATHETER IMPRESS KA2 FR5

Facility

$60.00

Service Code	HCPCS C1887
Hospital Charge Code	270658004
Hospital Revenue Code	278
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$14.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

CATHETER IMPRESS KA2 FR5

Facility

$51.79

Service Code	HCPCS C1725
Hospital Charge Code	270652004
Hospital Revenue Code	278
Min. Negotiated Rate	$7.77
Max. Negotiated Rate	$12.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.39
Rate for Payer: Qualcare PPO/HMO/WC	$7.77

CATHETER IMPRESS KA2 FR5

Facility

$60.00

Service Code	HCPCS C1887
Hospital Charge Code	270658004
Hospital Revenue Code	278
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Community & State	$1.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

CATHETER INDURA 5.64 8709

Facility

$2,604.00

Hospital Charge Code	270633447
Hospital Revenue Code	272
Min. Negotiated Rate	$390.60
Max. Negotiated Rate	$390.60
Rate for Payer: Qualcare PPO/HMO/WC	$390.60

CATHETER INDURA 5.64 8709

Facility

$2,604.00

Hospital Charge Code	270633447
Hospital Revenue Code	272
Min. Negotiated Rate	$62.76
Max. Negotiated Rate	$1,302.00
Rate for Payer: Aetna Commercial	$989.52
Rate for Payer: Aetna Medicare Advantage	$781.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$664.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$664.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$664.02
Rate for Payer: Cigna Commercial	$1,302.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$781.20
Rate for Payer: Oxford Commercial	$520.80
Rate for Payer: Qualcare PPO/HMO/WC	$390.60
Rate for Payer: UnitedHealthcare Commercial	$520.80
Rate for Payer: UnitedHealthcare Community & State	$62.76
Rate for Payer: Wellpoint Medicaid Managed Care	$69.01

CATHETER INFUSION 2.25I 20 GA

Facility

$210.00

Service Code	HCPCS C1751
Hospital Charge Code	270682903
Hospital Revenue Code	278
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$50.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$46.20
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

CATHETER INFUSION 2.25I 20 GA

Facility

$210.00

Service Code	HCPCS C1751
Hospital Charge Code	270682903
Hospital Revenue Code	278
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$105.00
Rate for Payer: Aetna Commercial	$79.80
Rate for Payer: Aetna Medicare Advantage	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.55
Rate for Payer: Cigna Commercial	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$46.20
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Community & State	$5.06
Rate for Payer: Wellpoint Medicaid Managed Care	$5.57

CATHETER,INFUSION,O/THAN HEMO

Facility

$21.40

Service Code	HCPCS C1751
Hospital Charge Code	4800910
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,INFUSION,O/THAN HEMO

Facility

$21.40

Service Code	HCPCS C1751
Hospital Charge Code	4800910
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 IV SAFETY 22GAX1 3350

Facility

$11.65

Hospital Charge Code	270621005
Hospital Revenue Code	272
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$5.83
Rate for Payer: Aetna Commercial	$4.43
Rate for Payer: Aetna Medicare Advantage	$3.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.97
Rate for Payer: Cigna Commercial	$5.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.50
Rate for Payer: Oxford Commercial	$2.33
Rate for Payer: Qualcare PPO/HMO/WC	$1.75
Rate for Payer: UnitedHealthcare Commercial	$2.33
Rate for Payer: UnitedHealthcare Community & State	$0.28
Rate for Payer: Wellpoint Medicaid Managed Care	$0.31

CATHETER IV SAFETY 22GAX1 3350

Facility

$11.65

Hospital Charge Code	270621005
Hospital Revenue Code	272
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$1.75
Rate for Payer: Qualcare PPO/HMO/WC	$1.75

CATHETER IV SURFLO TEFLON

Facility

$9.70

Hospital Charge Code	270658290
Hospital Revenue Code	272
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$1.46
Rate for Payer: Qualcare PPO/HMO/WC	$1.46

CATHETER IV SURFLO TEFLON

Facility

$9.70

Hospital Charge Code	270658290
Hospital Revenue Code	272
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.85
Rate for Payer: Aetna Commercial	$3.69
Rate for Payer: Aetna Medicare Advantage	$2.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.47
Rate for Payer: Cigna Commercial	$4.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.91
Rate for Payer: Oxford Commercial	$1.94
Rate for Payer: Qualcare PPO/HMO/WC	$1.46
Rate for Payer: UnitedHealthcare Commercial	$1.94
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

CATHETERIZE URETHRA, SIMPLE

Facility

$435.25

Service Code	HCPCS 51701
Hospital Charge Code	2500365
Hospital Revenue Code	761
Min. Negotiated Rate	$65.29
Max. Negotiated Rate	$65.29
Rate for Payer: Qualcare PPO/HMO/WC	$65.29

CATHETERIZE URETHRA, SIMPLE

Facility

$435.25

Service Code	HCPCS 51701
Hospital Charge Code	2500365
Hospital Revenue Code	761
Min. Negotiated Rate	$10.49
Max. Negotiated Rate	$570.55
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.57
Rate for Payer: Oxford Commercial	$87.05
Rate for Payer: Qualcare PPO/HMO/WC	$65.29
Rate for Payer: UnitedHealthcare Commercial	$87.05
Rate for Payer: UnitedHealthcare Community & State	$10.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$11.53

CATHETER JET 7 REPERFUTION TUB

Facility

$13,975.00

Hospital Charge Code	270685060S
Hospital Revenue Code	272
Min. Negotiated Rate	$2,096.25
Max. Negotiated Rate	$2,096.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25

CATHETER JET 7 REPERFUTION TUB

Facility

$13,975.00

Hospital Charge Code	270685060S
Hospital Revenue Code	272
Min. Negotiated Rate	$336.80
Max. Negotiated Rate	$6,987.50
Rate for Payer: Aetna Commercial	$5,310.50
Rate for Payer: Aetna Medicare Advantage	$4,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,563.62
Rate for Payer: Cigna Commercial	$6,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,192.50
Rate for Payer: Oxford Commercial	$2,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25
Rate for Payer: UnitedHealthcare Commercial	$2,795.00
Rate for Payer: UnitedHealthcare Community & State	$336.80
Rate for Payer: Wellpoint Medicaid Managed Care	$370.34

CATHETER JET 7 REPERFUTION TUB

Facility

$13,975.00

Hospital Charge Code	270685060
Hospital Revenue Code	272
Min. Negotiated Rate	$2,096.25
Max. Negotiated Rate	$2,096.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25

CATHETER JET 7 REPERFUTION TUB

Facility

$13,975.00

Hospital Charge Code	270685060
Hospital Revenue Code	272
Min. Negotiated Rate	$336.80
Max. Negotiated Rate	$6,987.50
Rate for Payer: Aetna Commercial	$5,310.50
Rate for Payer: Aetna Medicare Advantage	$4,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,563.62
Rate for Payer: Cigna Commercial	$6,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,192.50
Rate for Payer: Oxford Commercial	$2,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25
Rate for Payer: UnitedHealthcare Commercial	$2,795.00
Rate for Payer: UnitedHealthcare Community & State	$336.80
Rate for Payer: Wellpoint Medicaid Managed Care	$370.34

CATHETER JETSTREAM G3 SE 1.6

Facility

$16,500.00

Hospital Charge Code	2709007405
Hospital Revenue Code	272
Min. Negotiated Rate	$2,475.00
Max. Negotiated Rate	$2,475.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00

CATHETER JETSTREAM G3 SE 1.6

Facility

$16,500.00

Hospital Charge Code	2709007405
Hospital Revenue Code	272
Min. Negotiated Rate	$397.65
Max. Negotiated Rate	$8,250.00
Rate for Payer: Aetna Commercial	$6,270.00
Rate for Payer: Aetna Medicare Advantage	$4,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,207.50
Rate for Payer: Cigna Commercial	$8,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,950.00
Rate for Payer: Oxford Commercial	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00
Rate for Payer: UnitedHealthcare Commercial	$3,300.00
Rate for Payer: UnitedHealthcare Community & State	$397.65
Rate for Payer: Wellpoint Medicaid Managed Care	$437.25

CATHETER JETSTREAM G3 SF 1.6

Facility

$16,500.00

Hospital Charge Code	270CH0005
Hospital Revenue Code	272
Min. Negotiated Rate	$2,475.00
Max. Negotiated Rate	$2,475.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00

Know your out-of-pocket cost for care.

All Charges