Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER MARATHON NO STYLET

Facility

$4,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685190
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

CATHETER MARATHON NO STYLET

Facility

$4,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685190
Hospital Revenue Code	278
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

CATHETER MARATHON NO STYLET

Facility

$4,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685190S
Hospital Revenue Code	278
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

CATHETER MARATHON NO STYLET

Facility

$4,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685190S
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

CATHETER MARKSMAN 150 CM

Facility

$6,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685147
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$1,573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,430.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

CATHETER MARKSMAN 150 CM

Facility

$6,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685147S
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$1,573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,430.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

CATHETER MARKSMAN 150 CM

Facility

$6,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685147
Hospital Revenue Code	278
Min. Negotiated Rate	$156.65
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$2,470.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,430.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00
Rate for Payer: UnitedHealthcare Community & State	$156.65
Rate for Payer: Wellpoint Medicaid Managed Care	$172.25

CATHETER MARKSMAN 150 CM

Facility

$6,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685147S
Hospital Revenue Code	278
Min. Negotiated Rate	$156.65
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$2,470.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,430.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00
Rate for Payer: UnitedHealthcare Community & State	$156.65
Rate for Payer: Wellpoint Medicaid Managed Care	$172.25

CATHETER MARKSMAN 160 CM

Facility

$6,650.00

Service Code	HCPCS C1887
Hospital Charge Code	270685146S
Hospital Revenue Code	278
Min. Negotiated Rate	$160.26
Max. Negotiated Rate	$3,325.00
Rate for Payer: Aetna Commercial	$2,527.00
Rate for Payer: Aetna Medicare Advantage	$1,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,695.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,695.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,695.75
Rate for Payer: Cigna Commercial	$3,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,609.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,463.00
Rate for Payer: Qualcare PPO/HMO/WC	$997.50
Rate for Payer: UnitedHealthcare Community & State	$160.26
Rate for Payer: Wellpoint Medicaid Managed Care	$176.22

CATHETER MARKSMAN 160 CM

Facility

$6,650.00

Service Code	HCPCS C1887
Hospital Charge Code	270685146S
Hospital Revenue Code	278
Min. Negotiated Rate	$997.50
Max. Negotiated Rate	$1,609.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,609.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,463.00
Rate for Payer: Qualcare PPO/HMO/WC	$997.50

CATHETER MARKSMAN 160 CM

Facility

$6,650.00

Service Code	HCPCS C1887
Hospital Charge Code	270685146
Hospital Revenue Code	278
Min. Negotiated Rate	$160.26
Max. Negotiated Rate	$3,325.00
Rate for Payer: Aetna Commercial	$2,527.00
Rate for Payer: Aetna Medicare Advantage	$1,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,695.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,695.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,695.75
Rate for Payer: Cigna Commercial	$3,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,609.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,463.00
Rate for Payer: Qualcare PPO/HMO/WC	$997.50
Rate for Payer: UnitedHealthcare Community & State	$160.26
Rate for Payer: Wellpoint Medicaid Managed Care	$176.22

CATHETER MARKSMAN 160 CM

Facility

$6,650.00

Service Code	HCPCS C1887
Hospital Charge Code	270685146
Hospital Revenue Code	278
Min. Negotiated Rate	$997.50
Max. Negotiated Rate	$1,609.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,609.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,463.00
Rate for Payer: Qualcare PPO/HMO/WC	$997.50

CATHETER MICRO STC .018X150CM

Facility

$2,016.00

Service Code	HCPCS C1887
Hospital Charge Code	270669493
Hospital Revenue Code	278
Min. Negotiated Rate	$302.40
Max. Negotiated Rate	$487.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$403.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$443.52
Rate for Payer: Qualcare PPO/HMO/WC	$302.40

CATHETER MICRO STC .018X150CM

Facility

$2,016.00

Service Code	HCPCS C1887
Hospital Charge Code	270669493
Hospital Revenue Code	278
Min. Negotiated Rate	$48.59
Max. Negotiated Rate	$1,008.00
Rate for Payer: Aetna Commercial	$766.08
Rate for Payer: Aetna Medicare Advantage	$604.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$514.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$514.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$403.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$514.08
Rate for Payer: Cigna Commercial	$1,008.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$443.52
Rate for Payer: Qualcare PPO/HMO/WC	$302.40
Rate for Payer: UnitedHealthcare Community & State	$48.59
Rate for Payer: Wellpoint Medicaid Managed Care	$53.42

CATHETER MPA1 6FR 100cm 532667

Facility

$45.25

Hospital Charge Code	270640534
Hospital Revenue Code	272
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$22.62
Rate for Payer: Aetna Commercial	$17.20
Rate for Payer: Aetna Medicare Advantage	$13.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.54
Rate for Payer: Cigna Commercial	$22.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.57
Rate for Payer: Oxford Commercial	$9.05
Rate for Payer: Qualcare PPO/HMO/WC	$6.79
Rate for Payer: UnitedHealthcare Commercial	$9.05
Rate for Payer: UnitedHealthcare Community & State	$1.09
Rate for Payer: Wellpoint Medicaid Managed Care	$1.20

CATHETER MPA1 6FR 100cm 532667

Facility

$45.25

Hospital Charge Code	270640534
Hospital Revenue Code	272
Min. Negotiated Rate	$6.79
Max. Negotiated Rate	$6.79
Rate for Payer: Qualcare PPO/HMO/WC	$6.79

CATHETER MUSTANG 5FR 5.0X80MM

Facility

$1,250.00

Hospital Charge Code	270671668
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

CATHETER MUSTANG 5FR 5.0X80MM

Facility

$1,250.00

Hospital Charge Code	270671668
Hospital Revenue Code	278
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

CATHETER MUSTANG 5FR 6.0X80MM

Facility

$1,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270671669
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

CATHETER MUSTANG 5FR 6.0X80MM

Facility

$1,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270671669
Hospital Revenue Code	278
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

CATHETER NAVICROSS SUPPORT 30

Facility

$975.00

Service Code	HCPCS C1725
Hospital Charge Code	270665135
Hospital Revenue Code	278
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

CATHETER NAVICROSS SUPPORT 30

Facility

$975.00

Service Code	HCPCS C1725
Hospital Charge Code	270665135
Hospital Revenue Code	278
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$235.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATHETER NC TREK 2.5x8mm

Facility

$850.00

Hospital Charge Code	270652091
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

CATHETER NC TREK 2.5x8mm

Facility

$850.00

Hospital Charge Code	270652091
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.00
Rate for Payer: Oxford Commercial	$170.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$170.00
Rate for Payer: UnitedHealthcare Community & State	$20.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.52

CATHETER NC TREK 2 75MMX15MM

Facility

$850.00

Service Code	HCPCS C1725
Hospital Charge Code	270666553
Hospital Revenue Code	278
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Community & State	$20.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.52

Know your out-of-pocket cost for care.

All Charges