Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER NC TREK 2 75MMX15MM

Facility

$850.00

Service Code	HCPCS C1725
Hospital Charge Code	270666553
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
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

CATHETER NC TREK 3.0x12mm

Facility

$850.00

Hospital Charge Code	270652093
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 3.0x12mm

Facility

$850.00

Hospital Charge Code	270652093
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 3.25x12mm

Facility

$850.00

Hospital Charge Code	270652094
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 3.25x12mm

Facility

$850.00

Hospital Charge Code	270652094
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 3.5MM X 8MM

Facility

$850.00

Hospital Charge Code	270651814
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 3.5MM X 8MM

Facility

$850.00

Hospital Charge Code	270651814
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 NEEDLE YUEH CENTESIS

Facility

$110.25

Hospital Charge Code	270651793
Hospital Revenue Code	272
Min. Negotiated Rate	$2.66
Max. Negotiated Rate	$55.12
Rate for Payer: Aetna Commercial	$41.90
Rate for Payer: Aetna Medicare Advantage	$33.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.11
Rate for Payer: Cigna Commercial	$55.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.08
Rate for Payer: Oxford Commercial	$22.05
Rate for Payer: Qualcare PPO/HMO/WC	$16.54
Rate for Payer: UnitedHealthcare Commercial	$22.05
Rate for Payer: UnitedHealthcare Community & State	$2.66
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

CATHETER NEEDLE YUEH CENTESIS

Facility

$110.25

Hospital Charge Code	270651793R
Hospital Revenue Code	272
Min. Negotiated Rate	$16.54
Max. Negotiated Rate	$16.54
Rate for Payer: Qualcare PPO/HMO/WC	$16.54

CATHETER NEEDLE YUEH CENTESIS

Facility

$110.25

Hospital Charge Code	270651793R
Hospital Revenue Code	272
Min. Negotiated Rate	$2.66
Max. Negotiated Rate	$55.12
Rate for Payer: Aetna Commercial	$41.90
Rate for Payer: Aetna Medicare Advantage	$33.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.11
Rate for Payer: Cigna Commercial	$55.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.08
Rate for Payer: Oxford Commercial	$22.05
Rate for Payer: Qualcare PPO/HMO/WC	$16.54
Rate for Payer: UnitedHealthcare Commercial	$22.05
Rate for Payer: UnitedHealthcare Community & State	$2.66
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

CATHETER NEEDLE YUEH CENTESIS

Facility

$110.25

Hospital Charge Code	270651793
Hospital Revenue Code	272
Min. Negotiated Rate	$16.54
Max. Negotiated Rate	$16.54
Rate for Payer: Qualcare PPO/HMO/WC	$16.54

CATHETER NEEDLE YUEH DTVN-5.0F

Facility

$91.65

Hospital Charge Code	270CH0055
Hospital Revenue Code	278
Min. Negotiated Rate	$13.75
Max. Negotiated Rate	$22.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$20.16
Rate for Payer: Qualcare PPO/HMO/WC	$13.75

CATHETER NEEDLE YUEH DTVN-5.0F

Facility

$94.00

Hospital Charge Code	270CH0056
Hospital Revenue Code	278
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$22.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$20.68
Rate for Payer: Qualcare PPO/HMO/WC	$14.10

CATHETER NEEDLE YUEH DTVN-5.0F

Facility

$91.65

Hospital Charge Code	270CH0055
Hospital Revenue Code	278
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$45.83
Rate for Payer: Aetna Commercial	$34.83
Rate for Payer: Aetna Medicare Advantage	$27.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.37
Rate for Payer: Cigna Commercial	$45.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$20.16
Rate for Payer: Qualcare PPO/HMO/WC	$13.75
Rate for Payer: UnitedHealthcare Community & State	$2.21
Rate for Payer: Wellpoint Medicaid Managed Care	$2.43

CATHETER NEEDLE YUEH DTVN-5.0F

Facility

$94.00

Hospital Charge Code	270CH0056
Hospital Revenue Code	278
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) NJ Health	$18.80
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	$22.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$20.68
Rate for Payer: Qualcare PPO/HMO/WC	$14.10
Rate for Payer: UnitedHealthcare Community & State	$2.27
Rate for Payer: Wellpoint Medicaid Managed Care	$2.49

CATHETER NEONTATAL SILICONE

Facility

$269.87

Hospital Charge Code	270669981
Hospital Revenue Code	272
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$134.94
Rate for Payer: Aetna Commercial	$102.55
Rate for Payer: Aetna Medicare Advantage	$80.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.82
Rate for Payer: Cigna Commercial	$134.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.96
Rate for Payer: Oxford Commercial	$53.97
Rate for Payer: Qualcare PPO/HMO/WC	$40.48
Rate for Payer: UnitedHealthcare Commercial	$53.97
Rate for Payer: UnitedHealthcare Community & State	$6.50
Rate for Payer: Wellpoint Medicaid Managed Care	$7.15

CATHETER NEONTATAL SILICONE

Facility

$269.87

Hospital Charge Code	270669981
Hospital Revenue Code	272
Min. Negotiated Rate	$40.48
Max. Negotiated Rate	$40.48
Rate for Payer: Qualcare PPO/HMO/WC	$40.48

CATHETER NEURO AXS CAT 5

Facility

$10,901.25

Service Code	HCPCS C1887
Hospital Charge Code	270690868
Hospital Revenue Code	278
Min. Negotiated Rate	$1,635.19
Max. Negotiated Rate	$2,638.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,180.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,638.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,398.28
Rate for Payer: Qualcare PPO/HMO/WC	$1,635.19

CATHETER NEURO AXS CAT 5

Facility

$10,901.25

Service Code	HCPCS C1887
Hospital Charge Code	270690868
Hospital Revenue Code	278
Min. Negotiated Rate	$262.72
Max. Negotiated Rate	$5,450.62
Rate for Payer: Aetna Commercial	$4,142.48
Rate for Payer: Aetna Medicare Advantage	$3,270.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,779.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,779.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,180.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,779.82
Rate for Payer: Cigna Commercial	$5,450.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,638.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,398.28
Rate for Payer: Qualcare PPO/HMO/WC	$1,635.19
Rate for Payer: UnitedHealthcare Community & State	$262.72
Rate for Payer: Wellpoint Medicaid Managed Care	$288.88

CATHETER NEURO AXS CAT 7

Facility

$11,875.00

Service Code	HCPCS C1887
Hospital Charge Code	270690869
Hospital Revenue Code	278
Min. Negotiated Rate	$286.19
Max. Negotiated Rate	$5,937.50
Rate for Payer: Aetna Commercial	$4,512.50
Rate for Payer: Aetna Medicare Advantage	$3,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,028.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,028.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,028.12
Rate for Payer: Cigna Commercial	$5,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,873.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,612.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,781.25
Rate for Payer: UnitedHealthcare Community & State	$286.19
Rate for Payer: Wellpoint Medicaid Managed Care	$314.69

CATHETER NEURO AXS CAT 7

Facility

$11,875.00

Service Code	HCPCS C1887
Hospital Charge Code	270690869
Hospital Revenue Code	278
Min. Negotiated Rate	$1,781.25
Max. Negotiated Rate	$2,873.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,873.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,612.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,781.25

CATHETER OCELOT 5FR 135cm

Facility

$12,475.00

Hospital Charge Code	270671671
Hospital Revenue Code	272
Min. Negotiated Rate	$1,871.25
Max. Negotiated Rate	$1,871.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,871.25

CATHETER OCELOT 5FR 135cm

Facility

$12,475.00

Hospital Charge Code	270671671
Hospital Revenue Code	272
Min. Negotiated Rate	$300.65
Max. Negotiated Rate	$6,237.50
Rate for Payer: Aetna Commercial	$4,740.50
Rate for Payer: Aetna Medicare Advantage	$3,742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,181.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,181.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,181.12
Rate for Payer: Cigna Commercial	$6,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,742.50
Rate for Payer: Oxford Commercial	$2,495.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,871.25
Rate for Payer: UnitedHealthcare Commercial	$2,495.00
Rate for Payer: UnitedHealthcare Community & State	$300.65
Rate for Payer: Wellpoint Medicaid Managed Care	$330.59

CATHETER OCELOT 6FR 110cm

Facility

$12,475.00

Hospital Charge Code	270671670
Hospital Revenue Code	272
Min. Negotiated Rate	$1,871.25
Max. Negotiated Rate	$1,871.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,871.25

CATHETER OCELOT 6FR 110cm

Facility

$12,475.00

Hospital Charge Code	270671670
Hospital Revenue Code	272
Min. Negotiated Rate	$300.65
Max. Negotiated Rate	$6,237.50
Rate for Payer: Aetna Commercial	$4,740.50
Rate for Payer: Aetna Medicare Advantage	$3,742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,181.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,181.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,181.12
Rate for Payer: Cigna Commercial	$6,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,742.50
Rate for Payer: Oxford Commercial	$2,495.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,871.25
Rate for Payer: UnitedHealthcare Commercial	$2,495.00
Rate for Payer: UnitedHealthcare Community & State	$300.65
Rate for Payer: Wellpoint Medicaid Managed Care	$330.59

Know your out-of-pocket cost for care.

All Charges