Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER OTW XK 27CM SPLIT

Facility

$1,925.00

Service Code	HCPCS C1750
Hospital Charge Code	270661404N
Hospital Revenue Code	278
Min. Negotiated Rate	$288.75
Max. Negotiated Rate	$465.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$465.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$288.75

CATHETER OTW, XK, 27cm ST SPLI

Facility

$1,925.00

Hospital Charge Code	270CH0059
Hospital Revenue Code	272
Min. Negotiated Rate	$288.75
Max. Negotiated Rate	$288.75
Rate for Payer: Qualcare PPO/HMO/WC	$288.75

CATHETER OTW, XK, 27cm ST SPLI

Facility

$1,925.00

Hospital Charge Code	270CH0059
Hospital Revenue Code	272
Min. Negotiated Rate	$46.39
Max. Negotiated Rate	$962.50
Rate for Payer: Aetna Commercial	$731.50
Rate for Payer: Aetna Medicare Advantage	$577.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$490.88
Rate for Payer: Cigna Commercial	$962.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$577.50
Rate for Payer: Oxford Commercial	$385.00
Rate for Payer: Qualcare PPO/HMO/WC	$288.75
Rate for Payer: UnitedHealthcare Commercial	$385.00
Rate for Payer: UnitedHealthcare Community & State	$46.39
Rate for Payer: Wellpoint Medicaid Managed Care	$51.01

CATHETER OTW, XK, 31cm ST SPLI

Facility

$1,925.00

Hospital Charge Code	270CH0060
Hospital Revenue Code	272
Min. Negotiated Rate	$46.39
Max. Negotiated Rate	$962.50
Rate for Payer: Aetna Commercial	$731.50
Rate for Payer: Aetna Medicare Advantage	$577.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$490.88
Rate for Payer: Cigna Commercial	$962.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$577.50
Rate for Payer: Oxford Commercial	$385.00
Rate for Payer: Qualcare PPO/HMO/WC	$288.75
Rate for Payer: UnitedHealthcare Commercial	$385.00
Rate for Payer: UnitedHealthcare Community & State	$46.39
Rate for Payer: Wellpoint Medicaid Managed Care	$51.01

CATHETER OTW, XK, 31cm ST SPLI

Facility

$1,925.00

Hospital Charge Code	270CH0060
Hospital Revenue Code	272
Min. Negotiated Rate	$288.75
Max. Negotiated Rate	$288.75
Rate for Payer: Qualcare PPO/HMO/WC	$288.75

CATHETER OUTBACK RE-ENTRY

Facility

$11,490.00

Hospital Charge Code	2709003190
Hospital Revenue Code	272
Min. Negotiated Rate	$276.91
Max. Negotiated Rate	$5,745.00
Rate for Payer: Aetna Commercial	$4,366.20
Rate for Payer: Aetna Medicare Advantage	$3,447.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,929.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,929.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,929.95
Rate for Payer: Cigna Commercial	$5,745.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,447.00
Rate for Payer: Oxford Commercial	$2,298.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,723.50
Rate for Payer: UnitedHealthcare Commercial	$2,298.00
Rate for Payer: UnitedHealthcare Community & State	$276.91
Rate for Payer: Wellpoint Medicaid Managed Care	$304.49

CATHETER OUTBACK RE-ENTRY

Facility

$11,490.00

Hospital Charge Code	2709003190
Hospital Revenue Code	272
Min. Negotiated Rate	$1,723.50
Max. Negotiated Rate	$1,723.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,723.50

CATHETER PALINDRONE DIALY 19CM

Facility

$2,183.60

Hospital Charge Code	270669446
Hospital Revenue Code	278
Min. Negotiated Rate	$327.54
Max. Negotiated Rate	$528.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$436.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$528.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$480.39
Rate for Payer: Qualcare PPO/HMO/WC	$327.54

CATHETER PALINDRONE DIALY 19CM

Facility

$2,183.60

Hospital Charge Code	270669446
Hospital Revenue Code	278
Min. Negotiated Rate	$52.62
Max. Negotiated Rate	$1,091.80
Rate for Payer: Aetna Commercial	$829.77
Rate for Payer: Aetna Medicare Advantage	$655.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$556.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$556.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$436.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$556.82
Rate for Payer: Cigna Commercial	$1,091.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$528.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$480.39
Rate for Payer: Qualcare PPO/HMO/WC	$327.54
Rate for Payer: UnitedHealthcare Community & State	$52.62
Rate for Payer: Wellpoint Medicaid Managed Care	$57.87

CATHETER PALINDRONE DIALY 23CM

Facility

$2,183.60

Hospital Charge Code	270669447
Hospital Revenue Code	278
Min. Negotiated Rate	$52.62
Max. Negotiated Rate	$1,091.80
Rate for Payer: Aetna Commercial	$829.77
Rate for Payer: Aetna Medicare Advantage	$655.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$556.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$556.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$436.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$556.82
Rate for Payer: Cigna Commercial	$1,091.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$528.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$480.39
Rate for Payer: Qualcare PPO/HMO/WC	$327.54
Rate for Payer: UnitedHealthcare Community & State	$52.62
Rate for Payer: Wellpoint Medicaid Managed Care	$57.87

CATHETER PALINDRONE DIALY 23CM

Facility

$2,183.60

Hospital Charge Code	270669447
Hospital Revenue Code	278
Min. Negotiated Rate	$327.54
Max. Negotiated Rate	$528.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$436.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$528.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$480.39
Rate for Payer: Qualcare PPO/HMO/WC	$327.54

CATHETER PALINDRONE DIALY 28CM

Facility

$2,183.60

Hospital Charge Code	270669448
Hospital Revenue Code	278
Min. Negotiated Rate	$52.62
Max. Negotiated Rate	$1,091.80
Rate for Payer: Aetna Commercial	$829.77
Rate for Payer: Aetna Medicare Advantage	$655.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$556.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$556.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$436.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$556.82
Rate for Payer: Cigna Commercial	$1,091.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$528.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$480.39
Rate for Payer: Qualcare PPO/HMO/WC	$327.54
Rate for Payer: UnitedHealthcare Community & State	$52.62
Rate for Payer: Wellpoint Medicaid Managed Care	$57.87

CATHETER PALINDRONE DIALY 28CM

Facility

$2,183.60

Hospital Charge Code	270669448
Hospital Revenue Code	278
Min. Negotiated Rate	$327.54
Max. Negotiated Rate	$528.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$436.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$528.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$480.39
Rate for Payer: Qualcare PPO/HMO/WC	$327.54

CATHETER PASSER

Facility

$72.00

Hospital Charge Code	270335598
Hospital Revenue Code	272
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

CATHETER PASSER

Facility

$72.00

Hospital Charge Code	270335598
Hospital Revenue Code	272
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$36.00
Rate for Payer: Aetna Commercial	$27.36
Rate for Payer: Aetna Medicare Advantage	$21.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.36
Rate for Payer: Cigna Commercial	$36.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.60
Rate for Payer: Oxford Commercial	$14.40
Rate for Payer: Qualcare PPO/HMO/WC	$10.80
Rate for Payer: UnitedHealthcare Commercial	$14.40
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

CATHETER PASSER 36CM

Facility

$119.00

Hospital Charge Code	270335606
Hospital Revenue Code	272
Min. Negotiated Rate	$17.85
Max. Negotiated Rate	$17.85
Rate for Payer: Qualcare PPO/HMO/WC	$17.85

CATHETER PASSER 36CM

Facility

$119.00

Hospital Charge Code	270335606
Hospital Revenue Code	272
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$59.50
Rate for Payer: Aetna Commercial	$45.22
Rate for Payer: Aetna Medicare Advantage	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.34
Rate for Payer: Cigna Commercial	$59.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.70
Rate for Payer: Oxford Commercial	$23.80
Rate for Payer: Qualcare PPO/HMO/WC	$17.85
Rate for Payer: UnitedHealthcare Commercial	$23.80
Rate for Payer: UnitedHealthcare Community & State	$2.87
Rate for Payer: Wellpoint Medicaid Managed Care	$3.15

CATHETER PASSER 38CM

Facility

$490.00

Hospital Charge Code	270691735
Hospital Revenue Code	272
Min. Negotiated Rate	$11.81
Max. Negotiated Rate	$245.00
Rate for Payer: Aetna Commercial	$186.20
Rate for Payer: Aetna Medicare Advantage	$147.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.95
Rate for Payer: Cigna Commercial	$245.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.00
Rate for Payer: Oxford Commercial	$98.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.50
Rate for Payer: UnitedHealthcare Commercial	$98.00
Rate for Payer: UnitedHealthcare Community & State	$11.81
Rate for Payer: Wellpoint Medicaid Managed Care	$12.98

CATHETER PASSER 38CM

Facility

$490.00

Hospital Charge Code	270691735
Hospital Revenue Code	272
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$73.50
Rate for Payer: Qualcare PPO/HMO/WC	$73.50

CATHETER PASSER 55CM.

Facility

$142.00

Hospital Charge Code	270335605
Hospital Revenue Code	272
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$71.00
Rate for Payer: Aetna Commercial	$53.96
Rate for Payer: Aetna Medicare Advantage	$42.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.21
Rate for Payer: Cigna Commercial	$71.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.60
Rate for Payer: Oxford Commercial	$28.40
Rate for Payer: Qualcare PPO/HMO/WC	$21.30
Rate for Payer: UnitedHealthcare Commercial	$28.40
Rate for Payer: UnitedHealthcare Community & State	$3.42
Rate for Payer: Wellpoint Medicaid Managed Care	$3.76

CATHETER PASSER 55CM.

Facility

$142.00

Hospital Charge Code	270335605
Hospital Revenue Code	272
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$21.30
Rate for Payer: Qualcare PPO/HMO/WC	$21.30

CATHETER PEAR SHAPED

Facility

$8,250.00

Service Code	HCPCS C1886
Hospital Charge Code	270682728
Hospital Revenue Code	278
Min. Negotiated Rate	$1,237.50
Max. Negotiated Rate	$1,996.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50

CATHETER PEAR SHAPED

Facility

$8,250.00

Service Code	HCPCS C1886
Hospital Charge Code	270682728
Hospital Revenue Code	278
Min. Negotiated Rate	$198.82
Max. Negotiated Rate	$4,125.00
Rate for Payer: Aetna Commercial	$3,135.00
Rate for Payer: Aetna Medicare Advantage	$2,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,103.75
Rate for Payer: Cigna Commercial	$4,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50
Rate for Payer: UnitedHealthcare Community & State	$198.82
Rate for Payer: Wellpoint Medicaid Managed Care	$218.62

CATHETER PERF 6F 610038ULT1

Facility

$113.75

Service Code	HCPCS C1725
Hospital Charge Code	270667499
Hospital Revenue Code	278
Min. Negotiated Rate	$2.74
Max. Negotiated Rate	$56.88
Rate for Payer: Aetna Commercial	$43.23
Rate for Payer: Aetna Medicare Advantage	$34.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.01
Rate for Payer: Cigna Commercial	$56.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.02
Rate for Payer: Qualcare PPO/HMO/WC	$17.06
Rate for Payer: UnitedHealthcare Community & State	$2.74
Rate for Payer: Wellpoint Medicaid Managed Care	$3.01

CATHETER PERF 6F 610038ULT1

Facility

$113.75

Service Code	HCPCS C1725
Hospital Charge Code	270667499
Hospital Revenue Code	278
Min. Negotiated Rate	$17.06
Max. Negotiated Rate	$27.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.02
Rate for Payer: Qualcare PPO/HMO/WC	$17.06

Know your out-of-pocket cost for care.

All Charges