Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER PHENOM PLUS 120 CM

Facility

$9,250.00

Service Code	HCPCS C1887
Hospital Charge Code	270685196
Hospital Revenue Code	278
Min. Negotiated Rate	$222.93
Max. Negotiated Rate	$4,625.00
Rate for Payer: Aetna Commercial	$3,515.00
Rate for Payer: Aetna Medicare Advantage	$2,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,358.75
Rate for Payer: Cigna Commercial	$4,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,035.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50
Rate for Payer: UnitedHealthcare Community & State	$222.93
Rate for Payer: Wellpoint Medicaid Managed Care	$245.12

CATHETER PHENOM PLUS 120 CM

Facility

$9,250.00

Service Code	HCPCS C1887
Hospital Charge Code	270685196
Hospital Revenue Code	278
Min. Negotiated Rate	$1,387.50
Max. Negotiated Rate	$2,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,035.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50

CATHETER PHENOM PLUS 120 CM

Facility

$9,250.00

Service Code	HCPCS C1887
Hospital Charge Code	270685196S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,387.50
Max. Negotiated Rate	$2,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,035.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50

CATHETER PHENOM PLUS 120 CM

Facility

$9,250.00

Service Code	HCPCS C1887
Hospital Charge Code	270685196S
Hospital Revenue Code	278
Min. Negotiated Rate	$222.93
Max. Negotiated Rate	$4,625.00
Rate for Payer: Aetna Commercial	$3,515.00
Rate for Payer: Aetna Medicare Advantage	$2,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,358.75
Rate for Payer: Cigna Commercial	$4,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,035.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50
Rate for Payer: UnitedHealthcare Community & State	$222.93
Rate for Payer: Wellpoint Medicaid Managed Care	$245.12

CATHETER PICC LINE 5FR DUAL L

Facility

$1,975.00

Hospital Charge Code	270CH0063
Hospital Revenue Code	272
Min. Negotiated Rate	$296.25
Max. Negotiated Rate	$296.25
Rate for Payer: Qualcare PPO/HMO/WC	$296.25

CATHETER PICC LINE 5FR DUAL L

Facility

$1,975.00

Hospital Charge Code	270CH0063
Hospital Revenue Code	272
Min. Negotiated Rate	$47.60
Max. Negotiated Rate	$987.50
Rate for Payer: Aetna Commercial	$750.50
Rate for Payer: Aetna Medicare Advantage	$592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.62
Rate for Payer: Cigna Commercial	$987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.50
Rate for Payer: Oxford Commercial	$395.00
Rate for Payer: Qualcare PPO/HMO/WC	$296.25
Rate for Payer: UnitedHealthcare Commercial	$395.00
Rate for Payer: UnitedHealthcare Community & State	$47.60
Rate for Payer: Wellpoint Medicaid Managed Care	$52.34

CATHETER PIGTAIL 10FR NEPHRO

Facility

$830.00

Service Code	HCPCS C1729
Hospital Charge Code	270680007
Hospital Revenue Code	278
Min. Negotiated Rate	$124.50
Max. Negotiated Rate	$200.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$182.60
Rate for Payer: Qualcare PPO/HMO/WC	$124.50

CATHETER PIGTAIL 10FR NEPHRO

Facility

$830.00

Service Code	HCPCS C1729
Hospital Charge Code	270680007
Hospital Revenue Code	278
Min. Negotiated Rate	$20.00
Max. Negotiated Rate	$415.00
Rate for Payer: Aetna Commercial	$315.40
Rate for Payer: Aetna Medicare Advantage	$249.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.65
Rate for Payer: Cigna Commercial	$415.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$182.60
Rate for Payer: Qualcare PPO/HMO/WC	$124.50
Rate for Payer: UnitedHealthcare Community & State	$20.00
Rate for Payer: Wellpoint Medicaid Managed Care	$22.00

CATHETER PIG TAIL 5FR 65CM

Facility

$27.91

Hospital Charge Code	270669872
Hospital Revenue Code	272
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$4.19
Rate for Payer: Qualcare PPO/HMO/WC	$4.19

CATHETER PIG TAIL 5FR 65CM

Facility

$27.91

Hospital Charge Code	270669872
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 PIGTAIL 7FR 527-750S

Facility

$52.15

Hospital Charge Code	270612748
Hospital Revenue Code	272
Min. Negotiated Rate	$1.26
Max. Negotiated Rate	$26.07
Rate for Payer: Aetna Commercial	$19.82
Rate for Payer: Aetna Medicare Advantage	$15.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.30
Rate for Payer: Cigna Commercial	$26.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.64
Rate for Payer: Oxford Commercial	$10.43
Rate for Payer: Qualcare PPO/HMO/WC	$7.82
Rate for Payer: UnitedHealthcare Commercial	$10.43
Rate for Payer: UnitedHealthcare Community & State	$1.26
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

CATHETER PIGTAIL 7FR 527-750S

Facility

$52.15

Hospital Charge Code	270612748
Hospital Revenue Code	272
Min. Negotiated Rate	$7.82
Max. Negotiated Rate	$7.82
Rate for Payer: Qualcare PPO/HMO/WC	$7.82

CATHETER PIGTAIL 8FR NEPHRO

Facility

$830.00

Service Code	HCPCS C1729
Hospital Charge Code	270680006
Hospital Revenue Code	278
Min. Negotiated Rate	$20.00
Max. Negotiated Rate	$415.00
Rate for Payer: Aetna Commercial	$315.40
Rate for Payer: Aetna Medicare Advantage	$249.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.65
Rate for Payer: Cigna Commercial	$415.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$182.60
Rate for Payer: Qualcare PPO/HMO/WC	$124.50
Rate for Payer: UnitedHealthcare Community & State	$20.00
Rate for Payer: Wellpoint Medicaid Managed Care	$22.00

CATHETER PIGTAIL 8FR NEPHRO

Facility

$830.00

Service Code	HCPCS C1729
Hospital Charge Code	270680006
Hospital Revenue Code	278
Min. Negotiated Rate	$124.50
Max. Negotiated Rate	$200.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$182.60
Rate for Payer: Qualcare PPO/HMO/WC	$124.50

CATHETER POWER PICC 135CM 5FR

Facility

$635.00

Hospital Charge Code	270671561
Hospital Revenue Code	278
Min. Negotiated Rate	$95.25
Max. Negotiated Rate	$153.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$127.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$139.70
Rate for Payer: Qualcare PPO/HMO/WC	$95.25

CATHETER POWER PICC 135CM 5FR

Facility

$635.00

Hospital Charge Code	270671561
Hospital Revenue Code	278
Min. Negotiated Rate	$15.30
Max. Negotiated Rate	$317.50
Rate for Payer: Aetna Commercial	$241.30
Rate for Payer: Aetna Medicare Advantage	$190.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$127.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.93
Rate for Payer: Cigna Commercial	$317.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$139.70
Rate for Payer: Qualcare PPO/HMO/WC	$95.25
Rate for Payer: UnitedHealthcare Community & State	$15.30
Rate for Payer: Wellpoint Medicaid Managed Care	$16.83

CATHETER POWER PICC SOLO 5FR

Facility

$4,173.00

Service Code	HCPCS C1751
Hospital Charge Code	270682901N
Hospital Revenue Code	278
Min. Negotiated Rate	$100.57
Max. Negotiated Rate	$2,086.50
Rate for Payer: Aetna Commercial	$1,585.74
Rate for Payer: Aetna Medicare Advantage	$1,251.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,064.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,064.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$834.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,064.12
Rate for Payer: Cigna Commercial	$2,086.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,009.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$918.06
Rate for Payer: Qualcare PPO/HMO/WC	$625.95
Rate for Payer: UnitedHealthcare Community & State	$100.57
Rate for Payer: Wellpoint Medicaid Managed Care	$110.58

CATHETER POWER PICC SOLO 5FR

Facility

$4,173.00

Service Code	HCPCS C1751
Hospital Charge Code	270682901N
Hospital Revenue Code	278
Min. Negotiated Rate	$625.95
Max. Negotiated Rate	$1,009.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$834.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,009.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$918.06
Rate for Payer: Qualcare PPO/HMO/WC	$625.95

CATHETER POWER PICC SOLO 5FR

Facility

$1,391.00

Service Code	HCPCS C1751
Hospital Charge Code	270682901
Hospital Revenue Code	278
Min. Negotiated Rate	$208.65
Max. Negotiated Rate	$336.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$278.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$336.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$306.02
Rate for Payer: Qualcare PPO/HMO/WC	$208.65

CATHETER POWER PICC SOLO 5FR

Facility

$1,391.00

Service Code	HCPCS C1751
Hospital Charge Code	270682901
Hospital Revenue Code	278
Min. Negotiated Rate	$33.52
Max. Negotiated Rate	$695.50
Rate for Payer: Aetna Commercial	$528.58
Rate for Payer: Aetna Medicare Advantage	$417.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$354.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$354.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$278.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$354.70
Rate for Payer: Cigna Commercial	$695.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$336.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$306.02
Rate for Payer: Qualcare PPO/HMO/WC	$208.65
Rate for Payer: UnitedHealthcare Community & State	$33.52
Rate for Payer: Wellpoint Medicaid Managed Care	$36.86

CATHETER PRECISE 5X30MM

Facility

$10,565.00

Service Code	HCPCS C1876
Hospital Charge Code	270696950S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,584.75
Max. Negotiated Rate	$2,556.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,113.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,556.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,324.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,584.75

CATHETER PRECISE 5X30MM

Facility

$10,565.00

Service Code	HCPCS C1876
Hospital Charge Code	270696950S
Hospital Revenue Code	278
Min. Negotiated Rate	$254.62
Max. Negotiated Rate	$5,282.50
Rate for Payer: Aetna Commercial	$4,014.70
Rate for Payer: Aetna Medicare Advantage	$3,169.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,694.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,694.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,113.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,694.07
Rate for Payer: Cigna Commercial	$5,282.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,556.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,324.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,584.75
Rate for Payer: UnitedHealthcare Community & State	$254.62
Rate for Payer: Wellpoint Medicaid Managed Care	$279.97

CATHETER PRECISE PRO 5X40MM

Facility

$10,565.00

Service Code	HCPCS C1876
Hospital Charge Code	270696951S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,584.75
Max. Negotiated Rate	$2,556.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,113.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,556.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,324.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,584.75

CATHETER PRECISE PRO 5X40MM

Facility

$10,565.00

Service Code	HCPCS C1876
Hospital Charge Code	270696951S
Hospital Revenue Code	278
Min. Negotiated Rate	$254.62
Max. Negotiated Rate	$5,282.50
Rate for Payer: Aetna Commercial	$4,014.70
Rate for Payer: Aetna Medicare Advantage	$3,169.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,694.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,694.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,113.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,694.07
Rate for Payer: Cigna Commercial	$5,282.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,556.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,324.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,584.75
Rate for Payer: UnitedHealthcare Community & State	$254.62
Rate for Payer: Wellpoint Medicaid Managed Care	$279.97

CATHETER PROGREAT 2.4X 130 MM

Facility

$2,330.00

Hospital Charge Code	270696124
Hospital Revenue Code	279
Min. Negotiated Rate	$56.15
Max. Negotiated Rate	$1,165.00
Rate for Payer: Aetna Commercial	$885.40
Rate for Payer: Aetna Medicare Advantage	$699.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$594.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$594.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$594.15
Rate for Payer: Cigna Commercial	$1,165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$699.00
Rate for Payer: Oxford Commercial	$466.00
Rate for Payer: Qualcare PPO/HMO/WC	$349.50
Rate for Payer: UnitedHealthcare Commercial	$466.00
Rate for Payer: UnitedHealthcare Community & State	$56.15
Rate for Payer: Wellpoint Medicaid Managed Care	$61.74

Know your out-of-pocket cost for care.

All Charges