Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER TORCON C1 .038mmX65cm

Facility

$74.30

Hospital Charge Code	270678586
Hospital Revenue Code	272
Min. Negotiated Rate	$11.14
Max. Negotiated Rate	$11.14
Rate for Payer: Qualcare PPO/HMO/WC	$11.14

CATHETER TORCON C2 .038mmX65cm

Facility

$74.30

Hospital Charge Code	270678587
Hospital Revenue Code	272
Min. Negotiated Rate	$11.14
Max. Negotiated Rate	$11.14
Rate for Payer: Qualcare PPO/HMO/WC	$11.14

CATHETER TORCON C2 .038mmX65cm

Facility

$74.30

Hospital Charge Code	270678587
Hospital Revenue Code	272
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$37.15
Rate for Payer: Aetna Commercial	$28.23
Rate for Payer: Aetna Medicare Advantage	$22.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.95
Rate for Payer: Cigna Commercial	$37.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.29
Rate for Payer: Oxford Commercial	$14.86
Rate for Payer: Qualcare PPO/HMO/WC	$11.14
Rate for Payer: UnitedHealthcare Commercial	$14.86
Rate for Payer: UnitedHealthcare Community & State	$1.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1.97

CATHETER TRAIBLAZER 35cm 0.035

Facility

$666.67

Hospital Charge Code	2709007360
Hospital Revenue Code	272
Min. Negotiated Rate	$16.07
Max. Negotiated Rate	$333.33
Rate for Payer: Aetna Commercial	$253.33
Rate for Payer: Aetna Medicare Advantage	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.00
Rate for Payer: Cigna Commercial	$333.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.00
Rate for Payer: Oxford Commercial	$133.33
Rate for Payer: Qualcare PPO/HMO/WC	$100.00
Rate for Payer: UnitedHealthcare Commercial	$133.33
Rate for Payer: UnitedHealthcare Community & State	$16.07
Rate for Payer: Wellpoint Medicaid Managed Care	$17.67

CATHETER TRAIBLAZER 35cm 0.035

Facility

$666.67

Hospital Charge Code	2709007360
Hospital Revenue Code	272
Min. Negotiated Rate	$100.00
Max. Negotiated Rate	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.00

CATHETER TRAILBLAZER.035X135CM

Facility

$4,864.00

Service Code	HCPCS C1887
Hospital Charge Code	270689924
Hospital Revenue Code	278
Min. Negotiated Rate	$729.60
Max. Negotiated Rate	$1,177.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$972.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,177.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,070.08
Rate for Payer: Qualcare PPO/HMO/WC	$729.60

CATHETER TRAILBLAZER.035X135CM

Facility

$4,864.00

Service Code	HCPCS C1887
Hospital Charge Code	270689924
Hospital Revenue Code	278
Min. Negotiated Rate	$117.22
Max. Negotiated Rate	$2,432.00
Rate for Payer: Aetna Commercial	$1,848.32
Rate for Payer: Aetna Medicare Advantage	$1,459.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,240.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,240.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$972.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,240.32
Rate for Payer: Cigna Commercial	$2,432.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,177.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,070.08
Rate for Payer: Qualcare PPO/HMO/WC	$729.60
Rate for Payer: UnitedHealthcare Community & State	$117.22
Rate for Payer: Wellpoint Medicaid Managed Care	$128.90

CATHETER TRAILBLAZER .035X150

Facility

$4,864.00

Service Code	HCPCS C1887
Hospital Charge Code	270683677
Hospital Revenue Code	278
Min. Negotiated Rate	$117.22
Max. Negotiated Rate	$2,432.00
Rate for Payer: Aetna Commercial	$1,848.32
Rate for Payer: Aetna Medicare Advantage	$1,459.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,240.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,240.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$972.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,240.32
Rate for Payer: Cigna Commercial	$2,432.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,177.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,070.08
Rate for Payer: Qualcare PPO/HMO/WC	$729.60
Rate for Payer: UnitedHealthcare Community & State	$117.22
Rate for Payer: Wellpoint Medicaid Managed Care	$128.90

CATHETER TRAILBLAZER .035X150

Facility

$4,864.00

Service Code	HCPCS C1887
Hospital Charge Code	270683677
Hospital Revenue Code	278
Min. Negotiated Rate	$729.60
Max. Negotiated Rate	$1,177.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$972.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,177.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,070.08
Rate for Payer: Qualcare PPO/HMO/WC	$729.60

CATHETER TRAILBLAZER .035X90CM

Facility

$4,864.00

Service Code	HCPCS C1887
Hospital Charge Code	270683676
Hospital Revenue Code	278
Min. Negotiated Rate	$729.60
Max. Negotiated Rate	$1,177.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$972.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,177.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,070.08
Rate for Payer: Qualcare PPO/HMO/WC	$729.60

CATHETER TRAILBLAZER .035X90CM

Facility

$4,864.00

Service Code	HCPCS C1887
Hospital Charge Code	270683676
Hospital Revenue Code	278
Min. Negotiated Rate	$117.22
Max. Negotiated Rate	$2,432.00
Rate for Payer: Aetna Commercial	$1,848.32
Rate for Payer: Aetna Medicare Advantage	$1,459.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,240.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,240.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$972.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,240.32
Rate for Payer: Cigna Commercial	$2,432.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,177.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,070.08
Rate for Payer: Qualcare PPO/HMO/WC	$729.60
Rate for Payer: UnitedHealthcare Community & State	$117.22
Rate for Payer: Wellpoint Medicaid Managed Care	$128.90

CATHETER TRAILBLAZER .14X150 C

Facility

$4,864.00

Service Code	HCPCS C1887
Hospital Charge Code	270683674
Hospital Revenue Code	278
Min. Negotiated Rate	$117.22
Max. Negotiated Rate	$2,432.00
Rate for Payer: Aetna Commercial	$1,848.32
Rate for Payer: Aetna Medicare Advantage	$1,459.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,240.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,240.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$972.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,240.32
Rate for Payer: Cigna Commercial	$2,432.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,177.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,070.08
Rate for Payer: Qualcare PPO/HMO/WC	$729.60
Rate for Payer: UnitedHealthcare Community & State	$117.22
Rate for Payer: Wellpoint Medicaid Managed Care	$128.90

CATHETER TRAILBLAZER .14X150 C

Facility

$4,864.00

Service Code	HCPCS C1887
Hospital Charge Code	270683674
Hospital Revenue Code	278
Min. Negotiated Rate	$729.60
Max. Negotiated Rate	$1,177.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$972.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,177.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,070.08
Rate for Payer: Qualcare PPO/HMO/WC	$729.60

CATHETER TRAILBLAZER.18X150 CM

Facility

$4,864.00

Service Code	HCPCS C1887
Hospital Charge Code	270683675
Hospital Revenue Code	278
Min. Negotiated Rate	$117.22
Max. Negotiated Rate	$2,432.00
Rate for Payer: Aetna Commercial	$1,848.32
Rate for Payer: Aetna Medicare Advantage	$1,459.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,240.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,240.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$972.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,240.32
Rate for Payer: Cigna Commercial	$2,432.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,177.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,070.08
Rate for Payer: Qualcare PPO/HMO/WC	$729.60
Rate for Payer: UnitedHealthcare Community & State	$117.22
Rate for Payer: Wellpoint Medicaid Managed Care	$128.90

CATHETER TRAILBLAZER.18X150 CM

Facility

$4,864.00

Service Code	HCPCS C1887
Hospital Charge Code	270683675
Hospital Revenue Code	278
Min. Negotiated Rate	$729.60
Max. Negotiated Rate	$1,177.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$972.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,177.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,070.08
Rate for Payer: Qualcare PPO/HMO/WC	$729.60

CATHETER TREK

Facility

$850.00

Hospital Charge Code	270907085
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 TREK

Facility

$850.00

Hospital Charge Code	270907085
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

CATHETER TREK

Facility

$850.00

Hospital Charge Code	2709007081
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 TREK

Facility

$850.00

Hospital Charge Code	2709007081
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

CATHETER TREK CORONARY

Facility

$850.00

Hospital Charge Code	2909007079
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 TREK CORONARY

Facility

$850.00

Hospital Charge Code	2909007079
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

CATHETER TREK CORONARY DILATAT

Facility

$500.00

Service Code	HCPCS C1725
Hospital Charge Code	270645255
Hospital Revenue Code	278
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

CATHETER TREK CORONARY DILATAT

Facility

$500.00

Service Code	HCPCS C1725
Hospital Charge Code	270645240
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

CATHETER TREK CORONARY DILATAT

Facility

$850.00

Service Code	HCPCS C1725
Hospital Charge Code	270645255S
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 TREK CORONARY DILATAT

Facility

$850.00

Service Code	HCPCS C1725
Hospital Charge Code	270645255S
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