Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER URETERAL 5FR WHISTLE

Facility

$180.00

Hospital Charge Code	270331568
Hospital Revenue Code	278
Min. Negotiated Rate	$4.34
Max. Negotiated Rate	$90.00
Rate for Payer: Aetna Commercial	$68.40
Rate for Payer: Aetna Medicare Advantage	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.90
Rate for Payer: Cigna Commercial	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$39.60
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Community & State	$4.34
Rate for Payer: Wellpoint Medicaid Managed Care	$4.77

CATHETER URETERAL 5FR WHISTLE

Facility

$180.00

Hospital Charge Code	270331568
Hospital Revenue Code	278
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$43.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$39.60
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

CATHETER URETERAL 6FR OLIVETIP

Facility

$49.73

Hospital Charge Code	270658726
Hospital Revenue Code	270
Min. Negotiated Rate	$7.46
Max. Negotiated Rate	$7.46
Rate for Payer: Qualcare PPO/HMO/WC	$7.46

CATHETER URETERAL 6FR OLIVETIP

Facility

$49.73

Hospital Charge Code	270658726
Hospital Revenue Code	270
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$24.86
Rate for Payer: Aetna Commercial	$18.90
Rate for Payer: Aetna Medicare Advantage	$14.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.68
Rate for Payer: Cigna Commercial	$24.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.92
Rate for Payer: Oxford Commercial	$9.95
Rate for Payer: Qualcare PPO/HMO/WC	$7.46
Rate for Payer: UnitedHealthcare Commercial	$9.95
Rate for Payer: UnitedHealthcare Community & State	$1.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

CATHETER URETERAL CONE TIP

Facility

$614.25

Service Code	HCPCS C1758
Hospital Charge Code	270689505
Hospital Revenue Code	272
Min. Negotiated Rate	$14.80
Max. Negotiated Rate	$307.12
Rate for Payer: Aetna Commercial	$233.41
Rate for Payer: Aetna Medicare Advantage	$184.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.63
Rate for Payer: Cigna Commercial	$307.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.28
Rate for Payer: Oxford Commercial	$122.85
Rate for Payer: Qualcare PPO/HMO/WC	$92.14
Rate for Payer: UnitedHealthcare Commercial	$122.85
Rate for Payer: UnitedHealthcare Community & State	$14.80
Rate for Payer: Wellpoint Medicaid Managed Care	$16.28

CATHETER URETERAL CONE TIP

Facility

$614.25

Service Code	HCPCS C1758
Hospital Charge Code	270689505
Hospital Revenue Code	272
Min. Negotiated Rate	$92.14
Max. Negotiated Rate	$92.14
Rate for Payer: Qualcare PPO/HMO/WC	$92.14

CATHETER URETERAL OPEN END 5FR

Facility

$500.50

Hospital Charge Code	270684725
Hospital Revenue Code	272
Min. Negotiated Rate	$12.06
Max. Negotiated Rate	$250.25
Rate for Payer: Aetna Commercial	$190.19
Rate for Payer: Aetna Medicare Advantage	$150.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.63
Rate for Payer: Cigna Commercial	$250.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.15
Rate for Payer: Oxford Commercial	$100.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.08
Rate for Payer: UnitedHealthcare Commercial	$100.10
Rate for Payer: UnitedHealthcare Community & State	$12.06
Rate for Payer: Wellpoint Medicaid Managed Care	$13.26

CATHETER URETERAL OPEN END 5FR

Facility

$500.50

Hospital Charge Code	270684725
Hospital Revenue Code	272
Min. Negotiated Rate	$75.08
Max. Negotiated Rate	$75.08
Rate for Payer: Qualcare PPO/HMO/WC	$75.08

CATHETER URETERAL OPEN END 6FR

Facility

$80.56

Hospital Charge Code	270675130
Hospital Revenue Code	272
Min. Negotiated Rate	$1.94
Max. Negotiated Rate	$40.28
Rate for Payer: Aetna Commercial	$30.61
Rate for Payer: Aetna Medicare Advantage	$24.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.54
Rate for Payer: Cigna Commercial	$40.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.17
Rate for Payer: Oxford Commercial	$16.11
Rate for Payer: Qualcare PPO/HMO/WC	$12.08
Rate for Payer: UnitedHealthcare Commercial	$16.11
Rate for Payer: UnitedHealthcare Community & State	$1.94
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

CATHETER URETERAL OPEN END 6FR

Facility

$80.56

Hospital Charge Code	270675130
Hospital Revenue Code	272
Min. Negotiated Rate	$12.08
Max. Negotiated Rate	$12.08
Rate for Payer: Qualcare PPO/HMO/WC	$12.08

CATHETER URETERAL TIP 8 CONE

Facility

$262.15

Hospital Charge Code	270658469
Hospital Revenue Code	272
Min. Negotiated Rate	$39.32
Max. Negotiated Rate	$39.32
Rate for Payer: Qualcare PPO/HMO/WC	$39.32

CATHETER URETERAL TIP 8 CONE

Facility

$262.15

Hospital Charge Code	270658469
Hospital Revenue Code	272
Min. Negotiated Rate	$6.32
Max. Negotiated Rate	$131.07
Rate for Payer: Aetna Commercial	$99.62
Rate for Payer: Aetna Medicare Advantage	$78.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.85
Rate for Payer: Cigna Commercial	$131.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.64
Rate for Payer: Oxford Commercial	$52.43
Rate for Payer: Qualcare PPO/HMO/WC	$39.32
Rate for Payer: UnitedHealthcare Commercial	$52.43
Rate for Payer: UnitedHealthcare Community & State	$6.32
Rate for Payer: Wellpoint Medicaid Managed Care	$6.95

CATHETER URETHAL 2 EYE 8 FR.

Facility

$22.00

Hospital Charge Code	270331351
Hospital Revenue Code	272
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$11.00
Rate for Payer: Aetna Commercial	$8.36
Rate for Payer: Aetna Medicare Advantage	$6.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.61
Rate for Payer: Cigna Commercial	$11.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.60
Rate for Payer: Oxford Commercial	$4.40
Rate for Payer: Qualcare PPO/HMO/WC	$3.30
Rate for Payer: UnitedHealthcare Commercial	$4.40
Rate for Payer: UnitedHealthcare Community & State	$0.53
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

CATHETER URETHAL 2 EYE 8 FR.

Facility

$22.00

Hospital Charge Code	270331351
Hospital Revenue Code	272
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$3.30
Rate for Payer: Qualcare PPO/HMO/WC	$3.30

CATHETER URETHRAL 2 EYE 18FR

Facility

$22.00

Hospital Charge Code	270331352
Hospital Revenue Code	272
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$3.30
Rate for Payer: Qualcare PPO/HMO/WC	$3.30

CATHETER URETHRAL 2 EYE 18FR

Facility

$22.00

Hospital Charge Code	270331352
Hospital Revenue Code	272
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$11.00
Rate for Payer: Aetna Commercial	$8.36
Rate for Payer: Aetna Medicare Advantage	$6.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.61
Rate for Payer: Cigna Commercial	$11.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.60
Rate for Payer: Oxford Commercial	$4.40
Rate for Payer: Qualcare PPO/HMO/WC	$3.30
Rate for Payer: UnitedHealthcare Commercial	$4.40
Rate for Payer: UnitedHealthcare Community & State	$0.53
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

CATHETER URETHRAL 4FR WHISTLE

Facility

$148.00

Hospital Charge Code	270331565
Hospital Revenue Code	272
Min. Negotiated Rate	$3.57
Max. Negotiated Rate	$74.00
Rate for Payer: Aetna Commercial	$56.24
Rate for Payer: Aetna Medicare Advantage	$44.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.74
Rate for Payer: Cigna Commercial	$74.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.40
Rate for Payer: Oxford Commercial	$29.60
Rate for Payer: Qualcare PPO/HMO/WC	$22.20
Rate for Payer: UnitedHealthcare Commercial	$29.60
Rate for Payer: UnitedHealthcare Community & State	$3.57
Rate for Payer: Wellpoint Medicaid Managed Care	$3.92

CATHETER URETHRAL 4FR WHISTLE

Facility

$148.00

Hospital Charge Code	270331565
Hospital Revenue Code	272
Min. Negotiated Rate	$22.20
Max. Negotiated Rate	$22.20
Rate for Payer: Qualcare PPO/HMO/WC	$22.20

CATHETER URETHRAL 6FR WHISTLE

Facility

$151.00

Hospital Charge Code	270331581
Hospital Revenue Code	272
Min. Negotiated Rate	$22.65
Max. Negotiated Rate	$22.65
Rate for Payer: Qualcare PPO/HMO/WC	$22.65

CATHETER URETHRAL 6FR WHISTLE

Facility

$151.00

Hospital Charge Code	270331581
Hospital Revenue Code	272
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$75.50
Rate for Payer: Aetna Commercial	$57.38
Rate for Payer: Aetna Medicare Advantage	$45.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.51
Rate for Payer: Cigna Commercial	$75.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.30
Rate for Payer: Oxford Commercial	$30.20
Rate for Payer: Qualcare PPO/HMO/WC	$22.65
Rate for Payer: UnitedHealthcare Commercial	$30.20
Rate for Payer: UnitedHealthcare Community & State	$3.64
Rate for Payer: Wellpoint Medicaid Managed Care	$4.00

CATHETER URETHRAL OLIVE TIP 4F

Facility

$154.00

Hospital Charge Code	270331583
Hospital Revenue Code	272
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$77.00
Rate for Payer: Aetna Commercial	$58.52
Rate for Payer: Aetna Medicare Advantage	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.27
Rate for Payer: Cigna Commercial	$77.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.20
Rate for Payer: Oxford Commercial	$30.80
Rate for Payer: Qualcare PPO/HMO/WC	$23.10
Rate for Payer: UnitedHealthcare Commercial	$30.80
Rate for Payer: UnitedHealthcare Community & State	$3.71
Rate for Payer: Wellpoint Medicaid Managed Care	$4.08

CATHETER URETHRAL OLIVE TIP 4F

Facility

$154.00

Hospital Charge Code	270331583
Hospital Revenue Code	272
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

CATHETER URETHRAL OLIVE TIP 6F

Facility

$125.00

Hospital Charge Code	270331589
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

CATHETER URETHRAL OLIVE TIP 6F

Facility

$125.00

Hospital Charge Code	270331589
Hospital Revenue Code	272
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$25.00
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

CATHETER VAXCEL DIALYSIS 14x23

Facility

$1,820.00

Hospital Charge Code	270651771
Hospital Revenue Code	272
Min. Negotiated Rate	$43.86
Max. Negotiated Rate	$910.00
Rate for Payer: Aetna Commercial	$691.60
Rate for Payer: Aetna Medicare Advantage	$546.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$464.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$464.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$464.10
Rate for Payer: Cigna Commercial	$910.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$546.00
Rate for Payer: Oxford Commercial	$364.00
Rate for Payer: Qualcare PPO/HMO/WC	$273.00
Rate for Payer: UnitedHealthcare Commercial	$364.00
Rate for Payer: UnitedHealthcare Community & State	$43.86
Rate for Payer: Wellpoint Medicaid Managed Care	$48.23

Know your out-of-pocket cost for care.

All Charges