Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER VAXCEL DIALYSIS 14x23

Facility

$1,820.00

Hospital Charge Code	270651771
Hospital Revenue Code	272
Min. Negotiated Rate	$273.00
Max. Negotiated Rate	$273.00
Rate for Payer: Qualcare PPO/HMO/WC	$273.00

CATHETER VENTRICULAR BARI 35CM

Facility

$765.00

Hospital Charge Code	270669640
Hospital Revenue Code	278
Min. Negotiated Rate	$18.44
Max. Negotiated Rate	$382.50
Rate for Payer: Aetna Commercial	$290.70
Rate for Payer: Aetna Medicare Advantage	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.07
Rate for Payer: Cigna Commercial	$382.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$168.30
Rate for Payer: Qualcare PPO/HMO/WC	$114.75
Rate for Payer: UnitedHealthcare Community & State	$18.44
Rate for Payer: Wellpoint Medicaid Managed Care	$20.27

CATHETER VENTRICULAR BARI 35CM

Facility

$765.00

Hospital Charge Code	270669640
Hospital Revenue Code	278
Min. Negotiated Rate	$114.75
Max. Negotiated Rate	$185.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$168.30
Rate for Payer: Qualcare PPO/HMO/WC	$114.75

CATHETER VISION PV .035 IVUS

Facility

$4,750.00

Service Code	HCPCS C1753
Hospital Charge Code	270688658
Hospital Revenue Code	278
Min. Negotiated Rate	$114.47
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,805.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,045.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Community & State	$114.47
Rate for Payer: Wellpoint Medicaid Managed Care	$125.88

CATHETER VISION PV .035 IVUS

Facility

$4,750.00

Service Code	HCPCS C1753
Hospital Charge Code	270688658
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,045.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

CATHETER VISIPRO 8 X 37X 40

Facility

$5,198.90

Service Code	HCPCS C1876
Hospital Charge Code	270692310
Hospital Revenue Code	278
Min. Negotiated Rate	$779.84
Max. Negotiated Rate	$1,258.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,143.76
Rate for Payer: Qualcare PPO/HMO/WC	$779.84

CATHETER VISIPRO 8 X 37X 40

Facility

$5,198.90

Service Code	HCPCS C1876
Hospital Charge Code	270692310
Hospital Revenue Code	278
Min. Negotiated Rate	$125.29
Max. Negotiated Rate	$2,599.45
Rate for Payer: Aetna Commercial	$1,975.58
Rate for Payer: Aetna Medicare Advantage	$1,559.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,325.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,325.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,325.72
Rate for Payer: Cigna Commercial	$2,599.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,143.76
Rate for Payer: Qualcare PPO/HMO/WC	$779.84
Rate for Payer: UnitedHealthcare Community & State	$125.29
Rate for Payer: Wellpoint Medicaid Managed Care	$137.77

CATHETER VOLCANO PV 0.018

Facility

$3,775.00

Hospital Charge Code	270647773
Hospital Revenue Code	272
Min. Negotiated Rate	$90.98
Max. Negotiated Rate	$1,887.50
Rate for Payer: Aetna Commercial	$1,434.50
Rate for Payer: Aetna Medicare Advantage	$1,132.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$962.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$962.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$962.62
Rate for Payer: Cigna Commercial	$1,887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,132.50
Rate for Payer: Oxford Commercial	$755.00
Rate for Payer: Qualcare PPO/HMO/WC	$566.25
Rate for Payer: UnitedHealthcare Commercial	$755.00
Rate for Payer: UnitedHealthcare Community & State	$90.98
Rate for Payer: Wellpoint Medicaid Managed Care	$100.04

CATHETER VOLCANO PV 0.018

Facility

$3,775.00

Hospital Charge Code	270647773
Hospital Revenue Code	272
Min. Negotiated Rate	$566.25
Max. Negotiated Rate	$566.25
Rate for Payer: Qualcare PPO/HMO/WC	$566.25

CATHETER WORD BARTHOLIN 10F

Facility

$131.90

Hospital Charge Code	270654027
Hospital Revenue Code	278
Min. Negotiated Rate	$19.79
Max. Negotiated Rate	$31.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.02
Rate for Payer: Qualcare PPO/HMO/WC	$19.79

CATHETER WORD BARTHOLIN 10F

Facility

$131.90

Hospital Charge Code	270654027
Hospital Revenue Code	278
Min. Negotiated Rate	$3.18
Max. Negotiated Rate	$65.95
Rate for Payer: Aetna Commercial	$50.12
Rate for Payer: Aetna Medicare Advantage	$39.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.63
Rate for Payer: Cigna Commercial	$65.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.02
Rate for Payer: Qualcare PPO/HMO/WC	$19.79
Rate for Payer: UnitedHealthcare Community & State	$3.18
Rate for Payer: Wellpoint Medicaid Managed Care	$3.50

CATHETER XCEL

Facility

$1,025.00

Hospital Charge Code	270697249S
Hospital Revenue Code	272
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$153.75
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

CATHETER XCEL

Facility

$1,025.00

Hospital Charge Code	270697249S
Hospital Revenue Code	272
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$389.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.50
Rate for Payer: Oxford Commercial	$205.00
Rate for Payer: Qualcare PPO/HMO/WC	$153.75
Rate for Payer: UnitedHealthcare Commercial	$205.00
Rate for Payer: UnitedHealthcare Community & State	$24.70
Rate for Payer: Wellpoint Medicaid Managed Care	$27.16

CATHETER ZILVER PTX 6MM X 140M

Facility

$11,975.00

Service Code	HCPCS C1874
Hospital Charge Code	270682885
Hospital Revenue Code	278
Min. Negotiated Rate	$288.60
Max. Negotiated Rate	$5,987.50
Rate for Payer: Aetna Commercial	$4,550.50
Rate for Payer: Aetna Medicare Advantage	$3,592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,053.62
Rate for Payer: Cigna Commercial	$5,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,634.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25
Rate for Payer: UnitedHealthcare Community & State	$288.60
Rate for Payer: Wellpoint Medicaid Managed Care	$317.34

CATHETER ZILVER PTX 6MM X 140M

Facility

$11,975.00

Service Code	HCPCS C1874
Hospital Charge Code	270682885
Hospital Revenue Code	278
Min. Negotiated Rate	$1,796.25
Max. Negotiated Rate	$2,897.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,634.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25

CATHETER ZILVER PTX 7MMX140MM

Facility

$11,975.00

Service Code	HCPCS C1874
Hospital Charge Code	270682884N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,796.25
Max. Negotiated Rate	$2,897.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,634.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25

CATHETER ZILVER PTX 7MMX140MM

Facility

$11,975.00

Service Code	HCPCS C1874
Hospital Charge Code	270682884
Hospital Revenue Code	278
Min. Negotiated Rate	$288.60
Max. Negotiated Rate	$5,987.50
Rate for Payer: Aetna Commercial	$4,550.50
Rate for Payer: Aetna Medicare Advantage	$3,592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,053.62
Rate for Payer: Cigna Commercial	$5,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,634.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25
Rate for Payer: UnitedHealthcare Community & State	$288.60
Rate for Payer: Wellpoint Medicaid Managed Care	$317.34

CATHETER ZILVER PTX 7MMX140MM

Facility

$11,975.00

Service Code	HCPCS C1874
Hospital Charge Code	270682884N
Hospital Revenue Code	278
Min. Negotiated Rate	$288.60
Max. Negotiated Rate	$5,987.50
Rate for Payer: Aetna Commercial	$4,550.50
Rate for Payer: Aetna Medicare Advantage	$3,592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,053.62
Rate for Payer: Cigna Commercial	$5,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,634.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25
Rate for Payer: UnitedHealthcare Community & State	$288.60
Rate for Payer: Wellpoint Medicaid Managed Care	$317.34

CATHETER ZILVER PTX 7MMX140MM

Facility

$11,975.00

Service Code	HCPCS C1874
Hospital Charge Code	270682884
Hospital Revenue Code	278
Min. Negotiated Rate	$1,796.25
Max. Negotiated Rate	$2,897.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,634.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25

CATHETHER 6F LCB

Facility

$47.50

Hospital Charge Code	2709000321
Hospital Revenue Code	272
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$7.12
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

CATHETHER 6F LCB

Facility

$47.50

Hospital Charge Code	2709000321
Hospital Revenue Code	272
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$23.75
Rate for Payer: Aetna Commercial	$18.05
Rate for Payer: Aetna Medicare Advantage	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.11
Rate for Payer: Cigna Commercial	$23.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.25
Rate for Payer: Oxford Commercial	$9.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.12
Rate for Payer: UnitedHealthcare Commercial	$9.50
Rate for Payer: UnitedHealthcare Community & State	$1.14
Rate for Payer: Wellpoint Medicaid Managed Care	$1.26

CATHETHER BALLOON UT/SDS OTW

Facility

$1,355.00

Hospital Charge Code	270653592
Hospital Revenue Code	278
Min. Negotiated Rate	$203.25
Max. Negotiated Rate	$327.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$271.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$327.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$298.10
Rate for Payer: Qualcare PPO/HMO/WC	$203.25

CATHETHER BALLOON UT/SDS OTW

Facility

$1,355.00

Hospital Charge Code	270653592
Hospital Revenue Code	278
Min. Negotiated Rate	$32.66
Max. Negotiated Rate	$677.50
Rate for Payer: Aetna Commercial	$514.90
Rate for Payer: Aetna Medicare Advantage	$406.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$345.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$345.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$271.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$345.52
Rate for Payer: Cigna Commercial	$677.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$327.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$298.10
Rate for Payer: Qualcare PPO/HMO/WC	$203.25
Rate for Payer: UnitedHealthcare Community & State	$32.66
Rate for Payer: Wellpoint Medicaid Managed Care	$35.91

CATHETHER BALLOON UT/SDS OTW

Facility

$1,020.00

Hospital Charge Code	270653599
Hospital Revenue Code	278
Min. Negotiated Rate	$24.58
Max. Negotiated Rate	$510.00
Rate for Payer: Aetna Commercial	$387.60
Rate for Payer: Aetna Medicare Advantage	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.10
Rate for Payer: Cigna Commercial	$510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$224.40
Rate for Payer: Qualcare PPO/HMO/WC	$153.00
Rate for Payer: UnitedHealthcare Community & State	$24.58
Rate for Payer: Wellpoint Medicaid Managed Care	$27.03

CATHETHER BALLOON UT/SDS OTW

Facility

$1,020.00

Hospital Charge Code	270653599
Hospital Revenue Code	278
Min. Negotiated Rate	$153.00
Max. Negotiated Rate	$246.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$224.40
Rate for Payer: Qualcare PPO/HMO/WC	$153.00

Know your out-of-pocket cost for care.

All Charges