Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATHET PERFORMA PRGRSVE CORONA

Facility

$57.50

Hospital Charge Code	270658258
Hospital Revenue Code	278
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$13.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.65
Rate for Payer: Qualcare PPO/HMO/WC	$8.62

CATHET PERFORMA PRGRSVE CORONA

Facility

$57.50

Hospital Charge Code	270658258
Hospital Revenue Code	278
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$28.75
Rate for Payer: Aetna Commercial	$21.85
Rate for Payer: Aetna Medicare Advantage	$17.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.66
Rate for Payer: Cigna Commercial	$28.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.65
Rate for Payer: Qualcare PPO/HMO/WC	$8.62
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.52

CATHETR BALLN ADMRLXTRME 6/40

Facility

$700.00

Service Code	HCPCS C1725
Hospital Charge Code	270657948
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

CATHETR BALLN ADMRLXTRME 6/40

Facility

$700.00

Service Code	HCPCS C1725
Hospital Charge Code	270657948
Hospital Revenue Code	278
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

CATHETR BALLN ADMRLXTRME 8/20

Facility

$700.00

Service Code	HCPCS C1725
Hospital Charge Code	270657951
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

CATHETR BALLN ADMRLXTRME 8/20

Facility

$700.00

Service Code	HCPCS C1725
Hospital Charge Code	270657951
Hospital Revenue Code	278
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

CATH EVD BACTISEAL 3MMX35CM

Facility

$4,080.00

Service Code	HCPCS C1729
Hospital Charge Code	270695431
Hospital Revenue Code	278
Min. Negotiated Rate	$98.33
Max. Negotiated Rate	$2,040.00
Rate for Payer: Aetna Commercial	$1,550.40
Rate for Payer: Aetna Medicare Advantage	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,040.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,040.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$816.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,040.40
Rate for Payer: Cigna Commercial	$2,040.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$987.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$897.60
Rate for Payer: Qualcare PPO/HMO/WC	$612.00
Rate for Payer: UnitedHealthcare Community & State	$98.33
Rate for Payer: Wellpoint Medicaid Managed Care	$108.12

CATH EVD BACTISEAL 3MMX35CM

Facility

$4,080.00

Service Code	HCPCS C1729
Hospital Charge Code	270695431
Hospital Revenue Code	278
Min. Negotiated Rate	$612.00
Max. Negotiated Rate	$987.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$816.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$987.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$897.60
Rate for Payer: Qualcare PPO/HMO/WC	$612.00

CATH EXCELSIOR SL 10PS 90

Facility

$5,463.75

Service Code	HCPCS C1887
Hospital Charge Code	270695281S
Hospital Revenue Code	278
Min. Negotiated Rate	$131.68
Max. Negotiated Rate	$2,731.88
Rate for Payer: Aetna Commercial	$2,076.22
Rate for Payer: Aetna Medicare Advantage	$1,639.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,393.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,393.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,092.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,393.26
Rate for Payer: Cigna Commercial	$2,731.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,322.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,202.03
Rate for Payer: Qualcare PPO/HMO/WC	$819.56
Rate for Payer: UnitedHealthcare Community & State	$131.68
Rate for Payer: Wellpoint Medicaid Managed Care	$144.79

CATH EXCELSIOR SL 10PS 90

Facility

$5,463.75

Service Code	HCPCS C1887
Hospital Charge Code	270695281S
Hospital Revenue Code	278
Min. Negotiated Rate	$819.56
Max. Negotiated Rate	$1,322.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,092.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,322.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,202.03
Rate for Payer: Qualcare PPO/HMO/WC	$819.56

CATH EXCELSIOR SL 2TIP 6X150CM

Facility

$5,027.25

Service Code	HCPCS C1887
Hospital Charge Code	270695280S
Hospital Revenue Code	272
Min. Negotiated Rate	$121.16
Max. Negotiated Rate	$2,513.62
Rate for Payer: Aetna Commercial	$1,910.36
Rate for Payer: Aetna Medicare Advantage	$1,508.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,281.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,281.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,281.95
Rate for Payer: Cigna Commercial	$2,513.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,508.17
Rate for Payer: Oxford Commercial	$1,005.45
Rate for Payer: Qualcare PPO/HMO/WC	$754.09
Rate for Payer: UnitedHealthcare Commercial	$1,005.45
Rate for Payer: UnitedHealthcare Community & State	$121.16
Rate for Payer: Wellpoint Medicaid Managed Care	$133.22

CATH EXCELSIOR SL 2TIP 6X150CM

Facility

$5,027.25

Service Code	HCPCS C1887
Hospital Charge Code	270695280S
Hospital Revenue Code	272
Min. Negotiated Rate	$754.09
Max. Negotiated Rate	$754.09
Rate for Payer: Qualcare PPO/HMO/WC	$754.09

CATH EXCELSIOR SL2TIP PSC6X150

Facility

$5,027.25

Service Code	HCPCS C1887
Hospital Charge Code	270695285S
Hospital Revenue Code	272
Min. Negotiated Rate	$754.09
Max. Negotiated Rate	$754.09
Rate for Payer: Qualcare PPO/HMO/WC	$754.09

CATH EXCELSIOR SL2TIP PSC6X150

Facility

$5,027.25

Service Code	HCPCS C1887
Hospital Charge Code	270695285S
Hospital Revenue Code	272
Min. Negotiated Rate	$121.16
Max. Negotiated Rate	$2,513.62
Rate for Payer: Aetna Commercial	$1,910.36
Rate for Payer: Aetna Medicare Advantage	$1,508.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,281.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,281.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,281.95
Rate for Payer: Cigna Commercial	$2,513.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,508.17
Rate for Payer: Oxford Commercial	$1,005.45
Rate for Payer: Qualcare PPO/HMO/WC	$754.09
Rate for Payer: UnitedHealthcare Commercial	$1,005.45
Rate for Payer: UnitedHealthcare Community & State	$121.16
Rate for Payer: Wellpoint Medicaid Managed Care	$133.22

CATH EXCELSIOR XT17PS457.5X150

Facility

$4,982.00

Service Code	HCPCS C1887
Hospital Charge Code	270695288S
Hospital Revenue Code	272
Min. Negotiated Rate	$120.07
Max. Negotiated Rate	$2,491.00
Rate for Payer: Aetna Commercial	$1,893.16
Rate for Payer: Aetna Medicare Advantage	$1,494.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,270.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,270.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,270.41
Rate for Payer: Cigna Commercial	$2,491.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,494.60
Rate for Payer: Oxford Commercial	$996.40
Rate for Payer: Qualcare PPO/HMO/WC	$747.30
Rate for Payer: UnitedHealthcare Commercial	$996.40
Rate for Payer: UnitedHealthcare Community & State	$120.07
Rate for Payer: Wellpoint Medicaid Managed Care	$132.02

CATH EXCELSIOR XT17PS457.5X150

Facility

$4,982.00

Service Code	HCPCS C1887
Hospital Charge Code	270695288S
Hospital Revenue Code	272
Min. Negotiated Rate	$747.30
Max. Negotiated Rate	$747.30
Rate for Payer: Qualcare PPO/HMO/WC	$747.30

CATH EXPO 6F FR3 110 08641-01A

Facility

$107.95

Hospital Charge Code	270629431
Hospital Revenue Code	272
Min. Negotiated Rate	$16.19
Max. Negotiated Rate	$16.19
Rate for Payer: Qualcare PPO/HMO/WC	$16.19

CATH EXPO 6F FR3 110 08641-01A

Facility

$107.95

Hospital Charge Code	270629431
Hospital Revenue Code	272
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$53.98
Rate for Payer: Aetna Commercial	$41.02
Rate for Payer: Aetna Medicare Advantage	$32.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.53
Rate for Payer: Cigna Commercial	$53.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.38
Rate for Payer: Oxford Commercial	$21.59
Rate for Payer: Qualcare PPO/HMO/WC	$16.19
Rate for Payer: UnitedHealthcare Commercial	$21.59
Rate for Payer: UnitedHealthcare Community & State	$2.60
Rate for Payer: Wellpoint Medicaid Managed Care	$2.86

CATH EXPO 6FR FL3 100 0864120B

Facility

$107.95

Hospital Charge Code	270633300
Hospital Revenue Code	272
Min. Negotiated Rate	$16.19
Max. Negotiated Rate	$16.19
Rate for Payer: Qualcare PPO/HMO/WC	$16.19

CATH EXPO 6FR FL3 100 0864120B

Facility

$107.95

Hospital Charge Code	270633300
Hospital Revenue Code	272
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$53.98
Rate for Payer: Aetna Commercial	$41.02
Rate for Payer: Aetna Medicare Advantage	$32.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.53
Rate for Payer: Cigna Commercial	$53.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.38
Rate for Payer: Oxford Commercial	$21.59
Rate for Payer: Qualcare PPO/HMO/WC	$16.19
Rate for Payer: UnitedHealthcare Commercial	$21.59
Rate for Payer: UnitedHealthcare Community & State	$2.60
Rate for Payer: Wellpoint Medicaid Managed Care	$2.86

CATH EXTERNAL****

Facility

$30.00

Hospital Charge Code	8001042
Hospital Revenue Code	279
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$15.00
Rate for Payer: Aetna Commercial	$11.40
Rate for Payer: Aetna Medicare Advantage	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.65
Rate for Payer: Cigna Commercial	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.00
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.50
Rate for Payer: UnitedHealthcare Commercial	$6.00
Rate for Payer: UnitedHealthcare Community & State	$0.72
Rate for Payer: Wellpoint Medicaid Managed Care	$0.80

CATH EXTERNAL****

Facility

$30.00

Hospital Charge Code	8001042
Hospital Revenue Code	279
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

CATH EXTERNAL ADULT SELF-ADHES

Facility

$5.42

Hospital Charge Code	270649431
Hospital Revenue Code	272
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$0.81
Rate for Payer: Qualcare PPO/HMO/WC	$0.81

CATH EXTERNAL ADULT SELF-ADHES

Facility

$5.42

Hospital Charge Code	270649431
Hospital Revenue Code	272
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.71
Rate for Payer: Aetna Commercial	$2.06
Rate for Payer: Aetna Medicare Advantage	$1.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.38
Rate for Payer: Cigna Commercial	$2.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.63
Rate for Payer: Oxford Commercial	$1.08
Rate for Payer: Qualcare PPO/HMO/WC	$0.81
Rate for Payer: UnitedHealthcare Commercial	$1.08
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

CATH EZM ANGIO 4F 90CM

Facility

$133.65

Hospital Charge Code	270601455
Hospital Revenue Code	272
Min. Negotiated Rate	$20.05
Max. Negotiated Rate	$20.05
Rate for Payer: Qualcare PPO/HMO/WC	$20.05

Know your out-of-pocket cost for care.

All Charges