Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH FLEXIMA BILIARY 10/35TT

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270652210
Hospital Revenue Code	278
Min. Negotiated Rate	$60.19
Max. Negotiated Rate	$97.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.28
Rate for Payer: Qualcare PPO/HMO/WC	$60.19

CATH FLEXIMA BILIARY 10/35TT

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270652210
Hospital Revenue Code	278
Min. Negotiated Rate	$9.67
Max. Negotiated Rate	$200.62
Rate for Payer: Aetna Commercial	$152.47
Rate for Payer: Aetna Medicare Advantage	$120.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.32
Rate for Payer: Cigna Commercial	$200.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.28
Rate for Payer: Qualcare PPO/HMO/WC	$60.19
Rate for Payer: UnitedHealthcare Community & State	$9.67
Rate for Payer: Wellpoint Medicaid Managed Care	$10.63

CATH FLEXIMA BILIARY 10FR 35CM

Facility

$399.95

Service Code	HCPCS C1729
Hospital Charge Code	270654389S
Hospital Revenue Code	278
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$199.97
Rate for Payer: Aetna Commercial	$151.98
Rate for Payer: Aetna Medicare Advantage	$119.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.99
Rate for Payer: Cigna Commercial	$199.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$87.99
Rate for Payer: Qualcare PPO/HMO/WC	$59.99
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.60

CATH FLEXIMA BILIARY 10FR 35CM

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270654389N
Hospital Revenue Code	278
Min. Negotiated Rate	$60.19
Max. Negotiated Rate	$97.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.28
Rate for Payer: Qualcare PPO/HMO/WC	$60.19

CATH FLEXIMA BILIARY 10FR 35CM

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270654389N
Hospital Revenue Code	278
Min. Negotiated Rate	$9.67
Max. Negotiated Rate	$200.62
Rate for Payer: Aetna Commercial	$152.47
Rate for Payer: Aetna Medicare Advantage	$120.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.32
Rate for Payer: Cigna Commercial	$200.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.28
Rate for Payer: Qualcare PPO/HMO/WC	$60.19
Rate for Payer: UnitedHealthcare Community & State	$9.67
Rate for Payer: Wellpoint Medicaid Managed Care	$10.63

CATH FLEXIMA BILIARY 10FR 35CM

Facility

$399.95

Service Code	HCPCS C1729
Hospital Charge Code	270654389S
Hospital Revenue Code	278
Min. Negotiated Rate	$59.99
Max. Negotiated Rate	$96.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$87.99
Rate for Payer: Qualcare PPO/HMO/WC	$59.99

CATH FLEXIMA BILIARY REG 10FR

Facility

$425.00

Service Code	HCPCS C1729
Hospital Charge Code	270624213
Hospital Revenue Code	278
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

CATH FLEXIMA BILIARY REG 10FR

Facility

$425.00

Service Code	HCPCS C1729
Hospital Charge Code	270624213
Hospital Revenue Code	278
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

CATH FLEXIMA BILIARY REG 12FR

Facility

$425.00

Service Code	HCPCS C1729
Hospital Charge Code	270624214
Hospital Revenue Code	278
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

CATH FLEXIMA BILIARY REG 12FR

Facility

$425.00

Service Code	HCPCS C1729
Hospital Charge Code	270624214
Hospital Revenue Code	278
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

CATH FLEXIMA BILIARY REG 14FR

Facility

$405.00

Service Code	HCPCS C1729
Hospital Charge Code	270625345
Hospital Revenue Code	278
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$98.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$89.10
Rate for Payer: Qualcare PPO/HMO/WC	$60.75

CATH FLEXIMA BILIARY REG 14FR

Facility

$405.00

Service Code	HCPCS C1729
Hospital Charge Code	270625345
Hospital Revenue Code	278
Min. Negotiated Rate	$9.76
Max. Negotiated Rate	$202.50
Rate for Payer: Aetna Commercial	$153.90
Rate for Payer: Aetna Medicare Advantage	$121.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$103.28
Rate for Payer: Cigna Commercial	$202.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$89.10
Rate for Payer: Qualcare PPO/HMO/WC	$60.75
Rate for Payer: UnitedHealthcare Community & State	$9.76
Rate for Payer: Wellpoint Medicaid Managed Care	$10.73

CATH FLEXIMA BILIARY REG 8FR

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270624212
Hospital Revenue Code	278
Min. Negotiated Rate	$9.67
Max. Negotiated Rate	$200.62
Rate for Payer: Aetna Commercial	$152.47
Rate for Payer: Aetna Medicare Advantage	$120.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.32
Rate for Payer: Cigna Commercial	$200.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.28
Rate for Payer: Qualcare PPO/HMO/WC	$60.19
Rate for Payer: UnitedHealthcare Community & State	$9.67
Rate for Payer: Wellpoint Medicaid Managed Care	$10.63

CATH FLEXIMA BILIARY REG 8FR

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270624212
Hospital Revenue Code	278
Min. Negotiated Rate	$60.19
Max. Negotiated Rate	$97.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.28
Rate for Payer: Qualcare PPO/HMO/WC	$60.19

CATH FLEXIMA NEPHROS REG 10FR

Facility

$425.00

Service Code	HCPCS C1729
Hospital Charge Code	270623766
Hospital Revenue Code	278
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

CATH FLEXIMA NEPHROS REG 10FR

Facility

$425.00

Service Code	HCPCS C1729
Hospital Charge Code	270623766
Hospital Revenue Code	278
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

CATH FLEXIMA NEPHROS REG 10FR

Facility

$399.95

Service Code	HCPCS C1729
Hospital Charge Code	270623766S
Hospital Revenue Code	278
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$199.97
Rate for Payer: Aetna Commercial	$151.98
Rate for Payer: Aetna Medicare Advantage	$119.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.99
Rate for Payer: Cigna Commercial	$199.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$87.99
Rate for Payer: Qualcare PPO/HMO/WC	$59.99
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.60

CATH FLEXIMA NEPHROS REG 10FR

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270623766N
Hospital Revenue Code	278
Min. Negotiated Rate	$60.19
Max. Negotiated Rate	$97.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.28
Rate for Payer: Qualcare PPO/HMO/WC	$60.19

CATH FLEXIMA NEPHROS REG 10FR

Facility

$399.95

Service Code	HCPCS C1729
Hospital Charge Code	270623766S
Hospital Revenue Code	278
Min. Negotiated Rate	$59.99
Max. Negotiated Rate	$96.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$87.99
Rate for Payer: Qualcare PPO/HMO/WC	$59.99

CATH FLEXIMA NEPHROS REG 10FR

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270623766N
Hospital Revenue Code	278
Min. Negotiated Rate	$9.67
Max. Negotiated Rate	$200.62
Rate for Payer: Aetna Commercial	$152.47
Rate for Payer: Aetna Medicare Advantage	$120.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.32
Rate for Payer: Cigna Commercial	$200.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.28
Rate for Payer: Qualcare PPO/HMO/WC	$60.19
Rate for Payer: UnitedHealthcare Community & State	$9.67
Rate for Payer: Wellpoint Medicaid Managed Care	$10.63

CATH FLEXIMA NEPHROS REG 12FR

Facility

$399.95

Service Code	HCPCS C1729
Hospital Charge Code	270623971S
Hospital Revenue Code	278
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$199.97
Rate for Payer: Aetna Commercial	$151.98
Rate for Payer: Aetna Medicare Advantage	$119.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.99
Rate for Payer: Cigna Commercial	$199.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$87.99
Rate for Payer: Qualcare PPO/HMO/WC	$59.99
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.60

CATH FLEXIMA NEPHROS REG 12FR

Facility

$425.00

Service Code	HCPCS C1729
Hospital Charge Code	270623971
Hospital Revenue Code	278
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

CATH FLEXIMA NEPHROS REG 12FR

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270623971N
Hospital Revenue Code	278
Min. Negotiated Rate	$60.19
Max. Negotiated Rate	$97.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.28
Rate for Payer: Qualcare PPO/HMO/WC	$60.19

CATH FLEXIMA NEPHROS REG 12FR

Facility

$425.00

Service Code	HCPCS C1729
Hospital Charge Code	270623971
Hospital Revenue Code	278
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

CATH FLEXIMA NEPHROS REG 12FR

Facility

$399.95

Service Code	HCPCS C1729
Hospital Charge Code	270623971S
Hospital Revenue Code	278
Min. Negotiated Rate	$59.99
Max. Negotiated Rate	$96.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$87.99
Rate for Payer: Qualcare PPO/HMO/WC	$59.99

Know your out-of-pocket cost for care.

All Charges