Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH FLEXIMA NEPHROS REG 12FR

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270623971N
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 14FR

Facility

$395.00

Service Code	HCPCS C1729
Hospital Charge Code	270624215
Hospital Revenue Code	278
Min. Negotiated Rate	$59.25
Max. Negotiated Rate	$95.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$86.90
Rate for Payer: Qualcare PPO/HMO/WC	$59.25

CATH FLEXIMA NEPHROS REG 14FR

Facility

$395.00

Service Code	HCPCS C1729
Hospital Charge Code	270624215
Hospital Revenue Code	278
Min. Negotiated Rate	$9.52
Max. Negotiated Rate	$197.50
Rate for Payer: Aetna Commercial	$150.10
Rate for Payer: Aetna Medicare Advantage	$118.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.72
Rate for Payer: Cigna Commercial	$197.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$86.90
Rate for Payer: Qualcare PPO/HMO/WC	$59.25
Rate for Payer: UnitedHealthcare Community & State	$9.52
Rate for Payer: Wellpoint Medicaid Managed Care	$10.47

CATH FLEXIMA NEPHROS REG 8FR

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270601342N
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 8FR

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270601342N
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 8FR

Facility

$399.95

Service Code	HCPCS C1729
Hospital Charge Code	270601342
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 8FR

Facility

$399.95

Service Code	HCPCS C1729
Hospital Charge Code	270601342
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 8FR

Facility

$399.95

Service Code	HCPCS C1729
Hospital Charge Code	270601342S
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 8FR

Facility

$399.95

Service Code	HCPCS C1729
Hospital Charge Code	270601342S
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 FOGARTY 140806 ******

Facility

$390.00

Hospital Charge Code	1608371
Hospital Revenue Code	272
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$78.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$78.00
Rate for Payer: UnitedHealthcare Community & State	$9.40
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CATH FOGARTY 140806 ******

Facility

$390.00

Hospital Charge Code	1608371
Hospital Revenue Code	272
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CATH FOGARTY 140808 *******

Facility

$390.00

Hospital Charge Code	1608389
Hospital Revenue Code	272
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CATH FOGARTY 140808 *******

Facility

$390.00

Hospital Charge Code	1608389
Hospital Revenue Code	272
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$78.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$78.00
Rate for Payer: UnitedHealthcare Community & State	$9.40
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CATH FOGARTY BILIARY PROBE 3FR

Facility

$272.60

Hospital Charge Code	270651002
Hospital Revenue Code	272
Min. Negotiated Rate	$6.57
Max. Negotiated Rate	$136.30
Rate for Payer: Aetna Commercial	$103.59
Rate for Payer: Aetna Medicare Advantage	$81.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.51
Rate for Payer: Cigna Commercial	$136.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.78
Rate for Payer: Oxford Commercial	$54.52
Rate for Payer: Qualcare PPO/HMO/WC	$40.89
Rate for Payer: UnitedHealthcare Commercial	$54.52
Rate for Payer: UnitedHealthcare Community & State	$6.57
Rate for Payer: Wellpoint Medicaid Managed Care	$7.22

CATH FOGARTY BILIARY PROBE 3FR

Facility

$272.60

Hospital Charge Code	270651002
Hospital Revenue Code	272
Min. Negotiated Rate	$40.89
Max. Negotiated Rate	$40.89
Rate for Payer: Qualcare PPO/HMO/WC	$40.89

CATH FOGARTY EMBOLECTOMY 4FR

Facility

$382.50

Service Code	HCPCS C1757
Hospital Charge Code	270655969
Hospital Revenue Code	278
Min. Negotiated Rate	$9.22
Max. Negotiated Rate	$191.25
Rate for Payer: Aetna Commercial	$145.35
Rate for Payer: Aetna Medicare Advantage	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.54
Rate for Payer: Cigna Commercial	$191.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$84.15
Rate for Payer: Qualcare PPO/HMO/WC	$57.38
Rate for Payer: UnitedHealthcare Community & State	$9.22
Rate for Payer: Wellpoint Medicaid Managed Care	$10.14

CATH FOGARTY EMBOLECTOMY 4FR

Facility

$382.50

Service Code	HCPCS C1757
Hospital Charge Code	270655969
Hospital Revenue Code	278
Min. Negotiated Rate	$57.38
Max. Negotiated Rate	$92.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$84.15
Rate for Payer: Qualcare PPO/HMO/WC	$57.38

CATH FOGARTY IRRIG 4FR 220804F

Facility

$131.45

Hospital Charge Code	270600385
Hospital Revenue Code	272
Min. Negotiated Rate	$19.72
Max. Negotiated Rate	$19.72
Rate for Payer: Qualcare PPO/HMO/WC	$19.72

CATH FOGARTY IRRIG 4FR 220804F

Facility

$131.45

Hospital Charge Code	270600385
Hospital Revenue Code	272
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$65.72
Rate for Payer: Aetna Commercial	$49.95
Rate for Payer: Aetna Medicare Advantage	$39.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.52
Rate for Payer: Cigna Commercial	$65.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.44
Rate for Payer: Oxford Commercial	$26.29
Rate for Payer: Qualcare PPO/HMO/WC	$19.72
Rate for Payer: UnitedHealthcare Commercial	$26.29
Rate for Payer: UnitedHealthcare Community & State	$3.17
Rate for Payer: Wellpoint Medicaid Managed Care	$3.48

CATH FOGARTY IRRIG 6FR 220806F

Facility

$195.50

Hospital Charge Code	270600386
Hospital Revenue Code	272
Min. Negotiated Rate	$4.71
Max. Negotiated Rate	$97.75
Rate for Payer: Aetna Commercial	$74.29
Rate for Payer: Aetna Medicare Advantage	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.85
Rate for Payer: Cigna Commercial	$97.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.65
Rate for Payer: Oxford Commercial	$39.10
Rate for Payer: Qualcare PPO/HMO/WC	$29.32
Rate for Payer: UnitedHealthcare Commercial	$39.10
Rate for Payer: UnitedHealthcare Community & State	$4.71
Rate for Payer: Wellpoint Medicaid Managed Care	$5.18

CATH FOGARTY IRRIG 6FR 220806F

Facility

$195.50

Hospital Charge Code	270600386
Hospital Revenue Code	272
Min. Negotiated Rate	$29.32
Max. Negotiated Rate	$29.32
Rate for Payer: Qualcare PPO/HMO/WC	$29.32

CATH FOGATY TL 5F 0364LW405F35

Facility

$526.90

Hospital Charge Code	270636106V
Hospital Revenue Code	278
Min. Negotiated Rate	$12.70
Max. Negotiated Rate	$263.45
Rate for Payer: Aetna Commercial	$200.22
Rate for Payer: Aetna Medicare Advantage	$158.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$134.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$134.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$134.36
Rate for Payer: Cigna Commercial	$263.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.92
Rate for Payer: Qualcare PPO/HMO/WC	$79.03
Rate for Payer: UnitedHealthcare Community & State	$12.70
Rate for Payer: Wellpoint Medicaid Managed Care	$13.96

CATH FOGATY TL 5F 0364LW405F35

Facility

$526.90

Hospital Charge Code	270636106V
Hospital Revenue Code	278
Min. Negotiated Rate	$79.03
Max. Negotiated Rate	$127.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.92
Rate for Payer: Qualcare PPO/HMO/WC	$79.03

CATH FOGY LUMN 5F 0364lW405F35

Facility

$442.55

Service Code	HCPCS C1887
Hospital Charge Code	270636106
Hospital Revenue Code	278
Min. Negotiated Rate	$66.38
Max. Negotiated Rate	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$97.36
Rate for Payer: Qualcare PPO/HMO/WC	$66.38

CATH FOGY LUMN 5F 0364lW405F35

Facility

$442.55

Service Code	HCPCS C1887
Hospital Charge Code	270636106
Hospital Revenue Code	278
Min. Negotiated Rate	$10.67
Max. Negotiated Rate	$221.28
Rate for Payer: Aetna Commercial	$168.17
Rate for Payer: Aetna Medicare Advantage	$132.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.85
Rate for Payer: Cigna Commercial	$221.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$97.36
Rate for Payer: Qualcare PPO/HMO/WC	$66.38
Rate for Payer: UnitedHealthcare Community & State	$10.67
Rate for Payer: Wellpoint Medicaid Managed Care	$11.73

Know your out-of-pocket cost for care.

All Charges