Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH FOLEY COUDE 20FR 5cc 2W

Facility

$76.38

Service Code	HCPCS C1887
Hospital Charge Code	270649856
Hospital Revenue Code	278
Min. Negotiated Rate	$1.84
Max. Negotiated Rate	$38.19
Rate for Payer: Aetna Commercial	$29.02
Rate for Payer: Aetna Medicare Advantage	$22.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.48
Rate for Payer: Cigna Commercial	$38.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.80
Rate for Payer: Qualcare PPO/HMO/WC	$11.46
Rate for Payer: UnitedHealthcare Community & State	$1.84
Rate for Payer: Wellpoint Medicaid Managed Care	$2.02

CATH FOLEY COUDE 20FR 5cc 2W

Facility

$76.38

Service Code	HCPCS C1887
Hospital Charge Code	270649856
Hospital Revenue Code	278
Min. Negotiated Rate	$11.46
Max. Negotiated Rate	$18.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.80
Rate for Payer: Qualcare PPO/HMO/WC	$11.46

CATH FOLEY COUDE 22FR 5cc 2W

Facility

$72.53

Hospital Charge Code	270650056
Hospital Revenue Code	272
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$10.88
Rate for Payer: Qualcare PPO/HMO/WC	$10.88

CATH FOLEY COUDE 22FR 5cc 2W

Facility

$72.53

Hospital Charge Code	270650056
Hospital Revenue Code	272
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$36.27
Rate for Payer: Aetna Commercial	$27.56
Rate for Payer: Aetna Medicare Advantage	$21.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.50
Rate for Payer: Cigna Commercial	$36.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.76
Rate for Payer: Oxford Commercial	$14.51
Rate for Payer: Qualcare PPO/HMO/WC	$10.88
Rate for Payer: UnitedHealthcare Commercial	$14.51
Rate for Payer: UnitedHealthcare Community & State	$1.75
Rate for Payer: Wellpoint Medicaid Managed Care	$1.92

CATH FOLEY COUDE 24FR 2WAY

Facility

$72.53

Hospital Charge Code	270649859
Hospital Revenue Code	272
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$36.27
Rate for Payer: Aetna Commercial	$27.56
Rate for Payer: Aetna Medicare Advantage	$21.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.50
Rate for Payer: Cigna Commercial	$36.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.76
Rate for Payer: Oxford Commercial	$14.51
Rate for Payer: Qualcare PPO/HMO/WC	$10.88
Rate for Payer: UnitedHealthcare Commercial	$14.51
Rate for Payer: UnitedHealthcare Community & State	$1.75
Rate for Payer: Wellpoint Medicaid Managed Care	$1.92

CATH FOLEY COUDE 24FR 2WAY

Facility

$72.53

Hospital Charge Code	270649859
Hospital Revenue Code	272
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$10.88
Rate for Payer: Qualcare PPO/HMO/WC	$10.88

CATH FOLEY COUDE 5CC 16FR 2W

Facility

$72.70

Hospital Charge Code	270649023
Hospital Revenue Code	270
Min. Negotiated Rate	$10.90
Max. Negotiated Rate	$10.90
Rate for Payer: Qualcare PPO/HMO/WC	$10.90

CATH FOLEY COUDE 5CC 16FR 2W

Facility

$72.70

Hospital Charge Code	270649023
Hospital Revenue Code	270
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$36.35
Rate for Payer: Aetna Commercial	$27.63
Rate for Payer: Aetna Medicare Advantage	$21.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.54
Rate for Payer: Cigna Commercial	$36.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.81
Rate for Payer: Oxford Commercial	$14.54
Rate for Payer: Qualcare PPO/HMO/WC	$10.90
Rate for Payer: UnitedHealthcare Commercial	$14.54
Rate for Payer: UnitedHealthcare Community & State	$1.75
Rate for Payer: Wellpoint Medicaid Managed Care	$1.93

CATH FOLEY COUDE 5CC 18FR 2W

Facility

$72.81

Hospital Charge Code	270649024
Hospital Revenue Code	270
Min. Negotiated Rate	$10.92
Max. Negotiated Rate	$10.92
Rate for Payer: Qualcare PPO/HMO/WC	$10.92

CATH FOLEY COUDE 5CC 18FR 2W

Facility

$72.81

Hospital Charge Code	270649024
Hospital Revenue Code	270
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$36.41
Rate for Payer: Aetna Commercial	$27.67
Rate for Payer: Aetna Medicare Advantage	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.57
Rate for Payer: Cigna Commercial	$36.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.84
Rate for Payer: Oxford Commercial	$14.56
Rate for Payer: Qualcare PPO/HMO/WC	$10.92
Rate for Payer: UnitedHealthcare Commercial	$14.56
Rate for Payer: UnitedHealthcare Community & State	$1.75
Rate for Payer: Wellpoint Medicaid Managed Care	$1.93

CATH FOLEY COUDE 5CC 2FR 2W

Facility

$72.20

Hospital Charge Code	270649025
Hospital Revenue Code	272
Min. Negotiated Rate	$10.83
Max. Negotiated Rate	$10.83
Rate for Payer: Qualcare PPO/HMO/WC	$10.83

CATH FOLEY COUDE 5CC 2FR 2W

Facility

$72.20

Hospital Charge Code	270649025
Hospital Revenue Code	272
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$36.10
Rate for Payer: Aetna Commercial	$27.44
Rate for Payer: Aetna Medicare Advantage	$21.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.41
Rate for Payer: Cigna Commercial	$36.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.66
Rate for Payer: Oxford Commercial	$14.44
Rate for Payer: Qualcare PPO/HMO/WC	$10.83
Rate for Payer: UnitedHealthcare Commercial	$14.44
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

CATH FOLEY EDELMAN 18FR

Facility

$97.71

Hospital Charge Code	270605609
Hospital Revenue Code	272
Min. Negotiated Rate	$2.35
Max. Negotiated Rate	$48.85
Rate for Payer: Aetna Commercial	$37.13
Rate for Payer: Aetna Medicare Advantage	$29.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.92
Rate for Payer: Cigna Commercial	$48.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.31
Rate for Payer: Oxford Commercial	$19.54
Rate for Payer: Qualcare PPO/HMO/WC	$14.66
Rate for Payer: UnitedHealthcare Commercial	$19.54
Rate for Payer: UnitedHealthcare Community & State	$2.35
Rate for Payer: Wellpoint Medicaid Managed Care	$2.59

CATH FOLEY EDELMAN 18FR

Facility

$97.71

Hospital Charge Code	270605609
Hospital Revenue Code	272
Min. Negotiated Rate	$14.66
Max. Negotiated Rate	$14.66
Rate for Payer: Qualcare PPO/HMO/WC	$14.66

CATH FOLEY EDELMAN 18FR 5CC***

Facility

$259.00

Hospital Charge Code	1607209
Hospital Revenue Code	272
Min. Negotiated Rate	$6.24
Max. Negotiated Rate	$129.50
Rate for Payer: Aetna Commercial	$98.42
Rate for Payer: Aetna Medicare Advantage	$77.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.05
Rate for Payer: Cigna Commercial	$129.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.70
Rate for Payer: Oxford Commercial	$51.80
Rate for Payer: Qualcare PPO/HMO/WC	$38.85
Rate for Payer: UnitedHealthcare Commercial	$51.80
Rate for Payer: UnitedHealthcare Community & State	$6.24
Rate for Payer: Wellpoint Medicaid Managed Care	$6.86

CATH FOLEY EDELMAN 18FR 5CC***

Facility

$259.00

Hospital Charge Code	1607209
Hospital Revenue Code	272
Min. Negotiated Rate	$38.85
Max. Negotiated Rate	$38.85
Rate for Payer: Qualcare PPO/HMO/WC	$38.85

CATH FOLEY IC SILVER 12FR 5cc

Facility

$25.77

Hospital Charge Code	270649841
Hospital Revenue Code	272
Min. Negotiated Rate	$3.87
Max. Negotiated Rate	$3.87
Rate for Payer: Qualcare PPO/HMO/WC	$3.87

CATH FOLEY IC SILVER 12FR 5cc

Facility

$25.77

Hospital Charge Code	270649841
Hospital Revenue Code	272
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$12.88
Rate for Payer: Aetna Commercial	$9.79
Rate for Payer: Aetna Medicare Advantage	$7.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.57
Rate for Payer: Cigna Commercial	$12.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.73
Rate for Payer: Oxford Commercial	$5.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.87
Rate for Payer: UnitedHealthcare Commercial	$5.15
Rate for Payer: UnitedHealthcare Community & State	$0.62
Rate for Payer: Wellpoint Medicaid Managed Care	$0.68

CATH FOLEY IC SILVER 5CC 14FR

Facility

$64.79

Hospital Charge Code	270650204
Hospital Revenue Code	272
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$32.40
Rate for Payer: Aetna Commercial	$24.62
Rate for Payer: Aetna Medicare Advantage	$19.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.52
Rate for Payer: Cigna Commercial	$32.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.44
Rate for Payer: Oxford Commercial	$12.96
Rate for Payer: Qualcare PPO/HMO/WC	$9.72
Rate for Payer: UnitedHealthcare Commercial	$12.96
Rate for Payer: UnitedHealthcare Community & State	$1.56
Rate for Payer: Wellpoint Medicaid Managed Care	$1.72

CATH FOLEY IC SILVER 5CC 14FR

Facility

$64.79

Hospital Charge Code	270650204
Hospital Revenue Code	272
Min. Negotiated Rate	$9.72
Max. Negotiated Rate	$9.72
Rate for Payer: Qualcare PPO/HMO/WC	$9.72

CATH FOLEY IC SILVER 5CC 18FR

Facility

$39.35

Hospital Charge Code	270650202
Hospital Revenue Code	272
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$19.68
Rate for Payer: Aetna Commercial	$14.95
Rate for Payer: Aetna Medicare Advantage	$11.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.03
Rate for Payer: Cigna Commercial	$19.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.80
Rate for Payer: Oxford Commercial	$7.87
Rate for Payer: Qualcare PPO/HMO/WC	$5.90
Rate for Payer: UnitedHealthcare Commercial	$7.87
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

CATH FOLEY IC SILVER 5CC 18FR

Facility

$39.35

Hospital Charge Code	270650202
Hospital Revenue Code	272
Min. Negotiated Rate	$5.90
Max. Negotiated Rate	$5.90
Rate for Payer: Qualcare PPO/HMO/WC	$5.90

CATH FOLEY IC SILVER 5CC 22FR

Facility

$51.85

Hospital Charge Code	270650196
Hospital Revenue Code	270
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$25.93
Rate for Payer: Aetna Commercial	$19.70
Rate for Payer: Aetna Medicare Advantage	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.22
Rate for Payer: Cigna Commercial	$25.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.55
Rate for Payer: Oxford Commercial	$10.37
Rate for Payer: Qualcare PPO/HMO/WC	$7.78
Rate for Payer: UnitedHealthcare Commercial	$10.37
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.37

CATH FOLEY IC SILVER 5CC 22FR

Facility

$51.85

Hospital Charge Code	270650196
Hospital Revenue Code	270
Min. Negotiated Rate	$7.78
Max. Negotiated Rate	$7.78
Rate for Payer: Qualcare PPO/HMO/WC	$7.78

CATH FOLEY IC SLVR 3W18FR 30cc

Facility

$87.97

Service Code	HCPCS A4346
Hospital Charge Code	270649845
Hospital Revenue Code	272
Min. Negotiated Rate	$2.12
Max. Negotiated Rate	$43.98
Rate for Payer: Aetna Commercial	$33.43
Rate for Payer: Aetna Medicare Advantage	$26.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.43
Rate for Payer: Cigna Commercial	$43.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.39
Rate for Payer: Oxford Commercial	$17.59
Rate for Payer: Qualcare PPO/HMO/WC	$13.20
Rate for Payer: UnitedHealthcare Commercial	$17.59
Rate for Payer: UnitedHealthcare Community & State	$2.12
Rate for Payer: Wellpoint Medicaid Managed Care	$2.33

Know your out-of-pocket cost for care.

All Charges