Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH FOLEY IC SLVR 3W18FR 30cc

Facility

$87.97

Service Code	HCPCS A4346
Hospital Charge Code	270649845
Hospital Revenue Code	272
Min. Negotiated Rate	$13.20
Max. Negotiated Rate	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$13.20

CATH FOLEY IC SLVR 3W20FR 30cc

Facility

$65.35

Hospital Charge Code	270649846
Hospital Revenue Code	270
Min. Negotiated Rate	$9.80
Max. Negotiated Rate	$9.80
Rate for Payer: Qualcare PPO/HMO/WC	$9.80

CATH FOLEY IC SLVR 3W20FR 30cc

Facility

$65.35

Hospital Charge Code	270649846
Hospital Revenue Code	270
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$32.67
Rate for Payer: Aetna Commercial	$24.83
Rate for Payer: Aetna Medicare Advantage	$19.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.66
Rate for Payer: Cigna Commercial	$32.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.61
Rate for Payer: Oxford Commercial	$13.07
Rate for Payer: Qualcare PPO/HMO/WC	$9.80
Rate for Payer: UnitedHealthcare Commercial	$13.07
Rate for Payer: UnitedHealthcare Community & State	$1.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1.73

CATH FOLEY L/F 14 FR 2W 5CC

Facility

$50.85

Hospital Charge Code	270649030
Hospital Revenue Code	272
Min. Negotiated Rate	$7.63
Max. Negotiated Rate	$7.63
Rate for Payer: Qualcare PPO/HMO/WC	$7.63

CATH FOLEY L/F 14 FR 2W 5CC

Facility

$50.85

Hospital Charge Code	270649030
Hospital Revenue Code	272
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$25.43
Rate for Payer: Aetna Commercial	$19.32
Rate for Payer: Aetna Medicare Advantage	$15.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.97
Rate for Payer: Cigna Commercial	$25.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.26
Rate for Payer: Oxford Commercial	$10.17
Rate for Payer: Qualcare PPO/HMO/WC	$7.63
Rate for Payer: UnitedHealthcare Commercial	$10.17
Rate for Payer: UnitedHealthcare Community & State	$1.23
Rate for Payer: Wellpoint Medicaid Managed Care	$1.35

CATH FOLEY L/F 16FR 2W 5CC

Facility

$48.54

Hospital Charge Code	270649031
Hospital Revenue Code	272
Min. Negotiated Rate	$7.28
Max. Negotiated Rate	$7.28
Rate for Payer: Qualcare PPO/HMO/WC	$7.28

CATH FOLEY L/F 16FR 2W 5CC

Facility

$48.54

Hospital Charge Code	270649031
Hospital Revenue Code	272
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$24.27
Rate for Payer: Aetna Commercial	$18.45
Rate for Payer: Aetna Medicare Advantage	$14.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.38
Rate for Payer: Cigna Commercial	$24.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.56
Rate for Payer: Oxford Commercial	$9.71
Rate for Payer: Qualcare PPO/HMO/WC	$7.28
Rate for Payer: UnitedHealthcare Commercial	$9.71
Rate for Payer: UnitedHealthcare Community & State	$1.17
Rate for Payer: Wellpoint Medicaid Managed Care	$1.29

CATH FOLEY LF 24FR

Facility

$47.61

Hospital Charge Code	270649853
Hospital Revenue Code	270
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$23.80
Rate for Payer: Aetna Commercial	$18.09
Rate for Payer: Aetna Medicare Advantage	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.14
Rate for Payer: Cigna Commercial	$23.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.28
Rate for Payer: Oxford Commercial	$9.52
Rate for Payer: Qualcare PPO/HMO/WC	$7.14
Rate for Payer: UnitedHealthcare Commercial	$9.52
Rate for Payer: UnitedHealthcare Community & State	$1.15
Rate for Payer: Wellpoint Medicaid Managed Care	$1.26

CATH FOLEY LF 24FR

Facility

$47.61

Hospital Charge Code	270649853
Hospital Revenue Code	270
Min. Negotiated Rate	$7.14
Max. Negotiated Rate	$7.14
Rate for Payer: Qualcare PPO/HMO/WC	$7.14

CATH FOLEY PED 3cc 10FR

Facility

$41.33

Hospital Charge Code	270649033
Hospital Revenue Code	272
Min. Negotiated Rate	$6.20
Max. Negotiated Rate	$6.20
Rate for Payer: Qualcare PPO/HMO/WC	$6.20

CATH FOLEY PED 3cc 10FR

Facility

$41.33

Hospital Charge Code	270649033
Hospital Revenue Code	272
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$20.66
Rate for Payer: Aetna Commercial	$15.71
Rate for Payer: Aetna Medicare Advantage	$12.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.54
Rate for Payer: Cigna Commercial	$20.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.40
Rate for Payer: Oxford Commercial	$8.27
Rate for Payer: Qualcare PPO/HMO/WC	$6.20
Rate for Payer: UnitedHealthcare Commercial	$8.27
Rate for Payer: UnitedHealthcare Community & State	$1.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1.10

CATH FOLEY PED 3CC 10FR 2 WAY

Facility

$49.00

Hospital Charge Code	270649032
Hospital Revenue Code	272
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$7.35
Rate for Payer: Qualcare PPO/HMO/WC	$7.35

CATH FOLEY PED 3CC 10FR 2 WAY

Facility

$49.00

Hospital Charge Code	270649032
Hospital Revenue Code	272
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$24.50
Rate for Payer: Aetna Commercial	$18.62
Rate for Payer: Aetna Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.49
Rate for Payer: Cigna Commercial	$24.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.70
Rate for Payer: Oxford Commercial	$9.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.35
Rate for Payer: UnitedHealthcare Commercial	$9.80
Rate for Payer: UnitedHealthcare Community & State	$1.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1.30

CATH FOLEY PED 3cc 8FR

Facility

$41.33

Hospital Charge Code	270649034
Hospital Revenue Code	272
Min. Negotiated Rate	$6.20
Max. Negotiated Rate	$6.20
Rate for Payer: Qualcare PPO/HMO/WC	$6.20

CATH FOLEY PED 3cc 8FR

Facility

$41.33

Hospital Charge Code	270649034
Hospital Revenue Code	272
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$20.66
Rate for Payer: Aetna Commercial	$15.71
Rate for Payer: Aetna Medicare Advantage	$12.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.54
Rate for Payer: Cigna Commercial	$20.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.40
Rate for Payer: Oxford Commercial	$8.27
Rate for Payer: Qualcare PPO/HMO/WC	$6.20
Rate for Payer: UnitedHealthcare Commercial	$8.27
Rate for Payer: UnitedHealthcare Community & State	$1.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1.10

CATH FOLEY SILICONE 3WAY 30cc

Facility

$70.29

Hospital Charge Code	270644551
Hospital Revenue Code	272
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$10.54
Rate for Payer: Qualcare PPO/HMO/WC	$10.54

CATH FOLEY SILICONE 3WAY 30cc

Facility

$70.29

Hospital Charge Code	270644551
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$35.15
Rate for Payer: Aetna Commercial	$26.71
Rate for Payer: Aetna Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.92
Rate for Payer: Cigna Commercial	$35.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.09
Rate for Payer: Oxford Commercial	$14.06
Rate for Payer: Qualcare PPO/HMO/WC	$10.54
Rate for Payer: UnitedHealthcare Commercial	$14.06
Rate for Payer: UnitedHealthcare Community & State	$1.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1.86

CATH FOLEY TEFLON 5cc 18FR

Facility

$38.88

Hospital Charge Code	270649048
Hospital Revenue Code	272
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$5.83
Rate for Payer: Qualcare PPO/HMO/WC	$5.83

CATH FOLEY TEFLON 5cc 18FR

Facility

$38.88

Hospital Charge Code	270649048
Hospital Revenue Code	272
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$19.44
Rate for Payer: Aetna Commercial	$14.77
Rate for Payer: Aetna Medicare Advantage	$11.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.91
Rate for Payer: Cigna Commercial	$19.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.66
Rate for Payer: Oxford Commercial	$7.78
Rate for Payer: Qualcare PPO/HMO/WC	$5.83
Rate for Payer: UnitedHealthcare Commercial	$7.78
Rate for Payer: UnitedHealthcare Community & State	$0.94
Rate for Payer: Wellpoint Medicaid Managed Care	$1.03

CATH FOLEY TEMP PROBE 16FR

Facility

$57.44

Hospital Charge Code	270641656
Hospital Revenue Code	272
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$8.62
Rate for Payer: Qualcare PPO/HMO/WC	$8.62

CATH FOLEY TEMP PROBE 16FR

Facility

$57.44

Hospital Charge Code	270641656
Hospital Revenue Code	272
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$28.72
Rate for Payer: Aetna Commercial	$21.83
Rate for Payer: Aetna Medicare Advantage	$17.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.65
Rate for Payer: Cigna Commercial	$28.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.23
Rate for Payer: Oxford Commercial	$11.49
Rate for Payer: Qualcare PPO/HMO/WC	$8.62
Rate for Payer: UnitedHealthcare Commercial	$11.49
Rate for Payer: UnitedHealthcare Community & State	$1.38
Rate for Payer: Wellpoint Medicaid Managed Care	$1.52

CATH FOLLOWERS*******

Facility

$342.00

Hospital Charge Code	8000408
Hospital Revenue Code	279
Min. Negotiated Rate	$51.30
Max. Negotiated Rate	$51.30
Rate for Payer: Qualcare PPO/HMO/WC	$51.30

CATH FOLLOWERS*******

Facility

$342.00

Hospital Charge Code	8000408
Hospital Revenue Code	279
Min. Negotiated Rate	$8.24
Max. Negotiated Rate	$171.00
Rate for Payer: Aetna Commercial	$129.96
Rate for Payer: Aetna Medicare Advantage	$102.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.21
Rate for Payer: Cigna Commercial	$171.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.60
Rate for Payer: Oxford Commercial	$68.40
Rate for Payer: Qualcare PPO/HMO/WC	$51.30
Rate for Payer: UnitedHealthcare Commercial	$68.40
Rate for Payer: UnitedHealthcare Community & State	$8.24
Rate for Payer: Wellpoint Medicaid Managed Care	$9.06

CATH FOR AMPLATZ DIL SET 8 FR

Facility

$154.00

Hospital Charge Code	270331496
Hospital Revenue Code	272
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

CATH FOR AMPLATZ DIL SET 8 FR

Facility

$154.00

Hospital Charge Code	270331496
Hospital Revenue Code	272
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$77.00
Rate for Payer: Aetna Commercial	$58.52
Rate for Payer: Aetna Medicare Advantage	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.27
Rate for Payer: Cigna Commercial	$77.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.20
Rate for Payer: Oxford Commercial	$30.80
Rate for Payer: Qualcare PPO/HMO/WC	$23.10
Rate for Payer: UnitedHealthcare Commercial	$30.80
Rate for Payer: UnitedHealthcare Community & State	$3.71
Rate for Payer: Wellpoint Medicaid Managed Care	$4.08

Know your out-of-pocket cost for care.

All Charges