Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH FOXCROSS PTA 5x100x135cm

Facility

$775.00

Hospital Charge Code	270642703C
Hospital Revenue Code	278
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$187.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

CATH FOXCROSS PTA 5x20x135cm

Facility

$775.00

Hospital Charge Code	270644500C
Hospital Revenue Code	278
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25
Rate for Payer: UnitedHealthcare Community & State	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$20.54

CATH FOXCROSS PTA 5x20x135cm

Facility

$775.00

Hospital Charge Code	270644500C
Hospital Revenue Code	278
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$187.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

CATH FOXCROSS PTA 5x20x80cm

Facility

$775.00

Hospital Charge Code	270644990C
Hospital Revenue Code	278
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25
Rate for Payer: UnitedHealthcare Community & State	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$20.54

CATH FOXCROSS PTA 5x20x80cm

Facility

$775.00

Hospital Charge Code	270644990C
Hospital Revenue Code	278
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$187.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

CATH FOXCROSS PTA 5x20x80cm

Facility

$775.00

Hospital Charge Code	270644499C
Hospital Revenue Code	278
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25
Rate for Payer: UnitedHealthcare Community & State	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$20.54

CATH FOXCROSS PTA 5x20x80cm

Facility

$775.00

Hospital Charge Code	270644499C
Hospital Revenue Code	278
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$187.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

CATH FOXCROSS PTA 5x40x135cm

Facility

$775.00

Hospital Charge Code	270643926C
Hospital Revenue Code	278
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$187.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

CATH FOXCROSS PTA 5x40x135cm

Facility

$775.00

Hospital Charge Code	270643926C
Hospital Revenue Code	278
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25
Rate for Payer: UnitedHealthcare Community & State	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$20.54

CATH FOXCROSS PTA 5x40x80cm

Facility

$775.00

Hospital Charge Code	270644501C
Hospital Revenue Code	278
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25
Rate for Payer: UnitedHealthcare Community & State	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$20.54

CATH FOXCROSS PTA 5x40x80cm

Facility

$775.00

Hospital Charge Code	270644501C
Hospital Revenue Code	278
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$187.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

CATH FOXCROSS PTA 5x60MMx135CM

Facility

$775.00

Hospital Charge Code	270648368C
Hospital Revenue Code	278
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25
Rate for Payer: UnitedHealthcare Community & State	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$20.54

CATH FOXCROSS PTA 5x60MMx135CM

Facility

$775.00

Hospital Charge Code	270648368C
Hospital Revenue Code	278
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$187.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

CATH FOXCROSS PTA 6*100*135cm

Facility

$1,625.00

Hospital Charge Code	270648356C
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

CATH FOXCROSS PTA 6*100*135cm

Facility

$1,625.00

Hospital Charge Code	270648356C
Hospital Revenue Code	278
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

CATH FOXCROSS PTA 6x20MMx135CM

Facility

$775.00

Hospital Charge Code	270648369C
Hospital Revenue Code	278
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25
Rate for Payer: UnitedHealthcare Community & State	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$20.54

CATH FOXCROSS PTA 6x20MMx135CM

Facility

$775.00

Hospital Charge Code	270648369C
Hospital Revenue Code	278
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$187.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

CATH FOXCROSS PTA 6x20x80cm

Facility

$775.00

Hospital Charge Code	270644504C
Hospital Revenue Code	278
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$187.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

CATH FOXCROSS PTA 6x20x80cm

Facility

$775.00

Hospital Charge Code	270644504C
Hospital Revenue Code	278
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25
Rate for Payer: UnitedHealthcare Community & State	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$20.54

CATH FOXCROSS PTA 6x40x135cm

Facility

$775.00

Hospital Charge Code	270644397C
Hospital Revenue Code	278
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$187.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

CATH FOXCROSS PTA 6x40x135cm

Facility

$775.00

Hospital Charge Code	270644397C
Hospital Revenue Code	278
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25
Rate for Payer: UnitedHealthcare Community & State	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$20.54

CATH FOXCROSS PTA 6x40x80cm

Facility

$775.00

Hospital Charge Code	270644505C
Hospital Revenue Code	278
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$187.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

CATH FOXCROSS PTA 6x40x80cm

Facility

$775.00

Hospital Charge Code	270644505C
Hospital Revenue Code	278
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25
Rate for Payer: UnitedHealthcare Community & State	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$20.54

CATH FOXCROSS PTA 6x60MMx135CM

Facility

$775.00

Hospital Charge Code	270648371C
Hospital Revenue Code	278
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25
Rate for Payer: UnitedHealthcare Community & State	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$20.54

CATH FOXCROSS PTA 6x60MMx135CM

Facility

$775.00

Hospital Charge Code	270648371C
Hospital Revenue Code	278
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$187.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

Know your out-of-pocket cost for care.

All Charges