Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH GLIDEPATH 31CM STR

Facility

$1,752.00

Hospital Charge Code	270677506
Hospital Revenue Code	278
Min. Negotiated Rate	$262.80
Max. Negotiated Rate	$423.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$385.44
Rate for Payer: Qualcare PPO/HMO/WC	$262.80

CATH GLIDEPATH 42CM STR

Facility

$1,752.00

Hospital Charge Code	270677507
Hospital Revenue Code	278
Min. Negotiated Rate	$42.22
Max. Negotiated Rate	$876.00
Rate for Payer: Aetna Commercial	$665.76
Rate for Payer: Aetna Medicare Advantage	$525.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.76
Rate for Payer: Cigna Commercial	$876.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$385.44
Rate for Payer: Qualcare PPO/HMO/WC	$262.80
Rate for Payer: UnitedHealthcare Community & State	$42.22
Rate for Payer: Wellpoint Medicaid Managed Care	$46.43

CATH GLIDEPATH 42CM STR

Facility

$1,752.00

Hospital Charge Code	270677507
Hospital Revenue Code	278
Min. Negotiated Rate	$262.80
Max. Negotiated Rate	$423.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$385.44
Rate for Payer: Qualcare PPO/HMO/WC	$262.80

CATH GUID 6F EBU 5.0 LA6EBU50

Facility

$225.00

Service Code	HCPCS C1887
Hospital Charge Code	270641795C
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

CATH GUID 6F EBU 5.0 LA6EBU50

Facility

$225.00

Service Code	HCPCS C1887
Hospital Charge Code	270641795C
Hospital Revenue Code	278
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

CATH GUID 6F MACH 4.0 3435673

Facility

$255.00

Service Code	HCPCS C1887
Hospital Charge Code	270641796C
Hospital Revenue Code	278
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$127.50
Rate for Payer: Aetna Commercial	$96.90
Rate for Payer: Aetna Medicare Advantage	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.03
Rate for Payer: Cigna Commercial	$127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$56.10
Rate for Payer: Qualcare PPO/HMO/WC	$38.25
Rate for Payer: UnitedHealthcare Community & State	$6.15
Rate for Payer: Wellpoint Medicaid Managed Care	$6.76

CATH GUID 6F MACH 4.0 3435673

Facility

$255.00

Service Code	HCPCS C1887
Hospital Charge Code	270641796C
Hospital Revenue Code	278
Min. Negotiated Rate	$38.25
Max. Negotiated Rate	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$56.10
Rate for Payer: Qualcare PPO/HMO/WC	$38.25

CATH GUID 6F MACH 4.5 3435674

Facility

$310.00

Service Code	HCPCS C1887
Hospital Charge Code	270641797C
Hospital Revenue Code	278
Min. Negotiated Rate	$7.47
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$117.80
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$68.20
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Community & State	$7.47
Rate for Payer: Wellpoint Medicaid Managed Care	$8.21

CATH GUID 6F MACH 4.5 3435674

Facility

$310.00

Service Code	HCPCS C1887
Hospital Charge Code	270641797C
Hospital Revenue Code	278
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$75.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$68.20
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

CATH GUID 6F MACH 5.0 3435675

Facility

$310.00

Hospital Charge Code	270641798C
Hospital Revenue Code	278
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$75.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$68.20
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

CATH GUID 6F MACH 5.0 3435675

Facility

$310.00

Hospital Charge Code	270641798C
Hospital Revenue Code	278
Min. Negotiated Rate	$7.47
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$117.80
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$68.20
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Community & State	$7.47
Rate for Payer: Wellpoint Medicaid Managed Care	$8.21

CATH GUID 8FR XB 4.0 588894

Facility

$255.00

Hospital Charge Code	270637965C
Hospital Revenue Code	278
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$127.50
Rate for Payer: Aetna Commercial	$96.90
Rate for Payer: Aetna Medicare Advantage	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.03
Rate for Payer: Cigna Commercial	$127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$56.10
Rate for Payer: Qualcare PPO/HMO/WC	$38.25
Rate for Payer: UnitedHealthcare Community & State	$6.15
Rate for Payer: Wellpoint Medicaid Managed Care	$6.76

CATH GUID 8FR XB 4.0 588894

Facility

$255.00

Hospital Charge Code	270637965C
Hospital Revenue Code	278
Min. Negotiated Rate	$38.25
Max. Negotiated Rate	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$56.10
Rate for Payer: Qualcare PPO/HMO/WC	$38.25

CATH GUIDE 6F PTFE RENAL CRV

Facility

$280.00

Service Code	HCPCS C1887
Hospital Charge Code	270662342S
Hospital Revenue Code	278
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$106.40
Rate for Payer: Aetna Medicare Advantage	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.40
Rate for Payer: Cigna Commercial	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.60
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Community & State	$6.75
Rate for Payer: Wellpoint Medicaid Managed Care	$7.42

CATH GUIDE 6F PTFE RENAL CRV

Facility

$280.00

Service Code	HCPCS C1887
Hospital Charge Code	270662342S
Hospital Revenue Code	278
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$67.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.60
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

CATH GUIDE 6F PTFE RENAL CRVD

Facility

$280.00

Service Code	HCPCS C1887
Hospital Charge Code	270662342
Hospital Revenue Code	278
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$106.40
Rate for Payer: Aetna Medicare Advantage	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.40
Rate for Payer: Cigna Commercial	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.60
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Community & State	$6.75
Rate for Payer: Wellpoint Medicaid Managed Care	$7.42

CATH GUIDE 6F PTFE RENAL CRVD

Facility

$280.00

Service Code	HCPCS C1887
Hospital Charge Code	270662342
Hospital Revenue Code	278
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$67.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.60
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

CATH GUIDE 6FR .070 MPA-1 90CM

Facility

$427.00

Hospital Charge Code	270646506C
Hospital Revenue Code	278
Min. Negotiated Rate	$10.29
Max. Negotiated Rate	$213.50
Rate for Payer: Aetna Commercial	$162.26
Rate for Payer: Aetna Medicare Advantage	$128.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.89
Rate for Payer: Cigna Commercial	$213.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.94
Rate for Payer: Qualcare PPO/HMO/WC	$64.05
Rate for Payer: UnitedHealthcare Community & State	$10.29
Rate for Payer: Wellpoint Medicaid Managed Care	$11.32

CATH GUIDE 6FR .070 MPA-1 90CM

Facility

$427.00

Hospital Charge Code	270646506C
Hospital Revenue Code	278
Min. Negotiated Rate	$64.05
Max. Negotiated Rate	$103.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.94
Rate for Payer: Qualcare PPO/HMO/WC	$64.05

CATH GUIDE AMPLATZ 6F AL .75

Facility

$225.00

Service Code	HCPCS C1887
Hospital Charge Code	270651090N
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

CATH GUIDE AMPLATZ 6F AL .75

Facility

$225.00

Service Code	HCPCS C1887
Hospital Charge Code	270651090N
Hospital Revenue Code	278
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

CATH GUIDE AMPLATZ 6F AL .75

Facility

$225.00

Service Code	HCPCS C1887
Hospital Charge Code	270651090
Hospital Revenue Code	278
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

CATH GUIDE AMPLATZ 6F AL .75

Facility

$225.00

Service Code	HCPCS C1887
Hospital Charge Code	270651090
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

CATH GUIDE AMPLATZ LA6AL75

Facility

$225.00

Service Code	HCPCS C1887
Hospital Charge Code	270651090C
Hospital Revenue Code	278
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

CATH GUIDE AMPLATZ LA6AL75

Facility

$225.00

Service Code	HCPCS C1887
Hospital Charge Code	270651090C
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

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