Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH SH LNCHR 7FR EBU 4.0

Facility

$245.00

Hospital Charge Code	270645943C
Hospital Revenue Code	278
Min. Negotiated Rate	$5.90
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial	$93.10
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.90
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Community & State	$5.90
Rate for Payer: Wellpoint Medicaid Managed Care	$6.49

CATH SHOCKWAVE 3.0X40MM

Facility

$16,500.00

Service Code	HCPCS C1761
Hospital Charge Code	270694294S
Hospital Revenue Code	278
Min. Negotiated Rate	$397.65
Max. Negotiated Rate	$8,250.00
Rate for Payer: Aetna Commercial	$6,270.00
Rate for Payer: Aetna Medicare Advantage	$4,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,207.50
Rate for Payer: Cigna Commercial	$8,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,993.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00
Rate for Payer: UnitedHealthcare Community & State	$397.65
Rate for Payer: Wellpoint Medicaid Managed Care	$437.25

CATH SHOCKWAVE 3.0X40MM

Facility

$16,500.00

Service Code	HCPCS C1761
Hospital Charge Code	270694294S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,475.00
Max. Negotiated Rate	$3,993.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,993.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00

CATH SHOCKWAVE IVL 5.0X60MM

Facility

$17,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270698425
Hospital Revenue Code	272
Min. Negotiated Rate	$415.73
Max. Negotiated Rate	$8,625.00
Rate for Payer: Aetna Commercial	$6,555.00
Rate for Payer: Aetna Medicare Advantage	$5,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,398.75
Rate for Payer: Cigna Commercial	$8,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,175.00
Rate for Payer: Oxford Commercial	$3,450.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50
Rate for Payer: UnitedHealthcare Commercial	$3,450.00
Rate for Payer: UnitedHealthcare Community & State	$415.73
Rate for Payer: Wellpoint Medicaid Managed Care	$457.12

CATH SHOCKWAVE IVL 5.0X60MM

Facility

$17,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270698425
Hospital Revenue Code	272
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$2,587.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

CATH SHOCKWAVE M5 IVL 3.5X60MM

Facility

$17,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270698156S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$4,174.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

CATH SHOCKWAVE M5 IVL 3.5X60MM

Facility

$17,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270698156S
Hospital Revenue Code	278
Min. Negotiated Rate	$415.73
Max. Negotiated Rate	$8,625.00
Rate for Payer: Aetna Commercial	$6,555.00
Rate for Payer: Aetna Medicare Advantage	$5,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,398.75
Rate for Payer: Cigna Commercial	$8,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50
Rate for Payer: UnitedHealthcare Community & State	$415.73
Rate for Payer: Wellpoint Medicaid Managed Care	$457.12

CATH SHOCKWAVE M5 IVL 4.0X60MM

Facility

$17,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270698157S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$4,174.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

CATH SHOCKWAVE M5 IVL 4.0X60MM

Facility

$17,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270698157S
Hospital Revenue Code	278
Min. Negotiated Rate	$415.73
Max. Negotiated Rate	$8,625.00
Rate for Payer: Aetna Commercial	$6,555.00
Rate for Payer: Aetna Medicare Advantage	$5,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,398.75
Rate for Payer: Cigna Commercial	$8,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50
Rate for Payer: UnitedHealthcare Community & State	$415.73
Rate for Payer: Wellpoint Medicaid Managed Care	$457.12

CATH SHOCKWAVE M5 IVL 5.5X60

Facility

$17,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270698959S
Hospital Revenue Code	278
Min. Negotiated Rate	$415.73
Max. Negotiated Rate	$8,625.00
Rate for Payer: Aetna Commercial	$6,555.00
Rate for Payer: Aetna Medicare Advantage	$5,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,398.75
Rate for Payer: Cigna Commercial	$8,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50
Rate for Payer: UnitedHealthcare Community & State	$415.73
Rate for Payer: Wellpoint Medicaid Managed Care	$457.12

CATH SHOCKWAVE M5 IVL 5.5X60

Facility

$17,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270698959S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$4,174.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

CATH SHOCKWAVE M5 IVL 6.5X60MM

Facility

$17,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270698234S
Hospital Revenue Code	278
Min. Negotiated Rate	$415.73
Max. Negotiated Rate	$8,625.00
Rate for Payer: Aetna Commercial	$6,555.00
Rate for Payer: Aetna Medicare Advantage	$5,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,398.75
Rate for Payer: Cigna Commercial	$8,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50
Rate for Payer: UnitedHealthcare Community & State	$415.73
Rate for Payer: Wellpoint Medicaid Managed Care	$457.12

CATH SHOCKWAVE M5 IVL 6.5X60MM

Facility

$17,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270698234S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$4,174.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

CATH SHOCKWAVE PERIP 10.5X45MM

Facility

$6,740.00

Service Code	HCPCS C1725
Hospital Charge Code	270695232S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$1,631.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,482.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

CATH SHOCKWAVE PERIP 10.5X45MM

Facility

$6,740.00

Service Code	HCPCS C1725
Hospital Charge Code	270695232S
Hospital Revenue Code	278
Min. Negotiated Rate	$162.43
Max. Negotiated Rate	$3,370.00
Rate for Payer: Aetna Commercial	$2,561.20
Rate for Payer: Aetna Medicare Advantage	$2,022.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,718.70
Rate for Payer: Cigna Commercial	$3,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,482.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00
Rate for Payer: UnitedHealthcare Community & State	$162.43
Rate for Payer: Wellpoint Medicaid Managed Care	$178.61

CATH SHOCKWAVE PERIP 2.5X40MM

Facility

$16,500.00

Service Code	HCPCS C1725
Hospital Charge Code	270692157S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,475.00
Max. Negotiated Rate	$3,993.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,993.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00

CATH SHOCKWAVE PERIP 2.5X40MM

Facility

$16,500.00

Service Code	HCPCS C1725
Hospital Charge Code	270692157
Hospital Revenue Code	278
Min. Negotiated Rate	$2,475.00
Max. Negotiated Rate	$3,993.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,993.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00

CATH SHOCKWAVE PERIP 2.5X40MM

Facility

$16,500.00

Service Code	HCPCS C1725
Hospital Charge Code	270692157
Hospital Revenue Code	278
Min. Negotiated Rate	$397.65
Max. Negotiated Rate	$8,250.00
Rate for Payer: Aetna Commercial	$6,270.00
Rate for Payer: Aetna Medicare Advantage	$4,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,207.50
Rate for Payer: Cigna Commercial	$8,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,993.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00
Rate for Payer: UnitedHealthcare Community & State	$397.65
Rate for Payer: Wellpoint Medicaid Managed Care	$437.25

CATH SHOCKWAVE PERIP 2.5X40MM

Facility

$16,500.00

Service Code	HCPCS C1725
Hospital Charge Code	270692157S
Hospital Revenue Code	278
Min. Negotiated Rate	$397.65
Max. Negotiated Rate	$8,250.00
Rate for Payer: Aetna Commercial	$6,270.00
Rate for Payer: Aetna Medicare Advantage	$4,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,207.50
Rate for Payer: Cigna Commercial	$8,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,993.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00
Rate for Payer: UnitedHealthcare Community & State	$397.65
Rate for Payer: Wellpoint Medicaid Managed Care	$437.25

CATH SHOCKWAVE PERIP 3.0X40MM

Facility

$16,500.00

Service Code	HCPCS C1725
Hospital Charge Code	270694296S
Hospital Revenue Code	278
Min. Negotiated Rate	$397.65
Max. Negotiated Rate	$8,250.00
Rate for Payer: Aetna Commercial	$6,270.00
Rate for Payer: Aetna Medicare Advantage	$4,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,207.50
Rate for Payer: Cigna Commercial	$8,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,993.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00
Rate for Payer: UnitedHealthcare Community & State	$397.65
Rate for Payer: Wellpoint Medicaid Managed Care	$437.25

CATH SHOCKWAVE PERIP 3.0X40MM

Facility

$16,500.00

Service Code	HCPCS C1725
Hospital Charge Code	270694296S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,475.00
Max. Negotiated Rate	$3,993.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,993.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00

CATH SHOCKWAVE PERIP 4X40MM

Facility

$16,500.00

Service Code	HCPCS C1725
Hospital Charge Code	270692156S
Hospital Revenue Code	278
Min. Negotiated Rate	$397.65
Max. Negotiated Rate	$8,250.00
Rate for Payer: Aetna Commercial	$6,270.00
Rate for Payer: Aetna Medicare Advantage	$4,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,207.50
Rate for Payer: Cigna Commercial	$8,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,993.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00
Rate for Payer: UnitedHealthcare Community & State	$397.65
Rate for Payer: Wellpoint Medicaid Managed Care	$437.25

CATH SHOCKWAVE PERIP 4X40MM

Facility

$16,500.00

Service Code	HCPCS C1725
Hospital Charge Code	270692156
Hospital Revenue Code	278
Min. Negotiated Rate	$2,475.00
Max. Negotiated Rate	$3,993.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,993.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00

CATH SHOCKWAVE PERIP 4X40MM

Facility

$16,500.00

Service Code	HCPCS C1725
Hospital Charge Code	270692156
Hospital Revenue Code	278
Min. Negotiated Rate	$397.65
Max. Negotiated Rate	$8,250.00
Rate for Payer: Aetna Commercial	$6,270.00
Rate for Payer: Aetna Medicare Advantage	$4,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,207.50
Rate for Payer: Cigna Commercial	$8,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,993.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00
Rate for Payer: UnitedHealthcare Community & State	$397.65
Rate for Payer: Wellpoint Medicaid Managed Care	$437.25

CATH SHOCKWAVE PERIP 4X40MM

Facility

$16,500.00

Service Code	HCPCS C1725
Hospital Charge Code	270692156S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,475.00
Max. Negotiated Rate	$3,993.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,993.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00

Know your out-of-pocket cost for care.

All Charges