Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CATH SHOCKWAVE PERIP 5X60MM

Facility

$17,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270698425V
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 5X60MM

Facility

$17,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270698425V
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 PERIP 6.0X60MM

Facility

$16,500.00

Service Code	HCPCS C1725
Hospital Charge Code	270694233S
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 6.0X60MM

Facility

$16,500.00

Service Code	HCPCS C1725
Hospital Charge Code	270694233S
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 7.0X60MM

Facility

$16,500.00

Service Code	HCPCS C1725
Hospital Charge Code	270690506S
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 7.0X60MM

Facility

$16,500.00

Service Code	HCPCS C1725
Hospital Charge Code	270690506S
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 PERIPH 6X60MM

Facility

$17,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270696636S
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 PERIPH 6X60MM

Facility

$17,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270696636S
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 S4 IVL 3.5X40MM

Facility

$13,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270698155S
Hospital Revenue Code	278
Min. Negotiated Rate	$331.38
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$5,225.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50
Rate for Payer: UnitedHealthcare Community & State	$331.38
Rate for Payer: Wellpoint Medicaid Managed Care	$364.38

CATH SHOCKWAVE S4 IVL 3.5X40MM

Facility

$13,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270698155S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$3,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

CATH SHUTTLE JB1 6FR 125cm

Facility

$463.75

Hospital Charge Code	270636223
Hospital Revenue Code	272
Min. Negotiated Rate	$69.56
Max. Negotiated Rate	$69.56
Rate for Payer: Qualcare PPO/HMO/WC	$69.56

CATH SHUTTLE JB1 6FR 125cm

Facility

$463.75

Hospital Charge Code	270636223
Hospital Revenue Code	272
Min. Negotiated Rate	$11.18
Max. Negotiated Rate	$231.88
Rate for Payer: Aetna Commercial	$176.22
Rate for Payer: Aetna Medicare Advantage	$139.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.26
Rate for Payer: Cigna Commercial	$231.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.12
Rate for Payer: Oxford Commercial	$92.75
Rate for Payer: Qualcare PPO/HMO/WC	$69.56
Rate for Payer: UnitedHealthcare Commercial	$92.75
Rate for Payer: UnitedHealthcare Community & State	$11.18
Rate for Payer: Wellpoint Medicaid Managed Care	$12.29

CATH SILICATH

Facility

$25.00

Hospital Charge Code	8000341
Hospital Revenue Code	279
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$9.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.50
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$5.00
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

CATH SILICATH

Facility

$25.00

Hospital Charge Code	8000341
Hospital Revenue Code	279
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

CATH SILICONE 8.5FX22

Facility

$630.70

Service Code	HCPCS C2617
Hospital Charge Code	270697412
Hospital Revenue Code	278
Min. Negotiated Rate	$15.20
Max. Negotiated Rate	$315.35
Rate for Payer: Aetna Commercial	$239.67
Rate for Payer: Aetna Medicare Advantage	$189.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.83
Rate for Payer: Cigna Commercial	$315.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$138.75
Rate for Payer: Qualcare PPO/HMO/WC	$94.61
Rate for Payer: UnitedHealthcare Community & State	$15.20
Rate for Payer: Wellpoint Medicaid Managed Care	$16.71

CATH SILICONE 8.5FX22

Facility

$630.70

Service Code	HCPCS C2617
Hospital Charge Code	270697412
Hospital Revenue Code	278
Min. Negotiated Rate	$94.61
Max. Negotiated Rate	$152.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$138.75
Rate for Payer: Qualcare PPO/HMO/WC	$94.61

CATH SILVERHAWK 135x2.2 P4024

Facility

$14,975.00

Hospital Charge Code	270634057
Hospital Revenue Code	278
Min. Negotiated Rate	$360.90
Max. Negotiated Rate	$7,487.50
Rate for Payer: Aetna Commercial	$5,690.50
Rate for Payer: Aetna Medicare Advantage	$4,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,818.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,818.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,818.62
Rate for Payer: Cigna Commercial	$7,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,623.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,294.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,246.25
Rate for Payer: UnitedHealthcare Community & State	$360.90
Rate for Payer: Wellpoint Medicaid Managed Care	$396.84

CATH SILVERHAWK 135x2.2 P4024

Facility

$14,975.00

Hospital Charge Code	270634057
Hospital Revenue Code	278
Min. Negotiated Rate	$2,246.25
Max. Negotiated Rate	$3,623.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,623.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,294.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,246.25

CATH SILVERHAWK 1.85 135 P4028

Facility

$14,975.00

Hospital Charge Code	270637763
Hospital Revenue Code	278
Min. Negotiated Rate	$360.90
Max. Negotiated Rate	$7,487.50
Rate for Payer: Aetna Commercial	$5,690.50
Rate for Payer: Aetna Medicare Advantage	$4,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,818.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,818.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,818.62
Rate for Payer: Cigna Commercial	$7,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,623.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,294.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,246.25
Rate for Payer: UnitedHealthcare Community & State	$360.90
Rate for Payer: Wellpoint Medicaid Managed Care	$396.84

CATH SILVERHAWK 1.85 135 P4028

Facility

$14,975.00

Hospital Charge Code	270637763
Hospital Revenue Code	278
Min. Negotiated Rate	$2,246.25
Max. Negotiated Rate	$3,623.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,623.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,294.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,246.25

CATH SILVERHAWK 3 5 110C P4016

Facility

$17,335.25

Hospital Charge Code	270635437
Hospital Revenue Code	278
Min. Negotiated Rate	$417.78
Max. Negotiated Rate	$8,667.62
Rate for Payer: Aetna Commercial	$6,587.40
Rate for Payer: Aetna Medicare Advantage	$5,200.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,420.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,420.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,467.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,420.49
Rate for Payer: Cigna Commercial	$8,667.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,195.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,813.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,600.29
Rate for Payer: UnitedHealthcare Community & State	$417.78
Rate for Payer: Wellpoint Medicaid Managed Care	$459.38

CATH SILVERHAWK 3 5 110C P4016

Facility

$17,335.25

Hospital Charge Code	270635437
Hospital Revenue Code	278
Min. Negotiated Rate	$2,600.29
Max. Negotiated Rate	$4,195.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,467.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,195.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,813.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,600.29

CATH SILVERHAWK 6 0 110 P4056

Facility

$15,750.00

Hospital Charge Code	270643309C
Hospital Revenue Code	278
Min. Negotiated Rate	$379.57
Max. Negotiated Rate	$7,875.00
Rate for Payer: Aetna Commercial	$5,985.00
Rate for Payer: Aetna Medicare Advantage	$4,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,016.25
Rate for Payer: Cigna Commercial	$7,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,811.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,465.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,362.50
Rate for Payer: UnitedHealthcare Community & State	$379.57
Rate for Payer: Wellpoint Medicaid Managed Care	$417.38

CATH SILVERHAWK 6 0 110 P4056

Facility

$15,750.00

Hospital Charge Code	270643309C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,362.50
Max. Negotiated Rate	$3,811.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,811.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,465.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,362.50

CATH SILVERHAWK LS 110x6 P4012

Facility

$14,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270634056
Hospital Revenue Code	278
Min. Negotiated Rate	$360.90
Max. Negotiated Rate	$7,487.50
Rate for Payer: Aetna Commercial	$5,690.50
Rate for Payer: Aetna Medicare Advantage	$4,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,818.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,818.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,818.62
Rate for Payer: Cigna Commercial	$7,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,623.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,294.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,246.25
Rate for Payer: UnitedHealthcare Community & State	$360.90
Rate for Payer: Wellpoint Medicaid Managed Care	$396.84

Know your out-of-pocket cost for care.

All Charges