Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CORD ELECTRO TUR *********

Facility

$15.00

Hospital Charge Code	1600642
Hospital Revenue Code	272
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

CORD ELECTRO TUR *********

Facility

$15.00

Hospital Charge Code	1600642
Hospital Revenue Code	272
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$5.70
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.50
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$3.00
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

CORD ELECTRO TUR E0503

Facility

$16.41

Hospital Charge Code	270608043
Hospital Revenue Code	272
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$8.21
Rate for Payer: Aetna Commercial	$6.24
Rate for Payer: Aetna Medicare Advantage	$4.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.18
Rate for Payer: Cigna Commercial	$8.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.92
Rate for Payer: Oxford Commercial	$3.28
Rate for Payer: Qualcare PPO/HMO/WC	$2.46
Rate for Payer: UnitedHealthcare Commercial	$3.28
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.43

CORD ELECTRO TUR E0503

Facility

$16.41

Hospital Charge Code	270608043
Hospital Revenue Code	272
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$2.46
Rate for Payer: Qualcare PPO/HMO/WC	$2.46

COR DISPOSABLE KIT W/PERP

Facility

$6,880.00

Hospital Charge Code	270673199
Hospital Revenue Code	272
Min. Negotiated Rate	$1,032.00
Max. Negotiated Rate	$1,032.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,032.00

COR DISPOSABLE KIT W/PERP

Facility

$6,880.00

Hospital Charge Code	270673199
Hospital Revenue Code	272
Min. Negotiated Rate	$165.81
Max. Negotiated Rate	$3,440.00
Rate for Payer: Aetna Commercial	$2,614.40
Rate for Payer: Aetna Medicare Advantage	$2,064.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,754.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,754.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,754.40
Rate for Payer: Cigna Commercial	$3,440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,064.00
Rate for Payer: Oxford Commercial	$1,376.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,032.00
Rate for Payer: UnitedHealthcare Commercial	$1,376.00
Rate for Payer: UnitedHealthcare Community & State	$165.81
Rate for Payer: Wellpoint Medicaid Managed Care	$182.32

CORDIS PTA DILATION CATHETER

Facility

$785.00

Hospital Charge Code	270335507
Hospital Revenue Code	278
Min. Negotiated Rate	$117.75
Max. Negotiated Rate	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$172.70
Rate for Payer: Qualcare PPO/HMO/WC	$117.75

CORDIS PTA DILATION CATHETER

Facility

$785.00

Hospital Charge Code	270335507
Hospital Revenue Code	278
Min. Negotiated Rate	$18.92
Max. Negotiated Rate	$392.50
Rate for Payer: Aetna Commercial	$298.30
Rate for Payer: Aetna Medicare Advantage	$235.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.18
Rate for Payer: Cigna Commercial	$392.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$172.70
Rate for Payer: Qualcare PPO/HMO/WC	$117.75
Rate for Payer: UnitedHealthcare Community & State	$18.92
Rate for Payer: Wellpoint Medicaid Managed Care	$20.80

CORDIS TRAPESE VENA CAVA FILTE

Facility

$6,630.00

Service Code	HCPCS C1880
Hospital Charge Code	270657201
Hospital Revenue Code	278
Min. Negotiated Rate	$159.78
Max. Negotiated Rate	$3,315.00
Rate for Payer: Aetna Commercial	$2,519.40
Rate for Payer: Aetna Medicare Advantage	$1,989.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,690.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,690.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,326.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,690.65
Rate for Payer: Cigna Commercial	$3,315.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,604.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,458.60
Rate for Payer: Qualcare PPO/HMO/WC	$994.50
Rate for Payer: UnitedHealthcare Community & State	$159.78
Rate for Payer: Wellpoint Medicaid Managed Care	$175.69

CORDIS TRAPESE VENA CAVA FILTE

Facility

$6,630.00

Service Code	HCPCS C1880
Hospital Charge Code	270657201
Hospital Revenue Code	278
Min. Negotiated Rate	$994.50
Max. Negotiated Rate	$1,604.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,326.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,604.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,458.60
Rate for Payer: Qualcare PPO/HMO/WC	$994.50

CORD KS BIPOL 12FT DISP 104000

Facility

$22.45

Hospital Charge Code	270618273
Hospital Revenue Code	272
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$8.53
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.74
Rate for Payer: Oxford Commercial	$4.49
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$4.49
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.59

CORD KS BIPOL 12FT DISP 104000

Facility

$22.45

Hospital Charge Code	270618273
Hospital Revenue Code	272
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

CORD PROBE EXTENSION

Facility

$82.15

Hospital Charge Code	270666118
Hospital Revenue Code	270
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$41.08
Rate for Payer: Aetna Commercial	$31.22
Rate for Payer: Aetna Medicare Advantage	$24.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.95
Rate for Payer: Cigna Commercial	$41.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.64
Rate for Payer: Oxford Commercial	$16.43
Rate for Payer: Qualcare PPO/HMO/WC	$12.32
Rate for Payer: UnitedHealthcare Commercial	$16.43
Rate for Payer: UnitedHealthcare Community & State	$1.98
Rate for Payer: Wellpoint Medicaid Managed Care	$2.18

CORD PROBE EXTENSION

Facility

$82.15

Hospital Charge Code	270666118
Hospital Revenue Code	270
Min. Negotiated Rate	$12.32
Max. Negotiated Rate	$12.32
Rate for Payer: Qualcare PPO/HMO/WC	$12.32

CORD STZ BIPOLAR 26176LA

Facility

$1,112.85

Hospital Charge Code	270616695
Hospital Revenue Code	272
Min. Negotiated Rate	$26.82
Max. Negotiated Rate	$556.42
Rate for Payer: Aetna Commercial	$422.88
Rate for Payer: Aetna Medicare Advantage	$333.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$283.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$283.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$283.78
Rate for Payer: Cigna Commercial	$556.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.86
Rate for Payer: Oxford Commercial	$222.57
Rate for Payer: Qualcare PPO/HMO/WC	$166.93
Rate for Payer: UnitedHealthcare Commercial	$222.57
Rate for Payer: UnitedHealthcare Community & State	$26.82
Rate for Payer: Wellpoint Medicaid Managed Care	$29.49

CORD STZ BIPOLAR 26176LA

Facility

$1,112.85

Hospital Charge Code	270616695
Hospital Revenue Code	272
Min. Negotiated Rate	$166.93
Max. Negotiated Rate	$166.93
Rate for Payer: Qualcare PPO/HMO/WC	$166.93

CORD STZ BIPOLAR DISP 26176LD

Facility

$102.50

Hospital Charge Code	270616247
Hospital Revenue Code	272
Min. Negotiated Rate	$15.38
Max. Negotiated Rate	$15.38
Rate for Payer: Qualcare PPO/HMO/WC	$15.38

CORD STZ BIPOLAR DISP 26176LD

Facility

$102.50

Hospital Charge Code	270616247
Hospital Revenue Code	272
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$51.25
Rate for Payer: Aetna Commercial	$38.95
Rate for Payer: Aetna Medicare Advantage	$30.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.14
Rate for Payer: Cigna Commercial	$51.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.75
Rate for Payer: Oxford Commercial	$20.50
Rate for Payer: Qualcare PPO/HMO/WC	$15.38
Rate for Payer: UnitedHealthcare Commercial	$20.50
Rate for Payer: UnitedHealthcare Community & State	$2.47
Rate for Payer: Wellpoint Medicaid Managed Care	$2.72

CORD TRACTION 230 ROLL 967-03

Facility

$484.00

Hospital Charge Code	270300735
Hospital Revenue Code	270
Min. Negotiated Rate	$11.66
Max. Negotiated Rate	$242.00
Rate for Payer: Aetna Commercial	$183.92
Rate for Payer: Aetna Medicare Advantage	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.42
Rate for Payer: Cigna Commercial	$242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Oxford Commercial	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$72.60
Rate for Payer: UnitedHealthcare Commercial	$96.80
Rate for Payer: UnitedHealthcare Community & State	$11.66
Rate for Payer: Wellpoint Medicaid Managed Care	$12.83

CORD TRACTION 230 ROLL 967-03

Facility

$484.00

Hospital Charge Code	270300735
Hospital Revenue Code	270
Min. Negotiated Rate	$72.60
Max. Negotiated Rate	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

CORD TRACTION ZIMCODE

Facility

$190.40

Hospital Charge Code	270654050
Hospital Revenue Code	270
Min. Negotiated Rate	$4.59
Max. Negotiated Rate	$95.20
Rate for Payer: Aetna Commercial	$72.35
Rate for Payer: Aetna Medicare Advantage	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.55
Rate for Payer: Cigna Commercial	$95.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.12
Rate for Payer: Oxford Commercial	$38.08
Rate for Payer: Qualcare PPO/HMO/WC	$28.56
Rate for Payer: UnitedHealthcare Commercial	$38.08
Rate for Payer: UnitedHealthcare Community & State	$4.59
Rate for Payer: Wellpoint Medicaid Managed Care	$5.05

CORD TRACTION ZIMCODE

Facility

$190.40

Hospital Charge Code	270654050
Hospital Revenue Code	270
Min. Negotiated Rate	$28.56
Max. Negotiated Rate	$28.56
Rate for Payer: Qualcare PPO/HMO/WC	$28.56

CORE DEVICE 14GA SPRING

Facility

$460.75

Service Code	HCPCS A4649
Hospital Charge Code	270697942
Hospital Revenue Code	272
Min. Negotiated Rate	$69.11
Max. Negotiated Rate	$69.11
Rate for Payer: Qualcare PPO/HMO/WC	$69.11

CORE DEVICE 14GA SPRING

Facility

$460.75

Service Code	HCPCS A4649
Hospital Charge Code	270697942
Hospital Revenue Code	272
Min. Negotiated Rate	$11.10
Max. Negotiated Rate	$230.38
Rate for Payer: Aetna Commercial	$175.09
Rate for Payer: Aetna Medicare Advantage	$138.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.49
Rate for Payer: Cigna Commercial	$230.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.22
Rate for Payer: Oxford Commercial	$92.15
Rate for Payer: Qualcare PPO/HMO/WC	$69.11
Rate for Payer: UnitedHealthcare Commercial	$92.15
Rate for Payer: UnitedHealthcare Community & State	$11.10
Rate for Payer: Wellpoint Medicaid Managed Care	$12.21

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408LT
Hospital Charge Code	404632408L
Hospital Revenue Code	361
Min. Negotiated Rate	$204.83
Max. Negotiated Rate	$4,249.50
Rate for Payer: Aetna Commercial	$3,229.62
Rate for Payer: Aetna Medicare Advantage	$2,549.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,167.24
Rate for Payer: Cigna Commercial	$4,249.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,549.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85
Rate for Payer: UnitedHealthcare Community & State	$204.83
Rate for Payer: Wellpoint Medicaid Managed Care	$225.22

Know your out-of-pocket cost for care.

All Charges