Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GLIDECATH STR 150CM 4FR D-BRD

Facility

$1,080.00

Hospital Charge Code	270665134
Hospital Revenue Code	272
Min. Negotiated Rate	$162.00
Max. Negotiated Rate	$162.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.00

GLIDECATH STRAIGHT 4FR 65cm

Facility

$357.50

Service Code	HCPCS C2629
Hospital Charge Code	270645472C
Hospital Revenue Code	278
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$178.75
Rate for Payer: Aetna Commercial	$135.85
Rate for Payer: Aetna Medicare Advantage	$107.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.16
Rate for Payer: Cigna Commercial	$178.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$78.65
Rate for Payer: Qualcare PPO/HMO/WC	$53.62
Rate for Payer: UnitedHealthcare Community & State	$8.62
Rate for Payer: Wellpoint Medicaid Managed Care	$9.47

GLIDECATH STRAIGHT 4FR 65cm

Facility

$357.50

Service Code	HCPCS C2629
Hospital Charge Code	270645472C
Hospital Revenue Code	278
Min. Negotiated Rate	$53.62
Max. Negotiated Rate	$86.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$78.65
Rate for Payer: Qualcare PPO/HMO/WC	$53.62

GLIDECATH TORCON NB SIM1 5F 10

Facility

$74.30

Service Code	HCPCS C1887
Hospital Charge Code	270681566S
Hospital Revenue Code	278
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$37.15
Rate for Payer: Aetna Commercial	$28.23
Rate for Payer: Aetna Medicare Advantage	$22.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.95
Rate for Payer: Cigna Commercial	$37.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.35
Rate for Payer: Qualcare PPO/HMO/WC	$11.14
Rate for Payer: UnitedHealthcare Community & State	$1.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1.97

GLIDECATH TORCON NB SIM1 5F 10

Facility

$74.30

Service Code	HCPCS C1887
Hospital Charge Code	270681566S
Hospital Revenue Code	278
Min. Negotiated Rate	$11.14
Max. Negotiated Rate	$17.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.35
Rate for Payer: Qualcare PPO/HMO/WC	$11.14

GLIDE POWERGLIDE 10 CM

Facility

$570.00

Service Code	HCPCS C1887
Hospital Charge Code	270690135
Hospital Revenue Code	278
Min. Negotiated Rate	$13.74
Max. Negotiated Rate	$285.00
Rate for Payer: Aetna Commercial	$216.60
Rate for Payer: Aetna Medicare Advantage	$171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.35
Rate for Payer: Cigna Commercial	$285.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.40
Rate for Payer: Qualcare PPO/HMO/WC	$85.50
Rate for Payer: UnitedHealthcare Community & State	$13.74
Rate for Payer: Wellpoint Medicaid Managed Care	$15.11

GLIDE POWERGLIDE 10 CM

Facility

$570.00

Service Code	HCPCS C1887
Hospital Charge Code	270690135
Hospital Revenue Code	278
Min. Negotiated Rate	$85.50
Max. Negotiated Rate	$137.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.40
Rate for Payer: Qualcare PPO/HMO/WC	$85.50

GLIDERITE STYLET LARGE

Facility

$50.00

Hospital Charge Code	270689167
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

GLIDERITE STYLET LARGE

Facility

$50.00

Hospital Charge Code	270689167
Hospital Revenue Code	272
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$25.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$10.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

GLIDERITE SU STYLET

Facility

$30.00

Hospital Charge Code	270689157
Hospital Revenue Code	272
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$15.00
Rate for Payer: Aetna Commercial	$11.40
Rate for Payer: Aetna Medicare Advantage	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.65
Rate for Payer: Cigna Commercial	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.00
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.50
Rate for Payer: UnitedHealthcare Commercial	$6.00
Rate for Payer: UnitedHealthcare Community & State	$0.72
Rate for Payer: Wellpoint Medicaid Managed Care	$0.80

GLIDERITE SU STYLET

Facility

$30.00

Hospital Charge Code	270689157
Hospital Revenue Code	272
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

GLIDESCOPE BFLEX 5.0

Facility

$1,475.00

Hospital Charge Code	270689145
Hospital Revenue Code	272
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$442.50
Rate for Payer: Oxford Commercial	$295.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$295.00
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

GLIDESCOPE BFLEX 5.0

Facility

$1,475.00

Hospital Charge Code	270689145
Hospital Revenue Code	272
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$221.25
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

GLIDESCOPE BFLEX 5.0 MM

Facility

$1,700.00

Hospital Charge Code	270690090
Hospital Revenue Code	272
Min. Negotiated Rate	$40.97
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$646.00
Rate for Payer: Aetna Medicare Advantage	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$433.50
Rate for Payer: Cigna Commercial	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$510.00
Rate for Payer: Oxford Commercial	$340.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00
Rate for Payer: UnitedHealthcare Commercial	$340.00
Rate for Payer: UnitedHealthcare Community & State	$40.97
Rate for Payer: Wellpoint Medicaid Managed Care	$45.05

GLIDESCOPE BFLEX 5.0 MM

Facility

$1,700.00

Hospital Charge Code	270690090
Hospital Revenue Code	272
Min. Negotiated Rate	$255.00
Max. Negotiated Rate	$255.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00

GLIDESCOPE BFLEX 5.8

Facility

$1,700.00

Hospital Charge Code	270689144
Hospital Revenue Code	272
Min. Negotiated Rate	$40.97
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$646.00
Rate for Payer: Aetna Medicare Advantage	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$433.50
Rate for Payer: Cigna Commercial	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$510.00
Rate for Payer: Oxford Commercial	$340.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00
Rate for Payer: UnitedHealthcare Commercial	$340.00
Rate for Payer: UnitedHealthcare Community & State	$40.97
Rate for Payer: Wellpoint Medicaid Managed Care	$45.05

GLIDESCOPE BFLEX 5.8

Facility

$1,700.00

Hospital Charge Code	270689144
Hospital Revenue Code	272
Min. Negotiated Rate	$255.00
Max. Negotiated Rate	$255.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00

GLIDESCOPE BFLEX 5.8 MM

Facility

$1,700.00

Hospital Charge Code	270690089
Hospital Revenue Code	272
Min. Negotiated Rate	$40.97
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$646.00
Rate for Payer: Aetna Medicare Advantage	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$433.50
Rate for Payer: Cigna Commercial	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$510.00
Rate for Payer: Oxford Commercial	$340.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00
Rate for Payer: UnitedHealthcare Commercial	$340.00
Rate for Payer: UnitedHealthcare Community & State	$40.97
Rate for Payer: Wellpoint Medicaid Managed Care	$45.05

GLIDESCOPE BFLEX 5.8 MM

Facility

$1,700.00

Hospital Charge Code	270690089
Hospital Revenue Code	272
Min. Negotiated Rate	$255.00
Max. Negotiated Rate	$255.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00

GLIDESCOPE CORE ONE TOUCH

Facility

$72,765.00

Hospital Charge Code	270689146
Hospital Revenue Code	272
Min. Negotiated Rate	$1,753.64
Max. Negotiated Rate	$36,382.50
Rate for Payer: Aetna Commercial	$27,650.70
Rate for Payer: Aetna Medicare Advantage	$21,829.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18,555.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18,555.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18,555.08
Rate for Payer: Cigna Commercial	$36,382.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,829.50
Rate for Payer: Oxford Commercial	$14,553.00
Rate for Payer: Qualcare PPO/HMO/WC	$10,914.75
Rate for Payer: UnitedHealthcare Commercial	$14,553.00
Rate for Payer: UnitedHealthcare Community & State	$1,753.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1,928.27

GLIDESCOPE CORE ONE TOUCH

Facility

$72,765.00

Hospital Charge Code	270689146
Hospital Revenue Code	272
Min. Negotiated Rate	$10,914.75
Max. Negotiated Rate	$10,914.75
Rate for Payer: Qualcare PPO/HMO/WC	$10,914.75

GLIDESCOPE LOPRO S1

Facility

$260.00

Hospital Charge Code	270683598
Hospital Revenue Code	272
Min. Negotiated Rate	$6.27
Max. Negotiated Rate	$130.00
Rate for Payer: Aetna Commercial	$98.80
Rate for Payer: Aetna Medicare Advantage	$78.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.30
Rate for Payer: Cigna Commercial	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.00
Rate for Payer: Oxford Commercial	$52.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00
Rate for Payer: UnitedHealthcare Commercial	$52.00
Rate for Payer: UnitedHealthcare Community & State	$6.27
Rate for Payer: Wellpoint Medicaid Managed Care	$6.89

GLIDESCOPE LOPRO S1

Facility

$260.00

Hospital Charge Code	270683598
Hospital Revenue Code	272
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$39.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00

GLIDESCOPE LPPRO 2.5 PEDS DISP

Facility

$114.50

Hospital Charge Code	270678444
Hospital Revenue Code	272
Min. Negotiated Rate	$17.18
Max. Negotiated Rate	$17.18
Rate for Payer: Qualcare PPO/HMO/WC	$17.18

GLIDESCOPE LPPRO 2.5 PEDS DISP

Facility

$114.50

Hospital Charge Code	270678444
Hospital Revenue Code	272
Min. Negotiated Rate	$2.76
Max. Negotiated Rate	$57.25
Rate for Payer: Aetna Commercial	$43.51
Rate for Payer: Aetna Medicare Advantage	$34.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.20
Rate for Payer: Cigna Commercial	$57.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.35
Rate for Payer: Oxford Commercial	$22.90
Rate for Payer: Qualcare PPO/HMO/WC	$17.18
Rate for Payer: UnitedHealthcare Commercial	$22.90
Rate for Payer: UnitedHealthcare Community & State	$2.76
Rate for Payer: Wellpoint Medicaid Managed Care	$3.03

Know your out-of-pocket cost for care.

All Charges