Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GLIDESHEATH 6FR

Facility

$211.50

Service Code	HCPCS C1894
Hospital Charge Code	270686954N
Hospital Revenue Code	278
Min. Negotiated Rate	$31.73
Max. Negotiated Rate	$51.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$46.53
Rate for Payer: Qualcare PPO/HMO/WC	$31.73

GLIDESHEATH 6FR

Facility

$211.50

Service Code	HCPCS C1894
Hospital Charge Code	270686954S
Hospital Revenue Code	278
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$105.75
Rate for Payer: Aetna Commercial	$80.37
Rate for Payer: Aetna Medicare Advantage	$63.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.93
Rate for Payer: Cigna Commercial	$105.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$46.53
Rate for Payer: Qualcare PPO/HMO/WC	$31.73
Rate for Payer: UnitedHealthcare Community & State	$5.10
Rate for Payer: Wellpoint Medicaid Managed Care	$5.60

GLIDESHEATH 6FR

Facility

$211.50

Service Code	HCPCS C1894
Hospital Charge Code	270686954S
Hospital Revenue Code	278
Min. Negotiated Rate	$31.73
Max. Negotiated Rate	$51.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$46.53
Rate for Payer: Qualcare PPO/HMO/WC	$31.73

GLIDESHEATH 6FR

Facility

$211.50

Service Code	HCPCS C1894
Hospital Charge Code	270686954N
Hospital Revenue Code	278
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$105.75
Rate for Payer: Aetna Commercial	$80.37
Rate for Payer: Aetna Medicare Advantage	$63.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.93
Rate for Payer: Cigna Commercial	$105.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$46.53
Rate for Payer: Qualcare PPO/HMO/WC	$31.73
Rate for Payer: UnitedHealthcare Community & State	$5.10
Rate for Payer: Wellpoint Medicaid Managed Care	$5.60

GLIDESHEATH ACCESS KIT 5FR

Facility

$533.50

Hospital Charge Code	270644230C
Hospital Revenue Code	272
Min. Negotiated Rate	$12.86
Max. Negotiated Rate	$266.75
Rate for Payer: Aetna Commercial	$202.73
Rate for Payer: Aetna Medicare Advantage	$160.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.04
Rate for Payer: Cigna Commercial	$266.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.05
Rate for Payer: Oxford Commercial	$106.70
Rate for Payer: Qualcare PPO/HMO/WC	$80.03
Rate for Payer: UnitedHealthcare Commercial	$106.70
Rate for Payer: UnitedHealthcare Community & State	$12.86
Rate for Payer: Wellpoint Medicaid Managed Care	$14.14

GLIDESHEATH ACCESS KIT 5FR

Facility

$533.50

Hospital Charge Code	270644230C
Hospital Revenue Code	272
Min. Negotiated Rate	$80.03
Max. Negotiated Rate	$80.03
Rate for Payer: Qualcare PPO/HMO/WC	$80.03

GLIDESHEATH ACCESS KIT 5FR

Facility

$300.00

Hospital Charge Code	270644320C
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

GLIDESHEATH ACCESS KIT 5FR

Facility

$300.00

Hospital Charge Code	270644320C
Hospital Revenue Code	272
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.00
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$60.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

GLIDESHEATH B KIT INTRODUCER

Facility

$46.10

Hospital Charge Code	270682540
Hospital Revenue Code	272
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$6.92
Rate for Payer: Qualcare PPO/HMO/WC	$6.92

GLIDESHEATH B KIT INTRODUCER

Facility

$46.10

Hospital Charge Code	270682540
Hospital Revenue Code	272
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$23.05
Rate for Payer: Aetna Commercial	$17.52
Rate for Payer: Aetna Medicare Advantage	$13.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.76
Rate for Payer: Cigna Commercial	$23.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.83
Rate for Payer: Oxford Commercial	$9.22
Rate for Payer: Qualcare PPO/HMO/WC	$6.92
Rate for Payer: UnitedHealthcare Commercial	$9.22
Rate for Payer: UnitedHealthcare Community & State	$1.11
Rate for Payer: Wellpoint Medicaid Managed Care	$1.22

GLIDESHEATH NITINOL KIT .021

Facility

$74.12

Hospital Charge Code	270682541
Hospital Revenue Code	272
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$37.06
Rate for Payer: Aetna Commercial	$28.17
Rate for Payer: Aetna Medicare Advantage	$22.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.90
Rate for Payer: Cigna Commercial	$37.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.24
Rate for Payer: Oxford Commercial	$14.82
Rate for Payer: Qualcare PPO/HMO/WC	$11.12
Rate for Payer: UnitedHealthcare Commercial	$14.82
Rate for Payer: UnitedHealthcare Community & State	$1.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1.96

GLIDESHEATH NITINOL KIT .021

Facility

$74.12

Hospital Charge Code	270682541
Hospital Revenue Code	272
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$11.12
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

GLIDESHEATH RADL 6FR PINN 10cm

Facility

$247.50

Hospital Charge Code	270646471C
Hospital Revenue Code	272
Min. Negotiated Rate	$5.96
Max. Negotiated Rate	$123.75
Rate for Payer: Aetna Commercial	$94.05
Rate for Payer: Aetna Medicare Advantage	$74.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.11
Rate for Payer: Cigna Commercial	$123.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.25
Rate for Payer: Oxford Commercial	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.12
Rate for Payer: UnitedHealthcare Commercial	$49.50
Rate for Payer: UnitedHealthcare Community & State	$5.96
Rate for Payer: Wellpoint Medicaid Managed Care	$6.56

GLIDESHEATH RADL 6FR PINN 10cm

Facility

$247.50

Hospital Charge Code	270646471C
Hospital Revenue Code	272
Min. Negotiated Rate	$37.12
Max. Negotiated Rate	$37.12
Rate for Payer: Qualcare PPO/HMO/WC	$37.12

GLIDESHEATH RADL 6 RMAFGG10HAT

Facility

$446.00

Hospital Charge Code	270643103C
Hospital Revenue Code	272
Min. Negotiated Rate	$66.90
Max. Negotiated Rate	$66.90
Rate for Payer: Qualcare PPO/HMO/WC	$66.90

GLIDESHEATH RADL 6 RMAFGG10HAT

Facility

$446.00

Hospital Charge Code	270643103C
Hospital Revenue Code	272
Min. Negotiated Rate	$10.75
Max. Negotiated Rate	$223.00
Rate for Payer: Aetna Commercial	$169.48
Rate for Payer: Aetna Medicare Advantage	$133.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.73
Rate for Payer: Cigna Commercial	$223.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.80
Rate for Payer: Oxford Commercial	$89.20
Rate for Payer: Qualcare PPO/HMO/WC	$66.90
Rate for Payer: UnitedHealthcare Commercial	$89.20
Rate for Payer: UnitedHealthcare Community & State	$10.75
Rate for Payer: Wellpoint Medicaid Managed Care	$11.82

GLIDESHEATH SLENDER 5F 80-1050

Facility

$325.00

Service Code	HCPCS C1894
Hospital Charge Code	270696640V
Hospital Revenue Code	278
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$78.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

GLIDESHEATH SLENDER 5F 80-1050

Facility

$325.00

Service Code	HCPCS C1894
Hospital Charge Code	270696640V
Hospital Revenue Code	278
Min. Negotiated Rate	$7.83
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$123.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Community & State	$7.83
Rate for Payer: Wellpoint Medicaid Managed Care	$8.61

GLIDE SHEATH SLENDER 5 FR

Facility

$240.00

Hospital Charge Code	270675359
Hospital Revenue Code	272
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

GLIDE SHEATH SLENDER 5 FR

Facility

$240.00

Hospital Charge Code	270675359
Hospital Revenue Code	272
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.00
Rate for Payer: Oxford Commercial	$48.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Commercial	$48.00
Rate for Payer: UnitedHealthcare Community & State	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$6.36

GLIDE SHEATH SLENDER 6FR x 10c

Facility

$531.25

Hospital Charge Code	270665133
Hospital Revenue Code	270
Min. Negotiated Rate	$79.69
Max. Negotiated Rate	$79.69
Rate for Payer: Qualcare PPO/HMO/WC	$79.69

GLIDE SHEATH SLENDER 6FR x 10c

Facility

$375.00

Hospital Charge Code	270665133N
Hospital Revenue Code	270
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

GLIDE SHEATH SLENDER 6FR x 10c

Facility

$531.25

Hospital Charge Code	270665133
Hospital Revenue Code	270
Min. Negotiated Rate	$12.80
Max. Negotiated Rate	$265.62
Rate for Payer: Aetna Commercial	$201.88
Rate for Payer: Aetna Medicare Advantage	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.47
Rate for Payer: Cigna Commercial	$265.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.38
Rate for Payer: Oxford Commercial	$106.25
Rate for Payer: Qualcare PPO/HMO/WC	$79.69
Rate for Payer: UnitedHealthcare Commercial	$106.25
Rate for Payer: UnitedHealthcare Community & State	$12.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.08

GLIDE SHEATH SLENDER 6FR x 10c

Facility

$375.00

Hospital Charge Code	270665133N
Hospital Revenue Code	270
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$75.00
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

GLIDE SHEATH SLENDER 6FR x 10c

Facility

$531.25

Hospital Charge Code	270665133S
Hospital Revenue Code	270
Min. Negotiated Rate	$79.69
Max. Negotiated Rate	$79.69
Rate for Payer: Qualcare PPO/HMO/WC	$79.69

Know your out-of-pocket cost for care.

All Charges