Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GUIDE DRILL THREADED 3.5

Facility

$448.05

Hospital Charge Code	270646926
Hospital Revenue Code	272
Min. Negotiated Rate	$67.21
Max. Negotiated Rate	$67.21
Rate for Payer: Qualcare PPO/HMO/WC	$67.21

GUIDE DUOFLEX SPRING WIRE ****

Facility

$76.00

Hospital Charge Code	8004350
Hospital Revenue Code	272
Min. Negotiated Rate	$11.40
Max. Negotiated Rate	$11.40
Rate for Payer: Qualcare PPO/HMO/WC	$11.40

GUIDE DUOFLEX SPRING WIRE ****

Facility

$76.00

Hospital Charge Code	8004350
Hospital Revenue Code	272
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$38.00
Rate for Payer: Aetna Commercial	$28.88
Rate for Payer: Aetna Medicare Advantage	$22.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.38
Rate for Payer: Cigna Commercial	$38.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.80
Rate for Payer: Oxford Commercial	$15.20
Rate for Payer: Qualcare PPO/HMO/WC	$11.40
Rate for Payer: UnitedHealthcare Commercial	$15.20
Rate for Payer: UnitedHealthcare Community & State	$1.83
Rate for Payer: Wellpoint Medicaid Managed Care	$2.01

GUIDE INSERT 3.5 W/STOP

Facility

$864.00

Hospital Charge Code	270657125
Hospital Revenue Code	272
Min. Negotiated Rate	$129.60
Max. Negotiated Rate	$129.60
Rate for Payer: Qualcare PPO/HMO/WC	$129.60

GUIDE INSERT 3.5 W/STOP

Facility

$864.00

Hospital Charge Code	270657125
Hospital Revenue Code	272
Min. Negotiated Rate	$20.82
Max. Negotiated Rate	$432.00
Rate for Payer: Aetna Commercial	$328.32
Rate for Payer: Aetna Medicare Advantage	$259.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$220.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$220.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$220.32
Rate for Payer: Cigna Commercial	$432.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.20
Rate for Payer: Oxford Commercial	$172.80
Rate for Payer: Qualcare PPO/HMO/WC	$129.60
Rate for Payer: UnitedHealthcare Commercial	$172.80
Rate for Payer: UnitedHealthcare Community & State	$20.82
Rate for Payer: Wellpoint Medicaid Managed Care	$22.90

GUIDELINE HIWIRE .038 ANGL

Facility

$154.70

Hospital Charge Code	270647878
Hospital Revenue Code	278
Min. Negotiated Rate	$23.20
Max. Negotiated Rate	$37.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$34.03
Rate for Payer: Qualcare PPO/HMO/WC	$23.20

GUIDELINE HIWIRE .038 ANGL

Facility

$154.70

Hospital Charge Code	270647878
Hospital Revenue Code	278
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$77.35
Rate for Payer: Aetna Commercial	$58.79
Rate for Payer: Aetna Medicare Advantage	$46.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.45
Rate for Payer: Cigna Commercial	$77.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$34.03
Rate for Payer: Qualcare PPO/HMO/WC	$23.20
Rate for Payer: UnitedHealthcare Community & State	$3.73
Rate for Payer: Wellpoint Medicaid Managed Care	$4.10

GUIDE MT TRANSCEND T 46813

Facility

$910.00

Hospital Charge Code	270627379
Hospital Revenue Code	272
Min. Negotiated Rate	$21.93
Max. Negotiated Rate	$455.00
Rate for Payer: Aetna Commercial	$345.80
Rate for Payer: Aetna Medicare Advantage	$273.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.05
Rate for Payer: Cigna Commercial	$455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$273.00
Rate for Payer: Oxford Commercial	$182.00
Rate for Payer: Qualcare PPO/HMO/WC	$136.50
Rate for Payer: UnitedHealthcare Commercial	$182.00
Rate for Payer: UnitedHealthcare Community & State	$21.93
Rate for Payer: Wellpoint Medicaid Managed Care	$24.11

GUIDE MT TRANSCEND T 46813

Facility

$910.00

Hospital Charge Code	270627379
Hospital Revenue Code	272
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$136.50
Rate for Payer: Qualcare PPO/HMO/WC	$136.50

GUIDE NEEDLE

Facility

$71.88

Hospital Charge Code	270667234
Hospital Revenue Code	272
Min. Negotiated Rate	$10.78
Max. Negotiated Rate	$10.78
Rate for Payer: Qualcare PPO/HMO/WC	$10.78

GUIDE NEEDLE

Facility

$71.88

Hospital Charge Code	270667234
Hospital Revenue Code	272
Min. Negotiated Rate	$1.73
Max. Negotiated Rate	$35.94
Rate for Payer: Aetna Commercial	$27.31
Rate for Payer: Aetna Medicare Advantage	$21.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.33
Rate for Payer: Cigna Commercial	$35.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.56
Rate for Payer: Oxford Commercial	$14.38
Rate for Payer: Qualcare PPO/HMO/WC	$10.78
Rate for Payer: UnitedHealthcare Commercial	$14.38
Rate for Payer: UnitedHealthcare Community & State	$1.73
Rate for Payer: Wellpoint Medicaid Managed Care	$1.90

GUIDE NEEDLE EVIVA 9G

Facility

$42.25

Hospital Charge Code	270642615N
Hospital Revenue Code	272
Min. Negotiated Rate	$6.34
Max. Negotiated Rate	$6.34
Rate for Payer: Qualcare PPO/HMO/WC	$6.34

GUIDE NEEDLE EVIVA 9G

Facility

$42.25

Hospital Charge Code	270642615N
Hospital Revenue Code	272
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$21.12
Rate for Payer: Aetna Commercial	$16.05
Rate for Payer: Aetna Medicare Advantage	$12.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.77
Rate for Payer: Cigna Commercial	$21.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.68
Rate for Payer: Oxford Commercial	$8.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.34
Rate for Payer: UnitedHealthcare Commercial	$8.45
Rate for Payer: UnitedHealthcare Community & State	$1.02
Rate for Payer: Wellpoint Medicaid Managed Care	$1.12

GUIDE NEEDLE EVIVA 9G

Facility

$48.50

Hospital Charge Code	270642615R
Hospital Revenue Code	272
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$24.25
Rate for Payer: Aetna Commercial	$18.43
Rate for Payer: Aetna Medicare Advantage	$14.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.37
Rate for Payer: Cigna Commercial	$24.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.55
Rate for Payer: Oxford Commercial	$9.70
Rate for Payer: Qualcare PPO/HMO/WC	$7.28
Rate for Payer: UnitedHealthcare Commercial	$9.70
Rate for Payer: UnitedHealthcare Community & State	$1.17
Rate for Payer: Wellpoint Medicaid Managed Care	$1.29

GUIDE NEEDLE EVIVA 9G

Facility

$48.50

Hospital Charge Code	270642615
Hospital Revenue Code	272
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$24.25
Rate for Payer: Aetna Commercial	$18.43
Rate for Payer: Aetna Medicare Advantage	$14.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.37
Rate for Payer: Cigna Commercial	$24.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.55
Rate for Payer: Oxford Commercial	$9.70
Rate for Payer: Qualcare PPO/HMO/WC	$7.28
Rate for Payer: UnitedHealthcare Commercial	$9.70
Rate for Payer: UnitedHealthcare Community & State	$1.17
Rate for Payer: Wellpoint Medicaid Managed Care	$1.29

GUIDE NEEDLE EVIVA 9G

Facility

$48.50

Hospital Charge Code	270642615
Hospital Revenue Code	272
Min. Negotiated Rate	$7.28
Max. Negotiated Rate	$7.28
Rate for Payer: Qualcare PPO/HMO/WC	$7.28

GUIDE NEEDLE EVIVA 9G

Facility

$48.50

Hospital Charge Code	270642615R
Hospital Revenue Code	272
Min. Negotiated Rate	$7.28
Max. Negotiated Rate	$7.28
Rate for Payer: Qualcare PPO/HMO/WC	$7.28

GUIDE NEEDLE SITERITE

Facility

$85.00

Hospital Charge Code	270658267
Hospital Revenue Code	272
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$12.75
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

GUIDE NEEDLE SITERITE

Facility

$85.00

Hospital Charge Code	270658267
Hospital Revenue Code	272
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$42.50
Rate for Payer: Aetna Commercial	$32.30
Rate for Payer: Aetna Medicare Advantage	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.68
Rate for Payer: Cigna Commercial	$42.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.50
Rate for Payer: Oxford Commercial	$17.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.75
Rate for Payer: UnitedHealthcare Commercial	$17.00
Rate for Payer: UnitedHealthcare Community & State	$2.05
Rate for Payer: Wellpoint Medicaid Managed Care	$2.25

GUIDEPIN

Facility

$500.00

Hospital Charge Code	270703487
Hospital Revenue Code	278
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

GUIDEPIN

Facility

$500.00

Hospital Charge Code	270703487
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

GUIDE PIN .062x4

Facility

$480.00

Hospital Charge Code	270656319
Hospital Revenue Code	272
Min. Negotiated Rate	$72.00
Max. Negotiated Rate	$72.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.00

GUIDE PIN .062x4

Facility

$480.00

Hospital Charge Code	270656319
Hospital Revenue Code	272
Min. Negotiated Rate	$11.57
Max. Negotiated Rate	$240.00
Rate for Payer: Aetna Commercial	$182.40
Rate for Payer: Aetna Medicare Advantage	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.40
Rate for Payer: Cigna Commercial	$240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.00
Rate for Payer: Oxford Commercial	$96.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.00
Rate for Payer: UnitedHealthcare Commercial	$96.00
Rate for Payer: UnitedHealthcare Community & State	$11.57
Rate for Payer: Wellpoint Medicaid Managed Care	$12.72

GUIDE PIN 2.0

Facility

$420.00

Service Code	HCPCS C1713
Hospital Charge Code	270688881
Hospital Revenue Code	278
Min. Negotiated Rate	$10.12
Max. Negotiated Rate	$210.00
Rate for Payer: Aetna Commercial	$159.60
Rate for Payer: Aetna Medicare Advantage	$126.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.10
Rate for Payer: Cigna Commercial	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$92.40
Rate for Payer: Qualcare PPO/HMO/WC	$63.00
Rate for Payer: UnitedHealthcare Community & State	$10.12
Rate for Payer: Wellpoint Medicaid Managed Care	$11.13

GUIDE PIN 2.0

Facility

$420.00

Service Code	HCPCS C1713
Hospital Charge Code	270688881
Hospital Revenue Code	278
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$101.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$92.40
Rate for Payer: Qualcare PPO/HMO/WC	$63.00

Know your out-of-pocket cost for care.

All Charges