Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GUIDE ROD 2.5x280MM W/STOP

Facility

$285.00

Hospital Charge Code	270650157
Hospital Revenue Code	272
Min. Negotiated Rate	$42.75
Max. Negotiated Rate	$42.75
Rate for Payer: Qualcare PPO/HMO/WC	$42.75

GUIDE ROD 2.5x280MM W/STOP

Facility

$285.00

Hospital Charge Code	270650157
Hospital Revenue Code	272
Min. Negotiated Rate	$6.87
Max. Negotiated Rate	$142.50
Rate for Payer: Aetna Commercial	$108.30
Rate for Payer: Aetna Medicare Advantage	$85.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.67
Rate for Payer: Cigna Commercial	$142.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.50
Rate for Payer: Oxford Commercial	$57.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.75
Rate for Payer: UnitedHealthcare Commercial	$57.00
Rate for Payer: UnitedHealthcare Community & State	$6.87
Rate for Payer: Wellpoint Medicaid Managed Care	$7.55

GUIDEROD BALL 3.0x1000 7161126

Facility

$560.50

Hospital Charge Code	270633377
Hospital Revenue Code	272
Min. Negotiated Rate	$84.08
Max. Negotiated Rate	$84.08
Rate for Payer: Qualcare PPO/HMO/WC	$84.08

GUIDEROD BALL 3.0x1000 7161126

Facility

$560.50

Hospital Charge Code	270633377
Hospital Revenue Code	272
Min. Negotiated Rate	$13.51
Max. Negotiated Rate	$280.25
Rate for Payer: Aetna Commercial	$212.99
Rate for Payer: Aetna Medicare Advantage	$168.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.93
Rate for Payer: Cigna Commercial	$280.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.15
Rate for Payer: Oxford Commercial	$112.10
Rate for Payer: Qualcare PPO/HMO/WC	$84.08
Rate for Payer: UnitedHealthcare Commercial	$112.10
Rate for Payer: UnitedHealthcare Community & State	$13.51
Rate for Payer: Wellpoint Medicaid Managed Care	$14.85

GUIDE SAFEGUARD

Facility

$3,200.00

Hospital Charge Code	270668390
Hospital Revenue Code	270
Min. Negotiated Rate	$77.12
Max. Negotiated Rate	$1,600.00
Rate for Payer: Aetna Commercial	$1,216.00
Rate for Payer: Aetna Medicare Advantage	$960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$816.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$816.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$816.00
Rate for Payer: Cigna Commercial	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$960.00
Rate for Payer: Oxford Commercial	$640.00
Rate for Payer: Qualcare PPO/HMO/WC	$480.00
Rate for Payer: UnitedHealthcare Commercial	$640.00
Rate for Payer: UnitedHealthcare Community & State	$77.12
Rate for Payer: Wellpoint Medicaid Managed Care	$84.80

GUIDE SAFEGUARD

Facility

$3,200.00

Hospital Charge Code	270668390
Hospital Revenue Code	270
Min. Negotiated Rate	$480.00
Max. Negotiated Rate	$480.00
Rate for Payer: Qualcare PPO/HMO/WC	$480.00

GUIDESCOPE LOPRO S20

Facility

$260.00

Hospital Charge Code	270683599
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

GUIDESCOPE LOPRO S20

Facility

$260.00

Hospital Charge Code	270683599
Hospital Revenue Code	272
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$39.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00

GUIDE SDK DRILL 871601

Facility

$2,996.00

Hospital Charge Code	270609815
Hospital Revenue Code	272
Min. Negotiated Rate	$449.40
Max. Negotiated Rate	$449.40
Rate for Payer: Qualcare PPO/HMO/WC	$449.40

GUIDE SDK DRILL 871601

Facility

$2,996.00

Hospital Charge Code	270609815
Hospital Revenue Code	272
Min. Negotiated Rate	$72.20
Max. Negotiated Rate	$1,498.00
Rate for Payer: Aetna Commercial	$1,138.48
Rate for Payer: Aetna Medicare Advantage	$898.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$763.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$763.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$763.98
Rate for Payer: Cigna Commercial	$1,498.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$898.80
Rate for Payer: Oxford Commercial	$599.20
Rate for Payer: Qualcare PPO/HMO/WC	$449.40
Rate for Payer: UnitedHealthcare Commercial	$599.20
Rate for Payer: UnitedHealthcare Community & State	$72.20
Rate for Payer: Wellpoint Medicaid Managed Care	$79.39

GUIDE SHEALTH PINNACLE 8FR 90

Facility

$675.75

Service Code	HCPCS C1894
Hospital Charge Code	270686367O
Hospital Revenue Code	278
Min. Negotiated Rate	$101.36
Max. Negotiated Rate	$163.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.66
Rate for Payer: Qualcare PPO/HMO/WC	$101.36

GUIDE SHEALTH PINNACLE 8FR 90

Facility

$675.75

Service Code	HCPCS C1894
Hospital Charge Code	270686367
Hospital Revenue Code	278
Min. Negotiated Rate	$101.36
Max. Negotiated Rate	$163.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.66
Rate for Payer: Qualcare PPO/HMO/WC	$101.36

GUIDE SHEALTH PINNACLE 8FR 90

Facility

$675.75

Service Code	HCPCS C1894
Hospital Charge Code	270686367O
Hospital Revenue Code	278
Min. Negotiated Rate	$16.29
Max. Negotiated Rate	$337.88
Rate for Payer: Aetna Commercial	$256.79
Rate for Payer: Aetna Medicare Advantage	$202.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.32
Rate for Payer: Cigna Commercial	$337.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.66
Rate for Payer: Qualcare PPO/HMO/WC	$101.36
Rate for Payer: UnitedHealthcare Community & State	$16.29
Rate for Payer: Wellpoint Medicaid Managed Care	$17.91

GUIDE SHEALTH PINNACLE 8FR 90

Facility

$675.75

Service Code	HCPCS C1894
Hospital Charge Code	270686367
Hospital Revenue Code	278
Min. Negotiated Rate	$16.29
Max. Negotiated Rate	$337.88
Rate for Payer: Aetna Commercial	$256.79
Rate for Payer: Aetna Medicare Advantage	$202.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.32
Rate for Payer: Cigna Commercial	$337.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.66
Rate for Payer: Qualcare PPO/HMO/WC	$101.36
Rate for Payer: UnitedHealthcare Community & State	$16.29
Rate for Payer: Wellpoint Medicaid Managed Care	$17.91

GUIDESHEATH INTRO 6FR X 10

Facility

$280.00

Hospital Charge Code	270666813
Hospital Revenue Code	270
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$106.40
Rate for Payer: Aetna Medicare Advantage	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.40
Rate for Payer: Cigna Commercial	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.00
Rate for Payer: Oxford Commercial	$56.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Commercial	$56.00
Rate for Payer: UnitedHealthcare Community & State	$6.75
Rate for Payer: Wellpoint Medicaid Managed Care	$7.42

GUIDESHEATH INTRO 6FR X 10

Facility

$280.00

Hospital Charge Code	270666813
Hospital Revenue Code	270
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

GUIDE SHEATH PINNACLE 8FR 65

Facility

$614.80

Service Code	HCPCS C1894
Hospital Charge Code	270686366O
Hospital Revenue Code	278
Min. Negotiated Rate	$92.22
Max. Negotiated Rate	$148.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.26
Rate for Payer: Qualcare PPO/HMO/WC	$92.22

GUIDE SHEATH PINNACLE 8FR 65

Facility

$614.80

Service Code	HCPCS C1894
Hospital Charge Code	270686366O
Hospital Revenue Code	278
Min. Negotiated Rate	$14.82
Max. Negotiated Rate	$307.40
Rate for Payer: Aetna Commercial	$233.62
Rate for Payer: Aetna Medicare Advantage	$184.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.77
Rate for Payer: Cigna Commercial	$307.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.26
Rate for Payer: Qualcare PPO/HMO/WC	$92.22
Rate for Payer: UnitedHealthcare Community & State	$14.82
Rate for Payer: Wellpoint Medicaid Managed Care	$16.29

GUIDE SHEATH PINNACLE 8FR 65

Facility

$614.80

Service Code	HCPCS C1894
Hospital Charge Code	270686366
Hospital Revenue Code	278
Min. Negotiated Rate	$14.82
Max. Negotiated Rate	$307.40
Rate for Payer: Aetna Commercial	$233.62
Rate for Payer: Aetna Medicare Advantage	$184.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.77
Rate for Payer: Cigna Commercial	$307.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.26
Rate for Payer: Qualcare PPO/HMO/WC	$92.22
Rate for Payer: UnitedHealthcare Community & State	$14.82
Rate for Payer: Wellpoint Medicaid Managed Care	$16.29

GUIDE SHEATH PINNACLE 8FR 65

Facility

$614.80

Service Code	HCPCS C1894
Hospital Charge Code	270686366
Hospital Revenue Code	278
Min. Negotiated Rate	$92.22
Max. Negotiated Rate	$148.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.26
Rate for Payer: Qualcare PPO/HMO/WC	$92.22

GUIDE SIZING SPEED COMPRESS

Facility

$180.00

Hospital Charge Code	270681554
Hospital Revenue Code	272
Min. Negotiated Rate	$4.34
Max. Negotiated Rate	$90.00
Rate for Payer: Aetna Commercial	$68.40
Rate for Payer: Aetna Medicare Advantage	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.90
Rate for Payer: Cigna Commercial	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.00
Rate for Payer: Oxford Commercial	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Commercial	$36.00
Rate for Payer: UnitedHealthcare Community & State	$4.34
Rate for Payer: Wellpoint Medicaid Managed Care	$4.77

GUIDE SIZING SPEED COMPRESS

Facility

$180.00

Hospital Charge Code	270681554
Hospital Revenue Code	272
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

GUIDE SUBCLAVIAN **********

Facility

$176.00

Hospital Charge Code	8001828
Hospital Revenue Code	279
Min. Negotiated Rate	$4.24
Max. Negotiated Rate	$88.00
Rate for Payer: Aetna Commercial	$66.88
Rate for Payer: Aetna Medicare Advantage	$52.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.88
Rate for Payer: Cigna Commercial	$88.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.80
Rate for Payer: Oxford Commercial	$35.20
Rate for Payer: Qualcare PPO/HMO/WC	$26.40
Rate for Payer: UnitedHealthcare Commercial	$35.20
Rate for Payer: UnitedHealthcare Community & State	$4.24
Rate for Payer: Wellpoint Medicaid Managed Care	$4.66

GUIDE SUBCLAVIAN **********

Facility

$176.00

Hospital Charge Code	8001828
Hospital Revenue Code	279
Min. Negotiated Rate	$26.40
Max. Negotiated Rate	$26.40
Rate for Payer: Qualcare PPO/HMO/WC	$26.40

GUIDE WIRE

Facility

$125.00

Hospital Charge Code	270675634
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

Know your out-of-pocket cost for care.

All Charges