Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE .035x150CM

Facility

$300.00

Service Code	HCPCS C1769
Hospital Charge Code	270676578N
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

GUIDEWIRE .035x150CM

Facility

$300.00

Service Code	HCPCS C1769
Hospital Charge Code	270676578
Hospital Revenue Code	278
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) NJ Health	$60.00
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	$72.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

GUIDEWIRE .038 150cm STRAIGHT

Facility

$212.50

Hospital Charge Code	270605414
Hospital Revenue Code	272
Min. Negotiated Rate	$5.12
Max. Negotiated Rate	$106.25
Rate for Payer: Aetna Commercial	$80.75
Rate for Payer: Aetna Medicare Advantage	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.19
Rate for Payer: Cigna Commercial	$106.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.75
Rate for Payer: Oxford Commercial	$42.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.88
Rate for Payer: UnitedHealthcare Commercial	$42.50
Rate for Payer: UnitedHealthcare Community & State	$5.12
Rate for Payer: Wellpoint Medicaid Managed Care	$5.63

GUIDEWIRE .038 150cm STRAIGHT

Facility

$212.50

Hospital Charge Code	270605414
Hospital Revenue Code	272
Min. Negotiated Rate	$31.88
Max. Negotiated Rate	$31.88
Rate for Payer: Qualcare PPO/HMO/WC	$31.88

GUIDEWIRE .038 3MMJ 150CM

Facility

$37.50

Hospital Charge Code	270646396C
Hospital Revenue Code	278
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$18.75
Rate for Payer: Aetna Commercial	$14.25
Rate for Payer: Aetna Medicare Advantage	$11.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.56
Rate for Payer: Cigna Commercial	$18.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.62
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

GUIDEWIRE .038 3MMJ 150CM

Facility

$37.50

Hospital Charge Code	270646396C
Hospital Revenue Code	278
Min. Negotiated Rate	$5.62
Max. Negotiated Rate	$9.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.62

GUIDEWIRE .038 STRAIGHT TIP

Facility

$82.00

Hospital Charge Code	270331441
Hospital Revenue Code	278
Min. Negotiated Rate	$12.30
Max. Negotiated Rate	$19.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.04
Rate for Payer: Qualcare PPO/HMO/WC	$12.30

GUIDEWIRE .038 STRAIGHT TIP

Facility

$82.00

Hospital Charge Code	270331441
Hospital Revenue Code	278
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$41.00
Rate for Payer: Aetna Commercial	$31.16
Rate for Payer: Aetna Medicare Advantage	$24.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.91
Rate for Payer: Cigna Commercial	$41.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.04
Rate for Payer: Qualcare PPO/HMO/WC	$12.30
Rate for Payer: UnitedHealthcare Community & State	$1.98
Rate for Payer: Wellpoint Medicaid Managed Care	$2.17

GUIDE WIRE .038 X 145CM HEAVY

Facility

$154.00

Hospital Charge Code	270331273
Hospital Revenue Code	278
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$37.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.88
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

GUIDE WIRE .038 X 145CM HEAVY

Facility

$154.00

Hospital Charge Code	270331273
Hospital Revenue Code	278
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$77.00
Rate for Payer: Aetna Commercial	$58.52
Rate for Payer: Aetna Medicare Advantage	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.27
Rate for Payer: Cigna Commercial	$77.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.88
Rate for Payer: Qualcare PPO/HMO/WC	$23.10
Rate for Payer: UnitedHealthcare Community & State	$3.71
Rate for Payer: Wellpoint Medicaid Managed Care	$4.08

GUIDEWIRE 038x145 TCMT 067853

Facility

$63.00

Hospital Charge Code	270626249
Hospital Revenue Code	272
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$9.45

GUIDEWIRE 038x145 TCMT 067853

Facility

$63.00

Hospital Charge Code	270626249
Hospital Revenue Code	272
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna Commercial	$23.94
Rate for Payer: Aetna Medicare Advantage	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.07
Rate for Payer: Cigna Commercial	$31.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.90
Rate for Payer: Oxford Commercial	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.45
Rate for Payer: UnitedHealthcare Commercial	$12.60
Rate for Payer: UnitedHealthcare Community & State	$1.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1.67

GUIDEWIRE .038X150CM DUAL FLEX

Facility

$374.66

Service Code	HCPCS C1769
Hospital Charge Code	270684751
Hospital Revenue Code	278
Min. Negotiated Rate	$56.20
Max. Negotiated Rate	$90.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.43
Rate for Payer: Qualcare PPO/HMO/WC	$56.20

GUIDEWIRE .038X150CM DUAL FLEX

Facility

$374.66

Service Code	HCPCS C1769
Hospital Charge Code	270684751
Hospital Revenue Code	278
Min. Negotiated Rate	$9.03
Max. Negotiated Rate	$187.33
Rate for Payer: Aetna Commercial	$142.37
Rate for Payer: Aetna Medicare Advantage	$112.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.54
Rate for Payer: Cigna Commercial	$187.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.43
Rate for Payer: Qualcare PPO/HMO/WC	$56.20
Rate for Payer: UnitedHealthcare Community & State	$9.03
Rate for Payer: Wellpoint Medicaid Managed Care	$9.93

GUIDEWIRE .038 X150CMX15CM

Facility

$208.00

Hospital Charge Code	270332070
Hospital Revenue Code	278
Min. Negotiated Rate	$5.01
Max. Negotiated Rate	$104.00
Rate for Payer: Aetna Commercial	$79.04
Rate for Payer: Aetna Medicare Advantage	$62.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.04
Rate for Payer: Cigna Commercial	$104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$45.76
Rate for Payer: Qualcare PPO/HMO/WC	$31.20
Rate for Payer: UnitedHealthcare Community & State	$5.01
Rate for Payer: Wellpoint Medicaid Managed Care	$5.51

GUIDEWIRE .038 X150CMX15CM

Facility

$208.00

Hospital Charge Code	270332070
Hospital Revenue Code	278
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$50.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$45.76
Rate for Payer: Qualcare PPO/HMO/WC	$31.20

GUIDE WIRE .054 X 6

Facility

$80.00

Hospital Charge Code	270659705
Hospital Revenue Code	278
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$19.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$17.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.00

GUIDE WIRE .054 X 6

Facility

$80.00

Hospital Charge Code	270659705
Hospital Revenue Code	278
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$40.00
Rate for Payer: Aetna Commercial	$30.40
Rate for Payer: Aetna Medicare Advantage	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.40
Rate for Payer: Cigna Commercial	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$17.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.00
Rate for Payer: UnitedHealthcare Community & State	$1.93
Rate for Payer: Wellpoint Medicaid Managed Care	$2.12

GUIDE WIRE .059

Facility

$45.00

Hospital Charge Code	270637505
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.50
Rate for Payer: Oxford Commercial	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Commercial	$9.00
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

GUIDE WIRE .059

Facility

$45.00

Hospital Charge Code	270637505
Hospital Revenue Code	272
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

GUIDEWIRE 0.8x100MM

Facility

$642.70

Service Code	HCPCS C1769
Hospital Charge Code	270634210
Hospital Revenue Code	278
Min. Negotiated Rate	$96.41
Max. Negotiated Rate	$155.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.39
Rate for Payer: Qualcare PPO/HMO/WC	$96.41

GUIDEWIRE 0.8x100MM

Facility

$642.70

Service Code	HCPCS C1769
Hospital Charge Code	270634210
Hospital Revenue Code	278
Min. Negotiated Rate	$15.49
Max. Negotiated Rate	$321.35
Rate for Payer: Aetna Commercial	$244.23
Rate for Payer: Aetna Medicare Advantage	$192.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.89
Rate for Payer: Cigna Commercial	$321.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.39
Rate for Payer: Qualcare PPO/HMO/WC	$96.41
Rate for Payer: UnitedHealthcare Community & State	$15.49
Rate for Payer: Wellpoint Medicaid Managed Care	$17.03

GUIDE WIRE 100MM X0.9MM

Facility

$57.50

Service Code	HCPCS C1769
Hospital Charge Code	270679987
Hospital Revenue Code	278
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$13.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.65
Rate for Payer: Qualcare PPO/HMO/WC	$8.62

GUIDE WIRE 100MM X0.9MM

Facility

$57.50

Service Code	HCPCS C1769
Hospital Charge Code	270679987
Hospital Revenue Code	278
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$28.75
Rate for Payer: Aetna Commercial	$21.85
Rate for Payer: Aetna Medicare Advantage	$17.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.66
Rate for Payer: Cigna Commercial	$28.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.65
Rate for Payer: Qualcare PPO/HMO/WC	$8.62
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.52

GUIDE WIRE 100MM X 1.1MM

Facility

$57.50

Service Code	HCPCS C1769
Hospital Charge Code	270679986
Hospital Revenue Code	278
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$13.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.65
Rate for Payer: Qualcare PPO/HMO/WC	$8.62

Know your out-of-pocket cost for care.

All Charges