Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GUIDE WIRE 100MM X 1.1MM

Facility

$57.50

Service Code	HCPCS C1769
Hospital Charge Code	270679986
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 100X1.1MM

Facility

$57.50

Service Code	HCPCS C1769
Hospital Charge Code	270637828
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 100X1.1MM

Facility

$57.50

Service Code	HCPCS C1769
Hospital Charge Code	270637828
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

GUIDEWIRE 104

Facility

$361.25

Service Code	HCPCS C1713
Hospital Charge Code	270690802
Hospital Revenue Code	278
Min. Negotiated Rate	$8.71
Max. Negotiated Rate	$180.62
Rate for Payer: Aetna Commercial	$137.28
Rate for Payer: Aetna Medicare Advantage	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.12
Rate for Payer: Cigna Commercial	$180.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$79.47
Rate for Payer: Qualcare PPO/HMO/WC	$54.19
Rate for Payer: UnitedHealthcare Community & State	$8.71
Rate for Payer: Wellpoint Medicaid Managed Care	$9.57

GUIDEWIRE 104

Facility

$361.25

Service Code	HCPCS C1713
Hospital Charge Code	270690802
Hospital Revenue Code	278
Min. Negotiated Rate	$54.19
Max. Negotiated Rate	$87.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$79.47
Rate for Payer: Qualcare PPO/HMO/WC	$54.19

GUIDE WIRE 1.1 MM

Facility

$171.40

Hospital Charge Code	270925348
Hospital Revenue Code	278
Min. Negotiated Rate	$4.13
Max. Negotiated Rate	$85.70
Rate for Payer: Aetna Commercial	$65.13
Rate for Payer: Aetna Medicare Advantage	$51.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$85.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$37.71
Rate for Payer: Qualcare PPO/HMO/WC	$25.71
Rate for Payer: UnitedHealthcare Community & State	$4.13
Rate for Payer: Wellpoint Medicaid Managed Care	$4.54

GUIDE WIRE 1.1 MM

Facility

$171.40

Hospital Charge Code	270925348
Hospital Revenue Code	278
Min. Negotiated Rate	$25.71
Max. Negotiated Rate	$41.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$37.71
Rate for Payer: Qualcare PPO/HMO/WC	$25.71

GUIDE WIRE 1.1MM

Facility

$170.00

Hospital Charge Code	270625348
Hospital Revenue Code	278
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$41.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$37.40
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

GUIDE WIRE 1.1MM

Facility

$170.00

Hospital Charge Code	270625348
Hospital Revenue Code	278
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$85.00
Rate for Payer: Aetna Commercial	$64.60
Rate for Payer: Aetna Medicare Advantage	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.35
Rate for Payer: Cigna Commercial	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$37.40
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Community & State	$4.10
Rate for Payer: Wellpoint Medicaid Managed Care	$4.50

GUIDE WIRE 1.1MM 150MM THRD

Facility

$122.25

Hospital Charge Code	270622782
Hospital Revenue Code	278
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$61.12
Rate for Payer: Aetna Commercial	$46.45
Rate for Payer: Aetna Medicare Advantage	$36.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.17
Rate for Payer: Cigna Commercial	$61.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$18.34
Rate for Payer: UnitedHealthcare Community & State	$2.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.24

GUIDE WIRE 1.1MM 150MM THRD

Facility

$122.25

Hospital Charge Code	270622782
Hospital Revenue Code	278
Min. Negotiated Rate	$18.34
Max. Negotiated Rate	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$18.34

GUIDEWIRE 1.1MMX150MM TROCTIP

Facility

$343.75

Service Code	HCPCS C1713
Hospital Charge Code	270691913
Hospital Revenue Code	278
Min. Negotiated Rate	$51.56
Max. Negotiated Rate	$83.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$75.62
Rate for Payer: Qualcare PPO/HMO/WC	$51.56

GUIDEWIRE 1.1MMX150MM TROCTIP

Facility

$343.75

Service Code	HCPCS C1713
Hospital Charge Code	270691913
Hospital Revenue Code	278
Min. Negotiated Rate	$8.28
Max. Negotiated Rate	$171.88
Rate for Payer: Aetna Commercial	$130.62
Rate for Payer: Aetna Medicare Advantage	$103.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.66
Rate for Payer: Cigna Commercial	$171.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$75.62
Rate for Payer: Qualcare PPO/HMO/WC	$51.56
Rate for Payer: UnitedHealthcare Community & State	$8.28
Rate for Payer: Wellpoint Medicaid Managed Care	$9.11

GUIDEWIRE 1.1 X 100

Facility

$189.00

Service Code	HCPCS C1769
Hospital Charge Code	270667243
Hospital Revenue Code	278
Min. Negotiated Rate	$28.35
Max. Negotiated Rate	$45.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$41.58
Rate for Payer: Qualcare PPO/HMO/WC	$28.35

GUIDEWIRE 1.1 X 100

Facility

$189.00

Service Code	HCPCS C1769
Hospital Charge Code	270667243
Hospital Revenue Code	278
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$94.50
Rate for Payer: Aetna Commercial	$71.82
Rate for Payer: Aetna Medicare Advantage	$56.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.20
Rate for Payer: Cigna Commercial	$94.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$41.58
Rate for Payer: Qualcare PPO/HMO/WC	$28.35
Rate for Payer: UnitedHealthcare Community & State	$4.55
Rate for Payer: Wellpoint Medicaid Managed Care	$5.01

GUIDE WIRE 1.25M 150MM

Facility

$122.20

Service Code	HCPCS C1713
Hospital Charge Code	270642556
Hospital Revenue Code	278
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$61.10
Rate for Payer: Aetna Commercial	$46.44
Rate for Payer: Aetna Medicare Advantage	$36.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.16
Rate for Payer: Cigna Commercial	$61.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.88
Rate for Payer: Qualcare PPO/HMO/WC	$18.33
Rate for Payer: UnitedHealthcare Community & State	$2.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.24

GUIDE WIRE 1.25M 150MM

Facility

$122.20

Service Code	HCPCS C1713
Hospital Charge Code	270642556
Hospital Revenue Code	278
Min. Negotiated Rate	$18.33
Max. Negotiated Rate	$29.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.88
Rate for Payer: Qualcare PPO/HMO/WC	$18.33

GUIDE WIRE 1.2MM

Facility

$121.75

Service Code	HCPCS C1769
Hospital Charge Code	270661039
Hospital Revenue Code	278
Min. Negotiated Rate	$18.26
Max. Negotiated Rate	$29.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.79
Rate for Payer: Qualcare PPO/HMO/WC	$18.26

GUIDE WIRE 1.2MM

Facility

$121.75

Service Code	HCPCS C1769
Hospital Charge Code	270661039
Hospital Revenue Code	278
Min. Negotiated Rate	$2.93
Max. Negotiated Rate	$60.88
Rate for Payer: Aetna Commercial	$46.27
Rate for Payer: Aetna Medicare Advantage	$36.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.05
Rate for Payer: Cigna Commercial	$60.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.79
Rate for Payer: Qualcare PPO/HMO/WC	$18.26
Rate for Payer: UnitedHealthcare Community & State	$2.93
Rate for Payer: Wellpoint Medicaid Managed Care	$3.23

GUIDEWIRE 1.2MM

Facility

$150.00

Service Code	HCPCS C1769
Hospital Charge Code	270686758
Hospital Revenue Code	278
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

GUIDEWIRE 1.2MM

Facility

$150.00

Service Code	HCPCS C1769
Hospital Charge Code	270686758
Hospital Revenue Code	278
Min. Negotiated Rate	$3.62
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Community & State	$3.62
Rate for Payer: Wellpoint Medicaid Managed Care	$3.98

GUIDEWIRE 1.2MM

Facility

$115.00

Service Code	HCPCS C1769
Hospital Charge Code	270686223
Hospital Revenue Code	278
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$57.50
Rate for Payer: Aetna Commercial	$43.70
Rate for Payer: Aetna Medicare Advantage	$34.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.32
Rate for Payer: Cigna Commercial	$57.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.30
Rate for Payer: Qualcare PPO/HMO/WC	$17.25
Rate for Payer: UnitedHealthcare Community & State	$2.77
Rate for Payer: Wellpoint Medicaid Managed Care	$3.05

GUIDEWIRE 1.2MM

Facility

$115.00

Service Code	HCPCS C1769
Hospital Charge Code	270686223
Hospital Revenue Code	278
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$27.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.30
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

GUIDEWIRE 1.2x100mm

Facility

$110.00

Service Code	HCPCS C1769
Hospital Charge Code	270685400
Hospital Revenue Code	278
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$24.20
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

GUIDEWIRE 1.2x100mm

Facility

$110.00

Service Code	HCPCS C1769
Hospital Charge Code	270685400
Hospital Revenue Code	278
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$26.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$24.20
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

Know your out-of-pocket cost for care.

All Charges