Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE FIRM GWFRM

Facility

$750.00

Hospital Charge Code	270642018V
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

GUIDEWIRE FIRM GWFRM

Facility

$750.00

Hospital Charge Code	270642018
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

GUIDEWIRE FIRM GWFRM

Facility

$750.00

Hospital Charge Code	270642018
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

GUIDEWIRE FIXEDCORE .035 180cm

Facility

$71.25

Hospital Charge Code	270640146
Hospital Revenue Code	278
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$35.62
Rate for Payer: Aetna Commercial	$27.07
Rate for Payer: Aetna Medicare Advantage	$21.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.17
Rate for Payer: Cigna Commercial	$35.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.68
Rate for Payer: Qualcare PPO/HMO/WC	$10.69
Rate for Payer: UnitedHealthcare Community & State	$1.72
Rate for Payer: Wellpoint Medicaid Managed Care	$1.89

GUIDEWIRE FIXEDCORE .035 180cm

Facility

$71.25

Hospital Charge Code	270640146
Hospital Revenue Code	278
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$17.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.68
Rate for Payer: Qualcare PPO/HMO/WC	$10.69

GUIDE WIRE FIXED CORE .035X

Facility

$132.00

Hospital Charge Code	270331525
Hospital Revenue Code	278
Min. Negotiated Rate	$3.18
Max. Negotiated Rate	$66.00
Rate for Payer: Aetna Commercial	$50.16
Rate for Payer: Aetna Medicare Advantage	$39.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.66
Rate for Payer: Cigna Commercial	$66.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.04
Rate for Payer: Qualcare PPO/HMO/WC	$19.80
Rate for Payer: UnitedHealthcare Community & State	$3.18
Rate for Payer: Wellpoint Medicaid Managed Care	$3.50

GUIDE WIRE FIXED CORE .035X

Facility

$132.00

Hospital Charge Code	270331525
Hospital Revenue Code	278
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$31.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.04
Rate for Payer: Qualcare PPO/HMO/WC	$19.80

GUIDEWIRE FIXO 0.9X70MM

Facility

$455.00

Service Code	HCPCS C1713
Hospital Charge Code	270699952
Hospital Revenue Code	278
Min. Negotiated Rate	$10.97
Max. Negotiated Rate	$227.50
Rate for Payer: Aetna Commercial	$172.90
Rate for Payer: Aetna Medicare Advantage	$136.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.03
Rate for Payer: Cigna Commercial	$227.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$100.10
Rate for Payer: Qualcare PPO/HMO/WC	$68.25
Rate for Payer: UnitedHealthcare Community & State	$10.97
Rate for Payer: Wellpoint Medicaid Managed Care	$12.06

GUIDEWIRE FIXO 0.9X70MM

Facility

$455.00

Service Code	HCPCS C1713
Hospital Charge Code	270699952
Hospital Revenue Code	278
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$110.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$100.10
Rate for Payer: Qualcare PPO/HMO/WC	$68.25

GUIDEWIRE FLOPPY 14x300 22359M

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270632557
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

GUIDEWIRE FLOPPY 14x300 22359M

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270632557
Hospital Revenue Code	278
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) NJ Health	$75.00
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	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

GUIDEWIRE FLOPPY 300 595MEY014

Facility

$414.80

Hospital Charge Code	270637325C
Hospital Revenue Code	278
Min. Negotiated Rate	$10.00
Max. Negotiated Rate	$207.40
Rate for Payer: Aetna Commercial	$157.62
Rate for Payer: Aetna Medicare Advantage	$124.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.77
Rate for Payer: Cigna Commercial	$207.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$91.26
Rate for Payer: Qualcare PPO/HMO/WC	$62.22
Rate for Payer: UnitedHealthcare Community & State	$10.00
Rate for Payer: Wellpoint Medicaid Managed Care	$10.99

GUIDEWIRE FLOPPY 300 595MEY014

Facility

$414.80

Hospital Charge Code	270637325C
Hospital Revenue Code	278
Min. Negotiated Rate	$62.22
Max. Negotiated Rate	$100.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$91.26
Rate for Payer: Qualcare PPO/HMO/WC	$62.22

GUIDEWIRE GLIDE 46-152*****

Facility

$218.00

Hospital Charge Code	270624017
Hospital Revenue Code	272
Min. Negotiated Rate	$32.70
Max. Negotiated Rate	$32.70
Rate for Payer: Qualcare PPO/HMO/WC	$32.70

GUIDEWIRE GLIDE 46-152*****

Facility

$218.00

Hospital Charge Code	270624017
Hospital Revenue Code	272
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$109.00
Rate for Payer: Aetna Commercial	$82.84
Rate for Payer: Aetna Medicare Advantage	$65.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.59
Rate for Payer: Cigna Commercial	$109.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.40
Rate for Payer: Oxford Commercial	$43.60
Rate for Payer: Qualcare PPO/HMO/WC	$32.70
Rate for Payer: UnitedHealthcare Commercial	$43.60
Rate for Payer: UnitedHealthcare Community & State	$5.25
Rate for Payer: Wellpoint Medicaid Managed Care	$5.78

GUIDEWIRE GLIDE 46-308****

Facility

$185.00

Hospital Charge Code	270624018
Hospital Revenue Code	272
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$92.50
Rate for Payer: Aetna Commercial	$70.30
Rate for Payer: Aetna Medicare Advantage	$55.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.17
Rate for Payer: Cigna Commercial	$92.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.50
Rate for Payer: Oxford Commercial	$37.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.75
Rate for Payer: UnitedHealthcare Commercial	$37.00
Rate for Payer: UnitedHealthcare Community & State	$4.46
Rate for Payer: Wellpoint Medicaid Managed Care	$4.90

GUIDEWIRE GLIDE 46-308****

Facility

$185.00

Hospital Charge Code	270624018
Hospital Revenue Code	272
Min. Negotiated Rate	$27.75
Max. Negotiated Rate	$27.75
Rate for Payer: Qualcare PPO/HMO/WC	$27.75

GUIDEWIRE GOLD ANL 018X5 46244

Facility

$657.15

Hospital Charge Code	270634523
Hospital Revenue Code	278
Min. Negotiated Rate	$15.84
Max. Negotiated Rate	$328.57
Rate for Payer: Aetna Commercial	$249.72
Rate for Payer: Aetna Medicare Advantage	$197.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.57
Rate for Payer: Cigna Commercial	$328.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$144.57
Rate for Payer: Qualcare PPO/HMO/WC	$98.57
Rate for Payer: UnitedHealthcare Community & State	$15.84
Rate for Payer: Wellpoint Medicaid Managed Care	$17.41

GUIDEWIRE GOLD ANL 018X5 46244

Facility

$657.15

Hospital Charge Code	270634523
Hospital Revenue Code	278
Min. Negotiated Rate	$98.57
Max. Negotiated Rate	$159.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$144.57
Rate for Payer: Qualcare PPO/HMO/WC	$98.57

GUIDE WIRE HBS-G-WIRE

Facility

$70.00

Hospital Charge Code	270636599
Hospital Revenue Code	272
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.50

GUIDE WIRE HBS-G-WIRE

Facility

$70.00

Hospital Charge Code	270636599
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$35.00
Rate for Payer: Aetna Commercial	$26.60
Rate for Payer: Aetna Medicare Advantage	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.85
Rate for Payer: Cigna Commercial	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.00
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.50
Rate for Payer: UnitedHealthcare Commercial	$14.00
Rate for Payer: UnitedHealthcare Community & State	$1.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

GUIDEWIRE HEPARIN COATED 145CM

Facility

$61.70

Hospital Charge Code	270637378C
Hospital Revenue Code	278
Min. Negotiated Rate	$9.26
Max. Negotiated Rate	$14.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13.57
Rate for Payer: Qualcare PPO/HMO/WC	$9.26

GUIDEWIRE HEPARIN COATED 145CM

Facility

$61.70

Hospital Charge Code	270637378C
Hospital Revenue Code	278
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$30.85
Rate for Payer: Aetna Commercial	$23.45
Rate for Payer: Aetna Medicare Advantage	$18.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.73
Rate for Payer: Cigna Commercial	$30.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13.57
Rate for Payer: Qualcare PPO/HMO/WC	$9.26
Rate for Payer: UnitedHealthcare Community & State	$1.49
Rate for Payer: Wellpoint Medicaid Managed Care	$1.64

GUIDEWIRE H FLP 014x190 22339M

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270632556
Hospital Revenue Code	278
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) NJ Health	$75.00
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	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

GUIDEWIRE H FLP 014x190 22339M

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270632556
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

Know your out-of-pocket cost for care.

All Charges