Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE LUGE 182cm 1213001

Facility

$2,500.00

Service Code	HCPCS C1769
Hospital Charge Code	270631645
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

GUIDEWIRE LUGE 300cm 1210001

Facility

$595.25

Hospital Charge Code	270631646
Hospital Revenue Code	278
Min. Negotiated Rate	$14.35
Max. Negotiated Rate	$297.62
Rate for Payer: Aetna Commercial	$226.19
Rate for Payer: Aetna Medicare Advantage	$178.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.79
Rate for Payer: Cigna Commercial	$297.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$130.96
Rate for Payer: Qualcare PPO/HMO/WC	$89.29
Rate for Payer: UnitedHealthcare Community & State	$14.35
Rate for Payer: Wellpoint Medicaid Managed Care	$15.77

GUIDEWIRE LUGE 300cm 1210001

Facility

$595.25

Hospital Charge Code	270631646
Hospital Revenue Code	278
Min. Negotiated Rate	$89.29
Max. Negotiated Rate	$144.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$130.96
Rate for Payer: Qualcare PPO/HMO/WC	$89.29

GUIDEWIRE LUNRQIUST 035 278839

Facility

$236.90

Hospital Charge Code	270632729
Hospital Revenue Code	278
Min. Negotiated Rate	$35.53
Max. Negotiated Rate	$57.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.12
Rate for Payer: Qualcare PPO/HMO/WC	$35.53

GUIDEWIRE LUNRQIUST 035 278839

Facility

$236.90

Hospital Charge Code	270632729
Hospital Revenue Code	278
Min. Negotiated Rate	$5.71
Max. Negotiated Rate	$118.45
Rate for Payer: Aetna Commercial	$90.02
Rate for Payer: Aetna Medicare Advantage	$71.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.41
Rate for Payer: Cigna Commercial	$118.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.12
Rate for Payer: Qualcare PPO/HMO/WC	$35.53
Rate for Payer: UnitedHealthcare Community & State	$5.71
Rate for Payer: Wellpoint Medicaid Managed Care	$6.28

GUIDEWIRE MAGIC TORQUE 180cm

Facility

$258.33

Service Code	HCPCS C1769
Hospital Charge Code	270629355
Hospital Revenue Code	278
Min. Negotiated Rate	$6.23
Max. Negotiated Rate	$129.16
Rate for Payer: Aetna Commercial	$98.17
Rate for Payer: Aetna Medicare Advantage	$77.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.87
Rate for Payer: Cigna Commercial	$129.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$56.83
Rate for Payer: Qualcare PPO/HMO/WC	$38.75
Rate for Payer: UnitedHealthcare Community & State	$6.23
Rate for Payer: Wellpoint Medicaid Managed Care	$6.85

GUIDEWIRE MAGIC TORQUE 180cm

Facility

$258.33

Service Code	HCPCS C1769
Hospital Charge Code	270629355
Hospital Revenue Code	278
Min. Negotiated Rate	$38.75
Max. Negotiated Rate	$62.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$56.83
Rate for Payer: Qualcare PPO/HMO/WC	$38.75

GUIDEWIRE MAGIC TORUQE 260CM

Facility

$258.33

Hospital Charge Code	270675891
Hospital Revenue Code	278
Min. Negotiated Rate	$6.23
Max. Negotiated Rate	$129.16
Rate for Payer: Aetna Commercial	$98.17
Rate for Payer: Aetna Medicare Advantage	$77.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.87
Rate for Payer: Cigna Commercial	$129.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$56.83
Rate for Payer: Qualcare PPO/HMO/WC	$38.75
Rate for Payer: UnitedHealthcare Community & State	$6.23
Rate for Payer: Wellpoint Medicaid Managed Care	$6.85

GUIDEWIRE MAGIC TORUQE 260CM

Facility

$258.33

Hospital Charge Code	270675891
Hospital Revenue Code	278
Min. Negotiated Rate	$38.75
Max. Negotiated Rate	$62.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$56.83
Rate for Payer: Qualcare PPO/HMO/WC	$38.75

GUIDEWIRE MAILMAN JTIP 300CM

Facility

$86.00

Service Code	HCPCS C1769
Hospital Charge Code	270689907
Hospital Revenue Code	278
Min. Negotiated Rate	$2.07
Max. Negotiated Rate	$43.00
Rate for Payer: Aetna Commercial	$32.68
Rate for Payer: Aetna Medicare Advantage	$25.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.93
Rate for Payer: Cigna Commercial	$43.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.92
Rate for Payer: Qualcare PPO/HMO/WC	$12.90
Rate for Payer: UnitedHealthcare Community & State	$2.07
Rate for Payer: Wellpoint Medicaid Managed Care	$2.28

GUIDEWIRE MAILMAN JTIP 300CM

Facility

$86.00

Service Code	HCPCS C1769
Hospital Charge Code	270689907
Hospital Revenue Code	278
Min. Negotiated Rate	$12.90
Max. Negotiated Rate	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.92
Rate for Payer: Qualcare PPO/HMO/WC	$12.90

GUIDEWIRE MAXXWIRE SUPER .035

Facility

$750.00

Service Code	HCPCS C1769
Hospital Charge Code	270688796
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 MAXXWIRE SUPER .035

Facility

$750.00

Service Code	HCPCS C1769
Hospital Charge Code	270688796
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 MCV ZEBRA .035 5168

Facility

$832.85

Hospital Charge Code	270618520
Hospital Revenue Code	278
Min. Negotiated Rate	$124.93
Max. Negotiated Rate	$201.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.23
Rate for Payer: Qualcare PPO/HMO/WC	$124.93

GUIDEWIRE MCV ZEBRA .035 5168

Facility

$832.85

Hospital Charge Code	270618520
Hospital Revenue Code	278
Min. Negotiated Rate	$20.07
Max. Negotiated Rate	$416.43
Rate for Payer: Aetna Commercial	$316.48
Rate for Payer: Aetna Medicare Advantage	$249.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.38
Rate for Payer: Cigna Commercial	$416.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.23
Rate for Payer: Qualcare PPO/HMO/WC	$124.93
Rate for Payer: UnitedHealthcare Community & State	$20.07
Rate for Payer: Wellpoint Medicaid Managed Care	$22.07

GUIDEWIRE MICRO CTO 18G 300CM

Facility

$765.00

Service Code	HCPCS C1769
Hospital Charge Code	270671137N
Hospital Revenue Code	278
Min. Negotiated Rate	$18.44
Max. Negotiated Rate	$382.50
Rate for Payer: Aetna Commercial	$290.70
Rate for Payer: Aetna Medicare Advantage	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.07
Rate for Payer: Cigna Commercial	$382.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$168.30
Rate for Payer: Qualcare PPO/HMO/WC	$114.75
Rate for Payer: UnitedHealthcare Community & State	$18.44
Rate for Payer: Wellpoint Medicaid Managed Care	$20.27

GUIDEWIRE MICRO CTO 18G 300CM

Facility

$765.00

Service Code	HCPCS C1769
Hospital Charge Code	270671137S
Hospital Revenue Code	278
Min. Negotiated Rate	$114.75
Max. Negotiated Rate	$185.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$168.30
Rate for Payer: Qualcare PPO/HMO/WC	$114.75

GUIDEWIRE MICRO CTO 18G 300CM

Facility

$765.00

Service Code	HCPCS C1769
Hospital Charge Code	270671137
Hospital Revenue Code	278
Min. Negotiated Rate	$18.44
Max. Negotiated Rate	$382.50
Rate for Payer: Aetna Commercial	$290.70
Rate for Payer: Aetna Medicare Advantage	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.07
Rate for Payer: Cigna Commercial	$382.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$168.30
Rate for Payer: Qualcare PPO/HMO/WC	$114.75
Rate for Payer: UnitedHealthcare Community & State	$18.44
Rate for Payer: Wellpoint Medicaid Managed Care	$20.27

GUIDEWIRE MICRO CTO 18G 300CM

Facility

$765.00

Service Code	HCPCS C1769
Hospital Charge Code	270671137S
Hospital Revenue Code	278
Min. Negotiated Rate	$18.44
Max. Negotiated Rate	$382.50
Rate for Payer: Aetna Commercial	$290.70
Rate for Payer: Aetna Medicare Advantage	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.07
Rate for Payer: Cigna Commercial	$382.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$168.30
Rate for Payer: Qualcare PPO/HMO/WC	$114.75
Rate for Payer: UnitedHealthcare Community & State	$18.44
Rate for Payer: Wellpoint Medicaid Managed Care	$20.27

GUIDEWIRE MICRO CTO 18G 300CM

Facility

$765.00

Service Code	HCPCS C1769
Hospital Charge Code	270671137N
Hospital Revenue Code	278
Min. Negotiated Rate	$114.75
Max. Negotiated Rate	$185.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$168.30
Rate for Payer: Qualcare PPO/HMO/WC	$114.75

GUIDEWIRE MICRO CTO 18G 300CM

Facility

$765.00

Service Code	HCPCS C1769
Hospital Charge Code	270671137
Hospital Revenue Code	278
Min. Negotiated Rate	$114.75
Max. Negotiated Rate	$185.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$168.30
Rate for Payer: Qualcare PPO/HMO/WC	$114.75

GUIDEWIRE MIRAC 12X300 8290302

Facility

$625.00

Service Code	HCPCS C1769
Hospital Charge Code	270642967
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

GUIDEWIRE MIRAC 12X300 8290302

Facility

$625.00

Service Code	HCPCS C1769
Hospital Charge Code	270642967
Hospital Revenue Code	278
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

GUIDEWIRE MIRACLE BROS 3 180cm

Facility

$3,375.00

Hospital Charge Code	270645998
Hospital Revenue Code	278
Min. Negotiated Rate	$506.25
Max. Negotiated Rate	$816.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$816.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$742.50
Rate for Payer: Qualcare PPO/HMO/WC	$506.25

GUIDEWIRE MIRACLE BROS 3 180cm

Facility

$3,375.00

Hospital Charge Code	270645998
Hospital Revenue Code	278
Min. Negotiated Rate	$81.34
Max. Negotiated Rate	$1,687.50
Rate for Payer: Aetna Commercial	$1,282.50
Rate for Payer: Aetna Medicare Advantage	$1,012.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.62
Rate for Payer: Cigna Commercial	$1,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$816.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$742.50
Rate for Payer: Qualcare PPO/HMO/WC	$506.25
Rate for Payer: UnitedHealthcare Community & State	$81.34
Rate for Payer: Wellpoint Medicaid Managed Care	$89.44

Know your out-of-pocket cost for care.

All Charges