Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE MM .035 150 668241

Facility

$39.25

Service Code	HCPCS C1769
Hospital Charge Code	270623751
Hospital Revenue Code	278
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$19.62
Rate for Payer: Aetna Commercial	$14.91
Rate for Payer: Aetna Medicare Advantage	$11.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.01
Rate for Payer: Cigna Commercial	$19.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.63
Rate for Payer: Qualcare PPO/HMO/WC	$5.89
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

GUIDEWIRE MM .035 150 668241

Facility

$39.25

Service Code	HCPCS C1769
Hospital Charge Code	270623751
Hospital Revenue Code	278
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$9.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.63
Rate for Payer: Qualcare PPO/HMO/WC	$5.89

GUIDEWIRE MT .035 150CM 49-152

Facility

$60.00

Hospital Charge Code	270626581
Hospital Revenue Code	278
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$14.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

GUIDEWIRE MT .035 150CM 49-152

Facility

$60.00

Hospital Charge Code	270626581
Hospital Revenue Code	278
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Community & State	$1.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

GUIDEWIRE MT .035 180 46525

Facility

$220.00

Hospital Charge Code	270624725C
Hospital Revenue Code	278
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$83.60
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$48.40
Rate for Payer: Qualcare PPO/HMO/WC	$33.00
Rate for Payer: UnitedHealthcare Community & State	$5.30
Rate for Payer: Wellpoint Medicaid Managed Care	$5.83

GUIDEWIRE MT .035 180 46525

Facility

$220.00

Hospital Charge Code	270624725C
Hospital Revenue Code	278
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$53.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$48.40
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

GUIDEWIRE MT 325 550-301

Facility

$1,835.25

Hospital Charge Code	270626582
Hospital Revenue Code	278
Min. Negotiated Rate	$44.23
Max. Negotiated Rate	$917.62
Rate for Payer: Aetna Commercial	$697.39
Rate for Payer: Aetna Medicare Advantage	$550.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$467.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$467.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$367.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$467.99
Rate for Payer: Cigna Commercial	$917.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$444.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$403.75
Rate for Payer: Qualcare PPO/HMO/WC	$275.29
Rate for Payer: UnitedHealthcare Community & State	$44.23
Rate for Payer: Wellpoint Medicaid Managed Care	$48.63

GUIDEWIRE MT 325 550-301

Facility

$1,835.25

Hospital Charge Code	270626582
Hospital Revenue Code	278
Min. Negotiated Rate	$275.29
Max. Negotiated Rate	$444.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$367.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$444.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$403.75
Rate for Payer: Qualcare PPO/HMO/WC	$275.29

GUIDE WIRE MULTI HOLE

Facility

$5,310.45

Service Code	HCPCS C1769
Hospital Charge Code	270691508
Hospital Revenue Code	278
Min. Negotiated Rate	$127.98
Max. Negotiated Rate	$2,655.22
Rate for Payer: Aetna Commercial	$2,017.97
Rate for Payer: Aetna Medicare Advantage	$1,593.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,354.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,354.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,062.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,354.16
Rate for Payer: Cigna Commercial	$2,655.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,285.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,168.30
Rate for Payer: Qualcare PPO/HMO/WC	$796.57
Rate for Payer: UnitedHealthcare Community & State	$127.98
Rate for Payer: Wellpoint Medicaid Managed Care	$140.73

GUIDE WIRE MULTI HOLE

Facility

$5,310.45

Service Code	HCPCS C1769
Hospital Charge Code	270691508
Hospital Revenue Code	278
Min. Negotiated Rate	$796.57
Max. Negotiated Rate	$1,285.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,062.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,285.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,168.30
Rate for Payer: Qualcare PPO/HMO/WC	$796.57

GUIDEWIRE NAVIPRO .018 STR

Facility

$517.65

Hospital Charge Code	270677500
Hospital Revenue Code	278
Min. Negotiated Rate	$77.65
Max. Negotiated Rate	$125.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$113.88
Rate for Payer: Qualcare PPO/HMO/WC	$77.65

GUIDEWIRE NAVIPRO .018 STR

Facility

$517.65

Hospital Charge Code	270677500
Hospital Revenue Code	278
Min. Negotiated Rate	$12.48
Max. Negotiated Rate	$258.82
Rate for Payer: Aetna Commercial	$196.71
Rate for Payer: Aetna Medicare Advantage	$155.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.00
Rate for Payer: Cigna Commercial	$258.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$113.88
Rate for Payer: Qualcare PPO/HMO/WC	$77.65
Rate for Payer: UnitedHealthcare Community & State	$12.48
Rate for Payer: Wellpoint Medicaid Managed Care	$13.72

GUIDEWIRE NEWTON J .035 150cm

Facility

$56.58

Service Code	HCPCS C1769
Hospital Charge Code	270626619
Hospital Revenue Code	278
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$28.29
Rate for Payer: Aetna Commercial	$21.50
Rate for Payer: Aetna Medicare Advantage	$16.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.43
Rate for Payer: Cigna Commercial	$28.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.45
Rate for Payer: Qualcare PPO/HMO/WC	$8.49
Rate for Payer: UnitedHealthcare Community & State	$1.36
Rate for Payer: Wellpoint Medicaid Managed Care	$1.50

GUIDEWIRE NEWTON J .035 150cm

Facility

$56.58

Service Code	HCPCS C1769
Hospital Charge Code	270626619
Hospital Revenue Code	278
Min. Negotiated Rate	$8.49
Max. Negotiated Rate	$13.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.45
Rate for Payer: Qualcare PPO/HMO/WC	$8.49

GUIDEWIRE NEWTON J .035 150cm

Facility

$65.36

Service Code	HCPCS C1769
Hospital Charge Code	270643672
Hospital Revenue Code	278
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$32.68
Rate for Payer: Aetna Commercial	$24.84
Rate for Payer: Aetna Medicare Advantage	$19.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.67
Rate for Payer: Cigna Commercial	$32.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.38
Rate for Payer: Qualcare PPO/HMO/WC	$9.80
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.73

GUIDEWIRE NEWTON J .035 150cm

Facility

$65.36

Service Code	HCPCS C1769
Hospital Charge Code	270643672
Hospital Revenue Code	278
Min. Negotiated Rate	$9.80
Max. Negotiated Rate	$15.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.38
Rate for Payer: Qualcare PPO/HMO/WC	$9.80

GUIDEWIRE NEWTON ST 35X150

Facility

$45.00

Service Code	HCPCS C1769
Hospital Charge Code	270658324S
Hospital Revenue Code	278
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$10.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

GUIDEWIRE NEWTON ST 35X150

Facility

$45.00

Service Code	HCPCS C1769
Hospital Charge Code	270658324
Hospital Revenue Code	278
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$10.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

GUIDEWIRE NEWTON ST 35X150

Facility

$45.00

Service Code	HCPCS C1769
Hospital Charge Code	270658324S
Hospital Revenue Code	278
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) NJ Health	$9.00
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	$10.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

GUIDEWIRE NEWTON ST 35X150

Facility

$47.50

Service Code	HCPCS C1769
Hospital Charge Code	270658324N
Hospital Revenue Code	278
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$11.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$10.45
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

GUIDEWIRE NEWTON ST 35X150

Facility

$47.50

Service Code	HCPCS C1769
Hospital Charge Code	270658324N
Hospital Revenue Code	278
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$23.75
Rate for Payer: Aetna Commercial	$18.05
Rate for Payer: Aetna Medicare Advantage	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.11
Rate for Payer: Cigna Commercial	$23.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$10.45
Rate for Payer: Qualcare PPO/HMO/WC	$7.12
Rate for Payer: UnitedHealthcare Community & State	$1.14
Rate for Payer: Wellpoint Medicaid Managed Care	$1.26

GUIDEWIRE NEWTON ST 35X150

Facility

$45.00

Service Code	HCPCS C1769
Hospital Charge Code	270658324
Hospital Revenue Code	278
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) NJ Health	$9.00
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	$10.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

GUIDEWIRE NIT 18X60 MAK001N60

Facility

$164.75

Service Code	HCPCS C1769
Hospital Charge Code	270660310S
Hospital Revenue Code	278
Min. Negotiated Rate	$3.97
Max. Negotiated Rate	$82.38
Rate for Payer: Aetna Commercial	$62.60
Rate for Payer: Aetna Medicare Advantage	$49.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.01
Rate for Payer: Cigna Commercial	$82.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$36.24
Rate for Payer: Qualcare PPO/HMO/WC	$24.71
Rate for Payer: UnitedHealthcare Community & State	$3.97
Rate for Payer: Wellpoint Medicaid Managed Care	$4.37

GUIDEWIRE NIT 18X60 MAK001N60

Facility

$164.75

Service Code	HCPCS C1769
Hospital Charge Code	270660310
Hospital Revenue Code	278
Min. Negotiated Rate	$24.71
Max. Negotiated Rate	$39.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$36.24
Rate for Payer: Qualcare PPO/HMO/WC	$24.71

GUIDEWIRE NIT 18X60 MAK001N60

Facility

$164.75

Service Code	HCPCS C1769
Hospital Charge Code	270660310
Hospital Revenue Code	278
Min. Negotiated Rate	$3.97
Max. Negotiated Rate	$82.38
Rate for Payer: Aetna Commercial	$62.60
Rate for Payer: Aetna Medicare Advantage	$49.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.01
Rate for Payer: Cigna Commercial	$82.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$36.24
Rate for Payer: Qualcare PPO/HMO/WC	$24.71
Rate for Payer: UnitedHealthcare Community & State	$3.97
Rate for Payer: Wellpoint Medicaid Managed Care	$4.37

Know your out-of-pocket cost for care.

All Charges