Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE RUNTHROUGH NS 300c

Facility

$530.00

Service Code	HCPCS C1769
Hospital Charge Code	270642946C
Hospital Revenue Code	278
Min. Negotiated Rate	$12.77
Max. Negotiated Rate	$265.00
Rate for Payer: Aetna Commercial	$201.40
Rate for Payer: Aetna Medicare Advantage	$159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.15
Rate for Payer: Cigna Commercial	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.60
Rate for Payer: Qualcare PPO/HMO/WC	$79.50
Rate for Payer: UnitedHealthcare Community & State	$12.77
Rate for Payer: Wellpoint Medicaid Managed Care	$14.04

GUIDEWIRE RUNTHROUGH NS 300c

Facility

$530.00

Service Code	HCPCS C1769
Hospital Charge Code	270642946C
Hospital Revenue Code	278
Min. Negotiated Rate	$79.50
Max. Negotiated Rate	$128.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.60
Rate for Payer: Qualcare PPO/HMO/WC	$79.50

GUIDEWIRES

Facility

$1,680.00

Hospital Charge Code	270702849
Hospital Revenue Code	278
Min. Negotiated Rate	$252.00
Max. Negotiated Rate	$406.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$336.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$406.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$369.60
Rate for Payer: Qualcare PPO/HMO/WC	$252.00

GUIDEWIRES

Facility

$1,680.00

Hospital Charge Code	270702849
Hospital Revenue Code	278
Min. Negotiated Rate	$40.49
Max. Negotiated Rate	$840.00
Rate for Payer: Aetna Commercial	$638.40
Rate for Payer: Aetna Medicare Advantage	$504.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$428.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$428.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$428.40
Rate for Payer: Cigna Commercial	$840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$406.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$369.60
Rate for Payer: Qualcare PPO/HMO/WC	$252.00
Rate for Payer: UnitedHealthcare Community & State	$40.49
Rate for Payer: Wellpoint Medicaid Managed Care	$44.52

GUIDE WIRES 1.2MMX70MM

Facility

$265.00

Hospital Charge Code	270657351
Hospital Revenue Code	278
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$132.50
Rate for Payer: Aetna Commercial	$100.70
Rate for Payer: Aetna Medicare Advantage	$79.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.58
Rate for Payer: Cigna Commercial	$132.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$58.30
Rate for Payer: Qualcare PPO/HMO/WC	$39.75
Rate for Payer: UnitedHealthcare Community & State	$6.39
Rate for Payer: Wellpoint Medicaid Managed Care	$7.02

GUIDE WIRES 1.2MMX70MM

Facility

$265.00

Hospital Charge Code	270657351
Hospital Revenue Code	278
Min. Negotiated Rate	$39.75
Max. Negotiated Rate	$64.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$58.30
Rate for Payer: Qualcare PPO/HMO/WC	$39.75

GUIDEWIRE SCIMD 300 GW 1210001

Facility

$430.00

Service Code	HCPCS C1769
Hospital Charge Code	270629662
Hospital Revenue Code	278
Min. Negotiated Rate	$64.50
Max. Negotiated Rate	$104.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$94.60
Rate for Payer: Qualcare PPO/HMO/WC	$64.50

GUIDEWIRE SCIMD 300 GW 1210001

Facility

$430.00

Service Code	HCPCS C1769
Hospital Charge Code	270629662
Hospital Revenue Code	278
Min. Negotiated Rate	$10.36
Max. Negotiated Rate	$215.00
Rate for Payer: Aetna Commercial	$163.40
Rate for Payer: Aetna Medicare Advantage	$129.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.65
Rate for Payer: Cigna Commercial	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$94.60
Rate for Payer: Qualcare PPO/HMO/WC	$64.50
Rate for Payer: UnitedHealthcare Community & State	$10.36
Rate for Payer: Wellpoint Medicaid Managed Care	$11.39

GUIDEWIRE SCIMED 12130-01

Facility

$1,920.00

Hospital Charge Code	270629661
Hospital Revenue Code	278
Min. Negotiated Rate	$288.00
Max. Negotiated Rate	$464.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$384.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$422.40
Rate for Payer: Qualcare PPO/HMO/WC	$288.00

GUIDEWIRE SCIMED 12130-01

Facility

$1,920.00

Hospital Charge Code	270629661
Hospital Revenue Code	278
Min. Negotiated Rate	$46.27
Max. Negotiated Rate	$960.00
Rate for Payer: Aetna Commercial	$729.60
Rate for Payer: Aetna Medicare Advantage	$576.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$489.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$489.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$384.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$489.60
Rate for Payer: Cigna Commercial	$960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$422.40
Rate for Payer: Qualcare PPO/HMO/WC	$288.00
Rate for Payer: UnitedHealthcare Community & State	$46.27
Rate for Payer: Wellpoint Medicaid Managed Care	$50.88

GUIDEWIRE SDK SHARP 8670002

Facility

$291.25

Hospital Charge Code	270629194
Hospital Revenue Code	278
Min. Negotiated Rate	$7.02
Max. Negotiated Rate	$145.62
Rate for Payer: Aetna Commercial	$110.67
Rate for Payer: Aetna Medicare Advantage	$87.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.27
Rate for Payer: Cigna Commercial	$145.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$64.08
Rate for Payer: Qualcare PPO/HMO/WC	$43.69
Rate for Payer: UnitedHealthcare Community & State	$7.02
Rate for Payer: Wellpoint Medicaid Managed Care	$7.72

GUIDEWIRE SDK SHARP 8670002

Facility

$291.25

Hospital Charge Code	270629194
Hospital Revenue Code	278
Min. Negotiated Rate	$43.69
Max. Negotiated Rate	$70.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$64.08
Rate for Payer: Qualcare PPO/HMO/WC	$43.69

GUIDEWIRE SENSOR .035 SENSOR

Facility

$374.66

Service Code	HCPCS C1769
Hospital Charge Code	270685946
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 SENSOR .035 SENSOR

Facility

$374.66

Service Code	HCPCS C1769
Hospital Charge Code	270685946
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

GUIDE WIRE SHILEY SUB CANNV***

Facility

$64.00

Hospital Charge Code	8002487
Hospital Revenue Code	279
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

GUIDE WIRE SHILEY SUB CANNV***

Facility

$64.00

Hospital Charge Code	8002487
Hospital Revenue Code	279
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$32.00
Rate for Payer: Aetna Commercial	$24.32
Rate for Payer: Aetna Medicare Advantage	$19.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.32
Rate for Payer: Cigna Commercial	$32.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.20
Rate for Payer: Oxford Commercial	$12.80
Rate for Payer: Qualcare PPO/HMO/WC	$9.60
Rate for Payer: UnitedHealthcare Commercial	$12.80
Rate for Payer: UnitedHealthcare Community & State	$1.54
Rate for Payer: Wellpoint Medicaid Managed Care	$1.70

GUIDEWIRE SHINOBI 300c 547114X

Facility

$432.20

Hospital Charge Code	270632478
Hospital Revenue Code	272
Min. Negotiated Rate	$10.42
Max. Negotiated Rate	$216.10
Rate for Payer: Aetna Commercial	$164.24
Rate for Payer: Aetna Medicare Advantage	$129.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.21
Rate for Payer: Cigna Commercial	$216.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.66
Rate for Payer: Oxford Commercial	$86.44
Rate for Payer: Qualcare PPO/HMO/WC	$64.83
Rate for Payer: UnitedHealthcare Commercial	$86.44
Rate for Payer: UnitedHealthcare Community & State	$10.42
Rate for Payer: Wellpoint Medicaid Managed Care	$11.45

GUIDEWIRE SHINOBI 300c 547114X

Facility

$432.20

Hospital Charge Code	270632478
Hospital Revenue Code	272
Min. Negotiated Rate	$64.83
Max. Negotiated Rate	$64.83
Rate for Payer: Qualcare PPO/HMO/WC	$64.83

GUIDEWIRE SINGLE SHARP THREADE

Facility

$1,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270695152
Hospital Revenue Code	278
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

GUIDEWIRE SINGLE SHARP THREADE

Facility

$1,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270695152
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

GUIDEWIRE SMALL 2.0MM

Facility

$100.00

Service Code	HCPCS C1769
Hospital Charge Code	270698454
Hospital Revenue Code	278
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$24.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

GUIDEWIRE SMALL 2.0MM

Facility

$100.00

Service Code	HCPCS C1769
Hospital Charge Code	270698454
Hospital Revenue Code	278
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$38.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Community & State	$2.41
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

GUIDE WIRE SMOOTH TIPPED

Facility

$876.65

Service Code	HCPCS C1769
Hospital Charge Code	270661240
Hospital Revenue Code	278
Min. Negotiated Rate	$131.50
Max. Negotiated Rate	$212.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.86
Rate for Payer: Qualcare PPO/HMO/WC	$131.50

GUIDE WIRE SMOOTH TIPPED

Facility

$876.65

Service Code	HCPCS C1769
Hospital Charge Code	270661240
Hospital Revenue Code	278
Min. Negotiated Rate	$21.13
Max. Negotiated Rate	$438.32
Rate for Payer: Aetna Commercial	$333.13
Rate for Payer: Aetna Medicare Advantage	$263.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.55
Rate for Payer: Cigna Commercial	$438.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.86
Rate for Payer: Qualcare PPO/HMO/WC	$131.50
Rate for Payer: UnitedHealthcare Community & State	$21.13
Rate for Payer: Wellpoint Medicaid Managed Care	$23.23

GUIDE WIRE SMOOTH TIPPED

Facility

$1,475.00

Hospital Charge Code	270674284
Hospital Revenue Code	272
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$442.50
Rate for Payer: Oxford Commercial	$295.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$295.00
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

Know your out-of-pocket cost for care.

All Charges