Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE STRAIGHT .038/180CM

Facility

$255.00

Hospital Charge Code	270651267
Hospital Revenue Code	278
Min. Negotiated Rate	$38.25
Max. Negotiated Rate	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$56.10
Rate for Payer: Qualcare PPO/HMO/WC	$38.25

GUIDEWIRE STRAIGHT .038/180CM

Facility

$255.00

Hospital Charge Code	270651267
Hospital Revenue Code	278
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$127.50
Rate for Payer: Aetna Commercial	$96.90
Rate for Payer: Aetna Medicare Advantage	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.03
Rate for Payer: Cigna Commercial	$127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$56.10
Rate for Payer: Qualcare PPO/HMO/WC	$38.25
Rate for Payer: UnitedHealthcare Community & State	$6.15
Rate for Payer: Wellpoint Medicaid Managed Care	$6.76

GUIDE WIRE STRAIGHT TIP

Facility

$116.00

Hospital Charge Code	270331521
Hospital Revenue Code	278
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$58.00
Rate for Payer: Aetna Commercial	$44.08
Rate for Payer: Aetna Medicare Advantage	$34.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.58
Rate for Payer: Cigna Commercial	$58.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.52
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Community & State	$2.80
Rate for Payer: Wellpoint Medicaid Managed Care	$3.07

GUIDE WIRE STRAIGHT TIP

Facility

$116.00

Hospital Charge Code	270331521
Hospital Revenue Code	278
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$28.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.52
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

GUIDE WIRE STRAIGHT TIP O35X

Facility

$84.00

Hospital Charge Code	270331516
Hospital Revenue Code	278
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$20.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.48
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

GUIDE WIRE STRAIGHT TIP O35X

Facility

$84.00

Hospital Charge Code	270331516
Hospital Revenue Code	278
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$42.00
Rate for Payer: Aetna Commercial	$31.92
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.48
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Community & State	$2.02
Rate for Payer: Wellpoint Medicaid Managed Care	$2.23

GUIDEWIRE STR TIP .035 180cm

Facility

$219.58

Service Code	HCPCS C1769
Hospital Charge Code	270651264
Hospital Revenue Code	278
Min. Negotiated Rate	$5.29
Max. Negotiated Rate	$109.79
Rate for Payer: Aetna Commercial	$83.44
Rate for Payer: Aetna Medicare Advantage	$65.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.99
Rate for Payer: Cigna Commercial	$109.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$48.31
Rate for Payer: Qualcare PPO/HMO/WC	$32.94
Rate for Payer: UnitedHealthcare Community & State	$5.29
Rate for Payer: Wellpoint Medicaid Managed Care	$5.82

GUIDEWIRE STR TIP .035 180cm

Facility

$219.58

Service Code	HCPCS C1769
Hospital Charge Code	270651264
Hospital Revenue Code	278
Min. Negotiated Rate	$32.94
Max. Negotiated Rate	$53.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$48.31
Rate for Payer: Qualcare PPO/HMO/WC	$32.94

GUIDEWIRE SUPER STIFF .035/500

Facility

$557.09

Service Code	HCPCS C1769
Hospital Charge Code	270644082
Hospital Revenue Code	278
Min. Negotiated Rate	$83.56
Max. Negotiated Rate	$134.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$122.56
Rate for Payer: Qualcare PPO/HMO/WC	$83.56

GUIDEWIRE SUPER STIFF .035/500

Facility

$557.09

Service Code	HCPCS C1769
Hospital Charge Code	270644082
Hospital Revenue Code	278
Min. Negotiated Rate	$13.43
Max. Negotiated Rate	$278.55
Rate for Payer: Aetna Commercial	$211.69
Rate for Payer: Aetna Medicare Advantage	$167.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.06
Rate for Payer: Cigna Commercial	$278.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$122.56
Rate for Payer: Qualcare PPO/HMO/WC	$83.56
Rate for Payer: UnitedHealthcare Community & State	$13.43
Rate for Payer: Wellpoint Medicaid Managed Care	$14.76

GUIDEWIRE SV5 .018 503558

Facility

$498.45

Hospital Charge Code	270624011
Hospital Revenue Code	278
Min. Negotiated Rate	$74.77
Max. Negotiated Rate	$120.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$109.66
Rate for Payer: Qualcare PPO/HMO/WC	$74.77

GUIDEWIRE SV5 .018 503558

Facility

$498.45

Hospital Charge Code	270624011
Hospital Revenue Code	278
Min. Negotiated Rate	$12.01
Max. Negotiated Rate	$249.22
Rate for Payer: Aetna Commercial	$189.41
Rate for Payer: Aetna Medicare Advantage	$149.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.10
Rate for Payer: Cigna Commercial	$249.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$109.66
Rate for Payer: Qualcare PPO/HMO/WC	$74.77
Rate for Payer: UnitedHealthcare Community & State	$12.01
Rate for Payer: Wellpoint Medicaid Managed Care	$13.21

GUIDEWIRE SV OMNI FLUSH 4FR

Facility

$105.00

Hospital Charge Code	270654575
Hospital Revenue Code	278
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$52.50
Rate for Payer: Aetna Commercial	$39.90
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Community & State	$2.53
Rate for Payer: Wellpoint Medicaid Managed Care	$2.78

GUIDEWIRE SV OMNI FLUSH 4FR

Facility

$105.00

Hospital Charge Code	270654575
Hospital Revenue Code	278
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$25.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

GUIDEWIRE SYNCHNO .014IN X200

Facility

$2,850.00

Service Code	HCPCS C1769
Hospital Charge Code	270682516
Hospital Revenue Code	278
Min. Negotiated Rate	$68.69
Max. Negotiated Rate	$1,425.00
Rate for Payer: Aetna Commercial	$1,083.00
Rate for Payer: Aetna Medicare Advantage	$855.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$726.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$726.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$726.75
Rate for Payer: Cigna Commercial	$1,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$689.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$627.00
Rate for Payer: Qualcare PPO/HMO/WC	$427.50
Rate for Payer: UnitedHealthcare Community & State	$68.69
Rate for Payer: Wellpoint Medicaid Managed Care	$75.53

GUIDEWIRE SYNCHNO .014IN X200

Facility

$2,850.00

Service Code	HCPCS C1769
Hospital Charge Code	270682516
Hospital Revenue Code	278
Min. Negotiated Rate	$427.50
Max. Negotiated Rate	$689.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$570.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$689.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$627.00
Rate for Payer: Qualcare PPO/HMO/WC	$427.50

GUIDEWIRE SYNCHNO .014IN X200

Facility

$3,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270682516N
Hospital Revenue Code	278
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

GUIDEWIRE SYNCHNO .014IN X200

Facility

$3,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270682516S
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

GUIDEWIRE SYNCHNO .014IN X200

Facility

$3,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270682516S
Hospital Revenue Code	278
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

GUIDEWIRE SYNCHNO .014IN X200

Facility

$3,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270682516N
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

GUIDEWIRE SYNCHRO .014 200CM

Facility

$3,158.75

Service Code	HCPCS C1769
Hospital Charge Code	270693901S
Hospital Revenue Code	272
Min. Negotiated Rate	$473.81
Max. Negotiated Rate	$473.81
Rate for Payer: Qualcare PPO/HMO/WC	$473.81

GUIDEWIRE SYNCHRO .014 200CM

Facility

$3,158.75

Service Code	HCPCS C1769
Hospital Charge Code	270693901S
Hospital Revenue Code	272
Min. Negotiated Rate	$76.13
Max. Negotiated Rate	$1,579.38
Rate for Payer: Aetna Commercial	$1,200.33
Rate for Payer: Aetna Medicare Advantage	$947.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$805.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$805.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$805.48
Rate for Payer: Cigna Commercial	$1,579.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$947.62
Rate for Payer: Oxford Commercial	$631.75
Rate for Payer: Qualcare PPO/HMO/WC	$473.81
Rate for Payer: UnitedHealthcare Commercial	$631.75
Rate for Payer: UnitedHealthcare Community & State	$76.13
Rate for Payer: Wellpoint Medicaid Managed Care	$83.71

GUIDEWIRE SYNCHRO10 .01IN200CM

Facility

$3,058.00

Service Code	HCPCS C1769
Hospital Charge Code	270699939S
Hospital Revenue Code	278
Min. Negotiated Rate	$458.70
Max. Negotiated Rate	$740.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$611.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$672.76
Rate for Payer: Qualcare PPO/HMO/WC	$458.70

GUIDEWIRE SYNCHRO10 .01IN200CM

Facility

$3,058.00

Service Code	HCPCS C1769
Hospital Charge Code	270699939S
Hospital Revenue Code	278
Min. Negotiated Rate	$73.70
Max. Negotiated Rate	$1,529.00
Rate for Payer: Aetna Commercial	$1,162.04
Rate for Payer: Aetna Medicare Advantage	$917.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$779.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$779.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$611.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$779.79
Rate for Payer: Cigna Commercial	$1,529.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$672.76
Rate for Payer: Qualcare PPO/HMO/WC	$458.70
Rate for Payer: UnitedHealthcare Community & State	$73.70
Rate for Payer: Wellpoint Medicaid Managed Care	$81.04

GUIDEWIRE SYNCHRO 200CM

Facility

$3,000.00

Service Code	HCPCS C1789
Hospital Charge Code	270685069
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

Know your out-of-pocket cost for care.

All Charges