Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE THRD 1.4MMX150MM

Facility

$500.50

Service Code	HCPCS C1713
Hospital Charge Code	270697386
Hospital Revenue Code	278
Min. Negotiated Rate	$12.06
Max. Negotiated Rate	$250.25
Rate for Payer: Aetna Commercial	$190.19
Rate for Payer: Aetna Medicare Advantage	$150.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.63
Rate for Payer: Cigna Commercial	$250.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.11
Rate for Payer: Qualcare PPO/HMO/WC	$75.08
Rate for Payer: UnitedHealthcare Community & State	$12.06
Rate for Payer: Wellpoint Medicaid Managed Care	$13.26

GUIDEWIRE THRD 1.4MMX150MM

Facility

$500.50

Service Code	HCPCS C1713
Hospital Charge Code	270697386
Hospital Revenue Code	278
Min. Negotiated Rate	$75.08
Max. Negotiated Rate	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.11
Rate for Payer: Qualcare PPO/HMO/WC	$75.08

GUIDEWIRE THRD 1.6MMX220MM

Facility

$544.50

Service Code	HCPCS C1713
Hospital Charge Code	270697382
Hospital Revenue Code	278
Min. Negotiated Rate	$81.67
Max. Negotiated Rate	$131.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.79
Rate for Payer: Qualcare PPO/HMO/WC	$81.67

GUIDEWIRE THRD 1.6MMX220MM

Facility

$544.50

Service Code	HCPCS C1713
Hospital Charge Code	270697382
Hospital Revenue Code	278
Min. Negotiated Rate	$13.12
Max. Negotiated Rate	$272.25
Rate for Payer: Aetna Commercial	$206.91
Rate for Payer: Aetna Medicare Advantage	$163.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.85
Rate for Payer: Cigna Commercial	$272.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.79
Rate for Payer: Qualcare PPO/HMO/WC	$81.67
Rate for Payer: UnitedHealthcare Community & State	$13.12
Rate for Payer: Wellpoint Medicaid Managed Care	$14.43

GUIDEWIRE THRD 2.0x230MM

Facility

$171.50

Hospital Charge Code	270605007
Hospital Revenue Code	278
Min. Negotiated Rate	$4.13
Max. Negotiated Rate	$85.75
Rate for Payer: Aetna Commercial	$65.17
Rate for Payer: Aetna Medicare Advantage	$51.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.73
Rate for Payer: Cigna Commercial	$85.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$37.73
Rate for Payer: Qualcare PPO/HMO/WC	$25.73
Rate for Payer: UnitedHealthcare Community & State	$4.13
Rate for Payer: Wellpoint Medicaid Managed Care	$4.54

GUIDEWIRE THRD 2.0x230MM

Facility

$171.50

Hospital Charge Code	270605007
Hospital Revenue Code	278
Min. Negotiated Rate	$25.73
Max. Negotiated Rate	$41.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$37.73
Rate for Payer: Qualcare PPO/HMO/WC	$25.73

GUIDEWIRE THRD 2.8MMX220MM

Facility

$723.25

Service Code	HCPCS C1713
Hospital Charge Code	270697388
Hospital Revenue Code	278
Min. Negotiated Rate	$17.43
Max. Negotiated Rate	$361.62
Rate for Payer: Aetna Commercial	$274.83
Rate for Payer: Aetna Medicare Advantage	$216.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.43
Rate for Payer: Cigna Commercial	$361.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.12
Rate for Payer: Qualcare PPO/HMO/WC	$108.49
Rate for Payer: UnitedHealthcare Community & State	$17.43
Rate for Payer: Wellpoint Medicaid Managed Care	$19.17

GUIDEWIRE THRD 2.8MMX220MM

Facility

$723.25

Service Code	HCPCS C1713
Hospital Charge Code	270697388
Hospital Revenue Code	278
Min. Negotiated Rate	$108.49
Max. Negotiated Rate	$175.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.12
Rate for Payer: Qualcare PPO/HMO/WC	$108.49

GUIDEWIRE THRD BOTH ENDS 1.6x1

Facility

$173.45

Service Code	HCPCS C1769
Hospital Charge Code	270682258
Hospital Revenue Code	278
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$86.72
Rate for Payer: Aetna Commercial	$65.91
Rate for Payer: Aetna Medicare Advantage	$52.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.23
Rate for Payer: Cigna Commercial	$86.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.16
Rate for Payer: Qualcare PPO/HMO/WC	$26.02
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: Wellpoint Medicaid Managed Care	$4.60

GUIDEWIRE THRD BOTH ENDS 1.6x1

Facility

$173.45

Service Code	HCPCS C1769
Hospital Charge Code	270682258
Hospital Revenue Code	278
Min. Negotiated Rate	$26.02
Max. Negotiated Rate	$41.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.16
Rate for Payer: Qualcare PPO/HMO/WC	$26.02

GUIDE WIRE THREADED 3.2x300MM

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270656520
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

GUIDE WIRE THREADED 3.2x300MM

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270656520
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 THRUWAY .014 130cm

Facility

$400.00

Hospital Charge Code	270634367
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

GUIDEWIRE THRUWAY .014 130cm

Facility

$400.00

Hospital Charge Code	270634367
Hospital Revenue Code	278
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.60

GUIDEWIRE THRUWAY .014 190cm

Facility

$400.00

Hospital Charge Code	270634768
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

GUIDEWIRE THRUWAY .014 190cm

Facility

$400.00

Hospital Charge Code	270634768
Hospital Revenue Code	278
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.60

GUIDEWIRE THRUWAY .014/190CM

Facility

$581.25

Hospital Charge Code	2709002345
Hospital Revenue Code	272
Min. Negotiated Rate	$14.01
Max. Negotiated Rate	$290.62
Rate for Payer: Aetna Commercial	$220.88
Rate for Payer: Aetna Medicare Advantage	$174.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.22
Rate for Payer: Cigna Commercial	$290.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.38
Rate for Payer: Oxford Commercial	$116.25
Rate for Payer: Qualcare PPO/HMO/WC	$87.19
Rate for Payer: UnitedHealthcare Commercial	$116.25
Rate for Payer: UnitedHealthcare Community & State	$14.01
Rate for Payer: Wellpoint Medicaid Managed Care	$15.40

GUIDEWIRE THRUWAY .014/190CM

Facility

$581.25

Hospital Charge Code	2709002345
Hospital Revenue Code	272
Min. Negotiated Rate	$87.19
Max. Negotiated Rate	$87.19
Rate for Payer: Qualcare PPO/HMO/WC	$87.19

GUIDEWIRE THRUWAY .014 300cm

Facility

$625.00

Service Code	HCPCS C1769
Hospital Charge Code	270634769
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 THRUWAY .014 300cm

Facility

$625.00

Service Code	HCPCS C1769
Hospital Charge Code	270634769
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

GUIDE WIRE THSF-35-480

Facility

$300.70

Hospital Charge Code	270639711
Hospital Revenue Code	272
Min. Negotiated Rate	$45.10
Max. Negotiated Rate	$45.10
Rate for Payer: Qualcare PPO/HMO/WC	$45.10

GUIDE WIRE THSF-35-480

Facility

$300.70

Hospital Charge Code	270639711
Hospital Revenue Code	272
Min. Negotiated Rate	$7.25
Max. Negotiated Rate	$150.35
Rate for Payer: Aetna Commercial	$114.27
Rate for Payer: Aetna Medicare Advantage	$90.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.68
Rate for Payer: Cigna Commercial	$150.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.21
Rate for Payer: Oxford Commercial	$60.14
Rate for Payer: Qualcare PPO/HMO/WC	$45.10
Rate for Payer: UnitedHealthcare Commercial	$60.14
Rate for Payer: UnitedHealthcare Community & State	$7.25
Rate for Payer: Wellpoint Medicaid Managed Care	$7.97

GUIDEWIRE TORNUS 2.1FR

Facility

$3,975.00

Hospital Charge Code	270642954
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

GUIDEWIRE TORNUS 2.1FR

Facility

$3,975.00

Hospital Charge Code	270642954
Hospital Revenue Code	278
Min. Negotiated Rate	$95.80
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,510.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$596.25
Rate for Payer: UnitedHealthcare Community & State	$95.80
Rate for Payer: Wellpoint Medicaid Managed Care	$105.34

GUIDEWIRE TORNUS 2.6FR

Facility

$3,975.00

Hospital Charge Code	270642955
Hospital Revenue Code	278
Min. Negotiated Rate	$95.80
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,510.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$596.25
Rate for Payer: UnitedHealthcare Community & State	$95.80
Rate for Payer: Wellpoint Medicaid Managed Care	$105.34

Know your out-of-pocket cost for care.

All Charges