Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

INTRODUCER KIT PERCUTANEOUS

Facility

$450.00

Hospital Charge Code	270660590
Hospital Revenue Code	270
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

INTRODUCER KPN OSTEO FLUT A101

Facility

$1,853.65

Hospital Charge Code	270629340
Hospital Revenue Code	272
Min. Negotiated Rate	$44.67
Max. Negotiated Rate	$926.83
Rate for Payer: Aetna Commercial	$704.39
Rate for Payer: Aetna Medicare Advantage	$556.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$472.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$472.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$472.68
Rate for Payer: Cigna Commercial	$926.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.10
Rate for Payer: Oxford Commercial	$370.73
Rate for Payer: Qualcare PPO/HMO/WC	$278.05
Rate for Payer: UnitedHealthcare Commercial	$370.73
Rate for Payer: UnitedHealthcare Community & State	$44.67
Rate for Payer: Wellpoint Medicaid Managed Care	$49.12

INTRODUCER KPN OSTEO FLUT A101

Facility

$1,853.65

Hospital Charge Code	270629340
Hospital Revenue Code	272
Min. Negotiated Rate	$278.05
Max. Negotiated Rate	$278.05
Rate for Payer: Qualcare PPO/HMO/WC	$278.05

INTRODUCER LEAD 10 & 12 FR****

Facility

$113.00

Hospital Charge Code	1600618
Hospital Revenue Code	272
Min. Negotiated Rate	$2.72
Max. Negotiated Rate	$56.50
Rate for Payer: Aetna Commercial	$42.94
Rate for Payer: Aetna Medicare Advantage	$33.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.82
Rate for Payer: Cigna Commercial	$56.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.90
Rate for Payer: Oxford Commercial	$22.60
Rate for Payer: Qualcare PPO/HMO/WC	$16.95
Rate for Payer: UnitedHealthcare Commercial	$22.60
Rate for Payer: UnitedHealthcare Community & State	$2.72
Rate for Payer: Wellpoint Medicaid Managed Care	$2.99

INTRODUCER LEAD 10 & 12 FR****

Facility

$113.00

Hospital Charge Code	1600618
Hospital Revenue Code	272
Min. Negotiated Rate	$16.95
Max. Negotiated Rate	$16.95
Rate for Payer: Qualcare PPO/HMO/WC	$16.95

INTRODUCER MANDREL 5FR

Facility

$84.75

Hospital Charge Code	270676663N
Hospital Revenue Code	272
Min. Negotiated Rate	$12.71
Max. Negotiated Rate	$12.71
Rate for Payer: Qualcare PPO/HMO/WC	$12.71

INTRODUCER MANDREL 5FR

Facility

$84.75

Hospital Charge Code	270676663
Hospital Revenue Code	272
Min. Negotiated Rate	$12.71
Max. Negotiated Rate	$12.71
Rate for Payer: Qualcare PPO/HMO/WC	$12.71

INTRODUCER MANDREL 5FR

Facility

$84.75

Hospital Charge Code	270676663N
Hospital Revenue Code	272
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$42.38
Rate for Payer: Aetna Commercial	$32.20
Rate for Payer: Aetna Medicare Advantage	$25.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.61
Rate for Payer: Cigna Commercial	$42.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.43
Rate for Payer: Oxford Commercial	$16.95
Rate for Payer: Qualcare PPO/HMO/WC	$12.71
Rate for Payer: UnitedHealthcare Commercial	$16.95
Rate for Payer: UnitedHealthcare Community & State	$2.04
Rate for Payer: Wellpoint Medicaid Managed Care	$2.25

INTRODUCER MANDREL 5FR

Facility

$84.75

Hospital Charge Code	270676663
Hospital Revenue Code	272
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$42.38
Rate for Payer: Aetna Commercial	$32.20
Rate for Payer: Aetna Medicare Advantage	$25.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.61
Rate for Payer: Cigna Commercial	$42.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.43
Rate for Payer: Oxford Commercial	$16.95
Rate for Payer: Qualcare PPO/HMO/WC	$12.71
Rate for Payer: UnitedHealthcare Commercial	$16.95
Rate for Payer: UnitedHealthcare Community & State	$2.04
Rate for Payer: Wellpoint Medicaid Managed Care	$2.25

INTRODUCER MEDT 10.5FR 6210-SI

Facility

$612.00

Hospital Charge Code	270607572
Hospital Revenue Code	272
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

INTRODUCER MEDT 10.5FR 6210-SI

Facility

$612.00

Hospital Charge Code	270607572
Hospital Revenue Code	272
Min. Negotiated Rate	$14.75
Max. Negotiated Rate	$306.00
Rate for Payer: Aetna Commercial	$232.56
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.60
Rate for Payer: Oxford Commercial	$122.40
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Commercial	$122.40
Rate for Payer: UnitedHealthcare Community & State	$14.75
Rate for Payer: Wellpoint Medicaid Managed Care	$16.22

INTRODUCER MEDT 7FR 6207-S1

Facility

$296.00

Hospital Charge Code	270611063
Hospital Revenue Code	272
Min. Negotiated Rate	$7.13
Max. Negotiated Rate	$148.00
Rate for Payer: Aetna Commercial	$112.48
Rate for Payer: Aetna Medicare Advantage	$88.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.48
Rate for Payer: Cigna Commercial	$148.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.80
Rate for Payer: Oxford Commercial	$59.20
Rate for Payer: Qualcare PPO/HMO/WC	$44.40
Rate for Payer: UnitedHealthcare Commercial	$59.20
Rate for Payer: UnitedHealthcare Community & State	$7.13
Rate for Payer: Wellpoint Medicaid Managed Care	$7.84

INTRODUCER MEDT 7FR 6207-S1

Facility

$296.00

Hospital Charge Code	270611063
Hospital Revenue Code	272
Min. Negotiated Rate	$44.40
Max. Negotiated Rate	$44.40
Rate for Payer: Qualcare PPO/HMO/WC	$44.40

INTRODUCER MEDT 9FR 6209-S1

Facility

$272.85

Hospital Charge Code	270605468
Hospital Revenue Code	272
Min. Negotiated Rate	$6.58
Max. Negotiated Rate	$136.43
Rate for Payer: Aetna Commercial	$103.68
Rate for Payer: Aetna Medicare Advantage	$81.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.58
Rate for Payer: Cigna Commercial	$136.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.86
Rate for Payer: Oxford Commercial	$54.57
Rate for Payer: Qualcare PPO/HMO/WC	$40.93
Rate for Payer: UnitedHealthcare Commercial	$54.57
Rate for Payer: UnitedHealthcare Community & State	$6.58
Rate for Payer: Wellpoint Medicaid Managed Care	$7.23

INTRODUCER MEDT 9FR 6209-S1

Facility

$272.85

Hospital Charge Code	270605468
Hospital Revenue Code	272
Min. Negotiated Rate	$40.93
Max. Negotiated Rate	$40.93
Rate for Payer: Qualcare PPO/HMO/WC	$40.93

INTRODUCER OPTISEAL 8FR 13CM

Facility

$292.50

Hospital Charge Code	270677417
Hospital Revenue Code	272
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$146.25
Rate for Payer: Aetna Commercial	$111.15
Rate for Payer: Aetna Medicare Advantage	$87.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.59
Rate for Payer: Cigna Commercial	$146.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.75
Rate for Payer: Oxford Commercial	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$43.88
Rate for Payer: UnitedHealthcare Commercial	$58.50
Rate for Payer: UnitedHealthcare Community & State	$7.05
Rate for Payer: Wellpoint Medicaid Managed Care	$7.75

INTRODUCER OPTISEAL 8FR 13CM

Facility

$292.50

Hospital Charge Code	270677417
Hospital Revenue Code	272
Min. Negotiated Rate	$43.88
Max. Negotiated Rate	$43.88
Rate for Payer: Qualcare PPO/HMO/WC	$43.88

INTRODUCER PEEL AWAY 11FR

Facility

$300.00

Hospital Charge Code	270657082
Hospital Revenue Code	278
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

INTRODUCER PEEL AWAY 11FR

Facility

$300.00

Hospital Charge Code	270657082
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

INTRODUCER PEEL-AWAY 20FR

Facility

$246.95

Hospital Charge Code	270677522
Hospital Revenue Code	278
Min. Negotiated Rate	$5.95
Max. Negotiated Rate	$123.47
Rate for Payer: Aetna Commercial	$93.84
Rate for Payer: Aetna Medicare Advantage	$74.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.97
Rate for Payer: Cigna Commercial	$123.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.33
Rate for Payer: Qualcare PPO/HMO/WC	$37.04
Rate for Payer: UnitedHealthcare Community & State	$5.95
Rate for Payer: Wellpoint Medicaid Managed Care	$6.54

INTRODUCER PEEL-AWAY 20FR

Facility

$246.95

Hospital Charge Code	270677522
Hospital Revenue Code	278
Min. Negotiated Rate	$37.04
Max. Negotiated Rate	$59.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.33
Rate for Payer: Qualcare PPO/HMO/WC	$37.04

INTRODUCER PEEL AWAY SET

Facility

$291.25

Hospital Charge Code	270655673
Hospital Revenue Code	271
Min. Negotiated Rate	$43.69
Max. Negotiated Rate	$43.69
Rate for Payer: Qualcare PPO/HMO/WC	$43.69

INTRODUCER PEEL AWAY SET

Facility

$291.25

Hospital Charge Code	270655673
Hospital Revenue Code	271
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) PPO	$74.27
Rate for Payer: Cigna Commercial	$145.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.38
Rate for Payer: Oxford Commercial	$58.25
Rate for Payer: Qualcare PPO/HMO/WC	$43.69
Rate for Payer: UnitedHealthcare Commercial	$58.25
Rate for Payer: UnitedHealthcare Community & State	$7.02
Rate for Payer: Wellpoint Medicaid Managed Care	$7.72

INTRODUCER PERC 7fr 6207

Facility

$261.25

Hospital Charge Code	270640436
Hospital Revenue Code	272
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$130.62
Rate for Payer: Aetna Commercial	$99.28
Rate for Payer: Aetna Medicare Advantage	$78.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.62
Rate for Payer: Cigna Commercial	$130.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.38
Rate for Payer: Oxford Commercial	$52.25
Rate for Payer: Qualcare PPO/HMO/WC	$39.19
Rate for Payer: UnitedHealthcare Commercial	$52.25
Rate for Payer: UnitedHealthcare Community & State	$6.30
Rate for Payer: Wellpoint Medicaid Managed Care	$6.92

INTRODUCER PERC 7fr 6207

Facility

$261.25

Hospital Charge Code	270640436
Hospital Revenue Code	272
Min. Negotiated Rate	$39.19
Max. Negotiated Rate	$39.19
Rate for Payer: Qualcare PPO/HMO/WC	$39.19

Know your out-of-pocket cost for care.

All Charges