Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

INTRODUCER SHEATH 11CM 6FR

Facility

$371.00

Hospital Charge Code	270701577
Hospital Revenue Code	272
Min. Negotiated Rate	$55.65
Max. Negotiated Rate	$55.65
Rate for Payer: Qualcare PPO/HMO/WC	$55.65

INTRODUCER SHEATH 11CM 6FR

Facility

$371.00

Hospital Charge Code	270701577
Hospital Revenue Code	272
Min. Negotiated Rate	$8.94
Max. Negotiated Rate	$185.50
Rate for Payer: Aetna Commercial	$140.98
Rate for Payer: Aetna Medicare Advantage	$111.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.61
Rate for Payer: Cigna Commercial	$185.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.30
Rate for Payer: Oxford Commercial	$74.20
Rate for Payer: Qualcare PPO/HMO/WC	$55.65
Rate for Payer: UnitedHealthcare Commercial	$74.20
Rate for Payer: UnitedHealthcare Community & State	$8.94
Rate for Payer: Wellpoint Medicaid Managed Care	$9.83

INTRODUCER SHEATH 14FR 11CM

Facility

$51.73

Service Code	HCPCS C1894
Hospital Charge Code	270660038
Hospital Revenue Code	278
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$12.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.38
Rate for Payer: Qualcare PPO/HMO/WC	$7.76

INTRODUCER SHEATH 14FR 11CM

Facility

$51.73

Service Code	HCPCS C1894
Hospital Charge Code	270660038
Hospital Revenue Code	278
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$25.86
Rate for Payer: Aetna Commercial	$19.66
Rate for Payer: Aetna Medicare Advantage	$15.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.19
Rate for Payer: Cigna Commercial	$25.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.38
Rate for Payer: Qualcare PPO/HMO/WC	$7.76
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.37

INTRODUCER SHEATH 6FR 11CM

Facility

$57.25

Service Code	HCPCS C1894
Hospital Charge Code	270624176
Hospital Revenue Code	278
Min. Negotiated Rate	$8.59
Max. Negotiated Rate	$13.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$8.59

INTRODUCER SHEATH 6FR 11CM

Facility

$57.25

Service Code	HCPCS C1894
Hospital Charge Code	270624176
Hospital Revenue Code	278
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$28.62
Rate for Payer: Aetna Commercial	$21.75
Rate for Payer: Aetna Medicare Advantage	$17.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.60
Rate for Payer: Cigna Commercial	$28.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$8.59
Rate for Payer: UnitedHealthcare Community & State	$1.38
Rate for Payer: Wellpoint Medicaid Managed Care	$1.52

INTRODUCER SHEATH 6FR R/O 6CM

Facility

$1,287.50

Service Code	HCPCS C1894
Hospital Charge Code	270653781S
Hospital Revenue Code	278
Min. Negotiated Rate	$193.12
Max. Negotiated Rate	$311.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$283.25
Rate for Payer: Qualcare PPO/HMO/WC	$193.12

INTRODUCER SHEATH 6FR R/O 6CM

Facility

$1,287.50

Service Code	HCPCS C1894
Hospital Charge Code	270653781S
Hospital Revenue Code	278
Min. Negotiated Rate	$31.03
Max. Negotiated Rate	$643.75
Rate for Payer: Aetna Commercial	$489.25
Rate for Payer: Aetna Medicare Advantage	$386.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.31
Rate for Payer: Cigna Commercial	$643.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$283.25
Rate for Payer: Qualcare PPO/HMO/WC	$193.12
Rate for Payer: UnitedHealthcare Community & State	$31.03
Rate for Payer: Wellpoint Medicaid Managed Care	$34.12

INTRODUCER SHEATH 6FR R/O 6CM

Facility

$1,287.50

Service Code	HCPCS C1894
Hospital Charge Code	270653781N
Hospital Revenue Code	278
Min. Negotiated Rate	$193.12
Max. Negotiated Rate	$311.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$283.25
Rate for Payer: Qualcare PPO/HMO/WC	$193.12

INTRODUCER SHEATH 6FR R/O 6CM

Facility

$1,287.50

Service Code	HCPCS C1894
Hospital Charge Code	270653781N
Hospital Revenue Code	278
Min. Negotiated Rate	$31.03
Max. Negotiated Rate	$643.75
Rate for Payer: Aetna Commercial	$489.25
Rate for Payer: Aetna Medicare Advantage	$386.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.31
Rate for Payer: Cigna Commercial	$643.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$283.25
Rate for Payer: Qualcare PPO/HMO/WC	$193.12
Rate for Payer: UnitedHealthcare Community & State	$31.03
Rate for Payer: Wellpoint Medicaid Managed Care	$34.12

INTRODUCER SHEATH, ACCUSTIK

Facility

$623.00

Service Code	HCPCS C1894
Hospital Charge Code	2008105
Hospital Revenue Code	278
Min. Negotiated Rate	$15.01
Max. Negotiated Rate	$311.50
Rate for Payer: Aetna Commercial	$236.74
Rate for Payer: Aetna Medicare Advantage	$186.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.87
Rate for Payer: Cigna Commercial	$311.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.06
Rate for Payer: Qualcare PPO/HMO/WC	$93.45
Rate for Payer: UnitedHealthcare Community & State	$15.01
Rate for Payer: Wellpoint Medicaid Managed Care	$16.51

INTRODUCER SHEATH, ACCUSTIK

Facility

$623.00

Service Code	HCPCS C1894
Hospital Charge Code	2008105
Hospital Revenue Code	278
Min. Negotiated Rate	$93.45
Max. Negotiated Rate	$150.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.06
Rate for Payer: Qualcare PPO/HMO/WC	$93.45

INTRODUCER SURE SIGHT 9G

Facility

$4,868.75

Hospital Charge Code	270664831
Hospital Revenue Code	270
Min. Negotiated Rate	$730.31
Max. Negotiated Rate	$730.31
Rate for Payer: Qualcare PPO/HMO/WC	$730.31

INTRODUCER SURE SIGHT 9G

Facility

$4,868.75

Hospital Charge Code	270664831
Hospital Revenue Code	270
Min. Negotiated Rate	$117.34
Max. Negotiated Rate	$2,434.38
Rate for Payer: Aetna Commercial	$1,850.12
Rate for Payer: Aetna Medicare Advantage	$1,460.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,241.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,241.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,241.53
Rate for Payer: Cigna Commercial	$2,434.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,460.62
Rate for Payer: Oxford Commercial	$973.75
Rate for Payer: Qualcare PPO/HMO/WC	$730.31
Rate for Payer: UnitedHealthcare Commercial	$973.75
Rate for Payer: UnitedHealthcare Community & State	$117.34
Rate for Payer: Wellpoint Medicaid Managed Care	$129.02

INTRODUCER SYSTEM OSTEO T24A

Facility

$5,750.00

Hospital Charge Code	270637757
Hospital Revenue Code	272
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$862.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

INTRODUCER SYSTEM OSTEO T24A

Facility

$5,750.00

Hospital Charge Code	270637757
Hospital Revenue Code	272
Min. Negotiated Rate	$138.57
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$2,185.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,725.00
Rate for Payer: Oxford Commercial	$1,150.00
Rate for Payer: Qualcare PPO/HMO/WC	$862.50
Rate for Payer: UnitedHealthcare Commercial	$1,150.00
Rate for Payer: UnitedHealthcare Community & State	$138.57
Rate for Payer: Wellpoint Medicaid Managed Care	$152.38

INTRODUCER TEARAWAY SET 12 FR

Facility

$800.00

Hospital Charge Code	270669517
Hospital Revenue Code	272
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

INTRODUCER TEARAWAY SET 12 FR

Facility

$800.00

Hospital Charge Code	270669517
Hospital Revenue Code	272
Min. Negotiated Rate	$19.28
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.00
Rate for Payer: Oxford Commercial	$160.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$160.00
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$21.20

INTRODUCER THINWALL 19UT 7CM

Facility

$44.75

Service Code	HCPCS C1894
Hospital Charge Code	270669179C
Hospital Revenue Code	278
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.38
Rate for Payer: Aetna Commercial	$17.00
Rate for Payer: Aetna Medicare Advantage	$13.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.41
Rate for Payer: Cigna Commercial	$22.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$6.71
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

INTRODUCER THINWALL 19UT 7CM

Facility

$44.75

Service Code	HCPCS C1894
Hospital Charge Code	270669179C
Hospital Revenue Code	278
Min. Negotiated Rate	$6.71
Max. Negotiated Rate	$10.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$6.71

INTRODUCER TRANSRADIAL PRELUDE

Facility

$160.00

Hospital Charge Code	2709006916
Hospital Revenue Code	272
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

INTRODUCER TRANSRADIAL PRELUDE

Facility

$160.00

Hospital Charge Code	2709006916
Hospital Revenue Code	272
Min. Negotiated Rate	$3.86
Max. Negotiated Rate	$80.00
Rate for Payer: Aetna Commercial	$60.80
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.00
Rate for Payer: Oxford Commercial	$32.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$32.00
Rate for Payer: UnitedHealthcare Community & State	$3.86
Rate for Payer: Wellpoint Medicaid Managed Care	$4.24

INTRODUCER TRANSRADIAL PRELUDE

Facility

$160.00

Hospital Charge Code	2709002917
Hospital Revenue Code	272
Min. Negotiated Rate	$3.86
Max. Negotiated Rate	$80.00
Rate for Payer: Aetna Commercial	$60.80
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.00
Rate for Payer: Oxford Commercial	$32.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$32.00
Rate for Payer: UnitedHealthcare Community & State	$3.86
Rate for Payer: Wellpoint Medicaid Managed Care	$4.24

INTRODUCER TRANSRADIAL PRELUDE

Facility

$160.00

Hospital Charge Code	2709002917
Hospital Revenue Code	272
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

INTRODUCER VIS 7f 55c 4037553H

Facility

$281.85

Hospital Charge Code	270629332
Hospital Revenue Code	272
Min. Negotiated Rate	$6.79
Max. Negotiated Rate	$140.93
Rate for Payer: Aetna Commercial	$107.10
Rate for Payer: Aetna Medicare Advantage	$84.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.87
Rate for Payer: Cigna Commercial	$140.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.56
Rate for Payer: Oxford Commercial	$56.37
Rate for Payer: Qualcare PPO/HMO/WC	$42.28
Rate for Payer: UnitedHealthcare Commercial	$56.37
Rate for Payer: UnitedHealthcare Community & State	$6.79
Rate for Payer: Wellpoint Medicaid Managed Care	$7.47

Know your out-of-pocket cost for care.

All Charges