Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KIRSCH WIRE W/TROCAR TIP 2.5MM

Facility

$165.00

Service Code	HCPCS C1713
Hospital Charge Code	270688155
Hospital Revenue Code	278
Min. Negotiated Rate	$3.98
Max. Negotiated Rate	$82.50
Rate for Payer: Aetna Commercial	$62.70
Rate for Payer: Aetna Medicare Advantage	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.08
Rate for Payer: Cigna Commercial	$82.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$24.75
Rate for Payer: UnitedHealthcare Community & State	$3.98
Rate for Payer: Wellpoint Medicaid Managed Care	$4.37

KIRSHNER WIRES

Facility

$145.00

Hospital Charge Code	270335000
Hospital Revenue Code	278
Min. Negotiated Rate	$3.49
Max. Negotiated Rate	$72.50
Rate for Payer: Aetna Commercial	$55.10
Rate for Payer: Aetna Medicare Advantage	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.98
Rate for Payer: Cigna Commercial	$72.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$31.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.75
Rate for Payer: UnitedHealthcare Community & State	$3.49
Rate for Payer: Wellpoint Medicaid Managed Care	$3.84

KIRSHNER WIRES

Facility

$145.00

Hospital Charge Code	270335000
Hospital Revenue Code	278
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$31.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

KIT 11 CC CONFIDENCE

Facility

$23,635.00

Hospital Charge Code	270688639
Hospital Revenue Code	272
Min. Negotiated Rate	$3,545.25
Max. Negotiated Rate	$3,545.25
Rate for Payer: Qualcare PPO/HMO/WC	$3,545.25

KIT 11 CC CONFIDENCE

Facility

$23,635.00

Hospital Charge Code	270688639
Hospital Revenue Code	272
Min. Negotiated Rate	$569.60
Max. Negotiated Rate	$11,817.50
Rate for Payer: Aetna Commercial	$8,981.30
Rate for Payer: Aetna Medicare Advantage	$7,090.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,026.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,026.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,026.93
Rate for Payer: Cigna Commercial	$11,817.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,090.50
Rate for Payer: Oxford Commercial	$4,727.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,545.25
Rate for Payer: UnitedHealthcare Commercial	$4,727.00
Rate for Payer: UnitedHealthcare Community & State	$569.60
Rate for Payer: Wellpoint Medicaid Managed Care	$626.33

KIT 1.5MM DISPOSABLE

Facility

$1,700.00

Hospital Charge Code	270649663
Hospital Revenue Code	272
Min. Negotiated Rate	$255.00
Max. Negotiated Rate	$255.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00

KIT 1.5MM DISPOSABLE

Facility

$1,700.00

Hospital Charge Code	270649663
Hospital Revenue Code	272
Min. Negotiated Rate	$40.97
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$646.00
Rate for Payer: Aetna Medicare Advantage	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$433.50
Rate for Payer: Cigna Commercial	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$510.00
Rate for Payer: Oxford Commercial	$340.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00
Rate for Payer: UnitedHealthcare Commercial	$340.00
Rate for Payer: UnitedHealthcare Community & State	$40.97
Rate for Payer: Wellpoint Medicaid Managed Care	$45.05

KIT,2MM GUIDE PIN ,SINGLE

Facility

$585.00

Hospital Charge Code	270687345
Hospital Revenue Code	272
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$222.30
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.50
Rate for Payer: Oxford Commercial	$117.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Commercial	$117.00
Rate for Payer: UnitedHealthcare Community & State	$14.10
Rate for Payer: Wellpoint Medicaid Managed Care	$15.50

KIT,2MM GUIDE PIN ,SINGLE

Facility

$585.00

Hospital Charge Code	270687345
Hospital Revenue Code	272
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$87.75
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

KIT 5F COAXIAL MINI .018X.40CM

Facility

$25.00

Hospital Charge Code	270659910
Hospital Revenue Code	272
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

KIT 5F COAXIAL MINI .018X.40CM

Facility

$25.00

Hospital Charge Code	270659910
Hospital Revenue Code	272
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$9.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.50
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$5.00
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

KIT 5FR MCRPNCTRE 0.018x40CM

Facility

$1,750.00

Hospital Charge Code	270650009C
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

KIT 5FR MCRPNCTRE 0.018x40CM

Facility

$1,750.00

Hospital Charge Code	270650009C
Hospital Revenue Code	272
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$525.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$350.00
Rate for Payer: UnitedHealthcare Community & State	$42.17
Rate for Payer: Wellpoint Medicaid Managed Care	$46.38

KIT ABLATION ENDOMETRIAL HANDP

Facility

$18,300.00

Hospital Charge Code	270655612
Hospital Revenue Code	278
Min. Negotiated Rate	$441.03
Max. Negotiated Rate	$9,150.00
Rate for Payer: Aetna Commercial	$6,954.00
Rate for Payer: Aetna Medicare Advantage	$5,490.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,666.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,666.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,666.50
Rate for Payer: Cigna Commercial	$9,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,428.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,026.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,745.00
Rate for Payer: UnitedHealthcare Community & State	$441.03
Rate for Payer: Wellpoint Medicaid Managed Care	$484.95

KIT ABLATION ENDOMETRIAL HANDP

Facility

$18,300.00

Hospital Charge Code	270655612
Hospital Revenue Code	278
Min. Negotiated Rate	$2,745.00
Max. Negotiated Rate	$4,428.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,428.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,026.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,745.00

KIT ACCES 800 W/INHIZ 72006601

Facility

$2,625.00

Hospital Charge Code	270641449
Hospital Revenue Code	272
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$393.75
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

KIT ACCES 800 W/INHIZ 72006601

Facility

$2,625.00

Hospital Charge Code	270641449
Hospital Revenue Code	272
Min. Negotiated Rate	$63.26
Max. Negotiated Rate	$1,312.50
Rate for Payer: Aetna Commercial	$997.50
Rate for Payer: Aetna Medicare Advantage	$787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.38
Rate for Payer: Cigna Commercial	$1,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$787.50
Rate for Payer: Oxford Commercial	$525.00
Rate for Payer: Qualcare PPO/HMO/WC	$393.75
Rate for Payer: UnitedHealthcare Commercial	$525.00
Rate for Payer: UnitedHealthcare Community & State	$63.26
Rate for Payer: Wellpoint Medicaid Managed Care	$69.56

KIT ACCESS 9CM LARGE BORE

Facility

$76.00

Hospital Charge Code	270689931S
Hospital Revenue Code	272
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$38.00
Rate for Payer: Aetna Commercial	$28.88
Rate for Payer: Aetna Medicare Advantage	$22.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.38
Rate for Payer: Cigna Commercial	$38.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.80
Rate for Payer: Oxford Commercial	$15.20
Rate for Payer: Qualcare PPO/HMO/WC	$11.40
Rate for Payer: UnitedHealthcare Commercial	$15.20
Rate for Payer: UnitedHealthcare Community & State	$1.83
Rate for Payer: Wellpoint Medicaid Managed Care	$2.01

KIT ACCESS 9CM LARGE BORE

Facility

$76.00

Hospital Charge Code	270689931S
Hospital Revenue Code	272
Min. Negotiated Rate	$11.40
Max. Negotiated Rate	$11.40
Rate for Payer: Qualcare PPO/HMO/WC	$11.40

KIT ACCESS HIP

Facility

$1,000.00

Hospital Charge Code	270687980
Hospital Revenue Code	272
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) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$200.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

KIT ACCESS HIP

Facility

$1,000.00

Hospital Charge Code	270687980
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

KIT ACCESS MULTI-LEAD TRIALING

Facility

$1,000.00

Hospital Charge Code	270645617
Hospital Revenue Code	272
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) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$200.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

KIT ACCESS MULTI-LEAD TRIALING

Facility

$1,000.00

Hospital Charge Code	270645617
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

KIT ACCESSORY

Facility

$750.00

Hospital Charge Code	270648829
Hospital Revenue Code	271
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$150.00
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

KIT ACCESSORY

Facility

$750.00

Hospital Charge Code	270648829
Hospital Revenue Code	271
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

Know your out-of-pocket cost for care.

All Charges