Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LEAD 457453 PACE TRANSV

Facility

$2,795.00

Service Code	HCPCS C1898
Hospital Charge Code	270686929
Hospital Revenue Code	278
Min. Negotiated Rate	$419.25
Max. Negotiated Rate	$676.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$676.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$614.90
Rate for Payer: Qualcare PPO/HMO/WC	$419.25

LEAD-A

Facility

$1,875.00

Hospital Charge Code	270605467
Hospital Revenue Code	278
Min. Negotiated Rate	$45.19
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$712.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$49.69

LEAD-A

Facility

$1,875.00

Hospital Charge Code	270605467
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

LEAD ADAPTER MEDTRONIC

Facility

$2,575.00

Service Code	HCPCS C1779
Hospital Charge Code	270681603N
Hospital Revenue Code	275
Min. Negotiated Rate	$62.06
Max. Negotiated Rate	$1,287.50
Rate for Payer: Aetna Commercial	$978.50
Rate for Payer: Aetna Medicare Advantage	$772.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$656.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$656.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$515.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$656.62
Rate for Payer: Cigna Commercial	$1,287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$623.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$566.50
Rate for Payer: Qualcare PPO/HMO/WC	$386.25
Rate for Payer: UnitedHealthcare Community & State	$62.06
Rate for Payer: Wellpoint Medicaid Managed Care	$68.24

LEAD ADAPTER MEDTRONIC

Facility

$2,575.00

Service Code	HCPCS C1779
Hospital Charge Code	270681603
Hospital Revenue Code	272
Min. Negotiated Rate	$386.25
Max. Negotiated Rate	$386.25
Rate for Payer: Qualcare PPO/HMO/WC	$386.25

LEAD ADAPTER MEDTRONIC

Facility

$2,575.00

Service Code	HCPCS C1779
Hospital Charge Code	270681603
Hospital Revenue Code	272
Min. Negotiated Rate	$62.06
Max. Negotiated Rate	$1,287.50
Rate for Payer: Aetna Commercial	$978.50
Rate for Payer: Aetna Medicare Advantage	$772.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$656.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$656.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$656.62
Rate for Payer: Cigna Commercial	$1,287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$772.50
Rate for Payer: Oxford Commercial	$515.00
Rate for Payer: Qualcare PPO/HMO/WC	$386.25
Rate for Payer: UnitedHealthcare Commercial	$515.00
Rate for Payer: UnitedHealthcare Community & State	$62.06
Rate for Payer: Wellpoint Medicaid Managed Care	$68.24

LEAD ADAPTER MEDTRONIC

Facility

$2,575.00

Service Code	HCPCS C1779
Hospital Charge Code	270681603N
Hospital Revenue Code	275
Min. Negotiated Rate	$386.25
Max. Negotiated Rate	$623.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$515.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$623.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$566.50
Rate for Payer: Qualcare PPO/HMO/WC	$386.25

LEAD, ADULT, ANY SOURCE

Facility

$111.25

Service Code	HCPCS 83655
Hospital Charge Code	3001799
Hospital Revenue Code	301
Min. Negotiated Rate	$16.69
Max. Negotiated Rate	$16.69
Rate for Payer: Qualcare PPO/HMO/WC	$16.69

LEAD, ADULT, ANY SOURCE

Facility

$111.25

Service Code	HCPCS 83655
Hospital Charge Code	3001799
Hospital Revenue Code	301
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.94
Rate for Payer: Aetna Medicare Advantage	$39.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$55.62
Rate for Payer: Cigna Medicare Advantage	$12.11
Rate for Payer: Clover Medicare Advantage	$11.50
Rate for Payer: EmblemHealth Commercial	$36.33
Rate for Payer: Humana Medicare Advantage	$12.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.69
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.11
Rate for Payer: Wellcare Medicare Advantage	$12.11
Rate for Payer: Wellpoint Medicaid Managed Care	$2.95

LEAD ATRIAL 4524-53

Facility

$2,976.00

Hospital Charge Code	270627551
Hospital Revenue Code	275
Min. Negotiated Rate	$71.72
Max. Negotiated Rate	$1,488.00
Rate for Payer: Aetna Commercial	$1,130.88
Rate for Payer: Aetna Medicare Advantage	$892.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.88
Rate for Payer: Cigna Commercial	$1,488.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$720.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$654.72
Rate for Payer: Qualcare PPO/HMO/WC	$446.40
Rate for Payer: UnitedHealthcare Community & State	$71.72
Rate for Payer: Wellpoint Medicaid Managed Care	$78.86

LEAD ATRIAL 4524-53

Facility

$2,976.00

Hospital Charge Code	270627551
Hospital Revenue Code	275
Min. Negotiated Rate	$446.40
Max. Negotiated Rate	$720.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$720.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$654.72
Rate for Payer: Qualcare PPO/HMO/WC	$446.40

LEAD ATRIAL 45CM FOR PACEMAKER

Facility

$4,965.00

Hospital Charge Code	270645705
Hospital Revenue Code	275
Min. Negotiated Rate	$119.66
Max. Negotiated Rate	$2,482.50
Rate for Payer: Aetna Commercial	$1,886.70
Rate for Payer: Aetna Medicare Advantage	$1,489.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,266.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,266.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$993.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,266.08
Rate for Payer: Cigna Commercial	$2,482.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,201.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,092.30
Rate for Payer: Qualcare PPO/HMO/WC	$744.75
Rate for Payer: UnitedHealthcare Community & State	$119.66
Rate for Payer: Wellpoint Medicaid Managed Care	$131.57

LEAD ATRIAL 45CM FOR PACEMAKER

Facility

$4,965.00

Hospital Charge Code	270645705
Hospital Revenue Code	275
Min. Negotiated Rate	$744.75
Max. Negotiated Rate	$1,201.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$993.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,201.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,092.30
Rate for Payer: Qualcare PPO/HMO/WC	$744.75

LEAD ATRIAL 45CM FOR PM 508645

Facility

$4,965.00

Hospital Charge Code	270645705C
Hospital Revenue Code	275
Min. Negotiated Rate	$119.66
Max. Negotiated Rate	$2,482.50
Rate for Payer: Aetna Commercial	$1,886.70
Rate for Payer: Aetna Medicare Advantage	$1,489.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,266.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,266.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$993.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,266.08
Rate for Payer: Cigna Commercial	$2,482.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,201.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,092.30
Rate for Payer: Qualcare PPO/HMO/WC	$744.75
Rate for Payer: UnitedHealthcare Community & State	$119.66
Rate for Payer: Wellpoint Medicaid Managed Care	$131.57

LEAD ATRIAL 45CM FOR PM 508645

Facility

$4,965.00

Hospital Charge Code	270645705C
Hospital Revenue Code	275
Min. Negotiated Rate	$744.75
Max. Negotiated Rate	$1,201.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$993.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,201.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,092.30
Rate for Payer: Qualcare PPO/HMO/WC	$744.75

LEAD BIPOLAR ENDOCARDIA 52CM

Facility

$3,000.00

Hospital Charge Code	270662925
Hospital Revenue Code	275
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

LEAD BIPOLAR ENDOCARDIA 52CM

Facility

$3,000.00

Hospital Charge Code	270662925
Hospital Revenue Code	275
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

LEAD (BLOOD)***

Facility

$50.00

Hospital Charge Code	3011798
Hospital Revenue Code	309
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

LEAD (BLOOD)***

Facility

$50.00

Hospital Charge Code	3011798
Hospital Revenue Code	309
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

LEAD BLOOD

Facility

$325.00

Service Code	HCPCS 83655
Hospital Charge Code	38472446
Hospital Revenue Code	301
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

LEAD BLOOD

Facility

$325.00

Service Code	HCPCS 83655
Hospital Charge Code	38472446
Hospital Revenue Code	301
Min. Negotiated Rate	$8.61
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$32.94
Rate for Payer: Aetna Medicare Advantage	$39.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: Cigna Medicare Advantage	$12.11
Rate for Payer: Clover Medicare Advantage	$11.50
Rate for Payer: EmblemHealth Commercial	$36.33
Rate for Payer: Humana Medicare Advantage	$12.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.11
Rate for Payer: Wellcare Medicare Advantage	$12.11
Rate for Payer: Wellpoint Medicaid Managed Care	$8.61

LEAD,BLOOD

Facility

$667.59

Service Code	HCPCS 83655
Hospital Charge Code	39900102
Hospital Revenue Code	301
Min. Negotiated Rate	$9.69
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$32.94
Rate for Payer: Aetna Medicare Advantage	$39.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$12.11
Rate for Payer: Clover Medicare Advantage	$11.50
Rate for Payer: EmblemHealth Commercial	$36.33
Rate for Payer: Humana Medicare Advantage	$12.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.11
Rate for Payer: Wellcare Medicare Advantage	$12.11
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

LEAD,BLOOD

Facility

$667.59

Service Code	HCPCS 83655
Hospital Charge Code	39900102
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

LEAD CAPSURE

Facility

$3,080.00

Hospital Charge Code	270657301
Hospital Revenue Code	278
Min. Negotiated Rate	$462.00
Max. Negotiated Rate	$745.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$616.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$745.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$677.60
Rate for Payer: Qualcare PPO/HMO/WC	$462.00

LEAD CAPSURE

Facility

$3,080.00

Hospital Charge Code	270657301
Hospital Revenue Code	278
Min. Negotiated Rate	$74.23
Max. Negotiated Rate	$1,540.00
Rate for Payer: Aetna Commercial	$1,170.40
Rate for Payer: Aetna Medicare Advantage	$924.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$785.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$785.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$616.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$785.40
Rate for Payer: Cigna Commercial	$1,540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$745.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$677.60
Rate for Payer: Qualcare PPO/HMO/WC	$462.00
Rate for Payer: UnitedHealthcare Community & State	$74.23
Rate for Payer: Wellpoint Medicaid Managed Care	$81.62

Know your out-of-pocket cost for care.

All Charges