Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LEAD EON 60cm

Facility

$16,075.00

Service Code	HCPCS C1778
Hospital Charge Code	270642323
Hospital Revenue Code	278
Min. Negotiated Rate	$2,411.25
Max. Negotiated Rate	$3,890.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,890.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,536.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,411.25

LEAD FINELINE EZ ST PACEMKR

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270696940S
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

LEAD FINELINE EZ ST PACEMKR

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270696940S
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

LEAD FINELINE II EZ POSIT 4469

Facility

$3,000.00

Hospital Charge Code	270640191
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 FINELINE II EZ POSIT 4469

Facility

$3,000.00

Hospital Charge Code	270640191
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 FINELINE II PASSIVE 53

Facility

$5,325.00

Hospital Charge Code	270666558
Hospital Revenue Code	275
Min. Negotiated Rate	$128.33
Max. Negotiated Rate	$2,662.50
Rate for Payer: Aetna Commercial	$2,023.50
Rate for Payer: Aetna Medicare Advantage	$1,597.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,357.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,357.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,065.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,357.88
Rate for Payer: Cigna Commercial	$2,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,288.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,171.50
Rate for Payer: Qualcare PPO/HMO/WC	$798.75
Rate for Payer: UnitedHealthcare Community & State	$128.33
Rate for Payer: Wellpoint Medicaid Managed Care	$141.11

LEAD FINELINE II PASSIVE 53

Facility

$5,325.00

Hospital Charge Code	270666558
Hospital Revenue Code	275
Min. Negotiated Rate	$798.75
Max. Negotiated Rate	$1,288.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,065.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,288.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,171.50
Rate for Payer: Qualcare PPO/HMO/WC	$798.75

LEAD FINELIN II PASS 52CM 4456

Facility

$3,000.00

Hospital Charge Code	270640192
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 FINELIN II PASS 52CM 4456

Facility

$3,000.00

Hospital Charge Code	270640192
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 FPA BI SIL ATR STER US

Facility

$3,265.00

Hospital Charge Code	270667006
Hospital Revenue Code	275
Min. Negotiated Rate	$489.75
Max. Negotiated Rate	$790.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$653.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$790.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$718.30
Rate for Payer: Qualcare PPO/HMO/WC	$489.75

LEAD FPA BI SIL ATR STER US

Facility

$3,265.00

Hospital Charge Code	270667006
Hospital Revenue Code	275
Min. Negotiated Rate	$78.69
Max. Negotiated Rate	$1,632.50
Rate for Payer: Aetna Commercial	$1,240.70
Rate for Payer: Aetna Medicare Advantage	$979.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$832.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$832.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$653.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$832.58
Rate for Payer: Cigna Commercial	$1,632.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$790.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$718.30
Rate for Payer: Qualcare PPO/HMO/WC	$489.75
Rate for Payer: UnitedHealthcare Community & State	$78.69
Rate for Payer: Wellpoint Medicaid Managed Care	$86.52

LEAD FPA BI SIL ATR STER US

Facility

$3,265.00

Hospital Charge Code	270661941
Hospital Revenue Code	275
Min. Negotiated Rate	$78.69
Max. Negotiated Rate	$1,632.50
Rate for Payer: Aetna Commercial	$1,240.70
Rate for Payer: Aetna Medicare Advantage	$979.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$832.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$832.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$653.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$832.58
Rate for Payer: Cigna Commercial	$1,632.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$790.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$718.30
Rate for Payer: Qualcare PPO/HMO/WC	$489.75
Rate for Payer: UnitedHealthcare Community & State	$78.69
Rate for Payer: Wellpoint Medicaid Managed Care	$86.52

LEAD FPA BI SIL ATR STER US

Facility

$3,265.00

Hospital Charge Code	270661941
Hospital Revenue Code	275
Min. Negotiated Rate	$489.75
Max. Negotiated Rate	$790.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$653.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$790.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$718.30
Rate for Payer: Qualcare PPO/HMO/WC	$489.75

Lead Ingebity MRI 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270679666S
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

Lead Ingebity MRI 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270679666N
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

Lead Ingebity MRI 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270679666S
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

Lead Ingebity MRI 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270679666N
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

Lead Ingevity Cm

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270678803N
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

Lead Ingevity Cm

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270678803S
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

Lead Ingevity Cm

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270678803N
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

Lead Ingevity Cm

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270678803S
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

LEAD INGEVITY MRI 7741 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270677540
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

LEAD INGEVITY MRI 7741 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270677540N
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

LEAD INGEVITY MRI 7741 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270677540N
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

LEAD INGEVITY MRI 7741 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270677540
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

Know your out-of-pocket cost for care.

All Charges