Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LEAD ISOFLEX OPTIM LV 1948/

Facility

$4,395.00

Hospital Charge Code	270655929
Hospital Revenue Code	275
Min. Negotiated Rate	$105.92
Max. Negotiated Rate	$2,197.50
Rate for Payer: Aetna Commercial	$1,670.10
Rate for Payer: Aetna Medicare Advantage	$1,318.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,120.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,120.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$879.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,120.72
Rate for Payer: Cigna Commercial	$2,197.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,063.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$966.90
Rate for Payer: Qualcare PPO/HMO/WC	$659.25
Rate for Payer: UnitedHealthcare Community & State	$105.92
Rate for Payer: Wellpoint Medicaid Managed Care	$116.47

LEAD ISOFLEX OPTIM LV 1948/52

Facility

$4,395.00

Hospital Charge Code	270655929C
Hospital Revenue Code	275
Min. Negotiated Rate	$659.25
Max. Negotiated Rate	$1,063.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$879.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,063.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$966.90
Rate for Payer: Qualcare PPO/HMO/WC	$659.25

LEAD ISOFLEX OPTIM LV 1948/52

Facility

$4,395.00

Hospital Charge Code	270655929C
Hospital Revenue Code	275
Min. Negotiated Rate	$105.92
Max. Negotiated Rate	$2,197.50
Rate for Payer: Aetna Commercial	$1,670.10
Rate for Payer: Aetna Medicare Advantage	$1,318.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,120.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,120.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$879.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,120.72
Rate for Payer: Cigna Commercial	$2,197.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,063.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$966.90
Rate for Payer: Qualcare PPO/HMO/WC	$659.25
Rate for Payer: UnitedHealthcare Community & State	$105.92
Rate for Payer: Wellpoint Medicaid Managed Care	$116.47

LEAD ISOFLEX VENT 52cm 1646T

Facility

$3,875.00

Hospital Charge Code	270642138
Hospital Revenue Code	275
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$937.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$852.50
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

LEAD ISOFLEX VENT 52cm 1646T

Facility

$3,875.00

Hospital Charge Code	270642138
Hospital Revenue Code	275
Min. Negotiated Rate	$93.39
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,472.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$852.50
Rate for Payer: Qualcare PPO/HMO/WC	$581.25
Rate for Payer: UnitedHealthcare Community & State	$93.39
Rate for Payer: Wellpoint Medicaid Managed Care	$102.69

LEAD ISOFLEX VENT 52CM 1646T

Facility

$4,040.00

Hospital Charge Code	270642138C
Hospital Revenue Code	275
Min. Negotiated Rate	$606.00
Max. Negotiated Rate	$977.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$977.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$888.80
Rate for Payer: Qualcare PPO/HMO/WC	$606.00

LEAD ISOFLEX VENT 52CM 1646T

Facility

$4,040.00

Hospital Charge Code	270642138C
Hospital Revenue Code	275
Min. Negotiated Rate	$97.36
Max. Negotiated Rate	$2,020.00
Rate for Payer: Aetna Commercial	$1,535.20
Rate for Payer: Aetna Medicare Advantage	$1,212.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,030.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,030.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,030.20
Rate for Payer: Cigna Commercial	$2,020.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$977.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$888.80
Rate for Payer: Qualcare PPO/HMO/WC	$606.00
Rate for Payer: UnitedHealthcare Community & State	$97.36
Rate for Payer: Wellpoint Medicaid Managed Care	$107.06

LEAD ISOFLEX VENTRICULAR 58CM

Facility

$4,040.00

Hospital Charge Code	270645678C
Hospital Revenue Code	275
Min. Negotiated Rate	$97.36
Max. Negotiated Rate	$2,020.00
Rate for Payer: Aetna Commercial	$1,535.20
Rate for Payer: Aetna Medicare Advantage	$1,212.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,030.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,030.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,030.20
Rate for Payer: Cigna Commercial	$2,020.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$977.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$888.80
Rate for Payer: Qualcare PPO/HMO/WC	$606.00
Rate for Payer: UnitedHealthcare Community & State	$97.36
Rate for Payer: Wellpoint Medicaid Managed Care	$107.06

LEAD ISOFLEX VENTRICULAR 58CM

Facility

$4,040.00

Hospital Charge Code	270645678C
Hospital Revenue Code	275
Min. Negotiated Rate	$606.00
Max. Negotiated Rate	$977.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$977.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$888.80
Rate for Payer: Qualcare PPO/HMO/WC	$606.00

LEAD ISOFLEX VETNRICULAR 58cm

Facility

$4,040.00

Hospital Charge Code	270645678
Hospital Revenue Code	275
Min. Negotiated Rate	$97.36
Max. Negotiated Rate	$2,020.00
Rate for Payer: Aetna Commercial	$1,535.20
Rate for Payer: Aetna Medicare Advantage	$1,212.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,030.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,030.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,030.20
Rate for Payer: Cigna Commercial	$2,020.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$977.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$888.80
Rate for Payer: Qualcare PPO/HMO/WC	$606.00
Rate for Payer: UnitedHealthcare Community & State	$97.36
Rate for Payer: Wellpoint Medicaid Managed Care	$107.06

LEAD ISOFLEX VETNRICULAR 58cm

Facility

$4,040.00

Hospital Charge Code	270645678
Hospital Revenue Code	275
Min. Negotiated Rate	$606.00
Max. Negotiated Rate	$977.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$977.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$888.80
Rate for Payer: Qualcare PPO/HMO/WC	$606.00

LEAD ISTIME PNE TEST STIMN

Facility

$300.00

Service Code	HCPCS C1778
Hospital Charge Code	270691915
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

LEAD ISTIME PNE TEST STIMN

Facility

$300.00

Service Code	HCPCS C1778
Hospital Charge Code	270691915
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

LEAD ISTIME TEST KIT

Facility

$500.00

Service Code	HCPCS C1897
Hospital Charge Code	270691914
Hospital Revenue Code	272
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

LEAD ISTIME TEST KIT

Facility

$500.00

Service Code	HCPCS C1897
Hospital Charge Code	270691914
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

LEAD KIT 50 8 CON LIN SC221850

Facility

$12,000.00

Service Code	HCPCS C1778
Hospital Charge Code	270641627
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$2,904.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,640.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

LEAD KIT 50 8 CON LIN SC221850

Facility

$12,000.00

Service Code	HCPCS C1778
Hospital Charge Code	270641627
Hospital Revenue Code	278
Min. Negotiated Rate	$289.20
Max. Negotiated Rate	$6,000.00
Rate for Payer: Aetna Commercial	$4,560.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,640.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Community & State	$289.20
Rate for Payer: Wellpoint Medicaid Managed Care	$318.00

LEAD KIT CONTRACT INFINION 16

Facility

$3,750.00

Hospital Charge Code	270702403
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

LEAD KIT CONTRACT INFINION 16

Facility

$3,750.00

Hospital Charge Code	270701876
Hospital Revenue Code	278
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$99.38

LEAD KIT CONTRACT INFINION 16

Facility

$3,750.00

Hospital Charge Code	270701876
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

LEAD KIT CONTRACT INFINION 16

Facility

$3,750.00

Hospital Charge Code	270702403
Hospital Revenue Code	278
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$99.38

LEAD KIT NEUROSTIM 5X50 BLUE

Facility

$2,500.00

Service Code	HCPCS C1778
Hospital Charge Code	270693283
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$60.25
Rate for Payer: Wellpoint Medicaid Managed Care	$66.25

LEAD KIT NEUROSTIM 5X50 BLUE

Facility

$2,500.00

Service Code	HCPCS C1778
Hospital Charge Code	270693283
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

LEAD KIT TINED

Facility

$2,000.00

Hospital Charge Code	270684097
Hospital Revenue Code	272
Min. Negotiated Rate	$48.20
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.00
Rate for Payer: Oxford Commercial	$400.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Commercial	$400.00
Rate for Payer: UnitedHealthcare Community & State	$48.20
Rate for Payer: Wellpoint Medicaid Managed Care	$53.00

LEAD KIT TINED

Facility

$2,000.00

Hospital Charge Code	270684097
Hospital Revenue Code	272
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

Know your out-of-pocket cost for care.

All Charges