Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LEAD KIT TINED 28CM

Facility

$17,425.00

Service Code	HCPCS C1778
Hospital Charge Code	270671676
Hospital Revenue Code	278
Min. Negotiated Rate	$419.94
Max. Negotiated Rate	$8,712.50
Rate for Payer: Aetna Commercial	$6,621.50
Rate for Payer: Aetna Medicare Advantage	$5,227.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,443.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,443.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,443.38
Rate for Payer: Cigna Commercial	$8,712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,216.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,833.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,613.75
Rate for Payer: UnitedHealthcare Community & State	$419.94
Rate for Payer: Wellpoint Medicaid Managed Care	$461.76

LEAD KIT TINED 28CM

Facility

$17,425.00

Service Code	HCPCS C1778
Hospital Charge Code	270671676
Hospital Revenue Code	278
Min. Negotiated Rate	$2,613.75
Max. Negotiated Rate	$4,216.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,216.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,833.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,613.75

LEAD MEDT PCEMKER 5092-52CM

Facility

$2,420.00

Service Code	HCPCS C1779
Hospital Charge Code	270626470
Hospital Revenue Code	275
Min. Negotiated Rate	$58.32
Max. Negotiated Rate	$1,210.00
Rate for Payer: Aetna Commercial	$919.60
Rate for Payer: Aetna Medicare Advantage	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$617.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$617.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$617.10
Rate for Payer: Cigna Commercial	$1,210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$532.40
Rate for Payer: Qualcare PPO/HMO/WC	$363.00
Rate for Payer: UnitedHealthcare Community & State	$58.32
Rate for Payer: Wellpoint Medicaid Managed Care	$64.13

LEAD MEDT PCEMKER 5092-52CM

Facility

$2,420.00

Service Code	HCPCS C1779
Hospital Charge Code	270626470
Hospital Revenue Code	275
Min. Negotiated Rate	$363.00
Max. Negotiated Rate	$585.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$484.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$532.40
Rate for Payer: Qualcare PPO/HMO/WC	$363.00

LEAD MEDT PCEMKER 5092-52CM

Facility

$3,589.65

Hospital Charge Code	270626470C
Hospital Revenue Code	275
Min. Negotiated Rate	$538.45
Max. Negotiated Rate	$868.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$717.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$868.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$789.72
Rate for Payer: Qualcare PPO/HMO/WC	$538.45

LEAD MEDT PCEMKER 5092-52CM

Facility

$3,589.65

Hospital Charge Code	270626470C
Hospital Revenue Code	275
Min. Negotiated Rate	$86.51
Max. Negotiated Rate	$1,794.83
Rate for Payer: Aetna Commercial	$1,364.07
Rate for Payer: Aetna Medicare Advantage	$1,076.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$915.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$915.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$717.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$915.36
Rate for Payer: Cigna Commercial	$1,794.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$868.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$789.72
Rate for Payer: Qualcare PPO/HMO/WC	$538.45
Rate for Payer: UnitedHealthcare Community & State	$86.51
Rate for Payer: Wellpoint Medicaid Managed Care	$95.13

LEAD MEDT PCEMKR 4003M

Facility

$4,968.85

Hospital Charge Code	270602748
Hospital Revenue Code	275
Min. Negotiated Rate	$119.75
Max. Negotiated Rate	$2,484.43
Rate for Payer: Aetna Commercial	$1,888.16
Rate for Payer: Aetna Medicare Advantage	$1,490.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,267.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,267.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$993.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,267.06
Rate for Payer: Cigna Commercial	$2,484.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,202.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,093.15
Rate for Payer: Qualcare PPO/HMO/WC	$745.33
Rate for Payer: UnitedHealthcare Community & State	$119.75
Rate for Payer: Wellpoint Medicaid Managed Care	$131.67

LEAD MEDT PCEMKR 4003M

Facility

$4,968.85

Hospital Charge Code	270602748
Hospital Revenue Code	275
Min. Negotiated Rate	$745.33
Max. Negotiated Rate	$1,202.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$993.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,202.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,093.15
Rate for Payer: Qualcare PPO/HMO/WC	$745.33

LEAD MEDT PCEMKR 4003M

Facility

$4,968.85

Hospital Charge Code	270602748C
Hospital Revenue Code	275
Min. Negotiated Rate	$745.33
Max. Negotiated Rate	$1,202.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$993.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,202.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,093.15
Rate for Payer: Qualcare PPO/HMO/WC	$745.33

LEAD MEDT PCEMKR 4003M

Facility

$4,968.85

Hospital Charge Code	270602748C
Hospital Revenue Code	275
Min. Negotiated Rate	$119.75
Max. Negotiated Rate	$2,484.43
Rate for Payer: Aetna Commercial	$1,888.16
Rate for Payer: Aetna Medicare Advantage	$1,490.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,267.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,267.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$993.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,267.06
Rate for Payer: Cigna Commercial	$2,484.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,202.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,093.15
Rate for Payer: Qualcare PPO/HMO/WC	$745.33
Rate for Payer: UnitedHealthcare Community & State	$119.75
Rate for Payer: Wellpoint Medicaid Managed Care	$131.67

LEAD MEDT PCEMKR 4057M

Facility

$2,179.20

Hospital Charge Code	270602755
Hospital Revenue Code	275
Min. Negotiated Rate	$52.52
Max. Negotiated Rate	$1,089.60
Rate for Payer: Aetna Commercial	$828.10
Rate for Payer: Aetna Medicare Advantage	$653.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$555.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$555.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$435.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$555.70
Rate for Payer: Cigna Commercial	$1,089.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$527.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$479.42
Rate for Payer: Qualcare PPO/HMO/WC	$326.88
Rate for Payer: UnitedHealthcare Community & State	$52.52
Rate for Payer: Wellpoint Medicaid Managed Care	$57.75

LEAD MEDT PCEMKR 4057M

Facility

$2,179.20

Hospital Charge Code	270602755
Hospital Revenue Code	275
Min. Negotiated Rate	$326.88
Max. Negotiated Rate	$527.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$435.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$527.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$479.42
Rate for Payer: Qualcare PPO/HMO/WC	$326.88

LEAD MEDT PCEMKR 4058M

Facility

$3,125.00

Hospital Charge Code	270602756
Hospital Revenue Code	275
Min. Negotiated Rate	$75.31
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$75.31
Rate for Payer: Wellpoint Medicaid Managed Care	$82.81

LEAD MEDT PCEMKR 4058M

Facility

$3,125.00

Hospital Charge Code	270602756
Hospital Revenue Code	275
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

LEAD MEDT PCEMKR 4058M

Facility

$3,125.00

Hospital Charge Code	270602756C
Hospital Revenue Code	275
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

LEAD MEDT PCEMKR 4058M

Facility

$3,125.00

Hospital Charge Code	270602756C
Hospital Revenue Code	275
Min. Negotiated Rate	$75.31
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$75.31
Rate for Payer: Wellpoint Medicaid Managed Care	$82.81

LEAD MEDT PCEMKR 4058M-58

Facility

$2,724.00

Hospital Charge Code	270608017
Hospital Revenue Code	275
Min. Negotiated Rate	$408.60
Max. Negotiated Rate	$659.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$544.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$599.28
Rate for Payer: Qualcare PPO/HMO/WC	$408.60

LEAD MEDT PCEMKR 4058M-58

Facility

$2,724.00

Hospital Charge Code	270608017
Hospital Revenue Code	275
Min. Negotiated Rate	$65.65
Max. Negotiated Rate	$1,362.00
Rate for Payer: Aetna Commercial	$1,035.12
Rate for Payer: Aetna Medicare Advantage	$817.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$694.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$694.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$544.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$694.62
Rate for Payer: Cigna Commercial	$1,362.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$599.28
Rate for Payer: Qualcare PPO/HMO/WC	$408.60
Rate for Payer: UnitedHealthcare Community & State	$65.65
Rate for Payer: Wellpoint Medicaid Managed Care	$72.19

LEAD MEDT PCEMKR 4068-52

Facility

$3,026.45

Hospital Charge Code	270607755
Hospital Revenue Code	275
Min. Negotiated Rate	$453.97
Max. Negotiated Rate	$732.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$665.82
Rate for Payer: Qualcare PPO/HMO/WC	$453.97

LEAD MEDT PCEMKR 4068-52

Facility

$3,026.45

Hospital Charge Code	270607755
Hospital Revenue Code	275
Min. Negotiated Rate	$72.94
Max. Negotiated Rate	$1,513.22
Rate for Payer: Aetna Commercial	$1,150.05
Rate for Payer: Aetna Medicare Advantage	$907.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$771.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$771.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$771.74
Rate for Payer: Cigna Commercial	$1,513.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$665.82
Rate for Payer: Qualcare PPO/HMO/WC	$453.97
Rate for Payer: UnitedHealthcare Community & State	$72.94
Rate for Payer: Wellpoint Medicaid Managed Care	$80.20

LEAD MEDT PCEMKR 4068-58

Facility

$6,208.85

Hospital Charge Code	270610217
Hospital Revenue Code	275
Min. Negotiated Rate	$931.33
Max. Negotiated Rate	$1,502.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,241.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,502.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,365.95
Rate for Payer: Qualcare PPO/HMO/WC	$931.33

LEAD MEDT PCEMKR 4068-58

Facility

$6,208.85

Hospital Charge Code	270610217
Hospital Revenue Code	275
Min. Negotiated Rate	$149.63
Max. Negotiated Rate	$3,104.43
Rate for Payer: Aetna Commercial	$2,359.36
Rate for Payer: Aetna Medicare Advantage	$1,862.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,583.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,583.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,241.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,583.26
Rate for Payer: Cigna Commercial	$3,104.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,502.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,365.95
Rate for Payer: Qualcare PPO/HMO/WC	$931.33
Rate for Payer: UnitedHealthcare Community & State	$149.63
Rate for Payer: Wellpoint Medicaid Managed Care	$164.53

LEAD MEDT PCEMKR 4068-58CM

Facility

$3,026.45

Hospital Charge Code	270613934
Hospital Revenue Code	275
Min. Negotiated Rate	$453.97
Max. Negotiated Rate	$732.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$665.82
Rate for Payer: Qualcare PPO/HMO/WC	$453.97

LEAD MEDT PCEMKR 4068-58CM

Facility

$3,026.45

Hospital Charge Code	270613934
Hospital Revenue Code	275
Min. Negotiated Rate	$72.94
Max. Negotiated Rate	$1,513.22
Rate for Payer: Aetna Commercial	$1,150.05
Rate for Payer: Aetna Medicare Advantage	$907.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$771.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$771.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$771.74
Rate for Payer: Cigna Commercial	$1,513.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$665.82
Rate for Payer: Qualcare PPO/HMO/WC	$453.97
Rate for Payer: UnitedHealthcare Community & State	$72.94
Rate for Payer: Wellpoint Medicaid Managed Care	$80.20

LEAD MEDT PCEMKR 4503M

Facility

$4,968.85

Hospital Charge Code	270602749
Hospital Revenue Code	275
Min. Negotiated Rate	$119.75
Max. Negotiated Rate	$2,484.43
Rate for Payer: Aetna Commercial	$1,888.16
Rate for Payer: Aetna Medicare Advantage	$1,490.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,267.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,267.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$993.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,267.06
Rate for Payer: Cigna Commercial	$2,484.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,202.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,093.15
Rate for Payer: Qualcare PPO/HMO/WC	$745.33
Rate for Payer: UnitedHealthcare Community & State	$119.75
Rate for Payer: Wellpoint Medicaid Managed Care	$131.67

Know your out-of-pocket cost for care.

All Charges