Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LEAD MEDT PCEMKR SP 5524M-53

Facility

$2,724.00

Hospital Charge Code	270602744
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 SP 5524M-53

Facility

$2,724.00

Hospital Charge Code	270602744
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 SP 5524M-53

Facility

$3,125.00

Hospital Charge Code	270602744C
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 SP 5524M-53

Facility

$3,125.00

Hospital Charge Code	270602744C
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

LEADNEUROINTERSTIMSURESCAN28CM

Facility

$22,770.00

Service Code	HCPCS C1778
Hospital Charge Code	270692608
Hospital Revenue Code	278
Min. Negotiated Rate	$548.76
Max. Negotiated Rate	$11,385.00
Rate for Payer: Aetna Commercial	$8,652.60
Rate for Payer: Aetna Medicare Advantage	$6,831.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,806.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,806.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,554.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,806.35
Rate for Payer: Cigna Commercial	$11,385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,510.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,009.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,415.50
Rate for Payer: UnitedHealthcare Community & State	$548.76
Rate for Payer: Wellpoint Medicaid Managed Care	$603.40

LEADNEUROINTERSTIMSURESCAN28CM

Facility

$22,770.00

Service Code	HCPCS C1778
Hospital Charge Code	270692608
Hospital Revenue Code	278
Min. Negotiated Rate	$3,415.50
Max. Negotiated Rate	$5,510.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,554.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,510.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,009.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,415.50

LEADNEUROSTIMAVISTAMR56CM8MM

Facility

$14,500.00

Service Code	HCPCS C1778
Hospital Charge Code	270698495
Hospital Revenue Code	278
Min. Negotiated Rate	$2,175.00
Max. Negotiated Rate	$3,509.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,190.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00

LEADNEUROSTIMAVISTAMR56CM8MM

Facility

$14,500.00

Service Code	HCPCS C1778
Hospital Charge Code	270698495
Hospital Revenue Code	278
Min. Negotiated Rate	$349.45
Max. Negotiated Rate	$7,250.00
Rate for Payer: Aetna Commercial	$5,510.00
Rate for Payer: Aetna Medicare Advantage	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,697.50
Rate for Payer: Cigna Commercial	$7,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,190.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00
Rate for Payer: UnitedHealthcare Community & State	$349.45
Rate for Payer: Wellpoint Medicaid Managed Care	$384.25

LEAD NON PLUSE OXIMETER W/9FT

Facility

$610.00

Hospital Charge Code	270674512
Hospital Revenue Code	272
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

LEAD NON PLUSE OXIMETER W/9FT

Facility

$610.00

Hospital Charge Code	270674512
Hospital Revenue Code	272
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$305.00
Rate for Payer: Aetna Commercial	$231.80
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.00
Rate for Payer: Oxford Commercial	$122.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Commercial	$122.00
Rate for Payer: UnitedHealthcare Community & State	$14.70
Rate for Payer: Wellpoint Medicaid Managed Care	$16.16

LEAD PACEMAKER 5068-52

Facility

$3,720.00

Hospital Charge Code	270620202
Hospital Revenue Code	275
Min. Negotiated Rate	$89.65
Max. Negotiated Rate	$1,860.00
Rate for Payer: Aetna Commercial	$1,413.60
Rate for Payer: Aetna Medicare Advantage	$1,116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$948.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$948.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$948.60
Rate for Payer: Cigna Commercial	$1,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$900.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$818.40
Rate for Payer: Qualcare PPO/HMO/WC	$558.00
Rate for Payer: UnitedHealthcare Community & State	$89.65
Rate for Payer: Wellpoint Medicaid Managed Care	$98.58

LEAD PACEMAKER 5068-52

Facility

$3,720.00

Hospital Charge Code	270620202
Hospital Revenue Code	275
Min. Negotiated Rate	$558.00
Max. Negotiated Rate	$900.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$744.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$900.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$818.40
Rate for Payer: Qualcare PPO/HMO/WC	$558.00

LEAD PACEMAKER 5068-58

Facility

$3,720.00

Hospital Charge Code	270608184
Hospital Revenue Code	275
Min. Negotiated Rate	$89.65
Max. Negotiated Rate	$1,860.00
Rate for Payer: Aetna Commercial	$1,413.60
Rate for Payer: Aetna Medicare Advantage	$1,116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$948.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$948.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$948.60
Rate for Payer: Cigna Commercial	$1,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$900.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$818.40
Rate for Payer: Qualcare PPO/HMO/WC	$558.00
Rate for Payer: UnitedHealthcare Community & State	$89.65
Rate for Payer: Wellpoint Medicaid Managed Care	$98.58

LEAD PACEMAKER 5068-58

Facility

$3,720.00

Hospital Charge Code	270608184
Hospital Revenue Code	275
Min. Negotiated Rate	$558.00
Max. Negotiated Rate	$900.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$744.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$900.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$818.40
Rate for Payer: Qualcare PPO/HMO/WC	$558.00

LEAD PACEMAKER ATRIAL CAPSURE

Facility

$3,185.00

Hospital Charge Code	270609354C
Hospital Revenue Code	275
Min. Negotiated Rate	$76.76
Max. Negotiated Rate	$1,592.50
Rate for Payer: Aetna Commercial	$1,210.30
Rate for Payer: Aetna Medicare Advantage	$955.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$812.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$812.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$637.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$812.17
Rate for Payer: Cigna Commercial	$1,592.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$770.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$700.70
Rate for Payer: Qualcare PPO/HMO/WC	$477.75
Rate for Payer: UnitedHealthcare Community & State	$76.76
Rate for Payer: Wellpoint Medicaid Managed Care	$84.40

LEAD PACEMAKER ATRIAL CAPSURE

Facility

$3,185.00

Hospital Charge Code	270609354C
Hospital Revenue Code	275
Min. Negotiated Rate	$477.75
Max. Negotiated Rate	$770.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$637.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$770.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$700.70
Rate for Payer: Qualcare PPO/HMO/WC	$477.75

LEAD PACEMAKER CAPSURE 4568-45

Facility

$3,720.00

Hospital Charge Code	270615846
Hospital Revenue Code	275
Min. Negotiated Rate	$89.65
Max. Negotiated Rate	$1,860.00
Rate for Payer: Aetna Commercial	$1,413.60
Rate for Payer: Aetna Medicare Advantage	$1,116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$948.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$948.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$948.60
Rate for Payer: Cigna Commercial	$1,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$900.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$818.40
Rate for Payer: Qualcare PPO/HMO/WC	$558.00
Rate for Payer: UnitedHealthcare Community & State	$89.65
Rate for Payer: Wellpoint Medicaid Managed Care	$98.58

LEAD PACEMAKER CAPSURE 4568-45

Facility

$3,720.00

Hospital Charge Code	270615846
Hospital Revenue Code	275
Min. Negotiated Rate	$558.00
Max. Negotiated Rate	$900.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$744.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$900.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$818.40
Rate for Payer: Qualcare PPO/HMO/WC	$558.00

LEAD PACEMAKER CAPSURE 45 CM

Facility

$3,844.00

Service Code	HCPCS C1779
Hospital Charge Code	270623756N
Hospital Revenue Code	275
Min. Negotiated Rate	$92.64
Max. Negotiated Rate	$1,922.00
Rate for Payer: Aetna Commercial	$1,460.72
Rate for Payer: Aetna Medicare Advantage	$1,153.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$980.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$980.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$768.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$980.22
Rate for Payer: Cigna Commercial	$1,922.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$930.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$845.68
Rate for Payer: Qualcare PPO/HMO/WC	$576.60
Rate for Payer: UnitedHealthcare Community & State	$92.64
Rate for Payer: Wellpoint Medicaid Managed Care	$101.87

LEAD PACEMAKER CAPSURE 45 CM

Facility

$3,844.00

Service Code	HCPCS C1779
Hospital Charge Code	270623756N
Hospital Revenue Code	275
Min. Negotiated Rate	$576.60
Max. Negotiated Rate	$930.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$768.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$930.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$845.68
Rate for Payer: Qualcare PPO/HMO/WC	$576.60

LEAD PACEMAKER CAPSURE 52 CM

Facility

$4,324.85

Service Code	HCPCS C1779
Hospital Charge Code	270623124N
Hospital Revenue Code	275
Min. Negotiated Rate	$104.23
Max. Negotiated Rate	$2,162.43
Rate for Payer: Aetna Commercial	$1,643.44
Rate for Payer: Aetna Medicare Advantage	$1,297.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,102.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,102.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$864.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,102.84
Rate for Payer: Cigna Commercial	$2,162.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,046.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$951.47
Rate for Payer: Qualcare PPO/HMO/WC	$648.73
Rate for Payer: UnitedHealthcare Community & State	$104.23
Rate for Payer: Wellpoint Medicaid Managed Care	$114.61

LEAD PACEMAKER CAPSURE 52 CM

Facility

$4,324.85

Service Code	HCPCS C1779
Hospital Charge Code	270623124N
Hospital Revenue Code	275
Min. Negotiated Rate	$648.73
Max. Negotiated Rate	$1,046.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$864.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,046.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$951.47
Rate for Payer: Qualcare PPO/HMO/WC	$648.73

LEAD PACEMAKER CAPSURE 52 CM

Facility

$4,324.85

Service Code	HCPCS C1779
Hospital Charge Code	270623124S
Hospital Revenue Code	275
Min. Negotiated Rate	$648.73
Max. Negotiated Rate	$1,046.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$864.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,046.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$951.47
Rate for Payer: Qualcare PPO/HMO/WC	$648.73

LEAD PACEMAKER CAPSURE 52 CM

Facility

$4,324.85

Service Code	HCPCS C1779
Hospital Charge Code	270623124S
Hospital Revenue Code	275
Min. Negotiated Rate	$104.23
Max. Negotiated Rate	$2,162.43
Rate for Payer: Aetna Commercial	$1,643.44
Rate for Payer: Aetna Medicare Advantage	$1,297.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,102.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,102.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$864.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,102.84
Rate for Payer: Cigna Commercial	$2,162.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,046.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$951.47
Rate for Payer: Qualcare PPO/HMO/WC	$648.73
Rate for Payer: UnitedHealthcare Community & State	$104.23
Rate for Payer: Wellpoint Medicaid Managed Care	$114.61

LEAD PACEMAKER CAPSURE 58CM

Facility

$2,795.00

Service Code	HCPCS C1898
Hospital Charge Code	270622952S
Hospital Revenue Code	278
Min. Negotiated Rate	$67.36
Max. Negotiated Rate	$1,397.50
Rate for Payer: Aetna Commercial	$1,062.10
Rate for Payer: Aetna Medicare Advantage	$838.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$712.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$712.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$712.73
Rate for Payer: Cigna Commercial	$1,397.50
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
Rate for Payer: UnitedHealthcare Community & State	$67.36
Rate for Payer: Wellpoint Medicaid Managed Care	$74.07

Know your out-of-pocket cost for care.

All Charges