Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LEAD PACEMAKER CAPSURE 58CM

Facility

$2,795.00

Service Code	HCPCS C1898
Hospital Charge Code	270622952
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 PACEMAKER CAPSURE 58CM

Facility

$2,795.00

Service Code	HCPCS C1898
Hospital Charge Code	270622952
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

LEAD PACEMAKER CAPSURE 58CM

Facility

$3,125.00

Service Code	HCPCS C1898
Hospital Charge Code	270622952N
Hospital Revenue Code	278
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 PACEMAKER CAPSURE 58CM

Facility

$3,125.00

Service Code	HCPCS C1898
Hospital Charge Code	270622952N
Hospital Revenue Code	278
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 PACEMAKER CAPSURE 58CM

Facility

$2,795.00

Service Code	HCPCS C1898
Hospital Charge Code	270622952S
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 PACEMAKER CAPSURE 85CM

Facility

$2,795.00

Service Code	HCPCS C1779
Hospital Charge Code	270681437N
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 PACEMAKER CAPSURE 85CM

Facility

$2,795.00

Service Code	HCPCS C1779
Hospital Charge Code	270681437N
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

LEAD PACEMAKER CAPSURE 85CM

Facility

$2,795.00

Service Code	HCPCS C1779
Hospital Charge Code	270681437
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 PACEMAKER CAPSURE 85CM

Facility

$2,795.00

Service Code	HCPCS C1779
Hospital Charge Code	270681437
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

LEAD PACEMAKER CAPSURE ATRIAL

Facility

$2,795.00

Service Code	HCPCS C1779
Hospital Charge Code	270623756S
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 PACEMAKER CAPSURE ATRIAL

Facility

$2,795.00

Service Code	HCPCS C1779
Hospital Charge Code	270623756S
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

LEAD PACEMAKER CAPSURE ATRIAL

Facility

$3,000.00

Service Code	HCPCS C1779
Hospital Charge Code	270620989
Hospital Revenue Code	278
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 PACEMAKER CAPSURE ATRIAL

Facility

$3,000.00

Service Code	HCPCS C1779
Hospital Charge Code	270620989
Hospital Revenue Code	278
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 PACEMAKER CAPSURE SP

Facility

$2,940.00

Hospital Charge Code	270624061
Hospital Revenue Code	278
Min. Negotiated Rate	$441.00
Max. Negotiated Rate	$711.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$588.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$711.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$646.80
Rate for Payer: Qualcare PPO/HMO/WC	$441.00

LEAD PACEMAKER CAPSURE SP

Facility

$2,940.00

Hospital Charge Code	270624061
Hospital Revenue Code	278
Min. Negotiated Rate	$70.85
Max. Negotiated Rate	$1,470.00
Rate for Payer: Aetna Commercial	$1,117.20
Rate for Payer: Aetna Medicare Advantage	$882.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$749.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$749.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$588.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$749.70
Rate for Payer: Cigna Commercial	$1,470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$711.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$646.80
Rate for Payer: Qualcare PPO/HMO/WC	$441.00
Rate for Payer: UnitedHealthcare Community & State	$70.85
Rate for Payer: Wellpoint Medicaid Managed Care	$77.91

LEAD PACEMAKER CAPSURE SP

Facility

$3,185.00

Hospital Charge Code	270611035C
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 CAPSURE SP

Facility

$3,185.00

Hospital Charge Code	270611035C
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 CAP VENT 509258

Facility

$3,250.00

Hospital Charge Code	270911035C
Hospital Revenue Code	275
Min. Negotiated Rate	$78.33
Max. Negotiated Rate	$1,625.00
Rate for Payer: Aetna Commercial	$1,235.00
Rate for Payer: Aetna Medicare Advantage	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.75
Rate for Payer: Cigna Commercial	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$715.00
Rate for Payer: Qualcare PPO/HMO/WC	$487.50
Rate for Payer: UnitedHealthcare Community & State	$78.33
Rate for Payer: Wellpoint Medicaid Managed Care	$86.12

LEAD PACEMAKER CAP VENT 509258

Facility

$3,250.00

Hospital Charge Code	270911035C
Hospital Revenue Code	275
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$786.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$715.00
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

LEAD PACEMAKER TRANSV 52CM

Facility

$3,175.00

Hospital Charge Code	270676906
Hospital Revenue Code	278
Min. Negotiated Rate	$476.25
Max. Negotiated Rate	$768.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$635.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$768.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$698.50
Rate for Payer: Qualcare PPO/HMO/WC	$476.25

LEAD PACEMAKER TRANSV 52CM

Facility

$3,175.00

Hospital Charge Code	270676906
Hospital Revenue Code	278
Min. Negotiated Rate	$76.52
Max. Negotiated Rate	$1,587.50
Rate for Payer: Aetna Commercial	$1,206.50
Rate for Payer: Aetna Medicare Advantage	$952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$809.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$809.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$635.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$809.62
Rate for Payer: Cigna Commercial	$1,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$768.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$698.50
Rate for Payer: Qualcare PPO/HMO/WC	$476.25
Rate for Payer: UnitedHealthcare Community & State	$76.52
Rate for Payer: Wellpoint Medicaid Managed Care	$84.14

LEAD PACEMAKER TRANSV 58CM

Facility

$3,175.00

Service Code	HCPCS C1779
Hospital Charge Code	270677275S
Hospital Revenue Code	278
Min. Negotiated Rate	$76.52
Max. Negotiated Rate	$1,587.50
Rate for Payer: Aetna Commercial	$1,206.50
Rate for Payer: Aetna Medicare Advantage	$952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$809.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$809.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$635.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$809.62
Rate for Payer: Cigna Commercial	$1,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$768.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$698.50
Rate for Payer: Qualcare PPO/HMO/WC	$476.25
Rate for Payer: UnitedHealthcare Community & State	$76.52
Rate for Payer: Wellpoint Medicaid Managed Care	$84.14

LEAD PACEMAKER TRANSV 58CM

Facility

$3,175.00

Service Code	HCPCS C1779
Hospital Charge Code	270677275S
Hospital Revenue Code	278
Min. Negotiated Rate	$476.25
Max. Negotiated Rate	$768.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$635.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$768.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$698.50
Rate for Payer: Qualcare PPO/HMO/WC	$476.25

LEAD PACEMAKER TRANSV 58CM

Facility

$3,175.00

Service Code	HCPCS C1779
Hospital Charge Code	270677275
Hospital Revenue Code	278
Min. Negotiated Rate	$76.52
Max. Negotiated Rate	$1,587.50
Rate for Payer: Aetna Commercial	$1,206.50
Rate for Payer: Aetna Medicare Advantage	$952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$809.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$809.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$635.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$809.62
Rate for Payer: Cigna Commercial	$1,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$768.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$698.50
Rate for Payer: Qualcare PPO/HMO/WC	$476.25
Rate for Payer: UnitedHealthcare Community & State	$76.52
Rate for Payer: Wellpoint Medicaid Managed Care	$84.14

LEAD PACEMAKER TRANSV 58CM

Facility

$3,175.00

Service Code	HCPCS C1779
Hospital Charge Code	270677275
Hospital Revenue Code	278
Min. Negotiated Rate	$476.25
Max. Negotiated Rate	$768.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$635.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$768.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$698.50
Rate for Payer: Qualcare PPO/HMO/WC	$476.25

Know your out-of-pocket cost for care.

All Charges