Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LEAD PACEMAKER VENTRL 407652

Facility

$3,224.00

Hospital Charge Code	270633874
Hospital Revenue Code	275
Min. Negotiated Rate	$483.60
Max. Negotiated Rate	$780.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$644.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$780.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$709.28
Rate for Payer: Qualcare PPO/HMO/WC	$483.60

LEAD PACEMAKER VENTRL 407652

Facility

$3,224.00

Hospital Charge Code	270633874
Hospital Revenue Code	275
Min. Negotiated Rate	$77.70
Max. Negotiated Rate	$1,612.00
Rate for Payer: Aetna Commercial	$1,225.12
Rate for Payer: Aetna Medicare Advantage	$967.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$822.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$822.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$644.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$822.12
Rate for Payer: Cigna Commercial	$1,612.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$780.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$709.28
Rate for Payer: Qualcare PPO/HMO/WC	$483.60
Rate for Payer: UnitedHealthcare Community & State	$77.70
Rate for Payer: Wellpoint Medicaid Managed Care	$85.44

LEAD PACEMAKER VENTRL 407652

Facility

$3,625.00

Hospital Charge Code	270633874C
Hospital Revenue Code	275
Min. Negotiated Rate	$87.36
Max. Negotiated Rate	$1,812.50
Rate for Payer: Aetna Commercial	$1,377.50
Rate for Payer: Aetna Medicare Advantage	$1,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$924.38
Rate for Payer: Cigna Commercial	$1,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$797.50
Rate for Payer: Qualcare PPO/HMO/WC	$543.75
Rate for Payer: UnitedHealthcare Community & State	$87.36
Rate for Payer: Wellpoint Medicaid Managed Care	$96.06

LEAD PACEMAKER VENTRL 407652

Facility

$3,625.00

Hospital Charge Code	270633874C
Hospital Revenue Code	275
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$877.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$797.50
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

LEAD PACEMR CAP Z NOVUS 555453

Facility

$3,224.00

Hospital Charge Code	270634852
Hospital Revenue Code	275
Min. Negotiated Rate	$77.70
Max. Negotiated Rate	$1,612.00
Rate for Payer: Aetna Commercial	$1,225.12
Rate for Payer: Aetna Medicare Advantage	$967.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$822.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$822.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$644.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$822.12
Rate for Payer: Cigna Commercial	$1,612.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$780.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$709.28
Rate for Payer: Qualcare PPO/HMO/WC	$483.60
Rate for Payer: UnitedHealthcare Community & State	$77.70
Rate for Payer: Wellpoint Medicaid Managed Care	$85.44

LEAD PACEMR CAP Z NOVUS 555453

Facility

$3,224.00

Hospital Charge Code	270634852
Hospital Revenue Code	275
Min. Negotiated Rate	$483.60
Max. Negotiated Rate	$780.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$644.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$780.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$709.28
Rate for Payer: Qualcare PPO/HMO/WC	$483.60

LEAD PACING GUIDANT 53M 358754

Facility

$4,000.00

Service Code	HCPCS C1779
Hospital Charge Code	270661812
Hospital Revenue Code	275
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 PACING GUIDANT 53M 358754

Facility

$4,000.00

Service Code	HCPCS C1779
Hospital Charge Code	270661812
Hospital Revenue Code	275
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 PACING GUIDAT 60CM 358764

Facility

$4,000.00

Service Code	HCPCS C1779
Hospital Charge Code	270661813
Hospital Revenue Code	275
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 PACING GUIDAT 60CM 358764

Facility

$4,000.00

Service Code	HCPCS C1779
Hospital Charge Code	270661813
Hospital Revenue Code	275
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 PACING INGEVITY 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270695957S
Hospital Revenue Code	275
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 PACING INGEVITY 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270695957S
Hospital Revenue Code	275
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 PACING INGEVITY 59CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270695958S
Hospital Revenue Code	275
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 PACING INGEVITY 59CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270695958S
Hospital Revenue Code	275
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 PACING PERM BIP 4.1F 69CM

Facility

$3,300.00

Service Code	HCPCS C1898
Hospital Charge Code	270699655C
Hospital Revenue Code	278
Min. Negotiated Rate	$79.53
Max. Negotiated Rate	$1,650.00
Rate for Payer: Aetna Commercial	$1,254.00
Rate for Payer: Aetna Medicare Advantage	$990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$841.50
Rate for Payer: Cigna Commercial	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$495.00
Rate for Payer: UnitedHealthcare Community & State	$79.53
Rate for Payer: Wellpoint Medicaid Managed Care	$87.45

LEAD PACING PERM BIP 4.1F 69CM

Facility

$3,300.00

Service Code	HCPCS C1898
Hospital Charge Code	270699655C
Hospital Revenue Code	278
Min. Negotiated Rate	$495.00
Max. Negotiated Rate	$798.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$495.00

LEAD PASVE ATRIAL BIPOLAR 4592

Facility

$3,348.00

Hospital Charge Code	270629894
Hospital Revenue Code	275
Min. Negotiated Rate	$502.20
Max. Negotiated Rate	$810.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$669.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$810.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$736.56
Rate for Payer: Qualcare PPO/HMO/WC	$502.20

LEAD PASVE ATRIAL BIPOLAR 4592

Facility

$3,348.00

Hospital Charge Code	270629894
Hospital Revenue Code	275
Min. Negotiated Rate	$80.69
Max. Negotiated Rate	$1,674.00
Rate for Payer: Aetna Commercial	$1,272.24
Rate for Payer: Aetna Medicare Advantage	$1,004.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$853.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$853.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$669.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$853.74
Rate for Payer: Cigna Commercial	$1,674.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$810.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$736.56
Rate for Payer: Qualcare PPO/HMO/WC	$502.20
Rate for Payer: UnitedHealthcare Community & State	$80.69
Rate for Payer: Wellpoint Medicaid Managed Care	$88.72

LEAD PCEMAKER VENTRICLE 407658

Facility

$3,224.00

Service Code	HCPCS C1779
Hospital Charge Code	270633849
Hospital Revenue Code	275
Min. Negotiated Rate	$483.60
Max. Negotiated Rate	$780.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$644.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$780.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$709.28
Rate for Payer: Qualcare PPO/HMO/WC	$483.60

LEAD PCEMAKER VENTRICLE 407658

Facility

$3,465.00

Hospital Charge Code	270633849C
Hospital Revenue Code	275
Min. Negotiated Rate	$519.75
Max. Negotiated Rate	$838.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$693.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$838.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$762.30
Rate for Payer: Qualcare PPO/HMO/WC	$519.75

LEAD PCEMAKER VENTRICLE 407658

Facility

$3,224.00

Service Code	HCPCS C1779
Hospital Charge Code	270633849
Hospital Revenue Code	275
Min. Negotiated Rate	$77.70
Max. Negotiated Rate	$1,612.00
Rate for Payer: Aetna Commercial	$1,225.12
Rate for Payer: Aetna Medicare Advantage	$967.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$822.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$822.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$644.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$822.12
Rate for Payer: Cigna Commercial	$1,612.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$780.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$709.28
Rate for Payer: Qualcare PPO/HMO/WC	$483.60
Rate for Payer: UnitedHealthcare Community & State	$77.70
Rate for Payer: Wellpoint Medicaid Managed Care	$85.44

LEAD PCEMAKER VENTRICLE 407658

Facility

$3,465.00

Hospital Charge Code	270633849C
Hospital Revenue Code	275
Min. Negotiated Rate	$83.51
Max. Negotiated Rate	$1,732.50
Rate for Payer: Aetna Commercial	$1,316.70
Rate for Payer: Aetna Medicare Advantage	$1,039.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$883.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$883.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$693.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$883.58
Rate for Payer: Cigna Commercial	$1,732.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$838.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$762.30
Rate for Payer: Qualcare PPO/HMO/WC	$519.75
Rate for Payer: UnitedHealthcare Community & State	$83.51
Rate for Payer: Wellpoint Medicaid Managed Care	$91.82

LEAD PCEMKR 5024M-58****

Facility

$1,875.00

Hospital Charge Code	270608506
Hospital Revenue Code	275
Min. Negotiated Rate	$45.19
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$712.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$49.69

LEAD PCEMKR 5024M-58****

Facility

$1,875.00

Hospital Charge Code	270608506
Hospital Revenue Code	275
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

LEAD PCEMKR CPSRE NVUS 6092-58

Facility

$2,940.00

Hospital Charge Code	270647014C
Hospital Revenue Code	275
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

Know your out-of-pocket cost for care.

All Charges