Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LEAD TENDRIL 46cm

Facility

$4,040.00

Hospital Charge Code	2709007246
Hospital Revenue Code	272
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) PPO	$1,030.20
Rate for Payer: Cigna Commercial	$2,020.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,212.00
Rate for Payer: Oxford Commercial	$808.00
Rate for Payer: Qualcare PPO/HMO/WC	$606.00
Rate for Payer: UnitedHealthcare Commercial	$808.00
Rate for Payer: UnitedHealthcare Community & State	$97.36
Rate for Payer: Wellpoint Medicaid Managed Care	$107.06

LEAD TENDRIL 52cm

Facility

$4,040.00

Hospital Charge Code	270CH0118
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 TENDRIL 52cm

Facility

$4,040.00

Hospital Charge Code	270CH0118
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 TENDRIL 52cm

Facility

$4,040.00

Hospital Charge Code	2709007247
Hospital Revenue Code	272
Min. Negotiated Rate	$606.00
Max. Negotiated Rate	$606.00
Rate for Payer: Qualcare PPO/HMO/WC	$606.00

LEAD TENDRIL 52cm

Facility

$4,040.00

Hospital Charge Code	2709007247
Hospital Revenue Code	272
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) PPO	$1,030.20
Rate for Payer: Cigna Commercial	$2,020.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,212.00
Rate for Payer: Oxford Commercial	$808.00
Rate for Payer: Qualcare PPO/HMO/WC	$606.00
Rate for Payer: UnitedHealthcare Commercial	$808.00
Rate for Payer: UnitedHealthcare Community & State	$97.36
Rate for Payer: Wellpoint Medicaid Managed Care	$107.06

LEAD TENDRIL 58cm

Facility

$4,040.00

Hospital Charge Code	270CH0119
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 TENDRIL 58cm

Facility

$4,040.00

Hospital Charge Code	270CH0119
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 TENDRIL 58cm

Facility

$4,040.00

Hospital Charge Code	2709007248
Hospital Revenue Code	272
Min. Negotiated Rate	$606.00
Max. Negotiated Rate	$606.00
Rate for Payer: Qualcare PPO/HMO/WC	$606.00

LEAD TENDRIL 58cm

Facility

$4,040.00

Hospital Charge Code	2709007248
Hospital Revenue Code	272
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) PPO	$1,030.20
Rate for Payer: Cigna Commercial	$2,020.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,212.00
Rate for Payer: Oxford Commercial	$808.00
Rate for Payer: Qualcare PPO/HMO/WC	$606.00
Rate for Payer: UnitedHealthcare Commercial	$808.00
Rate for Payer: UnitedHealthcare Community & State	$97.36
Rate for Payer: Wellpoint Medicaid Managed Care	$107.06

LEAD TENDRIL SDX 46

Facility

$4,040.00

Hospital Charge Code	270646415
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 TENDRIL SDX 46

Facility

$4,040.00

Hospital Charge Code	270CH0115
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 TENDRIL SDX 46

Facility

$4,040.00

Hospital Charge Code	270CH0115
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 TENDRIL SDX 46

Facility

$4,040.00

Hospital Charge Code	270646415
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 TENDRIL SDX 46

Facility

$4,040.00

Hospital Charge Code	2709007232
Hospital Revenue Code	272
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) PPO	$1,030.20
Rate for Payer: Cigna Commercial	$2,020.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,212.00
Rate for Payer: Oxford Commercial	$808.00
Rate for Payer: Qualcare PPO/HMO/WC	$606.00
Rate for Payer: UnitedHealthcare Commercial	$808.00
Rate for Payer: UnitedHealthcare Community & State	$97.36
Rate for Payer: Wellpoint Medicaid Managed Care	$107.06

LEAD TENDRIL SDX 46

Facility

$4,040.00

Hospital Charge Code	2709007232
Hospital Revenue Code	272
Min. Negotiated Rate	$606.00
Max. Negotiated Rate	$606.00
Rate for Payer: Qualcare PPO/HMO/WC	$606.00

LEAD TENDRIL SDX 46CM 1688TC

Facility

$4,040.00

Hospital Charge Code	270646415C
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 TENDRIL SDX 46CM 1688TC

Facility

$4,040.00

Hospital Charge Code	270646415C
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 TENDRIL SDX 52

Facility

$4,040.00

Service Code	HCPCS C1898
Hospital Charge Code	270655924
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 TENDRIL SDX 52

Facility

$4,040.00

Service Code	HCPCS C1898
Hospital Charge Code	270655924
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 TENDRIL SDX 52

Facility

$4,040.00

Hospital Charge Code	270CH0114
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 TENDRIL SDX 52

Facility

$4,040.00

Hospital Charge Code	270CH0114
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 TENDRIL SDX 52

Facility

$4,040.00

Hospital Charge Code	2709007231
Hospital Revenue Code	272
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) PPO	$1,030.20
Rate for Payer: Cigna Commercial	$2,020.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,212.00
Rate for Payer: Oxford Commercial	$808.00
Rate for Payer: Qualcare PPO/HMO/WC	$606.00
Rate for Payer: UnitedHealthcare Commercial	$808.00
Rate for Payer: UnitedHealthcare Community & State	$97.36
Rate for Payer: Wellpoint Medicaid Managed Care	$107.06

LEAD TENDRIL SDX 52

Facility

$4,040.00

Hospital Charge Code	2709007231
Hospital Revenue Code	272
Min. Negotiated Rate	$606.00
Max. Negotiated Rate	$606.00
Rate for Payer: Qualcare PPO/HMO/WC	$606.00

LEAD TENDRIL SDX 52CM

Facility

$3,000.00

Hospital Charge Code	270639704
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 TENDRIL SDX 52CM

Facility

$3,000.00

Hospital Charge Code	270639704
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

Know your out-of-pocket cost for care.

All Charges