Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PACEMAKER ACCENT DR U PR

Facility

$31,920.00

Service Code	HCPCS C1785
Hospital Charge Code	270648446
Hospital Revenue Code	275
Min. Negotiated Rate	$769.27
Max. Negotiated Rate	$15,960.00
Rate for Payer: Aetna Commercial	$12,129.60
Rate for Payer: Aetna Medicare Advantage	$9,576.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,139.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,139.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,384.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,139.60
Rate for Payer: Cigna Commercial	$15,960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,724.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,022.40
Rate for Payer: Qualcare PPO/HMO/WC	$4,788.00
Rate for Payer: UnitedHealthcare Community & State	$769.27
Rate for Payer: Wellpoint Medicaid Managed Care	$845.88

PACEMAKER ACCENT RF DR PM2210

Facility

$33,600.00

Hospital Charge Code	270642570C
Hospital Revenue Code	275
Min. Negotiated Rate	$5,040.00
Max. Negotiated Rate	$8,131.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,720.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,131.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,392.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,040.00

PACEMAKER ACCENT RF DR PM2210

Facility

$33,600.00

Hospital Charge Code	270642570C
Hospital Revenue Code	275
Min. Negotiated Rate	$809.76
Max. Negotiated Rate	$16,800.00
Rate for Payer: Aetna Commercial	$12,768.00
Rate for Payer: Aetna Medicare Advantage	$10,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,568.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,568.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,720.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,568.00
Rate for Payer: Cigna Commercial	$16,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,131.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,392.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,040.00
Rate for Payer: UnitedHealthcare Community & State	$809.76
Rate for Payer: Wellpoint Medicaid Managed Care	$890.40

PACEMAKER ACCENT RF DR PM2210

Facility

$31,920.00

Hospital Charge Code	270642570
Hospital Revenue Code	275
Min. Negotiated Rate	$769.27
Max. Negotiated Rate	$15,960.00
Rate for Payer: Aetna Commercial	$12,129.60
Rate for Payer: Aetna Medicare Advantage	$9,576.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,139.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,139.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,384.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,139.60
Rate for Payer: Cigna Commercial	$15,960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,724.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,022.40
Rate for Payer: Qualcare PPO/HMO/WC	$4,788.00
Rate for Payer: UnitedHealthcare Community & State	$769.27
Rate for Payer: Wellpoint Medicaid Managed Care	$845.88

PACEMAKER ACCENT RF DR PM2210

Facility

$31,920.00

Hospital Charge Code	270642570
Hospital Revenue Code	275
Min. Negotiated Rate	$4,788.00
Max. Negotiated Rate	$7,724.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,384.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,724.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,022.40
Rate for Payer: Qualcare PPO/HMO/WC	$4,788.00

PACEMAKER ACCENT SR RFPGD/STER

Facility

$26,435.00

Hospital Charge Code	270660050
Hospital Revenue Code	275
Min. Negotiated Rate	$637.08
Max. Negotiated Rate	$13,217.50
Rate for Payer: Aetna Commercial	$10,045.30
Rate for Payer: Aetna Medicare Advantage	$7,930.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,740.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,740.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,287.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,740.93
Rate for Payer: Cigna Commercial	$13,217.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,397.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,815.70
Rate for Payer: Qualcare PPO/HMO/WC	$3,965.25
Rate for Payer: UnitedHealthcare Community & State	$637.08
Rate for Payer: Wellpoint Medicaid Managed Care	$700.53

PACEMAKER ACCENT SR RFPGD/STER

Facility

$26,435.00

Hospital Charge Code	270660050
Hospital Revenue Code	275
Min. Negotiated Rate	$3,965.25
Max. Negotiated Rate	$6,397.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,287.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,397.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,815.70
Rate for Payer: Qualcare PPO/HMO/WC	$3,965.25

PACEMAKER ACCOLADE MRI DR

Facility

$36,500.00

Service Code	HCPCS C1785
Hospital Charge Code	270678215N
Hospital Revenue Code	275
Min. Negotiated Rate	$879.65
Max. Negotiated Rate	$18,250.00
Rate for Payer: Aetna Commercial	$13,870.00
Rate for Payer: Aetna Medicare Advantage	$10,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,307.50
Rate for Payer: Cigna Commercial	$18,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,833.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,030.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,475.00
Rate for Payer: UnitedHealthcare Community & State	$879.65
Rate for Payer: Wellpoint Medicaid Managed Care	$967.25

PACEMAKER ACCOLADE MRI DR

Facility

$36,500.00

Service Code	HCPCS C1785
Hospital Charge Code	270678215N
Hospital Revenue Code	275
Min. Negotiated Rate	$5,475.00
Max. Negotiated Rate	$8,833.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,833.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,030.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,475.00

PACEMAKER ACCOLADE MRI DR

Facility

$40,000.00

Service Code	HCPCS C1785
Hospital Charge Code	270678215
Hospital Revenue Code	275
Min. Negotiated Rate	$6,000.00
Max. Negotiated Rate	$9,680.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,680.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00

PACEMAKER ACCOLADE MRI DR

Facility

$40,000.00

Service Code	HCPCS C1785
Hospital Charge Code	270678215
Hospital Revenue Code	275
Min. Negotiated Rate	$964.00
Max. Negotiated Rate	$20,000.00
Rate for Payer: Aetna Commercial	$15,200.00
Rate for Payer: Aetna Medicare Advantage	$12,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,200.00
Rate for Payer: Cigna Commercial	$20,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,680.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00
Rate for Payer: UnitedHealthcare Community & State	$964.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1,060.00

PACEMAKER ACCOLADE MRI DR IS-1

Facility

$38,000.00

Hospital Charge Code	270677287
Hospital Revenue Code	278
Min. Negotiated Rate	$5,700.00
Max. Negotiated Rate	$9,196.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,196.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,360.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,700.00

PACEMAKER ACCOLADE MRI DR IS-1

Facility

$38,000.00

Hospital Charge Code	270677287
Hospital Revenue Code	278
Min. Negotiated Rate	$915.80
Max. Negotiated Rate	$19,000.00
Rate for Payer: Aetna Commercial	$14,440.00
Rate for Payer: Aetna Medicare Advantage	$11,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,690.00
Rate for Payer: Cigna Commercial	$19,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,196.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,360.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,700.00
Rate for Payer: UnitedHealthcare Community & State	$915.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1,007.00

PACEMAKER ACCOLADE MRI VR

Facility

$33,500.00

Service Code	HCPCS C1786
Hospital Charge Code	270678188
Hospital Revenue Code	275
Min. Negotiated Rate	$807.35
Max. Negotiated Rate	$16,750.00
Rate for Payer: Aetna Commercial	$12,730.00
Rate for Payer: Aetna Medicare Advantage	$10,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,542.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,542.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,542.50
Rate for Payer: Cigna Commercial	$16,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,107.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,370.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,025.00
Rate for Payer: UnitedHealthcare Community & State	$807.35
Rate for Payer: Wellpoint Medicaid Managed Care	$887.75

PACEMAKER ACCOLADE MRI VR

Facility

$33,500.00

Service Code	HCPCS C1786
Hospital Charge Code	270678188
Hospital Revenue Code	275
Min. Negotiated Rate	$5,025.00
Max. Negotiated Rate	$8,107.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,107.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,370.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,025.00

PACEMAKER ACOLADE DR

Facility

$40,500.00

Service Code	HCPCS C1785
Hospital Charge Code	270675535
Hospital Revenue Code	275
Min. Negotiated Rate	$6,075.00
Max. Negotiated Rate	$9,801.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,801.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,910.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,075.00

PACEMAKER ACOLADE DR

Facility

$40,500.00

Service Code	HCPCS C1785
Hospital Charge Code	270675535
Hospital Revenue Code	275
Min. Negotiated Rate	$976.05
Max. Negotiated Rate	$20,250.00
Rate for Payer: Aetna Commercial	$15,390.00
Rate for Payer: Aetna Medicare Advantage	$12,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,327.50
Rate for Payer: Cigna Commercial	$20,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,801.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,910.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,075.00
Rate for Payer: UnitedHealthcare Community & State	$976.05
Rate for Payer: Wellpoint Medicaid Managed Care	$1,073.25

PACEMAKER ADAPTA ADDR06

Facility

$32,585.00

Hospital Charge Code	270638389C
Hospital Revenue Code	275
Min. Negotiated Rate	$785.30
Max. Negotiated Rate	$16,292.50
Rate for Payer: Aetna Commercial	$12,382.30
Rate for Payer: Aetna Medicare Advantage	$9,775.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,309.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,309.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,517.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,309.17
Rate for Payer: Cigna Commercial	$16,292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,885.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,168.70
Rate for Payer: Qualcare PPO/HMO/WC	$4,887.75
Rate for Payer: UnitedHealthcare Community & State	$785.30
Rate for Payer: Wellpoint Medicaid Managed Care	$863.50

PACEMAKER ADAPTA ADDR06

Facility

$32,585.00

Hospital Charge Code	270638389C
Hospital Revenue Code	275
Min. Negotiated Rate	$4,887.75
Max. Negotiated Rate	$7,885.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,517.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,885.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,168.70
Rate for Payer: Qualcare PPO/HMO/WC	$4,887.75

PACEMAKER ADAPTA ADSR03

Facility

$25,945.00

Hospital Charge Code	270639227C
Hospital Revenue Code	275
Min. Negotiated Rate	$625.27
Max. Negotiated Rate	$12,972.50
Rate for Payer: Aetna Commercial	$9,859.10
Rate for Payer: Aetna Medicare Advantage	$7,783.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,615.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,615.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,615.98
Rate for Payer: Cigna Commercial	$12,972.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,278.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,707.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,891.75
Rate for Payer: UnitedHealthcare Community & State	$625.27
Rate for Payer: Wellpoint Medicaid Managed Care	$687.54

PACEMAKER ADAPTA ADSR03

Facility

$25,945.00

Hospital Charge Code	270639227C
Hospital Revenue Code	275
Min. Negotiated Rate	$3,891.75
Max. Negotiated Rate	$6,278.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,189.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,278.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,707.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,891.75

PACEMAKER ADAPTA DR ADDR01

Facility

$22,020.00

Service Code	HCPCS C1785
Hospital Charge Code	270637950
Hospital Revenue Code	275
Min. Negotiated Rate	$3,303.00
Max. Negotiated Rate	$5,328.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,404.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,328.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,844.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,303.00

PACEMAKER ADAPTA DR ADDR01

Facility

$22,020.00

Service Code	HCPCS C1785
Hospital Charge Code	270637950
Hospital Revenue Code	275
Min. Negotiated Rate	$530.68
Max. Negotiated Rate	$11,010.00
Rate for Payer: Aetna Commercial	$8,367.60
Rate for Payer: Aetna Medicare Advantage	$6,606.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,615.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,615.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,404.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,615.10
Rate for Payer: Cigna Commercial	$11,010.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,328.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,844.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,303.00
Rate for Payer: UnitedHealthcare Community & State	$530.68
Rate for Payer: Wellpoint Medicaid Managed Care	$583.53

PACEMAKER ADAPTA DR ADDR01

Facility

$32,585.00

Hospital Charge Code	270637950C
Hospital Revenue Code	275
Min. Negotiated Rate	$785.30
Max. Negotiated Rate	$16,292.50
Rate for Payer: Aetna Commercial	$12,382.30
Rate for Payer: Aetna Medicare Advantage	$9,775.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,309.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,309.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,517.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,309.17
Rate for Payer: Cigna Commercial	$16,292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,885.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,168.70
Rate for Payer: Qualcare PPO/HMO/WC	$4,887.75
Rate for Payer: UnitedHealthcare Community & State	$785.30
Rate for Payer: Wellpoint Medicaid Managed Care	$863.50

PACEMAKER ADAPTA DR ADDR01

Facility

$32,585.00

Hospital Charge Code	270637950C
Hospital Revenue Code	275
Min. Negotiated Rate	$4,887.75
Max. Negotiated Rate	$7,885.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,517.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,885.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,168.70
Rate for Payer: Qualcare PPO/HMO/WC	$4,887.75

Know your out-of-pocket cost for care.

All Charges