Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PACEMAKER EVIA DR-T

Facility

$20,815.00

Hospital Charge Code	270675681
Hospital Revenue Code	275
Min. Negotiated Rate	$3,122.25
Max. Negotiated Rate	$5,037.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,163.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,037.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,579.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,122.25

PACEMAKER EVIA SR-T

Facility

$18,915.00

Service Code	HCPCS C1786
Hospital Charge Code	270673069
Hospital Revenue Code	275
Min. Negotiated Rate	$455.85
Max. Negotiated Rate	$9,457.50
Rate for Payer: Aetna Commercial	$7,187.70
Rate for Payer: Aetna Medicare Advantage	$5,674.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,823.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,823.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,783.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,823.32
Rate for Payer: Cigna Commercial	$9,457.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,577.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,161.30
Rate for Payer: Qualcare PPO/HMO/WC	$2,837.25
Rate for Payer: UnitedHealthcare Community & State	$455.85
Rate for Payer: Wellpoint Medicaid Managed Care	$501.25

PACEMAKER EVIA SR-T

Facility

$18,915.00

Service Code	HCPCS C1786
Hospital Charge Code	270673069
Hospital Revenue Code	275
Min. Negotiated Rate	$2,837.25
Max. Negotiated Rate	$4,577.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,783.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,577.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,161.30
Rate for Payer: Qualcare PPO/HMO/WC	$2,837.25

PACEMAKER FLUORO

Facility

$516.00

Service Code	HCPCS 76000
Hospital Charge Code	7411159
Hospital Revenue Code	320
Min. Negotiated Rate	$77.40
Max. Negotiated Rate	$77.40
Rate for Payer: Qualcare PPO/HMO/WC	$77.40

PACEMAKER FLUORO

Facility

$516.00

Service Code	HCPCS 76000
Hospital Charge Code	7411159
Hospital Revenue Code	320
Min. Negotiated Rate	$12.44
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.24
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$198.43
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.80
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$77.40
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$12.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$13.67

PACEMAKER GENERATOR

Facility

$34,975.00

Hospital Charge Code	270703090
Hospital Revenue Code	278
Min. Negotiated Rate	$842.90
Max. Negotiated Rate	$17,487.50
Rate for Payer: Aetna Commercial	$13,290.50
Rate for Payer: Aetna Medicare Advantage	$10,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,918.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,918.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,918.62
Rate for Payer: Cigna Commercial	$17,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,463.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,694.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,246.25
Rate for Payer: UnitedHealthcare Community & State	$842.90
Rate for Payer: Wellpoint Medicaid Managed Care	$926.84

PACEMAKER GENERATOR

Facility

$34,975.00

Hospital Charge Code	270703090
Hospital Revenue Code	278
Min. Negotiated Rate	$5,246.25
Max. Negotiated Rate	$8,463.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,463.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,694.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,246.25

PACEMAKER GENERATOR ALTRUA 60

Facility

$34,080.00

Hospital Charge Code	2709007326
Hospital Revenue Code	272
Min. Negotiated Rate	$821.33
Max. Negotiated Rate	$17,040.00
Rate for Payer: Aetna Commercial	$12,950.40
Rate for Payer: Aetna Medicare Advantage	$10,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,690.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,690.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,690.40
Rate for Payer: Cigna Commercial	$17,040.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,224.00
Rate for Payer: Oxford Commercial	$6,816.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,112.00
Rate for Payer: UnitedHealthcare Commercial	$6,816.00
Rate for Payer: UnitedHealthcare Community & State	$821.33
Rate for Payer: Wellpoint Medicaid Managed Care	$903.12

PACEMAKER GENERATOR ALTRUA 60

Facility

$34,080.00

Hospital Charge Code	2709007326
Hospital Revenue Code	272
Min. Negotiated Rate	$5,112.00
Max. Negotiated Rate	$5,112.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,112.00

PACEMAKER GENERATOR ALTRUA 60

Facility

$34,080.00

Hospital Charge Code	270CH0074
Hospital Revenue Code	275
Min. Negotiated Rate	$5,112.00
Max. Negotiated Rate	$8,247.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,816.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,247.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,497.60
Rate for Payer: Qualcare PPO/HMO/WC	$5,112.00

PACEMAKER GENERATOR ALTRUA 60

Facility

$34,080.00

Hospital Charge Code	270CH0074
Hospital Revenue Code	275
Min. Negotiated Rate	$821.33
Max. Negotiated Rate	$17,040.00
Rate for Payer: Aetna Commercial	$12,950.40
Rate for Payer: Aetna Medicare Advantage	$10,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,690.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,690.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,816.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,690.40
Rate for Payer: Cigna Commercial	$17,040.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,247.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,497.60
Rate for Payer: Qualcare PPO/HMO/WC	$5,112.00
Rate for Payer: UnitedHealthcare Community & State	$821.33
Rate for Payer: Wellpoint Medicaid Managed Care	$903.12

PACEMAKER GUI DISCOV SR 1174

Facility

$23,768.85

Hospital Charge Code	270617494
Hospital Revenue Code	275
Min. Negotiated Rate	$572.83
Max. Negotiated Rate	$11,884.42
Rate for Payer: Aetna Commercial	$9,032.16
Rate for Payer: Aetna Medicare Advantage	$7,130.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,061.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,061.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,753.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,061.06
Rate for Payer: Cigna Commercial	$11,884.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,752.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,229.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,565.33
Rate for Payer: UnitedHealthcare Community & State	$572.83
Rate for Payer: Wellpoint Medicaid Managed Care	$629.87

PACEMAKER GUI DISCOV SR 1174

Facility

$23,768.85

Hospital Charge Code	270617494
Hospital Revenue Code	275
Min. Negotiated Rate	$3,565.33
Max. Negotiated Rate	$5,752.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,753.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,752.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,229.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,565.33

PACEMAKER IDENTITY ADX DR 5380

Facility

$32,215.25

Hospital Charge Code	270633744
Hospital Revenue Code	275
Min. Negotiated Rate	$776.39
Max. Negotiated Rate	$16,107.62
Rate for Payer: Aetna Commercial	$12,241.80
Rate for Payer: Aetna Medicare Advantage	$9,664.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,214.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,214.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,443.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,214.89
Rate for Payer: Cigna Commercial	$16,107.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,796.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,087.35
Rate for Payer: Qualcare PPO/HMO/WC	$4,832.29
Rate for Payer: UnitedHealthcare Community & State	$776.39
Rate for Payer: Wellpoint Medicaid Managed Care	$853.70

PACEMAKER IDENTITY ADX DR 5380

Facility

$32,215.25

Hospital Charge Code	270633744C
Hospital Revenue Code	275
Min. Negotiated Rate	$4,832.29
Max. Negotiated Rate	$7,796.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,443.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,796.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,087.35
Rate for Payer: Qualcare PPO/HMO/WC	$4,832.29

PACEMAKER IDENTITY ADX DR 5380

Facility

$32,215.25

Hospital Charge Code	270633744
Hospital Revenue Code	275
Min. Negotiated Rate	$4,832.29
Max. Negotiated Rate	$7,796.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,443.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,796.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,087.35
Rate for Payer: Qualcare PPO/HMO/WC	$4,832.29

PACEMAKER IDENTITY ADX DR 5380

Facility

$32,215.25

Hospital Charge Code	270633744C
Hospital Revenue Code	275
Min. Negotiated Rate	$776.39
Max. Negotiated Rate	$16,107.62
Rate for Payer: Aetna Commercial	$12,241.80
Rate for Payer: Aetna Medicare Advantage	$9,664.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,214.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,214.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,443.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,214.89
Rate for Payer: Cigna Commercial	$16,107.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,796.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,087.35
Rate for Payer: Qualcare PPO/HMO/WC	$4,832.29
Rate for Payer: UnitedHealthcare Community & State	$776.39
Rate for Payer: Wellpoint Medicaid Managed Care	$853.70

PACEMAKER INDENTITY XL DR 5376

Facility

$31,223.25

Hospital Charge Code	270625331
Hospital Revenue Code	275
Min. Negotiated Rate	$752.48
Max. Negotiated Rate	$15,611.62
Rate for Payer: Aetna Commercial	$11,864.83
Rate for Payer: Aetna Medicare Advantage	$9,366.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,961.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,961.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,244.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,961.93
Rate for Payer: Cigna Commercial	$15,611.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,556.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,869.11
Rate for Payer: Qualcare PPO/HMO/WC	$4,683.49
Rate for Payer: UnitedHealthcare Community & State	$752.48
Rate for Payer: Wellpoint Medicaid Managed Care	$827.42

PACEMAKER INDENTITY XL DR 5376

Facility

$31,223.25

Hospital Charge Code	270625331
Hospital Revenue Code	275
Min. Negotiated Rate	$4,683.49
Max. Negotiated Rate	$7,556.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,244.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,556.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,869.11
Rate for Payer: Qualcare PPO/HMO/WC	$4,683.49

PACEMAKER INGENIO DR IS-1 K173

Facility

$26,750.00

Hospital Charge Code	270648711C
Hospital Revenue Code	275
Min. Negotiated Rate	$4,012.50
Max. Negotiated Rate	$6,473.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,473.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,885.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,012.50

PACEMAKER INGENIO DR IS-1 K173

Facility

$26,750.00

Hospital Charge Code	270648711C
Hospital Revenue Code	275
Min. Negotiated Rate	$644.67
Max. Negotiated Rate	$13,375.00
Rate for Payer: Aetna Commercial	$10,165.00
Rate for Payer: Aetna Medicare Advantage	$8,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,821.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,821.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,821.25
Rate for Payer: Cigna Commercial	$13,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,473.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,885.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,012.50
Rate for Payer: UnitedHealthcare Community & State	$644.67
Rate for Payer: Wellpoint Medicaid Managed Care	$708.88

PACEMAKER INGENIO DR IS1 K173

Facility

$36,000.00

Service Code	HCPCS C1785
Hospital Charge Code	270648711
Hospital Revenue Code	275
Min. Negotiated Rate	$5,400.00
Max. Negotiated Rate	$8,712.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,712.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,920.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,400.00

PACEMAKER INGENIO DR IS1 K173

Facility

$36,000.00

Service Code	HCPCS C1785
Hospital Charge Code	270648711
Hospital Revenue Code	275
Min. Negotiated Rate	$867.60
Max. Negotiated Rate	$18,000.00
Rate for Payer: Aetna Commercial	$13,680.00
Rate for Payer: Aetna Medicare Advantage	$10,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,180.00
Rate for Payer: Cigna Commercial	$18,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,712.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,920.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,400.00
Rate for Payer: UnitedHealthcare Community & State	$867.60
Rate for Payer: Wellpoint Medicaid Managed Care	$954.00

PACEMAKER INGENIO SINGLE CHAMB

Facility

$33,500.00

Service Code	HCPCS C1786
Hospital Charge Code	270665529
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 INGENIO SINGLE CHAMB

Facility

$33,500.00

Service Code	HCPCS C1786
Hospital Charge Code	270665529
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

Know your out-of-pocket cost for care.

All Charges