Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PACEMAKER MEDT 8960iU

Facility

$20,160.00

Service Code	HCPCS C1786
Hospital Charge Code	270602713
Hospital Revenue Code	275
Min. Negotiated Rate	$3,024.00
Max. Negotiated Rate	$4,878.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,032.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,878.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,435.20
Rate for Payer: Qualcare PPO/HMO/WC	$3,024.00

PACEMAKER MEDT 8960iU

Facility

$20,160.00

Service Code	HCPCS C1786
Hospital Charge Code	270602713
Hospital Revenue Code	275
Min. Negotiated Rate	$485.86
Max. Negotiated Rate	$10,080.00
Rate for Payer: Aetna Commercial	$7,660.80
Rate for Payer: Aetna Medicare Advantage	$6,048.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,140.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,140.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,032.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,140.80
Rate for Payer: Cigna Commercial	$10,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,878.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,435.20
Rate for Payer: Qualcare PPO/HMO/WC	$3,024.00
Rate for Payer: UnitedHealthcare Community & State	$485.86
Rate for Payer: Wellpoint Medicaid Managed Care	$534.24

PACEMAKER MEDT 8961i

Facility

$20,160.00

Hospital Charge Code	270602714
Hospital Revenue Code	275
Min. Negotiated Rate	$3,024.00
Max. Negotiated Rate	$4,878.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,032.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,878.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,435.20
Rate for Payer: Qualcare PPO/HMO/WC	$3,024.00

PACEMAKER MEDT 8961i

Facility

$20,160.00

Hospital Charge Code	270602714
Hospital Revenue Code	275
Min. Negotiated Rate	$485.86
Max. Negotiated Rate	$10,080.00
Rate for Payer: Aetna Commercial	$7,660.80
Rate for Payer: Aetna Medicare Advantage	$6,048.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,140.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,140.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,032.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,140.80
Rate for Payer: Cigna Commercial	$10,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,878.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,435.20
Rate for Payer: Qualcare PPO/HMO/WC	$3,024.00
Rate for Payer: UnitedHealthcare Community & State	$485.86
Rate for Payer: Wellpoint Medicaid Managed Care	$534.24

PACEMAKER MEDT 8962iB

Facility

$19,656.00

Hospital Charge Code	270602715
Hospital Revenue Code	275
Min. Negotiated Rate	$473.71
Max. Negotiated Rate	$9,828.00
Rate for Payer: Aetna Commercial	$7,469.28
Rate for Payer: Aetna Medicare Advantage	$5,896.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,012.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,012.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,931.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,012.28
Rate for Payer: Cigna Commercial	$9,828.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,756.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,324.32
Rate for Payer: Qualcare PPO/HMO/WC	$2,948.40
Rate for Payer: UnitedHealthcare Community & State	$473.71
Rate for Payer: Wellpoint Medicaid Managed Care	$520.88

PACEMAKER MEDT 8962iB

Facility

$19,656.00

Hospital Charge Code	270602715
Hospital Revenue Code	275
Min. Negotiated Rate	$2,948.40
Max. Negotiated Rate	$4,756.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,931.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,756.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,324.32
Rate for Payer: Qualcare PPO/HMO/WC	$2,948.40

PACEMAKER MEDT 8964B

Facility

$16,128.00

Hospital Charge Code	270608892
Hospital Revenue Code	275
Min. Negotiated Rate	$2,419.20
Max. Negotiated Rate	$3,902.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,548.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,419.20

PACEMAKER MEDT 8964B

Facility

$16,128.00

Hospital Charge Code	270608892
Hospital Revenue Code	275
Min. Negotiated Rate	$388.68
Max. Negotiated Rate	$8,064.00
Rate for Payer: Aetna Commercial	$6,128.64
Rate for Payer: Aetna Medicare Advantage	$4,838.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,112.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,112.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,112.64
Rate for Payer: Cigna Commercial	$8,064.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,548.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,419.20
Rate for Payer: UnitedHealthcare Community & State	$388.68
Rate for Payer: Wellpoint Medicaid Managed Care	$427.39

PACEMAKER MEDT 8964i

Facility

$17,539.25

Hospital Charge Code	270608016
Hospital Revenue Code	275
Min. Negotiated Rate	$2,630.89
Max. Negotiated Rate	$4,244.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,507.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,244.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,858.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,630.89

PACEMAKER MEDT 8964i

Facility

$17,539.25

Hospital Charge Code	270608016
Hospital Revenue Code	275
Min. Negotiated Rate	$422.70
Max. Negotiated Rate	$8,769.62
Rate for Payer: Aetna Commercial	$6,664.91
Rate for Payer: Aetna Medicare Advantage	$5,261.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,472.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,472.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,507.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,472.51
Rate for Payer: Cigna Commercial	$8,769.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,244.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,858.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,630.89
Rate for Payer: UnitedHealthcare Community & State	$422.70
Rate for Payer: Wellpoint Medicaid Managed Care	$464.79

PACEMAKER MEDT 8964iB

Facility

$16,128.00

Hospital Charge Code	270602727
Hospital Revenue Code	275
Min. Negotiated Rate	$388.68
Max. Negotiated Rate	$8,064.00
Rate for Payer: Aetna Commercial	$6,128.64
Rate for Payer: Aetna Medicare Advantage	$4,838.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,112.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,112.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,112.64
Rate for Payer: Cigna Commercial	$8,064.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,548.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,419.20
Rate for Payer: UnitedHealthcare Community & State	$388.68
Rate for Payer: Wellpoint Medicaid Managed Care	$427.39

PACEMAKER MEDT 8964iB

Facility

$16,128.00

Hospital Charge Code	270602727
Hospital Revenue Code	275
Min. Negotiated Rate	$2,419.20
Max. Negotiated Rate	$3,902.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,548.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,419.20

PACEMAKER MEDT 8964iU

Facility

$16,128.00

Hospital Charge Code	270602728
Hospital Revenue Code	275
Min. Negotiated Rate	$2,419.20
Max. Negotiated Rate	$3,902.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,548.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,419.20

PACEMAKER MEDT 8964iU

Facility

$16,128.00

Hospital Charge Code	270602728
Hospital Revenue Code	275
Min. Negotiated Rate	$388.68
Max. Negotiated Rate	$8,064.00
Rate for Payer: Aetna Commercial	$6,128.64
Rate for Payer: Aetna Medicare Advantage	$4,838.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,112.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,112.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,112.64
Rate for Payer: Cigna Commercial	$8,064.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,548.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,419.20
Rate for Payer: UnitedHealthcare Community & State	$388.68
Rate for Payer: Wellpoint Medicaid Managed Care	$427.39

PACEMAKER MEDT 8965i

Facility

$16,128.00

Hospital Charge Code	270602729
Hospital Revenue Code	275
Min. Negotiated Rate	$2,419.20
Max. Negotiated Rate	$3,902.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,548.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,419.20

PACEMAKER MEDT 8965i

Facility

$16,128.00

Hospital Charge Code	270602729
Hospital Revenue Code	275
Min. Negotiated Rate	$388.68
Max. Negotiated Rate	$8,064.00
Rate for Payer: Aetna Commercial	$6,128.64
Rate for Payer: Aetna Medicare Advantage	$4,838.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,112.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,112.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,112.64
Rate for Payer: Cigna Commercial	$8,064.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,548.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,419.20
Rate for Payer: UnitedHealthcare Community & State	$388.68
Rate for Payer: Wellpoint Medicaid Managed Care	$427.39

PACEMAKER MEDT 8966i

Facility

$16,128.00

Hospital Charge Code	270602730
Hospital Revenue Code	275
Min. Negotiated Rate	$388.68
Max. Negotiated Rate	$8,064.00
Rate for Payer: Aetna Commercial	$6,128.64
Rate for Payer: Aetna Medicare Advantage	$4,838.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,112.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,112.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,112.64
Rate for Payer: Cigna Commercial	$8,064.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,548.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,419.20
Rate for Payer: UnitedHealthcare Community & State	$388.68
Rate for Payer: Wellpoint Medicaid Managed Care	$427.39

PACEMAKER MEDT 8966i

Facility

$16,128.00

Hospital Charge Code	270602730
Hospital Revenue Code	275
Min. Negotiated Rate	$2,419.20
Max. Negotiated Rate	$3,902.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,548.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,419.20

PACEMAKER MEDT B SDR303

Facility

$18,144.00

Hospital Charge Code	270617980C
Hospital Revenue Code	275
Min. Negotiated Rate	$437.27
Max. Negotiated Rate	$9,072.00
Rate for Payer: Aetna Commercial	$6,894.72
Rate for Payer: Aetna Medicare Advantage	$5,443.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,626.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,626.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,628.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,626.72
Rate for Payer: Cigna Commercial	$9,072.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,390.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,991.68
Rate for Payer: Qualcare PPO/HMO/WC	$2,721.60
Rate for Payer: UnitedHealthcare Community & State	$437.27
Rate for Payer: Wellpoint Medicaid Managed Care	$480.82

PACEMAKER MEDT B SDR303

Facility

$18,144.00

Hospital Charge Code	270617980C
Hospital Revenue Code	275
Min. Negotiated Rate	$2,721.60
Max. Negotiated Rate	$4,390.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,628.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,390.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,991.68
Rate for Payer: Qualcare PPO/HMO/WC	$2,721.60

PACEMAKER MEDT DR403B

Facility

$19,998.75

Hospital Charge Code	270607438
Hospital Revenue Code	275
Min. Negotiated Rate	$481.97
Max. Negotiated Rate	$9,999.38
Rate for Payer: Aetna Commercial	$7,599.52
Rate for Payer: Aetna Medicare Advantage	$5,999.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,099.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,099.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,999.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,099.68
Rate for Payer: Cigna Commercial	$9,999.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,839.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,399.73
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.81
Rate for Payer: UnitedHealthcare Community & State	$481.97
Rate for Payer: Wellpoint Medicaid Managed Care	$529.97

PACEMAKER MEDT DR403B

Facility

$24,998.45

Hospital Charge Code	270607710
Hospital Revenue Code	275
Min. Negotiated Rate	$602.46
Max. Negotiated Rate	$12,499.23
Rate for Payer: Aetna Commercial	$9,499.41
Rate for Payer: Aetna Medicare Advantage	$7,499.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,374.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,374.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,999.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,374.60
Rate for Payer: Cigna Commercial	$12,499.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,049.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,499.66
Rate for Payer: Qualcare PPO/HMO/WC	$3,749.77
Rate for Payer: UnitedHealthcare Community & State	$602.46
Rate for Payer: Wellpoint Medicaid Managed Care	$662.46

PACEMAKER MEDT DR403B

Facility

$19,998.75

Hospital Charge Code	270607438
Hospital Revenue Code	275
Min. Negotiated Rate	$2,999.81
Max. Negotiated Rate	$4,839.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,999.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,839.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,399.73
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.81

PACEMAKER MEDT DR403B

Facility

$24,998.45

Hospital Charge Code	270607710
Hospital Revenue Code	275
Min. Negotiated Rate	$3,749.77
Max. Negotiated Rate	$6,049.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,999.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,049.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,499.66
Rate for Payer: Qualcare PPO/HMO/WC	$3,749.77

PACEMAKER MEDT DR403B

Facility

$24,998.45

Hospital Charge Code	270607710C
Hospital Revenue Code	275
Min. Negotiated Rate	$3,749.77
Max. Negotiated Rate	$6,049.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,999.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,049.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,499.66
Rate for Payer: Qualcare PPO/HMO/WC	$3,749.77

Know your out-of-pocket cost for care.

All Charges