Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PACEMAKER MEDT SDR303

Facility

$18,144.00

Hospital Charge Code	270617980
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 SIGMA SR SSR203

Facility

$12,353.65

Hospital Charge Code	270625759
Hospital Revenue Code	275
Min. Negotiated Rate	$1,853.05
Max. Negotiated Rate	$2,989.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,470.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,989.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,717.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,853.05

PACEMAKER MEDT SIGMA SR SSR203

Facility

$12,353.65

Hospital Charge Code	270625759
Hospital Revenue Code	275
Min. Negotiated Rate	$297.72
Max. Negotiated Rate	$6,176.82
Rate for Payer: Aetna Commercial	$4,694.39
Rate for Payer: Aetna Medicare Advantage	$3,706.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,150.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,150.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,470.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,150.18
Rate for Payer: Cigna Commercial	$6,176.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,989.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,717.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,853.05
Rate for Payer: UnitedHealthcare Community & State	$297.72
Rate for Payer: Wellpoint Medicaid Managed Care	$327.37

PACEMAKER MEDT SSR303B

Facility

$15,724.85

Hospital Charge Code	270616530
Hospital Revenue Code	275
Min. Negotiated Rate	$378.97
Max. Negotiated Rate	$7,862.43
Rate for Payer: Aetna Commercial	$5,975.44
Rate for Payer: Aetna Medicare Advantage	$4,717.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,009.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,009.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,144.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,009.84
Rate for Payer: Cigna Commercial	$7,862.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,805.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,459.47
Rate for Payer: Qualcare PPO/HMO/WC	$2,358.73
Rate for Payer: UnitedHealthcare Community & State	$378.97
Rate for Payer: Wellpoint Medicaid Managed Care	$416.71

PACEMAKER MEDT SSR303B

Facility

$15,724.85

Hospital Charge Code	270616530
Hospital Revenue Code	275
Min. Negotiated Rate	$2,358.73
Max. Negotiated Rate	$3,805.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,144.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,805.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,459.47
Rate for Payer: Qualcare PPO/HMO/WC	$2,358.73

PACEMAKER MEDT SSR303B

Facility

$15,724.85

Hospital Charge Code	270616530C
Hospital Revenue Code	275
Min. Negotiated Rate	$378.97
Max. Negotiated Rate	$7,862.43
Rate for Payer: Aetna Commercial	$5,975.44
Rate for Payer: Aetna Medicare Advantage	$4,717.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,009.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,009.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,144.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,009.84
Rate for Payer: Cigna Commercial	$7,862.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,805.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,459.47
Rate for Payer: Qualcare PPO/HMO/WC	$2,358.73
Rate for Payer: UnitedHealthcare Community & State	$378.97
Rate for Payer: Wellpoint Medicaid Managed Care	$416.71

PACEMAKER MEDT SSR303B

Facility

$15,724.85

Hospital Charge Code	270616530C
Hospital Revenue Code	275
Min. Negotiated Rate	$2,358.73
Max. Negotiated Rate	$3,805.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,144.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,805.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,459.47
Rate for Payer: Qualcare PPO/HMO/WC	$2,358.73

Pacemaker MRI UMRI Assurity

Facility

$15,000.00

Service Code	HCPCS C1785
Hospital Charge Code	270687052
Hospital Revenue Code	275
Min. Negotiated Rate	$361.50
Max. Negotiated Rate	$7,500.00
Rate for Payer: Aetna Commercial	$5,700.00
Rate for Payer: Aetna Medicare Advantage	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,825.00
Rate for Payer: Cigna Commercial	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00
Rate for Payer: UnitedHealthcare Community & State	$361.50
Rate for Payer: Wellpoint Medicaid Managed Care	$397.50

Pacemaker MRI UMRI Assurity

Facility

$15,000.00

Service Code	HCPCS C1785
Hospital Charge Code	270687052
Hospital Revenue Code	275
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

PACEMAKER MRI UMRI ASSURITY

Facility

$24,975.00

Service Code	HCPCS C1785
Hospital Charge Code	270687052S
Hospital Revenue Code	275
Min. Negotiated Rate	$601.90
Max. Negotiated Rate	$12,487.50
Rate for Payer: Aetna Commercial	$9,490.50
Rate for Payer: Aetna Medicare Advantage	$7,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,368.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,368.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,368.62
Rate for Payer: Cigna Commercial	$12,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,043.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,494.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,746.25
Rate for Payer: UnitedHealthcare Community & State	$601.90
Rate for Payer: Wellpoint Medicaid Managed Care	$661.84

PACEMAKER MRI UMRI ASSURITY

Facility

$24,975.00

Service Code	HCPCS C1785
Hospital Charge Code	270687052S
Hospital Revenue Code	275
Min. Negotiated Rate	$3,746.25
Max. Negotiated Rate	$6,043.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,043.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,494.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,746.25

PACEMAKER PCSTR SR 5136

Facility

$20,140.00

Hospital Charge Code	270621305C
Hospital Revenue Code	275
Min. Negotiated Rate	$485.37
Max. Negotiated Rate	$10,070.00
Rate for Payer: Aetna Commercial	$7,653.20
Rate for Payer: Aetna Medicare Advantage	$6,042.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,135.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,135.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,028.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,135.70
Rate for Payer: Cigna Commercial	$10,070.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,873.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,430.80
Rate for Payer: Qualcare PPO/HMO/WC	$3,021.00
Rate for Payer: UnitedHealthcare Community & State	$485.37
Rate for Payer: Wellpoint Medicaid Managed Care	$533.71

PACEMAKER PCSTR SR 5136

Facility

$20,140.00

Hospital Charge Code	270621305C
Hospital Revenue Code	275
Min. Negotiated Rate	$3,021.00
Max. Negotiated Rate	$4,873.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,028.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,873.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,430.80
Rate for Payer: Qualcare PPO/HMO/WC	$3,021.00

PACEMAKER PCSTR SR 5136

Facility

$20,140.00

Hospital Charge Code	270621305
Hospital Revenue Code	275
Min. Negotiated Rate	$3,021.00
Max. Negotiated Rate	$4,873.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,028.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,873.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,430.80
Rate for Payer: Qualcare PPO/HMO/WC	$3,021.00

PACEMAKER PCSTR SR 5136

Facility

$20,140.00

Hospital Charge Code	270621305
Hospital Revenue Code	275
Min. Negotiated Rate	$485.37
Max. Negotiated Rate	$10,070.00
Rate for Payer: Aetna Commercial	$7,653.20
Rate for Payer: Aetna Medicare Advantage	$6,042.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,135.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,135.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,028.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,135.70
Rate for Payer: Cigna Commercial	$10,070.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,873.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,430.80
Rate for Payer: Qualcare PPO/HMO/WC	$3,021.00
Rate for Payer: UnitedHealthcare Community & State	$485.37
Rate for Payer: Wellpoint Medicaid Managed Care	$533.71

PACEMAKER PCSTR SR 5136

Facility

$20,140.00

Hospital Charge Code	2702706213
Hospital Revenue Code	275
Min. Negotiated Rate	$3,021.00
Max. Negotiated Rate	$4,873.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,028.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,873.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,430.80
Rate for Payer: Qualcare PPO/HMO/WC	$3,021.00

PACEMAKER PCSTR SR 5136

Facility

$20,140.00

Hospital Charge Code	2702706213
Hospital Revenue Code	275
Min. Negotiated Rate	$485.37
Max. Negotiated Rate	$10,070.00
Rate for Payer: Aetna Commercial	$7,653.20
Rate for Payer: Aetna Medicare Advantage	$6,042.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,135.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,135.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,028.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,135.70
Rate for Payer: Cigna Commercial	$10,070.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,873.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,430.80
Rate for Payer: Qualcare PPO/HMO/WC	$3,021.00
Rate for Payer: UnitedHealthcare Community & State	$485.37
Rate for Payer: Wellpoint Medicaid Managed Care	$533.71

PACEMAKER PHILOS DR 331443

Facility

$20,807.25

Hospital Charge Code	270630739
Hospital Revenue Code	275
Min. Negotiated Rate	$3,121.09
Max. Negotiated Rate	$5,035.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,161.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,035.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,577.60
Rate for Payer: Qualcare PPO/HMO/WC	$3,121.09

PACEMAKER PHILOS DR 331443

Facility

$20,807.25

Hospital Charge Code	270630739
Hospital Revenue Code	275
Min. Negotiated Rate	$501.45
Max. Negotiated Rate	$10,403.62
Rate for Payer: Aetna Commercial	$7,906.76
Rate for Payer: Aetna Medicare Advantage	$6,242.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,305.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,305.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,161.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,305.85
Rate for Payer: Cigna Commercial	$10,403.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,035.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,577.60
Rate for Payer: Qualcare PPO/HMO/WC	$3,121.09
Rate for Payer: UnitedHealthcare Community & State	$501.45
Rate for Payer: Wellpoint Medicaid Managed Care	$551.39

PACEMAKER PHILOS II DRT 343175

Facility

$29,500.00

Hospital Charge Code	270641510
Hospital Revenue Code	275
Min. Negotiated Rate	$710.95
Max. Negotiated Rate	$14,750.00
Rate for Payer: Aetna Commercial	$11,210.00
Rate for Payer: Aetna Medicare Advantage	$8,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,522.50
Rate for Payer: Cigna Commercial	$14,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,139.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,490.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,425.00
Rate for Payer: UnitedHealthcare Community & State	$710.95
Rate for Payer: Wellpoint Medicaid Managed Care	$781.75

PACEMAKER PHILOS II DRT 343175

Facility

$29,500.00

Hospital Charge Code	270641510C
Hospital Revenue Code	275
Min. Negotiated Rate	$710.95
Max. Negotiated Rate	$14,750.00
Rate for Payer: Aetna Commercial	$11,210.00
Rate for Payer: Aetna Medicare Advantage	$8,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,522.50
Rate for Payer: Cigna Commercial	$14,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,139.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,490.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,425.00
Rate for Payer: UnitedHealthcare Community & State	$710.95
Rate for Payer: Wellpoint Medicaid Managed Care	$781.75

PACEMAKER PHILOS II DRT 343175

Facility

$29,500.00

Hospital Charge Code	270641510C
Hospital Revenue Code	275
Min. Negotiated Rate	$4,425.00
Max. Negotiated Rate	$7,139.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,139.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,490.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,425.00

PACEMAKER PHILOS II DRT 343175

Facility

$29,500.00

Hospital Charge Code	270641510
Hospital Revenue Code	275
Min. Negotiated Rate	$4,425.00
Max. Negotiated Rate	$7,139.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,139.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,490.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,425.00

PACEMAKER PHILOS II SR 341824

Facility

$29,975.00

Hospital Charge Code	270638834
Hospital Revenue Code	275
Min. Negotiated Rate	$4,496.25
Max. Negotiated Rate	$7,253.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,253.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,594.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,496.25

PACEMAKER PHILOS II SR 341824

Facility

$29,975.00

Hospital Charge Code	270638834
Hospital Revenue Code	275
Min. Negotiated Rate	$722.40
Max. Negotiated Rate	$14,987.50
Rate for Payer: Aetna Commercial	$11,390.50
Rate for Payer: Aetna Medicare Advantage	$8,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,643.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,643.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,643.62
Rate for Payer: Cigna Commercial	$14,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,253.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,594.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,496.25
Rate for Payer: UnitedHealthcare Community & State	$722.40
Rate for Payer: Wellpoint Medicaid Managed Care	$794.34

Know your out-of-pocket cost for care.

All Charges