Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BALL DIAMOND 5MM MEDNEXT

Facility

$703.00

Hospital Charge Code	270657267
Hospital Revenue Code	278
Min. Negotiated Rate	$16.94
Max. Negotiated Rate	$351.50
Rate for Payer: Aetna Commercial	$267.14
Rate for Payer: Aetna Medicare Advantage	$210.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.26
Rate for Payer: Cigna Commercial	$351.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.66
Rate for Payer: Qualcare PPO/HMO/WC	$105.45
Rate for Payer: UnitedHealthcare Community & State	$16.94
Rate for Payer: Wellpoint Medicaid Managed Care	$18.63

BALL DIAMOND 5MM MEDNEXT

Facility

$731.50

Hospital Charge Code	270657269
Hospital Revenue Code	278
Min. Negotiated Rate	$17.63
Max. Negotiated Rate	$365.75
Rate for Payer: Aetna Commercial	$277.97
Rate for Payer: Aetna Medicare Advantage	$219.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.53
Rate for Payer: Cigna Commercial	$365.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$160.93
Rate for Payer: Qualcare PPO/HMO/WC	$109.72
Rate for Payer: UnitedHealthcare Community & State	$17.63
Rate for Payer: Wellpoint Medicaid Managed Care	$19.38

BALL DIAMOND 5MM MEDNEXT

Facility

$731.50

Hospital Charge Code	270657269
Hospital Revenue Code	278
Min. Negotiated Rate	$109.72
Max. Negotiated Rate	$177.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$160.93
Rate for Payer: Qualcare PPO/HMO/WC	$109.72

BALL DIAMOND 6MM

Facility

$703.00

Hospital Charge Code	270657270
Hospital Revenue Code	278
Min. Negotiated Rate	$16.94
Max. Negotiated Rate	$351.50
Rate for Payer: Aetna Commercial	$267.14
Rate for Payer: Aetna Medicare Advantage	$210.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.26
Rate for Payer: Cigna Commercial	$351.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.66
Rate for Payer: Qualcare PPO/HMO/WC	$105.45
Rate for Payer: UnitedHealthcare Community & State	$16.94
Rate for Payer: Wellpoint Medicaid Managed Care	$18.63

BALL DIAMOND 6MM

Facility

$703.00

Hospital Charge Code	270657270
Hospital Revenue Code	278
Min. Negotiated Rate	$105.45
Max. Negotiated Rate	$170.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.66
Rate for Payer: Qualcare PPO/HMO/WC	$105.45

BALL DIAMOND MEDNEXT 4MM

Facility

$703.00

Hospital Charge Code	270657263
Hospital Revenue Code	278
Min. Negotiated Rate	$16.94
Max. Negotiated Rate	$351.50
Rate for Payer: Aetna Commercial	$267.14
Rate for Payer: Aetna Medicare Advantage	$210.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.26
Rate for Payer: Cigna Commercial	$351.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.66
Rate for Payer: Qualcare PPO/HMO/WC	$105.45
Rate for Payer: UnitedHealthcare Community & State	$16.94
Rate for Payer: Wellpoint Medicaid Managed Care	$18.63

BALL DIAMOND MEDNEXT 4MM

Facility

$717.25

Hospital Charge Code	270657265
Hospital Revenue Code	278
Min. Negotiated Rate	$17.29
Max. Negotiated Rate	$358.62
Rate for Payer: Aetna Commercial	$272.56
Rate for Payer: Aetna Medicare Advantage	$215.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.90
Rate for Payer: Cigna Commercial	$358.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$157.79
Rate for Payer: Qualcare PPO/HMO/WC	$107.59
Rate for Payer: UnitedHealthcare Community & State	$17.29
Rate for Payer: Wellpoint Medicaid Managed Care	$19.01

BALL DIAMOND MEDNEXT 4MM

Facility

$717.25

Hospital Charge Code	270657265
Hospital Revenue Code	278
Min. Negotiated Rate	$107.59
Max. Negotiated Rate	$173.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$157.79
Rate for Payer: Qualcare PPO/HMO/WC	$107.59

BALL DIAMOND MEDNEXT 4MM

Facility

$703.00

Hospital Charge Code	270657263
Hospital Revenue Code	278
Min. Negotiated Rate	$105.45
Max. Negotiated Rate	$170.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.66
Rate for Payer: Qualcare PPO/HMO/WC	$105.45

BALL ELECTRODE 5MM

Facility

$75.00

Hospital Charge Code	270655609
Hospital Revenue Code	272
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

BALL ELECTRODE 5MM

Facility

$75.00

Hospital Charge Code	270655609
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

BALLN ADM X 6x120 ADM060120130

Facility

$725.00

Hospital Charge Code	270639217V
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

BALLN ADM X 6x120 ADM060120130

Facility

$725.00

Hospital Charge Code	270639217V
Hospital Revenue Code	278
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Community & State	$17.47
Rate for Payer: Wellpoint Medicaid Managed Care	$19.21

BALLN ADM XTREM 4x4 ADM0400130

Facility

$800.00

Hospital Charge Code	270639669C
Hospital Revenue Code	278
Min. Negotiated Rate	$19.28
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$21.20

BALLN ADM XTREM 4x4 ADM0400130

Facility

$800.00

Hospital Charge Code	270639669C
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

BALLN ADXTR 4x120 ADM040120130

Facility

$625.00

Hospital Charge Code	270644089V
Hospital Revenue Code	278
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

BALLN ADXTR 4x120 ADM040120130

Facility

$625.00

Hospital Charge Code	270644089V
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

BALLN APEX MONO 4X15 389591540

Facility

$1,225.00

Hospital Charge Code	270664228
Hospital Revenue Code	278
Min. Negotiated Rate	$183.75
Max. Negotiated Rate	$296.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$245.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.50
Rate for Payer: Qualcare PPO/HMO/WC	$183.75

BALLN APEX MONO 4X15 389591540

Facility

$1,225.00

Hospital Charge Code	270664228
Hospital Revenue Code	278
Min. Negotiated Rate	$29.52
Max. Negotiated Rate	$612.50
Rate for Payer: Aetna Commercial	$465.50
Rate for Payer: Aetna Medicare Advantage	$367.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$312.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$312.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$245.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$312.38
Rate for Payer: Cigna Commercial	$612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.50
Rate for Payer: Qualcare PPO/HMO/WC	$183.75
Rate for Payer: UnitedHealthcare Community & State	$29.52
Rate for Payer: Wellpoint Medicaid Managed Care	$32.46

BALLN AVIATOR PLUS 6X20X142

Facility

$3,925.00

Service Code	HCPCS C1725
Hospital Charge Code	270631631N
Hospital Revenue Code	278
Min. Negotiated Rate	$94.59
Max. Negotiated Rate	$1,962.50
Rate for Payer: Aetna Commercial	$1,491.50
Rate for Payer: Aetna Medicare Advantage	$1,177.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,000.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,000.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,000.88
Rate for Payer: Cigna Commercial	$1,962.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$949.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$863.50
Rate for Payer: Qualcare PPO/HMO/WC	$588.75
Rate for Payer: UnitedHealthcare Community & State	$94.59
Rate for Payer: Wellpoint Medicaid Managed Care	$104.01

BALLN AVIATOR PLUS 6X20X142

Facility

$3,925.00

Service Code	HCPCS C1725
Hospital Charge Code	270631631N
Hospital Revenue Code	278
Min. Negotiated Rate	$588.75
Max. Negotiated Rate	$949.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$785.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$949.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$863.50
Rate for Payer: Qualcare PPO/HMO/WC	$588.75

BALLN CATH ADM040040080

Facility

$600.00

Service Code	HCPCS C1725
Hospital Charge Code	270661867
Hospital Revenue Code	278
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

BALLN CATH ADM040040080

Facility

$600.00

Service Code	HCPCS C1725
Hospital Charge Code	270661867
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

BALLN CATH AORC CODA 10 G36042

Facility

$2,215.00

Service Code	HCPCS C2628
Hospital Charge Code	270634570
Hospital Revenue Code	278
Min. Negotiated Rate	$332.25
Max. Negotiated Rate	$536.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$443.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$536.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$487.30
Rate for Payer: Qualcare PPO/HMO/WC	$332.25

BALLN CATH AORC CODA 10 G36042

Facility

$2,215.00

Service Code	HCPCS C2628
Hospital Charge Code	270634570
Hospital Revenue Code	278
Min. Negotiated Rate	$53.38
Max. Negotiated Rate	$1,107.50
Rate for Payer: Aetna Commercial	$841.70
Rate for Payer: Aetna Medicare Advantage	$664.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$564.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$564.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$443.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$564.83
Rate for Payer: Cigna Commercial	$1,107.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$536.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$487.30
Rate for Payer: Qualcare PPO/HMO/WC	$332.25
Rate for Payer: UnitedHealthcare Community & State	$53.38
Rate for Payer: Wellpoint Medicaid Managed Care	$58.70

Know your out-of-pocket cost for care.

All Charges