Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BALLN OCCLN LG 30 LDOB63510030

Facility

$1,016.85

Hospital Charge Code	270633658
Hospital Revenue Code	278
Min. Negotiated Rate	$24.51
Max. Negotiated Rate	$508.43
Rate for Payer: Aetna Commercial	$386.40
Rate for Payer: Aetna Medicare Advantage	$305.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$259.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$259.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$259.30
Rate for Payer: Cigna Commercial	$508.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$223.71
Rate for Payer: Qualcare PPO/HMO/WC	$152.53
Rate for Payer: UnitedHealthcare Community & State	$24.51
Rate for Payer: Wellpoint Medicaid Managed Care	$26.95

BALLN OCCLN LG 30 LDOB63510030

Facility

$1,016.85

Hospital Charge Code	270633658
Hospital Revenue Code	278
Min. Negotiated Rate	$152.53
Max. Negotiated Rate	$246.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$223.71
Rate for Payer: Qualcare PPO/HMO/WC	$152.53

BALLN OCCLN LG 30 LDOB63510030

Facility

$1,016.85

Hospital Charge Code	270633658V
Hospital Revenue Code	278
Min. Negotiated Rate	$24.51
Max. Negotiated Rate	$508.43
Rate for Payer: Aetna Commercial	$386.40
Rate for Payer: Aetna Medicare Advantage	$305.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$259.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$259.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$259.30
Rate for Payer: Cigna Commercial	$508.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$223.71
Rate for Payer: Qualcare PPO/HMO/WC	$152.53
Rate for Payer: UnitedHealthcare Community & State	$24.51
Rate for Payer: Wellpoint Medicaid Managed Care	$26.95

BALL NOSE GUIDE WIRE 100CM

Facility

$552.50

Service Code	HCPCS C1769
Hospital Charge Code	270679320
Hospital Revenue Code	278
Min. Negotiated Rate	$13.32
Max. Negotiated Rate	$276.25
Rate for Payer: Aetna Commercial	$209.95
Rate for Payer: Aetna Medicare Advantage	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.89
Rate for Payer: Cigna Commercial	$276.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.55
Rate for Payer: Qualcare PPO/HMO/WC	$82.88
Rate for Payer: UnitedHealthcare Community & State	$13.32
Rate for Payer: Wellpoint Medicaid Managed Care	$14.64

BALL NOSE GUIDE WIRE 100CM

Facility

$552.50

Service Code	HCPCS C1769
Hospital Charge Code	270679320
Hospital Revenue Code	278
Min. Negotiated Rate	$82.88
Max. Negotiated Rate	$133.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.55
Rate for Payer: Qualcare PPO/HMO/WC	$82.88

BALL NOSE GUIDE WIRE 80CM

Facility

$1,200.00

Service Code	HCPCS C1769
Hospital Charge Code	270686319
Hospital Revenue Code	278
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$290.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$264.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.00

BALL NOSE GUIDE WIRE 80CM

Facility

$1,200.00

Service Code	HCPCS C1769
Hospital Charge Code	270686319
Hospital Revenue Code	278
Min. Negotiated Rate	$28.92
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$456.00
Rate for Payer: Aetna Medicare Advantage	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$306.00
Rate for Payer: Cigna Commercial	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$264.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.00
Rate for Payer: UnitedHealthcare Community & State	$28.92
Rate for Payer: Wellpoint Medicaid Managed Care	$31.80

BALLN PC6.0x100 AB18W060100150

Facility

$1,125.00

Service Code	HCPCS C1725
Hospital Charge Code	270644459C
Hospital Revenue Code	278
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

BALLN PC6.0x100 AB18W060100150

Facility

$1,125.00

Service Code	HCPCS C1725
Hospital Charge Code	270644459C
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BALLN PC 6.0x60 AB18W060060150

Facility

$1,125.00

Service Code	HCPCS C1725
Hospital Charge Code	270644236C
Hospital Revenue Code	278
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

BALLN PC 6.0x60 AB18W060060150

Facility

$1,125.00

Service Code	HCPCS C1725
Hospital Charge Code	270644236C
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BALLN PRESS REG 61-70 72400024

Facility

$8,580.00

Hospital Charge Code	270641450
Hospital Revenue Code	278
Min. Negotiated Rate	$1,287.00
Max. Negotiated Rate	$2,076.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,716.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,076.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,887.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,287.00

BALLN PRESS REG 61-70 72400024

Facility

$8,580.00

Hospital Charge Code	270641450
Hospital Revenue Code	278
Min. Negotiated Rate	$206.78
Max. Negotiated Rate	$4,290.00
Rate for Payer: Aetna Commercial	$3,260.40
Rate for Payer: Aetna Medicare Advantage	$2,574.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,187.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,187.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,716.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,187.90
Rate for Payer: Cigna Commercial	$4,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,076.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,887.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,287.00
Rate for Payer: UnitedHealthcare Community & State	$206.78
Rate for Payer: Wellpoint Medicaid Managed Care	$227.37

BALLN QUAN MON 4.5x8 380800845

Facility

$1,295.00

Hospital Charge Code	270640729C
Hospital Revenue Code	278
Min. Negotiated Rate	$31.21
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$492.10
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Community & State	$31.21
Rate for Payer: Wellpoint Medicaid Managed Care	$34.32

BALLN QUAN MON 4.5x8 380800845

Facility

$1,295.00

Hospital Charge Code	270640729C
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLN SPRNT1.25x06MM SPL12506X

Facility

$525.00

Service Code	HCPCS C1725
Hospital Charge Code	270650634C
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

BALLN SPRNT1.25x06MM SPL12506X

Facility

$525.00

Service Code	HCPCS C1725
Hospital Charge Code	270650634C
Hospital Revenue Code	278
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

BALLN SPRNT 1.25x10M SPL12510X

Facility

$750.00

Service Code	HCPCS C1725
Hospital Charge Code	270650653C
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

BALLN SPRNT 1.25x10M SPL12510X

Facility

$750.00

Service Code	HCPCS C1725
Hospital Charge Code	270650653C
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

BALLN STEL 3x20 135 3903130201

Facility

$1,906.50

Hospital Charge Code	270643335C
Hospital Revenue Code	278
Min. Negotiated Rate	$45.95
Max. Negotiated Rate	$953.25
Rate for Payer: Aetna Commercial	$724.47
Rate for Payer: Aetna Medicare Advantage	$571.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$486.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$486.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$381.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$486.16
Rate for Payer: Cigna Commercial	$953.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$461.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$419.43
Rate for Payer: Qualcare PPO/HMO/WC	$285.98
Rate for Payer: UnitedHealthcare Community & State	$45.95
Rate for Payer: Wellpoint Medicaid Managed Care	$50.52

BALLN STEL 3x20 135 3903130201

Facility

$1,906.50

Hospital Charge Code	270643335C
Hospital Revenue Code	278
Min. Negotiated Rate	$285.98
Max. Negotiated Rate	$461.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$381.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$461.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$419.43
Rate for Payer: Qualcare PPO/HMO/WC	$285.98

BALLN STERL 4x40mm 135cm

Facility

$1,493.50

Service Code	HCPCS C1725
Hospital Charge Code	270639030C
Hospital Revenue Code	278
Min. Negotiated Rate	$224.03
Max. Negotiated Rate	$361.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$328.57
Rate for Payer: Qualcare PPO/HMO/WC	$224.03

BALLN STERL 4x40mm 135cm

Facility

$1,493.50

Service Code	HCPCS C1725
Hospital Charge Code	270639030C
Hospital Revenue Code	278
Min. Negotiated Rate	$35.99
Max. Negotiated Rate	$746.75
Rate for Payer: Aetna Commercial	$567.53
Rate for Payer: Aetna Medicare Advantage	$448.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$380.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$380.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$380.84
Rate for Payer: Cigna Commercial	$746.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$328.57
Rate for Payer: Qualcare PPO/HMO/WC	$224.03
Rate for Payer: UnitedHealthcare Community & State	$35.99
Rate for Payer: Wellpoint Medicaid Managed Care	$39.58

BALLN VOY 2.25x12 1009440012

Facility

$1,275.00

Hospital Charge Code	270643822C
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$308.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$280.50
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY 2.25x12 1009440012

Facility

$1,275.00

Hospital Charge Code	270643822C
Hospital Revenue Code	278
Min. Negotiated Rate	$30.73
Max. Negotiated Rate	$637.50
Rate for Payer: Aetna Commercial	$484.50
Rate for Payer: Aetna Medicare Advantage	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.12
Rate for Payer: Cigna Commercial	$637.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$280.50
Rate for Payer: Qualcare PPO/HMO/WC	$191.25
Rate for Payer: UnitedHealthcare Community & State	$30.73
Rate for Payer: Wellpoint Medicaid Managed Care	$33.79

Know your out-of-pocket cost for care.

All Charges