Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SEAMGUARD 45MM

Facility

$975.00

Hospital Charge Code	270672594
Hospital Revenue Code	272
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

SEAMGUARD 60MM

Facility

$1,090.00

Hospital Charge Code	270672595
Hospital Revenue Code	272
Min. Negotiated Rate	$26.27
Max. Negotiated Rate	$545.00
Rate for Payer: Aetna Commercial	$414.20
Rate for Payer: Aetna Medicare Advantage	$327.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$277.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$277.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$277.95
Rate for Payer: Cigna Commercial	$545.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$327.00
Rate for Payer: Oxford Commercial	$218.00
Rate for Payer: Qualcare PPO/HMO/WC	$163.50
Rate for Payer: UnitedHealthcare Commercial	$218.00
Rate for Payer: UnitedHealthcare Community & State	$26.27
Rate for Payer: Wellpoint Medicaid Managed Care	$28.89

SEAMGUARD 60MM

Facility

$1,090.00

Hospital Charge Code	270672595
Hospital Revenue Code	272
Min. Negotiated Rate	$163.50
Max. Negotiated Rate	$163.50
Rate for Payer: Qualcare PPO/HMO/WC	$163.50

SEAMGUARD BIOABSRB BLK60

Facility

$835.00

Service Code	HCPCS C1781
Hospital Charge Code	270693068
Hospital Revenue Code	278
Min. Negotiated Rate	$125.25
Max. Negotiated Rate	$202.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$167.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.70
Rate for Payer: Qualcare PPO/HMO/WC	$125.25

SEAMGUARD BIOABSRB BLK60

Facility

$835.00

Service Code	HCPCS C1781
Hospital Charge Code	270693068
Hospital Revenue Code	278
Min. Negotiated Rate	$20.12
Max. Negotiated Rate	$417.50
Rate for Payer: Aetna Commercial	$317.30
Rate for Payer: Aetna Medicare Advantage	$250.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$167.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.93
Rate for Payer: Cigna Commercial	$417.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.70
Rate for Payer: Qualcare PPO/HMO/WC	$125.25
Rate for Payer: UnitedHealthcare Community & State	$20.12
Rate for Payer: Wellpoint Medicaid Managed Care	$22.13

SEAMGUARD BIOABSRB GRN/BL 60

Facility

$835.00

Service Code	HCPCS C1781
Hospital Charge Code	270693069
Hospital Revenue Code	278
Min. Negotiated Rate	$125.25
Max. Negotiated Rate	$202.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$167.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.70
Rate for Payer: Qualcare PPO/HMO/WC	$125.25

SEAMGUARD BIOABSRB GRN/BL 60

Facility

$835.00

Service Code	HCPCS C1781
Hospital Charge Code	270693069
Hospital Revenue Code	278
Min. Negotiated Rate	$20.12
Max. Negotiated Rate	$417.50
Rate for Payer: Aetna Commercial	$317.30
Rate for Payer: Aetna Medicare Advantage	$250.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$167.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.93
Rate for Payer: Cigna Commercial	$417.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.70
Rate for Payer: Qualcare PPO/HMO/WC	$125.25
Rate for Payer: UnitedHealthcare Community & State	$20.12
Rate for Payer: Wellpoint Medicaid Managed Care	$22.13

SEAMGUARD GIA 60 ASG003

Facility

$1,078.80

Hospital Charge Code	270623269
Hospital Revenue Code	278
Min. Negotiated Rate	$161.82
Max. Negotiated Rate	$261.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$237.34
Rate for Payer: Qualcare PPO/HMO/WC	$161.82

SEAMGUARD GIA 60 ASG003

Facility

$862.45

Hospital Charge Code	270632269
Hospital Revenue Code	272
Min. Negotiated Rate	$129.37
Max. Negotiated Rate	$129.37
Rate for Payer: Qualcare PPO/HMO/WC	$129.37

SEAMGUARD GIA 60 ASG003

Facility

$862.45

Hospital Charge Code	270632269
Hospital Revenue Code	272
Min. Negotiated Rate	$20.79
Max. Negotiated Rate	$431.23
Rate for Payer: Aetna Commercial	$327.73
Rate for Payer: Aetna Medicare Advantage	$258.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.92
Rate for Payer: Cigna Commercial	$431.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.74
Rate for Payer: Oxford Commercial	$172.49
Rate for Payer: Qualcare PPO/HMO/WC	$129.37
Rate for Payer: UnitedHealthcare Commercial	$172.49
Rate for Payer: UnitedHealthcare Community & State	$20.79
Rate for Payer: Wellpoint Medicaid Managed Care	$22.85

SEAMGUARD GIA 60 ASG003

Facility

$1,078.80

Hospital Charge Code	270623269
Hospital Revenue Code	278
Min. Negotiated Rate	$26.00
Max. Negotiated Rate	$539.40
Rate for Payer: Aetna Commercial	$409.94
Rate for Payer: Aetna Medicare Advantage	$323.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.09
Rate for Payer: Cigna Commercial	$539.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$237.34
Rate for Payer: Qualcare PPO/HMO/WC	$161.82
Rate for Payer: UnitedHealthcare Community & State	$26.00
Rate for Payer: Wellpoint Medicaid Managed Care	$28.59

SEAMGUARD GORTEX

Facility

$1,073.65

Hospital Charge Code	270605794
Hospital Revenue Code	278
Min. Negotiated Rate	$25.87
Max. Negotiated Rate	$536.83
Rate for Payer: Aetna Commercial	$407.99
Rate for Payer: Aetna Medicare Advantage	$322.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$273.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$273.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$273.78
Rate for Payer: Cigna Commercial	$536.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.20
Rate for Payer: Qualcare PPO/HMO/WC	$161.05
Rate for Payer: UnitedHealthcare Community & State	$25.87
Rate for Payer: Wellpoint Medicaid Managed Care	$28.45

SEAMGUARD GORTEX

Facility

$1,073.65

Hospital Charge Code	270605794
Hospital Revenue Code	278
Min. Negotiated Rate	$161.05
Max. Negotiated Rate	$259.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.20
Rate for Payer: Qualcare PPO/HMO/WC	$161.05

SEAMGUARD STAPLE LINE 6.5

Facility

$1,450.00

Hospital Charge Code	270658079
Hospital Revenue Code	278
Min. Negotiated Rate	$34.95
Max. Negotiated Rate	$725.00
Rate for Payer: Aetna Commercial	$551.00
Rate for Payer: Aetna Medicare Advantage	$435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$369.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$369.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$369.75
Rate for Payer: Cigna Commercial	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$319.00
Rate for Payer: Qualcare PPO/HMO/WC	$217.50
Rate for Payer: UnitedHealthcare Community & State	$34.95
Rate for Payer: Wellpoint Medicaid Managed Care	$38.42

SEAMGUARD STAPLE LINE 6.5

Facility

$1,450.00

Hospital Charge Code	270658079
Hospital Revenue Code	278
Min. Negotiated Rate	$217.50
Max. Negotiated Rate	$350.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$319.00
Rate for Payer: Qualcare PPO/HMO/WC	$217.50

SEATH DRYSEAL 18FR

Facility

$1,475.00

Hospital Charge Code	270644341
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SEATH DRYSEAL 18FR

Facility

$1,475.00

Hospital Charge Code	270644341
Hospital Revenue Code	278
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

SEATH PINNACLE R/O II INTROD

Facility

$29.70

Hospital Charge Code	270658239
Hospital Revenue Code	278
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$7.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6.53
Rate for Payer: Qualcare PPO/HMO/WC	$4.46

SEATH PINNACLE R/O II INTROD

Facility

$29.70

Hospital Charge Code	270658239
Hospital Revenue Code	278
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$14.85
Rate for Payer: Aetna Commercial	$11.29
Rate for Payer: Aetna Medicare Advantage	$8.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.57
Rate for Payer: Cigna Commercial	$14.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6.53
Rate for Payer: Qualcare PPO/HMO/WC	$4.46
Rate for Payer: UnitedHealthcare Community & State	$0.72
Rate for Payer: Wellpoint Medicaid Managed Care	$0.79

SEATH PINNACLE R/O II INTRODUC

Facility

$31.90

Service Code	HCPCS C1766
Hospital Charge Code	270654359S
Hospital Revenue Code	278
Min. Negotiated Rate	$4.79
Max. Negotiated Rate	$7.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7.02
Rate for Payer: Qualcare PPO/HMO/WC	$4.79

SEATH PINNACLE R/O II INTRODUC

Facility

$31.90

Service Code	HCPCS C1766
Hospital Charge Code	270654359
Hospital Revenue Code	278
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$15.95
Rate for Payer: Aetna Commercial	$12.12
Rate for Payer: Aetna Medicare Advantage	$9.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.13
Rate for Payer: Cigna Commercial	$15.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7.02
Rate for Payer: Qualcare PPO/HMO/WC	$4.79
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

SEATH PINNACLE R/O II INTRODUC

Facility

$31.90

Service Code	HCPCS C1766
Hospital Charge Code	270654359N
Hospital Revenue Code	278
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$15.95
Rate for Payer: Aetna Commercial	$12.12
Rate for Payer: Aetna Medicare Advantage	$9.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.13
Rate for Payer: Cigna Commercial	$15.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7.02
Rate for Payer: Qualcare PPO/HMO/WC	$4.79
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

SEATH PINNACLE R/O II INTRODUC

Facility

$31.90

Service Code	HCPCS C1766
Hospital Charge Code	270654359S
Hospital Revenue Code	278
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$15.95
Rate for Payer: Aetna Commercial	$12.12
Rate for Payer: Aetna Medicare Advantage	$9.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.13
Rate for Payer: Cigna Commercial	$15.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7.02
Rate for Payer: Qualcare PPO/HMO/WC	$4.79
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

SEATH PINNACLE R/O II INTRODUC

Facility

$31.90

Service Code	HCPCS C1766
Hospital Charge Code	270654359N
Hospital Revenue Code	278
Min. Negotiated Rate	$4.79
Max. Negotiated Rate	$7.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7.02
Rate for Payer: Qualcare PPO/HMO/WC	$4.79

SEATH PINNACLE R/O II INTRODUC

Facility

$31.90

Service Code	HCPCS C1766
Hospital Charge Code	270654359
Hospital Revenue Code	278
Min. Negotiated Rate	$4.79
Max. Negotiated Rate	$7.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7.02
Rate for Payer: Qualcare PPO/HMO/WC	$4.79

Know your out-of-pocket cost for care.

All Charges