Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SHEATH ANSEL 7FR 45CM

Facility

$375.00

Service Code	HCPCS C1894
Hospital Charge Code	270677225N
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

SHEATH ANSEL HI FLX 6FR 55CM

Facility

$320.00

Service Code	HCPCS C1894
Hospital Charge Code	270675906S
Hospital Revenue Code	278
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$77.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$70.40
Rate for Payer: Qualcare PPO/HMO/WC	$48.00

SHEATH ANSEL HI FLX 6FR 55CM

Facility

$320.00

Service Code	HCPCS C1894
Hospital Charge Code	270675906
Hospital Revenue Code	278
Min. Negotiated Rate	$7.71
Max. Negotiated Rate	$160.00
Rate for Payer: Aetna Commercial	$121.60
Rate for Payer: Aetna Medicare Advantage	$96.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.60
Rate for Payer: Cigna Commercial	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$70.40
Rate for Payer: Qualcare PPO/HMO/WC	$48.00
Rate for Payer: UnitedHealthcare Community & State	$7.71
Rate for Payer: Wellpoint Medicaid Managed Care	$8.48

SHEATH ANSEL HI FLX 6FR 55CM

Facility

$320.00

Service Code	HCPCS C1894
Hospital Charge Code	270675906
Hospital Revenue Code	278
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$77.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$70.40
Rate for Payer: Qualcare PPO/HMO/WC	$48.00

SHEATH ANSEL HI FLX 6FR 55CM

Facility

$320.00

Service Code	HCPCS C1894
Hospital Charge Code	270675906S
Hospital Revenue Code	278
Min. Negotiated Rate	$7.71
Max. Negotiated Rate	$160.00
Rate for Payer: Aetna Commercial	$121.60
Rate for Payer: Aetna Medicare Advantage	$96.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.60
Rate for Payer: Cigna Commercial	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$70.40
Rate for Payer: Qualcare PPO/HMO/WC	$48.00
Rate for Payer: UnitedHealthcare Community & State	$7.71
Rate for Payer: Wellpoint Medicaid Managed Care	$8.48

SHEATH ANSEL HI FLX 7FR 55CM

Facility

$320.00

Service Code	HCPCS C1894
Hospital Charge Code	270675907
Hospital Revenue Code	278
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$77.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$70.40
Rate for Payer: Qualcare PPO/HMO/WC	$48.00

SHEATH ANSEL HI FLX 7FR 55CM

Facility

$320.00

Service Code	HCPCS C1894
Hospital Charge Code	270675907
Hospital Revenue Code	278
Min. Negotiated Rate	$7.71
Max. Negotiated Rate	$160.00
Rate for Payer: Aetna Commercial	$121.60
Rate for Payer: Aetna Medicare Advantage	$96.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.60
Rate for Payer: Cigna Commercial	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$70.40
Rate for Payer: Qualcare PPO/HMO/WC	$48.00
Rate for Payer: UnitedHealthcare Community & State	$7.71
Rate for Payer: Wellpoint Medicaid Managed Care	$8.48

SHEATH ANSEL HI FLX 7FR 55CM

Facility

$320.00

Service Code	HCPCS C1894
Hospital Charge Code	270675907S
Hospital Revenue Code	278
Min. Negotiated Rate	$7.71
Max. Negotiated Rate	$160.00
Rate for Payer: Aetna Commercial	$121.60
Rate for Payer: Aetna Medicare Advantage	$96.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.60
Rate for Payer: Cigna Commercial	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$70.40
Rate for Payer: Qualcare PPO/HMO/WC	$48.00
Rate for Payer: UnitedHealthcare Community & State	$7.71
Rate for Payer: Wellpoint Medicaid Managed Care	$8.48

SHEATH ANSEL HI FLX 7FR 55CM

Facility

$320.00

Service Code	HCPCS C1894
Hospital Charge Code	270675907S
Hospital Revenue Code	278
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$77.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$70.40
Rate for Payer: Qualcare PPO/HMO/WC	$48.00

SHEATH ANSEL HI FLX 7FR 70CM

Facility

$370.00

Service Code	HCPCS C1894
Hospital Charge Code	270675908S
Hospital Revenue Code	278
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$89.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$81.40
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

SHEATH ANSEL HI FLX 7FR 70CM

Facility

$370.00

Service Code	HCPCS C1894
Hospital Charge Code	270675908
Hospital Revenue Code	278
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$89.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$81.40
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

SHEATH ANSEL HI FLX 7FR 70CM

Facility

$370.00

Service Code	HCPCS C1894
Hospital Charge Code	270675908S
Hospital Revenue Code	278
Min. Negotiated Rate	$8.92
Max. Negotiated Rate	$185.00
Rate for Payer: Aetna Commercial	$140.60
Rate for Payer: Aetna Medicare Advantage	$111.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.35
Rate for Payer: Cigna Commercial	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$81.40
Rate for Payer: Qualcare PPO/HMO/WC	$55.50
Rate for Payer: UnitedHealthcare Community & State	$8.92
Rate for Payer: Wellpoint Medicaid Managed Care	$9.80

SHEATH ANSEL HI FLX 7FR 70CM

Facility

$370.00

Service Code	HCPCS C1894
Hospital Charge Code	270675908
Hospital Revenue Code	278
Min. Negotiated Rate	$8.92
Max. Negotiated Rate	$185.00
Rate for Payer: Aetna Commercial	$140.60
Rate for Payer: Aetna Medicare Advantage	$111.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.35
Rate for Payer: Cigna Commercial	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$81.40
Rate for Payer: Qualcare PPO/HMO/WC	$55.50
Rate for Payer: UnitedHealthcare Community & State	$8.92
Rate for Payer: Wellpoint Medicaid Managed Care	$9.80

SHEATH BALKIN GUIDING 6.0

Facility

$251.50

Hospital Charge Code	2709003237
Hospital Revenue Code	272
Min. Negotiated Rate	$37.73
Max. Negotiated Rate	$37.73
Rate for Payer: Qualcare PPO/HMO/WC	$37.73

SHEATH BALKIN GUIDING 6.0

Facility

$251.50

Hospital Charge Code	2709003237
Hospital Revenue Code	272
Min. Negotiated Rate	$6.06
Max. Negotiated Rate	$125.75
Rate for Payer: Aetna Commercial	$95.57
Rate for Payer: Aetna Medicare Advantage	$75.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.13
Rate for Payer: Cigna Commercial	$125.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.45
Rate for Payer: Oxford Commercial	$50.30
Rate for Payer: Qualcare PPO/HMO/WC	$37.73
Rate for Payer: UnitedHealthcare Commercial	$50.30
Rate for Payer: UnitedHealthcare Community & State	$6.06
Rate for Payer: Wellpoint Medicaid Managed Care	$6.66

SHEATH BALKIN GUIDING 7.0

Facility

$251.50

Hospital Charge Code	2709003236
Hospital Revenue Code	272
Min. Negotiated Rate	$6.06
Max. Negotiated Rate	$125.75
Rate for Payer: Aetna Commercial	$95.57
Rate for Payer: Aetna Medicare Advantage	$75.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.13
Rate for Payer: Cigna Commercial	$125.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.45
Rate for Payer: Oxford Commercial	$50.30
Rate for Payer: Qualcare PPO/HMO/WC	$37.73
Rate for Payer: UnitedHealthcare Commercial	$50.30
Rate for Payer: UnitedHealthcare Community & State	$6.06
Rate for Payer: Wellpoint Medicaid Managed Care	$6.66

SHEATH BALKIN GUIDING 7.0

Facility

$251.50

Hospital Charge Code	2709003236
Hospital Revenue Code	272
Min. Negotiated Rate	$37.73
Max. Negotiated Rate	$37.73
Rate for Payer: Qualcare PPO/HMO/WC	$37.73

SHEATH BIO IFIX TIBL 30 254621

Facility

$925.00

Hospital Charge Code	270635266
Hospital Revenue Code	272
Min. Negotiated Rate	$22.29
Max. Negotiated Rate	$462.50
Rate for Payer: Aetna Commercial	$351.50
Rate for Payer: Aetna Medicare Advantage	$277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.50
Rate for Payer: Oxford Commercial	$185.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.75
Rate for Payer: UnitedHealthcare Commercial	$185.00
Rate for Payer: UnitedHealthcare Community & State	$22.29
Rate for Payer: Wellpoint Medicaid Managed Care	$24.51

SHEATH BIO IFIX TIBL 30 254621

Facility

$925.00

Hospital Charge Code	270635266
Hospital Revenue Code	272
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$138.75
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

SHEATH BIO INTRAFIX

Facility

$1,140.00

Hospital Charge Code	270640008
Hospital Revenue Code	272
Min. Negotiated Rate	$27.47
Max. Negotiated Rate	$570.00
Rate for Payer: Aetna Commercial	$433.20
Rate for Payer: Aetna Medicare Advantage	$342.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.70
Rate for Payer: Cigna Commercial	$570.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$342.00
Rate for Payer: Oxford Commercial	$228.00
Rate for Payer: Qualcare PPO/HMO/WC	$171.00
Rate for Payer: UnitedHealthcare Commercial	$228.00
Rate for Payer: UnitedHealthcare Community & State	$27.47
Rate for Payer: Wellpoint Medicaid Managed Care	$30.21

SHEATH BIO INTRAFIX

Facility

$1,140.00

Hospital Charge Code	270640008
Hospital Revenue Code	272
Min. Negotiated Rate	$171.00
Max. Negotiated Rate	$171.00
Rate for Payer: Qualcare PPO/HMO/WC	$171.00

SHEATH BIO INTRAFIX LG 254628

Facility

$1,220.00

Hospital Charge Code	270642094
Hospital Revenue Code	272
Min. Negotiated Rate	$29.40
Max. Negotiated Rate	$610.00
Rate for Payer: Aetna Commercial	$463.60
Rate for Payer: Aetna Medicare Advantage	$366.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.10
Rate for Payer: Cigna Commercial	$610.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$366.00
Rate for Payer: Oxford Commercial	$244.00
Rate for Payer: Qualcare PPO/HMO/WC	$183.00
Rate for Payer: UnitedHealthcare Commercial	$244.00
Rate for Payer: UnitedHealthcare Community & State	$29.40
Rate for Payer: Wellpoint Medicaid Managed Care	$32.33

SHEATH BIO INTRAFIX LG 254628

Facility

$1,220.00

Hospital Charge Code	270642094
Hospital Revenue Code	272
Min. Negotiated Rate	$183.00
Max. Negotiated Rate	$183.00
Rate for Payer: Qualcare PPO/HMO/WC	$183.00

SHEATH BRITE TIP 5F 55 40155M

Facility

$114.15

Hospital Charge Code	270633607
Hospital Revenue Code	272
Min. Negotiated Rate	$17.12
Max. Negotiated Rate	$17.12
Rate for Payer: Qualcare PPO/HMO/WC	$17.12

SHEATH BRITE TIP 5F 55 40155M

Facility

$114.15

Hospital Charge Code	270633607
Hospital Revenue Code	272
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$57.08
Rate for Payer: Aetna Commercial	$43.38
Rate for Payer: Aetna Medicare Advantage	$34.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.11
Rate for Payer: Cigna Commercial	$57.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.24
Rate for Payer: Oxford Commercial	$22.83
Rate for Payer: Qualcare PPO/HMO/WC	$17.12
Rate for Payer: UnitedHealthcare Commercial	$22.83
Rate for Payer: UnitedHealthcare Community & State	$2.75
Rate for Payer: Wellpoint Medicaid Managed Care	$3.02

Know your out-of-pocket cost for care.

All Charges