Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SHEATH GUIDING PINNACLE 7FR

Facility

$637.50

Service Code	HCPCS C1894
Hospital Charge Code	270676233
Hospital Revenue Code	278
Min. Negotiated Rate	$15.36
Max. Negotiated Rate	$318.75
Rate for Payer: Aetna Commercial	$242.25
Rate for Payer: Aetna Medicare Advantage	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$162.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$162.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$162.56
Rate for Payer: Cigna Commercial	$318.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$140.25
Rate for Payer: Qualcare PPO/HMO/WC	$95.62
Rate for Payer: UnitedHealthcare Community & State	$15.36
Rate for Payer: Wellpoint Medicaid Managed Care	$16.89

SHEATH GUIDING PINNACLE 7FR

Facility

$550.00

Service Code	HCPCS C1894
Hospital Charge Code	270676233N
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

SHEATH GUIDING PINNACLE 7FR

Facility

$550.00

Hospital Charge Code	676233
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

SHEATH GUIDING PINNACLE 7FR

Facility

$550.00

Hospital Charge Code	676233
Hospital Revenue Code	278
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

SHEATHGUIDPIN6FR45X35X2 CROSS

Facility

$450.00

Hospital Charge Code	2709006533
Hospital Revenue Code	272
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.00
Rate for Payer: Oxford Commercial	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Commercial	$90.00
Rate for Payer: UnitedHealthcare Community & State	$10.85
Rate for Payer: Wellpoint Medicaid Managed Care	$11.93

SHEATHGUIDPIN6FR45X35X2 CROSS

Facility

$450.00

Hospital Charge Code	2709006533
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

SHEATHGUIDPIN6FR65X35X2.5 CROS

Facility

$500.00

Hospital Charge Code	2709006534
Hospital Revenue Code	272
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

SHEATHGUIDPIN6FR65X35X2.5 CROS

Facility

$500.00

Hospital Charge Code	2709006534
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SHEATHGUIDPIN6FR90X15X5 CROSS

Facility

$550.00

Hospital Charge Code	2709006535
Hospital Revenue Code	272
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.00
Rate for Payer: Oxford Commercial	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$110.00
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

SHEATHGUIDPIN6FR90X15X5 CROSS

Facility

$550.00

Hospital Charge Code	2709006535
Hospital Revenue Code	272
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

SHEATHGUIDPIN7FR45X35X2 CROSS

Facility

$450.00

Hospital Charge Code	2709006536
Hospital Revenue Code	272
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.00
Rate for Payer: Oxford Commercial	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Commercial	$90.00
Rate for Payer: UnitedHealthcare Community & State	$10.85
Rate for Payer: Wellpoint Medicaid Managed Care	$11.93

SHEATHGUIDPIN7FR45X35X2 CROSS

Facility

$450.00

Hospital Charge Code	2709006536
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

SHEATHGUIDPIN7FR65X35X2.5 CROS

Facility

$500.00

Hospital Charge Code	2709006537
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SHEATHGUIDPIN7FR65X35X2.5 CROS

Facility

$500.00

Hospital Charge Code	2709006537
Hospital Revenue Code	272
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

SHEATHGUIDPIN7FR90X15X5 CROSS

Facility

$550.00

Hospital Charge Code	2709006538
Hospital Revenue Code	272
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

SHEATHGUIDPIN7FR90X15X5 CROSS

Facility

$550.00

Hospital Charge Code	2709006538
Hospital Revenue Code	272
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.00
Rate for Payer: Oxford Commercial	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$110.00
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

SHEATH GUID PINN 7 F 45X35X2

Facility

$522.50

Service Code	HCPCS C1766
Hospital Charge Code	270658257S
Hospital Revenue Code	278
Min. Negotiated Rate	$12.59
Max. Negotiated Rate	$261.25
Rate for Payer: Aetna Commercial	$198.55
Rate for Payer: Aetna Medicare Advantage	$156.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.24
Rate for Payer: Cigna Commercial	$261.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$78.38
Rate for Payer: UnitedHealthcare Community & State	$12.59
Rate for Payer: Wellpoint Medicaid Managed Care	$13.85

SHEATH GUID PINN 7 F 45X35X2

Facility

$522.50

Service Code	HCPCS C1766
Hospital Charge Code	270658257
Hospital Revenue Code	278
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$126.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

SHEATH GUID PINN 7 F 45X35X2

Facility

$522.50

Service Code	HCPCS C1766
Hospital Charge Code	270658257
Hospital Revenue Code	278
Min. Negotiated Rate	$12.59
Max. Negotiated Rate	$261.25
Rate for Payer: Aetna Commercial	$198.55
Rate for Payer: Aetna Medicare Advantage	$156.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.24
Rate for Payer: Cigna Commercial	$261.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$78.38
Rate for Payer: UnitedHealthcare Community & State	$12.59
Rate for Payer: Wellpoint Medicaid Managed Care	$13.85

SHEATH GUID PINN 7 F 45X35X2

Facility

$522.50

Service Code	HCPCS C1766
Hospital Charge Code	270658257S
Hospital Revenue Code	278
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$126.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

SHEATH GUID PINN 7 F 45X35X2

Facility

$450.00

Service Code	HCPCS C1766
Hospital Charge Code	270658257N
Hospital Revenue Code	278
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Community & State	$10.85
Rate for Payer: Wellpoint Medicaid Managed Care	$11.93

SHEATH GUID PINN 7 F 45X35X2

Facility

$450.00

Service Code	HCPCS C1766
Hospital Charge Code	270658257N
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$108.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

SHEATH GUID PINNAC 6 FR RSC05

Facility

$550.00

Service Code	HCPCS C1766
Hospital Charge Code	270658261N
Hospital Revenue Code	278
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

SHEATH GUID PINNAC 6 FR RSC05

Facility

$792.50

Hospital Charge Code	270658261
Hospital Revenue Code	278
Min. Negotiated Rate	$19.10
Max. Negotiated Rate	$396.25
Rate for Payer: Aetna Commercial	$301.15
Rate for Payer: Aetna Medicare Advantage	$237.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$202.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$202.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$202.09
Rate for Payer: Cigna Commercial	$396.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$174.35
Rate for Payer: Qualcare PPO/HMO/WC	$118.88
Rate for Payer: UnitedHealthcare Community & State	$19.10
Rate for Payer: Wellpoint Medicaid Managed Care	$21.00

SHEATH GUID PINNAC 6 FR RSC05

Facility

$792.50

Hospital Charge Code	270658261
Hospital Revenue Code	278
Min. Negotiated Rate	$118.88
Max. Negotiated Rate	$191.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$174.35
Rate for Payer: Qualcare PPO/HMO/WC	$118.88

Know your out-of-pocket cost for care.

All Charges