Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SHEATH GUID PINNAC 6 FR RSC05

Facility

$550.00

Service Code	HCPCS C1766
Hospital Charge Code	270658261N
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 GUID PINNAC 6 FR RSC05

Facility

$637.50

Service Code	HCPCS C1766
Hospital Charge Code	270658261S
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 GUID PINNAC 6 FR RSC05

Facility

$637.50

Service Code	HCPCS C1766
Hospital Charge Code	270658261S
Hospital Revenue Code	278
Min. Negotiated Rate	$95.62
Max. Negotiated Rate	$154.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$127.50
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

SHEATH GUID PISHNN6 FR 45X35X2

Facility

$522.50

Hospital Charge Code	270658263
Hospital Revenue Code	272
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) PPO	$133.24
Rate for Payer: Cigna Commercial	$261.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.75
Rate for Payer: Oxford Commercial	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.38
Rate for Payer: UnitedHealthcare Commercial	$104.50
Rate for Payer: UnitedHealthcare Community & State	$12.59
Rate for Payer: Wellpoint Medicaid Managed Care	$13.85

SHEATH GUID PISHNN6 FR 45X35X2

Facility

$522.50

Hospital Charge Code	270658263S
Hospital Revenue Code	272
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) PPO	$133.24
Rate for Payer: Cigna Commercial	$261.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.75
Rate for Payer: Oxford Commercial	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.38
Rate for Payer: UnitedHealthcare Commercial	$104.50
Rate for Payer: UnitedHealthcare Community & State	$12.59
Rate for Payer: Wellpoint Medicaid Managed Care	$13.85

SHEATH GUID PISHNN6 FR 45X35X2

Facility

$522.50

Hospital Charge Code	270658263
Hospital Revenue Code	272
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$78.38
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

SHEATH GUID PISHNN6 FR 45X35X2

Facility

$522.50

Hospital Charge Code	270658263S
Hospital Revenue Code	272
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$78.38
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

SHEATH GUID PISHNN6 FR 45X35X2

Facility

$450.00

Hospital Charge Code	270658263N
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

SHEATH GUID PISHNN6 FR 45X35X2

Facility

$450.00

Hospital Charge Code	270658263N
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

SHEATH HEMOSTATIC 9FR BLK

Facility

$58.50

Hospital Charge Code	270672004
Hospital Revenue Code	272
Min. Negotiated Rate	$1.41
Max. Negotiated Rate	$29.25
Rate for Payer: Aetna Commercial	$22.23
Rate for Payer: Aetna Medicare Advantage	$17.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.92
Rate for Payer: Cigna Commercial	$29.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.55
Rate for Payer: Oxford Commercial	$11.70
Rate for Payer: Qualcare PPO/HMO/WC	$8.78
Rate for Payer: UnitedHealthcare Commercial	$11.70
Rate for Payer: UnitedHealthcare Community & State	$1.41
Rate for Payer: Wellpoint Medicaid Managed Care	$1.55

SHEATH HEMOSTATIC 9FR BLK

Facility

$58.50

Hospital Charge Code	270672004
Hospital Revenue Code	272
Min. Negotiated Rate	$8.78
Max. Negotiated Rate	$8.78
Rate for Payer: Qualcare PPO/HMO/WC	$8.78

SHEATH INTRODC 6F 11CM 504606X

Facility

$238.75

Service Code	HCPCS C2629
Hospital Charge Code	270600706
Hospital Revenue Code	279
Min. Negotiated Rate	$5.75
Max. Negotiated Rate	$119.38
Rate for Payer: Aetna Commercial	$90.72
Rate for Payer: Aetna Medicare Advantage	$71.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.88
Rate for Payer: Cigna Commercial	$119.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.62
Rate for Payer: Oxford Commercial	$47.75
Rate for Payer: Qualcare PPO/HMO/WC	$35.81
Rate for Payer: UnitedHealthcare Commercial	$47.75
Rate for Payer: UnitedHealthcare Community & State	$5.75
Rate for Payer: Wellpoint Medicaid Managed Care	$6.33

SHEATH INTRODC 6F 11CM 504606X

Facility

$238.75

Service Code	HCPCS C2629
Hospital Charge Code	270600706
Hospital Revenue Code	279
Min. Negotiated Rate	$35.81
Max. Negotiated Rate	$35.81
Rate for Payer: Qualcare PPO/HMO/WC	$35.81

SHEATH INTRODC PACR 9F 6209-SI

Facility

$609.65

Hospital Charge Code	270607571
Hospital Revenue Code	278
Min. Negotiated Rate	$14.69
Max. Negotiated Rate	$304.82
Rate for Payer: Aetna Commercial	$231.67
Rate for Payer: Aetna Medicare Advantage	$182.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.46
Rate for Payer: Cigna Commercial	$304.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.12
Rate for Payer: Qualcare PPO/HMO/WC	$91.45
Rate for Payer: UnitedHealthcare Community & State	$14.69
Rate for Payer: Wellpoint Medicaid Managed Care	$16.16

SHEATH INTRODC PACR 9F 6209-SI

Facility

$609.65

Hospital Charge Code	270607571
Hospital Revenue Code	278
Min. Negotiated Rate	$91.45
Max. Negotiated Rate	$147.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.12
Rate for Payer: Qualcare PPO/HMO/WC	$91.45

SHEATH INTROD PIN 5X10 RSB502

Facility

$159.50

Service Code	HCPCS C1766
Hospital Charge Code	270654367
Hospital Revenue Code	278
Min. Negotiated Rate	$23.93
Max. Negotiated Rate	$38.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$35.09
Rate for Payer: Qualcare PPO/HMO/WC	$23.93

SHEATH INTROD PIN 5X10 RSB502

Facility

$159.50

Service Code	HCPCS C1766
Hospital Charge Code	270654367S
Hospital Revenue Code	278
Min. Negotiated Rate	$23.93
Max. Negotiated Rate	$38.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$35.09
Rate for Payer: Qualcare PPO/HMO/WC	$23.93

SHEATH INTROD PIN 5X10 RSB502

Facility

$159.50

Service Code	HCPCS C1766
Hospital Charge Code	270654367S
Hospital Revenue Code	278
Min. Negotiated Rate	$3.84
Max. Negotiated Rate	$79.75
Rate for Payer: Aetna Commercial	$60.61
Rate for Payer: Aetna Medicare Advantage	$47.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.67
Rate for Payer: Cigna Commercial	$79.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$35.09
Rate for Payer: Qualcare PPO/HMO/WC	$23.93
Rate for Payer: UnitedHealthcare Community & State	$3.84
Rate for Payer: Wellpoint Medicaid Managed Care	$4.23

SHEATH INTROD PIN 5X10 RSB502

Facility

$159.50

Service Code	HCPCS C1766
Hospital Charge Code	270654367N
Hospital Revenue Code	278
Min. Negotiated Rate	$23.93
Max. Negotiated Rate	$38.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$35.09
Rate for Payer: Qualcare PPO/HMO/WC	$23.93

SHEATH INTROD PIN 5X10 RSB502

Facility

$159.50

Service Code	HCPCS C1766
Hospital Charge Code	270654367
Hospital Revenue Code	278
Min. Negotiated Rate	$3.84
Max. Negotiated Rate	$79.75
Rate for Payer: Aetna Commercial	$60.61
Rate for Payer: Aetna Medicare Advantage	$47.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.67
Rate for Payer: Cigna Commercial	$79.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$35.09
Rate for Payer: Qualcare PPO/HMO/WC	$23.93
Rate for Payer: UnitedHealthcare Community & State	$3.84
Rate for Payer: Wellpoint Medicaid Managed Care	$4.23

SHEATH INTROD PIN 5X10 RSB502

Facility

$159.50

Service Code	HCPCS C1766
Hospital Charge Code	270654367N
Hospital Revenue Code	278
Min. Negotiated Rate	$3.84
Max. Negotiated Rate	$79.75
Rate for Payer: Aetna Commercial	$60.61
Rate for Payer: Aetna Medicare Advantage	$47.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.67
Rate for Payer: Cigna Commercial	$79.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$35.09
Rate for Payer: Qualcare PPO/HMO/WC	$23.93
Rate for Payer: UnitedHealthcare Community & State	$3.84
Rate for Payer: Wellpoint Medicaid Managed Care	$4.23

SHEATH INTROD PINA 6X25 RSB603

Facility

$166.00

Service Code	HCPCS C1766
Hospital Charge Code	270658253
Hospital Revenue Code	278
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$83.00
Rate for Payer: Aetna Commercial	$63.08
Rate for Payer: Aetna Medicare Advantage	$49.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.33
Rate for Payer: Cigna Commercial	$83.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$36.52
Rate for Payer: Qualcare PPO/HMO/WC	$24.90
Rate for Payer: UnitedHealthcare Community & State	$4.00
Rate for Payer: Wellpoint Medicaid Managed Care	$4.40

SHEATH INTROD PINA 6X25 RSB603

Facility

$166.00

Service Code	HCPCS C1766
Hospital Charge Code	270658253S
Hospital Revenue Code	278
Min. Negotiated Rate	$24.90
Max. Negotiated Rate	$40.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$36.52
Rate for Payer: Qualcare PPO/HMO/WC	$24.90

SHEATH INTROD PINA 6X25 RSB603

Facility

$166.00

Service Code	HCPCS C1766
Hospital Charge Code	270658253
Hospital Revenue Code	278
Min. Negotiated Rate	$24.90
Max. Negotiated Rate	$40.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$36.52
Rate for Payer: Qualcare PPO/HMO/WC	$24.90

SHEATH INTROD PINA 6X25 RSB603

Facility

$166.00

Service Code	HCPCS C1766
Hospital Charge Code	270658253S
Hospital Revenue Code	278
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$83.00
Rate for Payer: Aetna Commercial	$63.08
Rate for Payer: Aetna Medicare Advantage	$49.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.33
Rate for Payer: Cigna Commercial	$83.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$36.52
Rate for Payer: Qualcare PPO/HMO/WC	$24.90
Rate for Payer: UnitedHealthcare Community & State	$4.00
Rate for Payer: Wellpoint Medicaid Managed Care	$4.40

Know your out-of-pocket cost for care.

All Charges