Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SHEATH INTROD PINA 6X25 RSB603

Facility

$195.50

Service Code	HCPCS C1766
Hospital Charge Code	270658253N
Hospital Revenue Code	278
Min. Negotiated Rate	$29.32
Max. Negotiated Rate	$47.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$43.01
Rate for Payer: Qualcare PPO/HMO/WC	$29.32

SHEATH INTROD PINA 6X25 RSB603

Facility

$195.50

Service Code	HCPCS C1766
Hospital Charge Code	270658253N
Hospital Revenue Code	278
Min. Negotiated Rate	$4.71
Max. Negotiated Rate	$97.75
Rate for Payer: Aetna Commercial	$74.29
Rate for Payer: Aetna Medicare Advantage	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.85
Rate for Payer: Cigna Commercial	$97.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$43.01
Rate for Payer: Qualcare PPO/HMO/WC	$29.32
Rate for Payer: UnitedHealthcare Community & State	$4.71
Rate for Payer: Wellpoint Medicaid Managed Care	$5.18

SHEATH INTRODUCER 4 FR 10CM

Facility

$51.73

Service Code	HCPCS C1894
Hospital Charge Code	270652526
Hospital Revenue Code	278
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$12.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.38
Rate for Payer: Qualcare PPO/HMO/WC	$7.76

SHEATH INTRODUCER 4 FR 10CM

Facility

$51.73

Service Code	HCPCS C1894
Hospital Charge Code	270652526
Hospital Revenue Code	278
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$25.86
Rate for Payer: Aetna Commercial	$19.66
Rate for Payer: Aetna Medicare Advantage	$15.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.19
Rate for Payer: Cigna Commercial	$25.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.38
Rate for Payer: Qualcare PPO/HMO/WC	$7.76
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.37

SHEATH INTRODUCER 5FR .018

Facility

$154.50

Service Code	HCPCS C1894
Hospital Charge Code	270650595
Hospital Revenue Code	278
Min. Negotiated Rate	$23.18
Max. Negotiated Rate	$37.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.99
Rate for Payer: Qualcare PPO/HMO/WC	$23.18

SHEATH INTRODUCER 5FR .018

Facility

$154.50

Service Code	HCPCS C1894
Hospital Charge Code	270650595
Hospital Revenue Code	278
Min. Negotiated Rate	$3.72
Max. Negotiated Rate	$77.25
Rate for Payer: Aetna Commercial	$58.71
Rate for Payer: Aetna Medicare Advantage	$46.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.40
Rate for Payer: Cigna Commercial	$77.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.99
Rate for Payer: Qualcare PPO/HMO/WC	$23.18
Rate for Payer: UnitedHealthcare Community & State	$3.72
Rate for Payer: Wellpoint Medicaid Managed Care	$4.09

SHEATH INTRODUCER 6FR .018

Facility

$154.50

Service Code	HCPCS C1894
Hospital Charge Code	270669990
Hospital Revenue Code	278
Min. Negotiated Rate	$3.72
Max. Negotiated Rate	$77.25
Rate for Payer: Aetna Commercial	$58.71
Rate for Payer: Aetna Medicare Advantage	$46.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.40
Rate for Payer: Cigna Commercial	$77.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.99
Rate for Payer: Qualcare PPO/HMO/WC	$23.18
Rate for Payer: UnitedHealthcare Community & State	$3.72
Rate for Payer: Wellpoint Medicaid Managed Care	$4.09

SHEATH INTRODUCER 6FR .018

Facility

$154.50

Service Code	HCPCS C1894
Hospital Charge Code	270669990
Hospital Revenue Code	278
Min. Negotiated Rate	$23.18
Max. Negotiated Rate	$37.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.99
Rate for Payer: Qualcare PPO/HMO/WC	$23.18

SHEATH INTRODUCER 7FR 10CM.035

Facility

$700.00

Hospital Charge Code	270689906
Hospital Revenue Code	272
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SHEATH INTRODUCER 7FR 10CM.035

Facility

$700.00

Hospital Charge Code	270689906
Hospital Revenue Code	272
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Commercial	$140.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

SHEATH INTRODUCER 8FR

Facility

$215.30

Hospital Charge Code	270658584
Hospital Revenue Code	270
Min. Negotiated Rate	$32.30
Max. Negotiated Rate	$32.30
Rate for Payer: Qualcare PPO/HMO/WC	$32.30

SHEATH INTRODUCER 8FR

Facility

$215.30

Hospital Charge Code	270658584
Hospital Revenue Code	270
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$107.65
Rate for Payer: Aetna Commercial	$81.81
Rate for Payer: Aetna Medicare Advantage	$64.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.90
Rate for Payer: Cigna Commercial	$107.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.59
Rate for Payer: Oxford Commercial	$43.06
Rate for Payer: Qualcare PPO/HMO/WC	$32.30
Rate for Payer: UnitedHealthcare Commercial	$43.06
Rate for Payer: UnitedHealthcare Community & State	$5.19
Rate for Payer: Wellpoint Medicaid Managed Care	$5.71

SHEATH INTRODUCER PINNACLE

Facility

$54.35

Hospital Charge Code	270672897
Hospital Revenue Code	272
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$27.18
Rate for Payer: Aetna Commercial	$20.65
Rate for Payer: Aetna Medicare Advantage	$16.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.86
Rate for Payer: Cigna Commercial	$27.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.30
Rate for Payer: Oxford Commercial	$10.87
Rate for Payer: Qualcare PPO/HMO/WC	$8.15
Rate for Payer: UnitedHealthcare Commercial	$10.87
Rate for Payer: UnitedHealthcare Community & State	$1.31
Rate for Payer: Wellpoint Medicaid Managed Care	$1.44

SHEATH INTRODUCER PINNACLE

Facility

$54.35

Hospital Charge Code	270672897
Hospital Revenue Code	272
Min. Negotiated Rate	$8.15
Max. Negotiated Rate	$8.15
Rate for Payer: Qualcare PPO/HMO/WC	$8.15

SHEATH INTRODUCER PINNACLE

Facility

$101.75

Hospital Charge Code	270672897N
Hospital Revenue Code	272
Min. Negotiated Rate	$15.26
Max. Negotiated Rate	$15.26
Rate for Payer: Qualcare PPO/HMO/WC	$15.26

SHEATH INTRODUCER PINNACLE

Facility

$101.75

Hospital Charge Code	270672897N
Hospital Revenue Code	272
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$50.88
Rate for Payer: Aetna Commercial	$38.66
Rate for Payer: Aetna Medicare Advantage	$30.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.95
Rate for Payer: Cigna Commercial	$50.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.52
Rate for Payer: Oxford Commercial	$20.35
Rate for Payer: Qualcare PPO/HMO/WC	$15.26
Rate for Payer: UnitedHealthcare Commercial	$20.35
Rate for Payer: UnitedHealthcare Community & State	$2.45
Rate for Payer: Wellpoint Medicaid Managed Care	$2.70

SHEATH INTRO PIN 10C NGW 15964

Facility

$153.40

Hospital Charge Code	270628013
Hospital Revenue Code	278
Min. Negotiated Rate	$23.01
Max. Negotiated Rate	$37.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$23.01

SHEATH INTRO PIN 10C NGW 15964

Facility

$153.40

Hospital Charge Code	270628013
Hospital Revenue Code	278
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$76.70
Rate for Payer: Aetna Commercial	$58.29
Rate for Payer: Aetna Medicare Advantage	$46.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.12
Rate for Payer: Cigna Commercial	$76.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$23.01
Rate for Payer: UnitedHealthcare Community & State	$3.70
Rate for Payer: Wellpoint Medicaid Managed Care	$4.07

SHEATH INTRO PINNL 4X6 RSB401

Facility

$148.50

Hospital Charge Code	270658255
Hospital Revenue Code	278
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$74.25
Rate for Payer: Aetna Commercial	$56.43
Rate for Payer: Aetna Medicare Advantage	$44.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.87
Rate for Payer: Cigna Commercial	$74.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$22.27
Rate for Payer: UnitedHealthcare Community & State	$3.58
Rate for Payer: Wellpoint Medicaid Managed Care	$3.94

SHEATH INTRO PINNL 4X6 RSB401

Facility

$148.50

Hospital Charge Code	270658255
Hospital Revenue Code	278
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$35.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$22.27

SHEATH INTRO RAABE 9F70CM

Facility

$287.00

Service Code	HCPCS C1894
Hospital Charge Code	270658314C
Hospital Revenue Code	272
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$143.50
Rate for Payer: Aetna Commercial	$109.06
Rate for Payer: Aetna Medicare Advantage	$86.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.19
Rate for Payer: Cigna Commercial	$143.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.10
Rate for Payer: Oxford Commercial	$57.40
Rate for Payer: Qualcare PPO/HMO/WC	$43.05
Rate for Payer: UnitedHealthcare Commercial	$57.40
Rate for Payer: UnitedHealthcare Community & State	$6.92
Rate for Payer: Wellpoint Medicaid Managed Care	$7.61

SHEATH INTRO RAABE 9F70CM

Facility

$287.00

Service Code	HCPCS C1894
Hospital Charge Code	270658314C
Hospital Revenue Code	272
Min. Negotiated Rate	$43.05
Max. Negotiated Rate	$43.05
Rate for Payer: Qualcare PPO/HMO/WC	$43.05

SHEATH MC INTRODC 16F MCVSI16S

Facility

$153.65

Hospital Charge Code	270619950
Hospital Revenue Code	278
Min. Negotiated Rate	$23.05
Max. Negotiated Rate	$37.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.80
Rate for Payer: Qualcare PPO/HMO/WC	$23.05

SHEATH MC INTRODC 16F MCVSI16S

Facility

$153.65

Hospital Charge Code	270619950
Hospital Revenue Code	278
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$76.83
Rate for Payer: Aetna Commercial	$58.39
Rate for Payer: Aetna Medicare Advantage	$46.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.18
Rate for Payer: Cigna Commercial	$76.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.80
Rate for Payer: Qualcare PPO/HMO/WC	$23.05
Rate for Payer: UnitedHealthcare Community & State	$3.70
Rate for Payer: Wellpoint Medicaid Managed Care	$4.07

SHEATH MC INTRODC 18F MCVSI18S

Facility

$923.25

Hospital Charge Code	270601156
Hospital Revenue Code	278
Min. Negotiated Rate	$138.49
Max. Negotiated Rate	$223.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$203.12
Rate for Payer: Qualcare PPO/HMO/WC	$138.49

Know your out-of-pocket cost for care.

All Charges