Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SHEATH MC INTRODC 18F MCVSI18S

Facility

$923.25

Hospital Charge Code	270601156
Hospital Revenue Code	278
Min. Negotiated Rate	$22.25
Max. Negotiated Rate	$461.62
Rate for Payer: Aetna Commercial	$350.83
Rate for Payer: Aetna Medicare Advantage	$276.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.43
Rate for Payer: Cigna Commercial	$461.62
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
Rate for Payer: UnitedHealthcare Community & State	$22.25
Rate for Payer: Wellpoint Medicaid Managed Care	$24.47

SHEATH MCV DILATOR 8/10 260120

Facility

$407.90

Hospital Charge Code	270616468
Hospital Revenue Code	272
Min. Negotiated Rate	$9.83
Max. Negotiated Rate	$203.95
Rate for Payer: Aetna Commercial	$155.00
Rate for Payer: Aetna Medicare Advantage	$122.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.01
Rate for Payer: Cigna Commercial	$203.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.37
Rate for Payer: Oxford Commercial	$81.58
Rate for Payer: Qualcare PPO/HMO/WC	$61.19
Rate for Payer: UnitedHealthcare Commercial	$81.58
Rate for Payer: UnitedHealthcare Community & State	$9.83
Rate for Payer: Wellpoint Medicaid Managed Care	$10.81

SHEATH MCV DILATOR 8/10 260120

Facility

$407.90

Hospital Charge Code	270616468
Hospital Revenue Code	272
Min. Negotiated Rate	$61.19
Max. Negotiated Rate	$61.19
Rate for Payer: Qualcare PPO/HMO/WC	$61.19

SHEATH MITEK SUCTN 3.5 225402

Facility

$116.85

Hospital Charge Code	270619104
Hospital Revenue Code	272
Min. Negotiated Rate	$17.53
Max. Negotiated Rate	$17.53
Rate for Payer: Qualcare PPO/HMO/WC	$17.53

SHEATH MITEK SUCTN 3.5 225402

Facility

$116.85

Hospital Charge Code	270619104
Hospital Revenue Code	272
Min. Negotiated Rate	$2.82
Max. Negotiated Rate	$58.42
Rate for Payer: Aetna Commercial	$44.40
Rate for Payer: Aetna Medicare Advantage	$35.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.80
Rate for Payer: Cigna Commercial	$58.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.05
Rate for Payer: Oxford Commercial	$23.37
Rate for Payer: Qualcare PPO/HMO/WC	$17.53
Rate for Payer: UnitedHealthcare Commercial	$23.37
Rate for Payer: UnitedHealthcare Community & State	$2.82
Rate for Payer: Wellpoint Medicaid Managed Care	$3.10

SHEATH MT INTRODC 7F 15-713

Facility

$145.65

Hospital Charge Code	270618566
Hospital Revenue Code	278
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$72.83
Rate for Payer: Aetna Commercial	$55.35
Rate for Payer: Aetna Medicare Advantage	$43.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.14
Rate for Payer: Cigna Commercial	$72.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.04
Rate for Payer: Qualcare PPO/HMO/WC	$21.85
Rate for Payer: UnitedHealthcare Community & State	$3.51
Rate for Payer: Wellpoint Medicaid Managed Care	$3.86

SHEATH MT INTRODC 7F 15-713

Facility

$145.65

Hospital Charge Code	270618566
Hospital Revenue Code	278
Min. Negotiated Rate	$21.85
Max. Negotiated Rate	$35.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.04
Rate for Payer: Qualcare PPO/HMO/WC	$21.85

SHEATH MT INTRODC PIN 7F156610

Facility

$136.85

Hospital Charge Code	270605532
Hospital Revenue Code	278
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$68.42
Rate for Payer: Aetna Commercial	$52.00
Rate for Payer: Aetna Medicare Advantage	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.90
Rate for Payer: Cigna Commercial	$68.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.11
Rate for Payer: Qualcare PPO/HMO/WC	$20.53
Rate for Payer: UnitedHealthcare Community & State	$3.30
Rate for Payer: Wellpoint Medicaid Managed Care	$3.63

SHEATH MT INTRODC PIN 7F156610

Facility

$136.85

Hospital Charge Code	270605532
Hospital Revenue Code	278
Min. Negotiated Rate	$20.53
Max. Negotiated Rate	$33.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.11
Rate for Payer: Qualcare PPO/HMO/WC	$20.53

SHEATH MT INTRODC PIN 8F 15954

Facility

$1,965.65

Hospital Charge Code	270623266
Hospital Revenue Code	278
Min. Negotiated Rate	$294.85
Max. Negotiated Rate	$475.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$393.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$475.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$432.44
Rate for Payer: Qualcare PPO/HMO/WC	$294.85

SHEATH MT INTRODC PIN 8F 15954

Facility

$1,965.65

Hospital Charge Code	270623266
Hospital Revenue Code	278
Min. Negotiated Rate	$47.37
Max. Negotiated Rate	$982.83
Rate for Payer: Aetna Commercial	$746.95
Rate for Payer: Aetna Medicare Advantage	$589.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$501.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$501.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$393.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$501.24
Rate for Payer: Cigna Commercial	$982.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$475.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$432.44
Rate for Payer: Qualcare PPO/HMO/WC	$294.85
Rate for Payer: UnitedHealthcare Community & State	$47.37
Rate for Payer: Wellpoint Medicaid Managed Care	$52.09

SHEATH MT PINN 6x25 15-965

Facility

$182.45

Hospital Charge Code	270628466
Hospital Revenue Code	278
Min. Negotiated Rate	$27.37
Max. Negotiated Rate	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$40.14
Rate for Payer: Qualcare PPO/HMO/WC	$27.37

SHEATH MT PINN 6x25 15-965

Facility

$182.45

Hospital Charge Code	270628466
Hospital Revenue Code	278
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$91.22
Rate for Payer: Aetna Commercial	$69.33
Rate for Payer: Aetna Medicare Advantage	$54.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.52
Rate for Payer: Cigna Commercial	$91.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$40.14
Rate for Payer: Qualcare PPO/HMO/WC	$27.37
Rate for Payer: UnitedHealthcare Community & State	$4.40
Rate for Payer: Wellpoint Medicaid Managed Care	$4.83

SHEATH PEEL AWAY 5FR

Facility

$500.00

Hospital Charge Code	270669565
Hospital Revenue Code	278
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) NJ Health	$100.00
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	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

SHEATH PEEL AWAY 5FR

Facility

$500.00

Hospital Charge Code	270669565
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SHEATH PEEL AWAY 7FR

Facility

$500.00

Hospital Charge Code	270669566
Hospital Revenue Code	278
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) NJ Health	$100.00
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	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

SHEATH PEEL AWAY 7FR

Facility

$500.00

Hospital Charge Code	270669566
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SHEATH PEEL AWAY 8FR

Facility

$500.00

Hospital Charge Code	270669567
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SHEATH PEEL AWAY 8FR

Facility

$500.00

Hospital Charge Code	270669567
Hospital Revenue Code	278
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) NJ Health	$100.00
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	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

SHEATH PIN 9Fx10CM NGW 15-725

Facility

$60.25

Hospital Charge Code	270628418
Hospital Revenue Code	278
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$14.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13.26
Rate for Payer: Qualcare PPO/HMO/WC	$9.04

SHEATH PIN 9Fx10CM NGW 15-725

Facility

$60.25

Hospital Charge Code	270628418
Hospital Revenue Code	278
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$30.12
Rate for Payer: Aetna Commercial	$22.89
Rate for Payer: Aetna Medicare Advantage	$18.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.36
Rate for Payer: Cigna Commercial	$30.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13.26
Rate for Payer: Qualcare PPO/HMO/WC	$9.04
Rate for Payer: UnitedHealthcare Community & State	$1.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1.60

SHEATH PINCLE 7FR 45CM RSR04

Facility

$522.50

Service Code	HCPCS C1887
Hospital Charge Code	270642216C
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 PINCLE 7FR 45CM RSR04

Facility

$522.50

Service Code	HCPCS C1887
Hospital Charge Code	270642216C
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 PINNACLE 10FR 10CM

Facility

$51.73

Service Code	HCPCS C2629
Hospital Charge Code	270625051
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 PINNACLE 10FR 10CM

Facility

$51.73

Service Code	HCPCS C2629
Hospital Charge Code	270625051
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

Know your out-of-pocket cost for care.

All Charges