Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SHEATH PNCLE 11F 10Cx038 15727

Facility

$51.73

Service Code	HCPCS C1887
Hospital Charge Code	270628465
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 PNCLE 11F 10Cx038 15727

Facility

$51.73

Service Code	HCPCS C1887
Hospital Charge Code	270628465
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 POLYPECTOMY SNARE

Facility

$300.85

Hospital Charge Code	270600988
Hospital Revenue Code	272
Min. Negotiated Rate	$7.25
Max. Negotiated Rate	$150.43
Rate for Payer: Aetna Commercial	$114.32
Rate for Payer: Aetna Medicare Advantage	$90.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.72
Rate for Payer: Cigna Commercial	$150.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.25
Rate for Payer: Oxford Commercial	$60.17
Rate for Payer: Qualcare PPO/HMO/WC	$45.13
Rate for Payer: UnitedHealthcare Commercial	$60.17
Rate for Payer: UnitedHealthcare Community & State	$7.25
Rate for Payer: Wellpoint Medicaid Managed Care	$7.97

SHEATH POLYPECTOMY SNARE

Facility

$300.85

Hospital Charge Code	270600988
Hospital Revenue Code	272
Min. Negotiated Rate	$45.13
Max. Negotiated Rate	$45.13
Rate for Payer: Qualcare PPO/HMO/WC	$45.13

SHEATH PRECUTANEOUS INTROD 7FR

Facility

$168.77

Hospital Charge Code	270649711
Hospital Revenue Code	270
Min. Negotiated Rate	$4.07
Max. Negotiated Rate	$84.39
Rate for Payer: Aetna Commercial	$64.13
Rate for Payer: Aetna Medicare Advantage	$50.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.04
Rate for Payer: Cigna Commercial	$84.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.63
Rate for Payer: Oxford Commercial	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$25.32
Rate for Payer: UnitedHealthcare Commercial	$33.75
Rate for Payer: UnitedHealthcare Community & State	$4.07
Rate for Payer: Wellpoint Medicaid Managed Care	$4.47

SHEATH PRECUTANEOUS INTROD 7FR

Facility

$168.77

Hospital Charge Code	270649711
Hospital Revenue Code	270
Min. Negotiated Rate	$25.32
Max. Negotiated Rate	$25.32
Rate for Payer: Qualcare PPO/HMO/WC	$25.32

SHEATH R2P DEST SLEN 6FR 119CM

Facility

$1,508.75

Service Code	HCPCS C1894
Hospital Charge Code	270691239S
Hospital Revenue Code	278
Min. Negotiated Rate	$226.31
Max. Negotiated Rate	$365.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$301.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$365.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$331.93
Rate for Payer: Qualcare PPO/HMO/WC	$226.31

SHEATH R2P DEST SLEN 6FR 119CM

Facility

$1,508.75

Service Code	HCPCS C1894
Hospital Charge Code	270691239S
Hospital Revenue Code	278
Min. Negotiated Rate	$36.36
Max. Negotiated Rate	$754.38
Rate for Payer: Aetna Commercial	$573.33
Rate for Payer: Aetna Medicare Advantage	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$384.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$384.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$301.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$384.73
Rate for Payer: Cigna Commercial	$754.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$365.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$331.93
Rate for Payer: Qualcare PPO/HMO/WC	$226.31
Rate for Payer: UnitedHealthcare Community & State	$36.36
Rate for Payer: Wellpoint Medicaid Managed Care	$39.98

SHEATH RAABE FLEXOR 5FR 90cm

Facility

$277.00

Hospital Charge Code	270665568
Hospital Revenue Code	272
Min. Negotiated Rate	$41.55
Max. Negotiated Rate	$41.55
Rate for Payer: Qualcare PPO/HMO/WC	$41.55

SHEATH RAABE FLEXOR 5FR 90cm

Facility

$277.00

Hospital Charge Code	270665568
Hospital Revenue Code	272
Min. Negotiated Rate	$6.68
Max. Negotiated Rate	$138.50
Rate for Payer: Aetna Commercial	$105.26
Rate for Payer: Aetna Medicare Advantage	$83.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.64
Rate for Payer: Cigna Commercial	$138.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.10
Rate for Payer: Oxford Commercial	$55.40
Rate for Payer: Qualcare PPO/HMO/WC	$41.55
Rate for Payer: UnitedHealthcare Commercial	$55.40
Rate for Payer: UnitedHealthcare Community & State	$6.68
Rate for Payer: Wellpoint Medicaid Managed Care	$7.34

SHEATH RADIAL 6F

Facility

$225.00

Hospital Charge Code	270676664
Hospital Revenue Code	272
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

SHEATH RADIAL 6F

Facility

$225.00

Hospital Charge Code	270676664N
Hospital Revenue Code	272
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.50
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$45.00
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

SHEATH RADIAL 6F

Facility

$225.00

Hospital Charge Code	270676664
Hospital Revenue Code	272
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.50
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$45.00
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

SHEATH RADIAL 6F

Facility

$225.00

Hospital Charge Code	270676664N
Hospital Revenue Code	272
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

SHEATH RADIAL 6FR

Facility

$200.00

Hospital Charge Code	2709003649
Hospital Revenue Code	272
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

SHEATH RADIAL 6FR

Facility

$200.00

Hospital Charge Code	2709003649
Hospital Revenue Code	272
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.00
Rate for Payer: Oxford Commercial	$40.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Commercial	$40.00
Rate for Payer: UnitedHealthcare Community & State	$4.82
Rate for Payer: Wellpoint Medicaid Managed Care	$5.30

SHEATH RAIN 5FR

Facility

$320.00

Service Code	HCPCS C1766
Hospital Charge Code	270699120
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 RAIN 5FR

Facility

$320.00

Service Code	HCPCS C1766
Hospital Charge Code	270699120
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 RAIN 6FR

Facility

$275.00

Service Code	HCPCS C1894
Hospital Charge Code	270699121
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$66.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

SHEATH RAIN 6FR

Facility

$275.00

Service Code	HCPCS C1894
Hospital Charge Code	270699121
Hospital Revenue Code	278
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$6.63
Rate for Payer: Wellpoint Medicaid Managed Care	$7.29

SHEATH RAIN 6FR 10CM

Facility

$275.00

Service Code	HCPCS C1894
Hospital Charge Code	270699121C
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$66.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

SHEATH RAIN 6FR 10CM

Facility

$275.00

Service Code	HCPCS C1894
Hospital Charge Code	270699121C
Hospital Revenue Code	278
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$6.63
Rate for Payer: Wellpoint Medicaid Managed Care	$7.29

SHEATH RAIN 6FR 10CW NW RAD

Facility

$320.00

Service Code	HCPCS C1894
Hospital Charge Code	270699122C
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 RAIN 6FR 10CW NW RAD

Facility

$320.00

Service Code	HCPCS C1894
Hospital Charge Code	270699122C
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 RAIN RADIAL 6FR

Facility

$1,600.00

Hospital Charge Code	270699122
Hospital Revenue Code	279
Min. Negotiated Rate	$38.56
Max. Negotiated Rate	$800.00
Rate for Payer: Aetna Commercial	$608.00
Rate for Payer: Aetna Medicare Advantage	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$408.00
Rate for Payer: Cigna Commercial	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$480.00
Rate for Payer: Oxford Commercial	$320.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00
Rate for Payer: UnitedHealthcare Commercial	$320.00
Rate for Payer: UnitedHealthcare Community & State	$38.56
Rate for Payer: Wellpoint Medicaid Managed Care	$42.40

Know your out-of-pocket cost for care.

All Charges