Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TIGHT ROPE TITANIUM

Facility

$4,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270654984
Hospital Revenue Code	278
Min. Negotiated Rate	$106.04
Max. Negotiated Rate	$2,200.00
Rate for Payer: Aetna Commercial	$1,672.00
Rate for Payer: Aetna Medicare Advantage	$1,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$880.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,122.00
Rate for Payer: Cigna Commercial	$2,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,064.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$660.00
Rate for Payer: UnitedHealthcare Community & State	$106.04
Rate for Payer: Wellpoint Medicaid Managed Care	$116.60

TIGHTROPE TITANIUM XP

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270682061
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,644.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

TIGHTROPE TITANIUM XP

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270682061
Hospital Revenue Code	278
Min. Negotiated Rate	$180.15
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,644.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Community & State	$180.15
Rate for Payer: Wellpoint Medicaid Managed Care	$198.09

TIGHTROPE WITH FIBER TAG

Facility

$1,675.00

Hospital Charge Code	270690999
Hospital Revenue Code	272
Min. Negotiated Rate	$40.37
Max. Negotiated Rate	$837.50
Rate for Payer: Aetna Commercial	$636.50
Rate for Payer: Aetna Medicare Advantage	$502.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$427.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$427.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$427.12
Rate for Payer: Cigna Commercial	$837.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$502.50
Rate for Payer: Oxford Commercial	$335.00
Rate for Payer: Qualcare PPO/HMO/WC	$251.25
Rate for Payer: UnitedHealthcare Commercial	$335.00
Rate for Payer: UnitedHealthcare Community & State	$40.37
Rate for Payer: Wellpoint Medicaid Managed Care	$44.39

TIGHTROPE WITH FIBER TAG

Facility

$1,675.00

Hospital Charge Code	270690999
Hospital Revenue Code	272
Min. Negotiated Rate	$251.25
Max. Negotiated Rate	$251.25
Rate for Payer: Qualcare PPO/HMO/WC	$251.25

TIGHTROPE XP STAINLESS

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270655935
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,644.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

TIGHTROPE XP STAINLESS

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270655935
Hospital Revenue Code	278
Min. Negotiated Rate	$180.15
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,644.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Community & State	$180.15
Rate for Payer: Wellpoint Medicaid Managed Care	$198.09

TIGHTTOPE WTH FIBER TAG

Facility

$2,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270690695
Hospital Revenue Code	278
Min. Negotiated Rate	$63.26
Max. Negotiated Rate	$1,312.50
Rate for Payer: Aetna Commercial	$997.50
Rate for Payer: Aetna Medicare Advantage	$787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.38
Rate for Payer: Cigna Commercial	$1,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$577.50
Rate for Payer: Qualcare PPO/HMO/WC	$393.75
Rate for Payer: UnitedHealthcare Community & State	$63.26
Rate for Payer: Wellpoint Medicaid Managed Care	$69.56

TIGHTTOPE WTH FIBER TAG

Facility

$2,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270690695
Hospital Revenue Code	278
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$635.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$577.50
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

TIGRIS VASCULAR STENT

Facility

$7,475.00

Service Code	HCPCS C1874
Hospital Charge Code	270680396
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,644.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

TIGRIS VASCULAR STENT

Facility

$7,475.00

Service Code	HCPCS C1874
Hospital Charge Code	270680396
Hospital Revenue Code	278
Min. Negotiated Rate	$180.15
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,644.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Community & State	$180.15
Rate for Payer: Wellpoint Medicaid Managed Care	$198.09

TILADE INHALER

Facility

$172.00

Hospital Charge Code	60634910
Hospital Revenue Code	250
Min. Negotiated Rate	$25.80
Max. Negotiated Rate	$25.80
Rate for Payer: Qualcare PPO/HMO/WC	$25.80

TILADE INHALER

Facility

$172.00

Hospital Charge Code	60634910
Hospital Revenue Code	250
Min. Negotiated Rate	$4.15
Max. Negotiated Rate	$86.00
Rate for Payer: Aetna Commercial	$65.36
Rate for Payer: Aetna Medicare Advantage	$51.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.86
Rate for Payer: Cigna Commercial	$86.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.60
Rate for Payer: Oxford Commercial	$34.40
Rate for Payer: Qualcare PPO/HMO/WC	$25.80
Rate for Payer: UnitedHealthcare Commercial	$34.40
Rate for Payer: UnitedHealthcare Community & State	$4.15
Rate for Payer: Wellpoint Medicaid Managed Care	$4.56

TILDA LEAD 45CM

Facility

$2,125.00

Service Code	HCPCS C1898
Hospital Charge Code	270663606
Hospital Revenue Code	278
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$514.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$467.50
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

TILDA LEAD 45CM

Facility

$2,125.00

Service Code	HCPCS C1898
Hospital Charge Code	270663606
Hospital Revenue Code	278
Min. Negotiated Rate	$51.21
Max. Negotiated Rate	$1,062.50
Rate for Payer: Aetna Commercial	$807.50
Rate for Payer: Aetna Medicare Advantage	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$541.88
Rate for Payer: Cigna Commercial	$1,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$467.50
Rate for Payer: Qualcare PPO/HMO/WC	$318.75
Rate for Payer: UnitedHealthcare Community & State	$51.21
Rate for Payer: Wellpoint Medicaid Managed Care	$56.31

TILDA LEAD 53CM

Facility

$2,125.00

Service Code	HCPCS C1898
Hospital Charge Code	270675292
Hospital Revenue Code	278
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$514.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$467.50
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

TILDA LEAD 53CM

Facility

$2,125.00

Service Code	HCPCS C1898
Hospital Charge Code	270675292
Hospital Revenue Code	278
Min. Negotiated Rate	$51.21
Max. Negotiated Rate	$1,062.50
Rate for Payer: Aetna Commercial	$807.50
Rate for Payer: Aetna Medicare Advantage	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$541.88
Rate for Payer: Cigna Commercial	$1,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$467.50
Rate for Payer: Qualcare PPO/HMO/WC	$318.75
Rate for Payer: UnitedHealthcare Community & State	$51.21
Rate for Payer: Wellpoint Medicaid Managed Care	$56.31

TILDA LEAD R53

Facility

$2,125.00

Service Code	HCPCS C1898
Hospital Charge Code	270662058
Hospital Revenue Code	278
Min. Negotiated Rate	$51.21
Max. Negotiated Rate	$1,062.50
Rate for Payer: Aetna Commercial	$807.50
Rate for Payer: Aetna Medicare Advantage	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$541.88
Rate for Payer: Cigna Commercial	$1,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$467.50
Rate for Payer: Qualcare PPO/HMO/WC	$318.75
Rate for Payer: UnitedHealthcare Community & State	$51.21
Rate for Payer: Wellpoint Medicaid Managed Care	$56.31

TILDA LEAD R53

Facility

$2,125.00

Service Code	HCPCS C1898
Hospital Charge Code	270662058
Hospital Revenue Code	278
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$514.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$467.50
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

TILDA R45 RIGHT ATRIAL LEAD

Facility

$2,125.00

Service Code	HCPCS C1898
Hospital Charge Code	270663696
Hospital Revenue Code	275
Min. Negotiated Rate	$51.21
Max. Negotiated Rate	$1,062.50
Rate for Payer: Aetna Commercial	$807.50
Rate for Payer: Aetna Medicare Advantage	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$541.88
Rate for Payer: Cigna Commercial	$1,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$467.50
Rate for Payer: Qualcare PPO/HMO/WC	$318.75
Rate for Payer: UnitedHealthcare Community & State	$51.21
Rate for Payer: Wellpoint Medicaid Managed Care	$56.31

TILDA R45 RIGHT ATRIAL LEAD

Facility

$2,125.00

Service Code	HCPCS C1898
Hospital Charge Code	270663696
Hospital Revenue Code	275
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$514.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$467.50
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

TI LIFE ANT LORD CERV CAGE SM

Facility

$19,975.00

Hospital Charge Code	270702199
Hospital Revenue Code	278
Min. Negotiated Rate	$481.40
Max. Negotiated Rate	$9,987.50
Rate for Payer: Aetna Commercial	$7,590.50
Rate for Payer: Aetna Medicare Advantage	$5,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,093.62
Rate for Payer: Cigna Commercial	$9,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,833.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,394.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25
Rate for Payer: UnitedHealthcare Community & State	$481.40
Rate for Payer: Wellpoint Medicaid Managed Care	$529.34

TI LIFE ANT LORD CERV CAGE SM

Facility

$19,975.00

Hospital Charge Code	270702199
Hospital Revenue Code	278
Min. Negotiated Rate	$2,996.25
Max. Negotiated Rate	$4,833.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,833.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,394.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25

TI LIFE ANT LORDOTIC CERV CAGE

Facility

$19,975.00

Hospital Charge Code	270702205
Hospital Revenue Code	278
Min. Negotiated Rate	$2,996.25
Max. Negotiated Rate	$4,833.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,833.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,394.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25

TI LIFE ANT LORDOTIC CERV CAGE

Facility

$19,975.00

Hospital Charge Code	270702205
Hospital Revenue Code	278
Min. Negotiated Rate	$481.40
Max. Negotiated Rate	$9,987.50
Rate for Payer: Aetna Commercial	$7,590.50
Rate for Payer: Aetna Medicare Advantage	$5,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,093.62
Rate for Payer: Cigna Commercial	$9,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,833.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,394.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25
Rate for Payer: UnitedHealthcare Community & State	$481.40
Rate for Payer: Wellpoint Medicaid Managed Care	$529.34

Know your out-of-pocket cost for care.

All Charges