Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TORQUE DEVICE RADIFOCUS

Facility

$195.00

Service Code	HCPCS C1760
Hospital Charge Code	270623569
Hospital Revenue Code	278
Min. Negotiated Rate	$4.70
Max. Negotiated Rate	$97.50
Rate for Payer: Aetna Commercial	$74.10
Rate for Payer: Aetna Medicare Advantage	$58.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.73
Rate for Payer: Cigna Commercial	$97.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$42.90
Rate for Payer: Qualcare PPO/HMO/WC	$29.25
Rate for Payer: UnitedHealthcare Community & State	$4.70
Rate for Payer: Wellpoint Medicaid Managed Care	$5.17

TORQUE DEVICE RADIFOCUS

Facility

$195.00

Service Code	HCPCS C1760
Hospital Charge Code	270623569
Hospital Revenue Code	278
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$42.90
Rate for Payer: Qualcare PPO/HMO/WC	$29.25

TORQUE DEVICE RADIFOCUS

Facility

$253.25

Service Code	HCPCS C1760
Hospital Charge Code	270623569S
Hospital Revenue Code	278
Min. Negotiated Rate	$37.99
Max. Negotiated Rate	$61.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.72
Rate for Payer: Qualcare PPO/HMO/WC	$37.99

TORQUE DEVICE RADIFOCUS

Facility

$39.90

Hospital Charge Code	2709002566
Hospital Revenue Code	272
Min. Negotiated Rate	$5.99
Max. Negotiated Rate	$5.99
Rate for Payer: Qualcare PPO/HMO/WC	$5.99

TORQUE DEVICE RADIFOCUS

Facility

$39.90

Hospital Charge Code	2709002566
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$19.95
Rate for Payer: Aetna Commercial	$15.16
Rate for Payer: Aetna Medicare Advantage	$11.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.17
Rate for Payer: Cigna Commercial	$19.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.97
Rate for Payer: Oxford Commercial	$7.98
Rate for Payer: Qualcare PPO/HMO/WC	$5.99
Rate for Payer: UnitedHealthcare Commercial	$7.98
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

TORQUE DEVICE RADIFOCUS

Facility

$7.98

Service Code	HCPCS C1760
Hospital Charge Code	270623569N
Hospital Revenue Code	278
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1.76
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

TORQUE DEVICE RADIFOCUS

Facility

$253.25

Service Code	HCPCS C1760
Hospital Charge Code	270623569S
Hospital Revenue Code	278
Min. Negotiated Rate	$6.10
Max. Negotiated Rate	$126.62
Rate for Payer: Aetna Commercial	$96.23
Rate for Payer: Aetna Medicare Advantage	$75.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.58
Rate for Payer: Cigna Commercial	$126.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.72
Rate for Payer: Qualcare PPO/HMO/WC	$37.99
Rate for Payer: UnitedHealthcare Community & State	$6.10
Rate for Payer: Wellpoint Medicaid Managed Care	$6.71

TORQUE DEVICE RADIFOCUS

Facility

$7.98

Service Code	HCPCS C1760
Hospital Charge Code	270623569N
Hospital Revenue Code	278
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.99
Rate for Payer: Aetna Commercial	$3.03
Rate for Payer: Aetna Medicare Advantage	$2.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.03
Rate for Payer: Cigna Commercial	$3.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1.76
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

TORQUE DRIVER LIMITING MSP

Facility

$1,400.00

Hospital Charge Code	270694090
Hospital Revenue Code	270
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$210.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.00

TORQUE DRIVER LIMITING MSP

Facility

$1,400.00

Hospital Charge Code	270694090
Hospital Revenue Code	270
Min. Negotiated Rate	$33.74
Max. Negotiated Rate	$700.00
Rate for Payer: Aetna Commercial	$532.00
Rate for Payer: Aetna Medicare Advantage	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.00
Rate for Payer: Cigna Commercial	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$420.00
Rate for Payer: Oxford Commercial	$280.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.00
Rate for Payer: UnitedHealthcare Commercial	$280.00
Rate for Payer: UnitedHealthcare Community & State	$33.74
Rate for Payer: Wellpoint Medicaid Managed Care	$37.10

TORQUE GUIDE WIRE DEVICE

Facility

$22.50

Service Code	HCPCS C1769
Hospital Charge Code	270654971N
Hospital Revenue Code	278
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$11.25
Rate for Payer: Aetna Commercial	$8.55
Rate for Payer: Aetna Medicare Advantage	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.74
Rate for Payer: Cigna Commercial	$11.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.60

TORQUE GUIDE WIRE DEVICE

Facility

$18.30

Service Code	HCPCS C1769
Hospital Charge Code	270654971
Hospital Revenue Code	278
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$4.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4.03
Rate for Payer: Qualcare PPO/HMO/WC	$2.75

TORQUE GUIDE WIRE DEVICE

Facility

$18.30

Service Code	HCPCS C1769
Hospital Charge Code	270654971S
Hospital Revenue Code	278
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$9.15
Rate for Payer: Aetna Commercial	$6.95
Rate for Payer: Aetna Medicare Advantage	$5.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.67
Rate for Payer: Cigna Commercial	$9.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4.03
Rate for Payer: Qualcare PPO/HMO/WC	$2.75
Rate for Payer: UnitedHealthcare Community & State	$0.44
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

TORQUE GUIDE WIRE DEVICE

Facility

$18.30

Service Code	HCPCS C1769
Hospital Charge Code	270654971S
Hospital Revenue Code	278
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$4.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4.03
Rate for Payer: Qualcare PPO/HMO/WC	$2.75

TORQUE GUIDE WIRE DEVICE

Facility

$22.50

Service Code	HCPCS C1769
Hospital Charge Code	270654971N
Hospital Revenue Code	278
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$5.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

TORQUE GUIDE WIRE DEVICE

Facility

$18.30

Service Code	HCPCS C1769
Hospital Charge Code	270654971
Hospital Revenue Code	278
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$9.15
Rate for Payer: Aetna Commercial	$6.95
Rate for Payer: Aetna Medicare Advantage	$5.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.67
Rate for Payer: Cigna Commercial	$9.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4.03
Rate for Payer: Qualcare PPO/HMO/WC	$2.75
Rate for Payer: UnitedHealthcare Community & State	$0.44
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

TORQUE LIMITING ATTACH 1.5NM

Facility

$8,139.00

Hospital Charge Code	270671056
Hospital Revenue Code	272
Min. Negotiated Rate	$1,220.85
Max. Negotiated Rate	$1,220.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,220.85

TORQUE LIMITING ATTACH 1.5NM

Facility

$8,139.00

Hospital Charge Code	270671056
Hospital Revenue Code	272
Min. Negotiated Rate	$196.15
Max. Negotiated Rate	$4,069.50
Rate for Payer: Aetna Commercial	$3,092.82
Rate for Payer: Aetna Medicare Advantage	$2,441.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,075.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,075.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,075.45
Rate for Payer: Cigna Commercial	$4,069.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,441.70
Rate for Payer: Oxford Commercial	$1,627.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,220.85
Rate for Payer: UnitedHealthcare Commercial	$1,627.80
Rate for Payer: UnitedHealthcare Community & State	$196.15
Rate for Payer: Wellpoint Medicaid Managed Care	$215.68

TORQUE SHAFT

Facility

$4,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270685773
Hospital Revenue Code	278
Min. Negotiated Rate	$109.66
Max. Negotiated Rate	$2,275.00
Rate for Payer: Aetna Commercial	$1,729.00
Rate for Payer: Aetna Medicare Advantage	$1,365.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,160.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,160.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$910.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,160.25
Rate for Payer: Cigna Commercial	$2,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,101.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,001.00
Rate for Payer: Qualcare PPO/HMO/WC	$682.50
Rate for Payer: UnitedHealthcare Community & State	$109.66
Rate for Payer: Wellpoint Medicaid Managed Care	$120.58

TORQUE SHAFT

Facility

$4,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270685773
Hospital Revenue Code	278
Min. Negotiated Rate	$682.50
Max. Negotiated Rate	$1,101.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$910.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,101.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,001.00
Rate for Payer: Qualcare PPO/HMO/WC	$682.50

TORSEMIDE 10 MG TAB

Facility

$4.69

Service Code	NDC 31722053001
Hospital Charge Code	60628726
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.35
Rate for Payer: Aetna Commercial	$1.78
Rate for Payer: Aetna Medicare Advantage	$1.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.20
Rate for Payer: Cigna Commercial	$2.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.41
Rate for Payer: Oxford Commercial	$0.94
Rate for Payer: Qualcare PPO/HMO/WC	$0.70
Rate for Payer: UnitedHealthcare Commercial	$0.94
Rate for Payer: UnitedHealthcare Community & State	$0.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

TORSEMIDE 10 MG TAB

Facility

$4.69

Service Code	NDC 31722053001
Hospital Charge Code	60628726
Hospital Revenue Code	250
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$0.70
Rate for Payer: Qualcare PPO/HMO/WC	$0.70

TORSEMIDE 20MG/2ML

Facility

$37.00

Hospital Charge Code	60635728
Hospital Revenue Code	250
Min. Negotiated Rate	$5.55
Max. Negotiated Rate	$5.55
Rate for Payer: Qualcare PPO/HMO/WC	$5.55

TORSEMIDE 20MG/2ML

Facility

$37.00

Hospital Charge Code	60635728
Hospital Revenue Code	250
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$18.50
Rate for Payer: Aetna Commercial	$14.06
Rate for Payer: Aetna Medicare Advantage	$11.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.44
Rate for Payer: Cigna Commercial	$18.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.10
Rate for Payer: Oxford Commercial	$7.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.55
Rate for Payer: UnitedHealthcare Commercial	$7.40
Rate for Payer: UnitedHealthcare Community & State	$0.89
Rate for Payer: Wellpoint Medicaid Managed Care	$0.98

TORSEMIDE 20 MG/2ML INJ

Facility

$16.85

Hospital Charge Code	60628796
Hospital Revenue Code	250
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.43
Rate for Payer: Aetna Commercial	$6.40
Rate for Payer: Aetna Medicare Advantage	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.05
Rate for Payer: Oxford Commercial	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$3.37
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

Know your out-of-pocket cost for care.

All Charges