Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TREVO NXT 3X32+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689891
Hospital Revenue Code	278
Min. Negotiated Rate	$5,696.44
Max. Negotiated Rate	$9,190.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,354.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44

TREVO NXT 4MM X 28MM - US

Facility

$37,026.25

Hospital Charge Code	270689896
Hospital Revenue Code	278
Min. Negotiated Rate	$892.33
Max. Negotiated Rate	$18,513.12
Rate for Payer: Aetna Commercial	$14,069.98
Rate for Payer: Aetna Medicare Advantage	$11,107.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,441.69
Rate for Payer: Cigna Commercial	$18,513.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,145.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94
Rate for Payer: UnitedHealthcare Community & State	$892.33
Rate for Payer: Wellpoint Medicaid Managed Care	$981.20

TREVO NXT 4MM X 28MM - US

Facility

$37,026.25

Hospital Charge Code	270689896
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$8,960.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,145.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 4MM X 28MM - US

Facility

$37,026.25

Hospital Charge Code	270689896S
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$8,960.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,145.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 4MM X 28MM - US

Facility

$37,026.25

Hospital Charge Code	270689896S
Hospital Revenue Code	278
Min. Negotiated Rate	$892.33
Max. Negotiated Rate	$18,513.12
Rate for Payer: Aetna Commercial	$14,069.98
Rate for Payer: Aetna Medicare Advantage	$11,107.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,441.69
Rate for Payer: Cigna Commercial	$18,513.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,145.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94
Rate for Payer: UnitedHealthcare Community & State	$892.33
Rate for Payer: Wellpoint Medicaid Managed Care	$981.20

TREVO NXT 4MM X 41MM - US

Facility

$37,026.25

Hospital Charge Code	270689897
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$8,960.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,145.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 4MM X 41MM - US

Facility

$37,026.25

Hospital Charge Code	270689897S
Hospital Revenue Code	278
Min. Negotiated Rate	$892.33
Max. Negotiated Rate	$18,513.12
Rate for Payer: Aetna Commercial	$14,069.98
Rate for Payer: Aetna Medicare Advantage	$11,107.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,441.69
Rate for Payer: Cigna Commercial	$18,513.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,145.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94
Rate for Payer: UnitedHealthcare Community & State	$892.33
Rate for Payer: Wellpoint Medicaid Managed Care	$981.20

TREVO NXT 4MM X 41MM - US

Facility

$37,026.25

Hospital Charge Code	270689897
Hospital Revenue Code	278
Min. Negotiated Rate	$892.33
Max. Negotiated Rate	$18,513.12
Rate for Payer: Aetna Commercial	$14,069.98
Rate for Payer: Aetna Medicare Advantage	$11,107.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,441.69
Rate for Payer: Cigna Commercial	$18,513.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,145.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94
Rate for Payer: UnitedHealthcare Community & State	$892.33
Rate for Payer: Wellpoint Medicaid Managed Care	$981.20

TREVO NXT 4MM X 41MM - US

Facility

$37,026.25

Hospital Charge Code	270689897S
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$8,960.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,145.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 4X28+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689892
Hospital Revenue Code	278
Min. Negotiated Rate	$5,696.44
Max. Negotiated Rate	$9,190.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,354.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44

TREVO NXT 4X28+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689892
Hospital Revenue Code	278
Min. Negotiated Rate	$915.23
Max. Negotiated Rate	$18,988.12
Rate for Payer: Aetna Commercial	$14,430.98
Rate for Payer: Aetna Medicare Advantage	$11,392.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,683.94
Rate for Payer: Cigna Commercial	$18,988.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,354.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44
Rate for Payer: UnitedHealthcare Community & State	$915.23
Rate for Payer: Wellpoint Medicaid Managed Care	$1,006.37

TREVO NXT 4X41+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689893
Hospital Revenue Code	278
Min. Negotiated Rate	$915.23
Max. Negotiated Rate	$18,988.12
Rate for Payer: Aetna Commercial	$14,430.98
Rate for Payer: Aetna Medicare Advantage	$11,392.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,683.94
Rate for Payer: Cigna Commercial	$18,988.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,354.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44
Rate for Payer: UnitedHealthcare Community & State	$915.23
Rate for Payer: Wellpoint Medicaid Managed Care	$1,006.37

TREVO NXT 4X41+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689893
Hospital Revenue Code	278
Min. Negotiated Rate	$5,696.44
Max. Negotiated Rate	$9,190.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,354.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44

TREVO NXT 6MM X 37MM - US

Facility

$37,026.25

Service Code	HCPCS C1757
Hospital Charge Code	270689898
Hospital Revenue Code	278
Min. Negotiated Rate	$892.33
Max. Negotiated Rate	$18,513.12
Rate for Payer: Aetna Commercial	$14,069.98
Rate for Payer: Aetna Medicare Advantage	$11,107.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,441.69
Rate for Payer: Cigna Commercial	$18,513.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,145.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94
Rate for Payer: UnitedHealthcare Community & State	$892.33
Rate for Payer: Wellpoint Medicaid Managed Care	$981.20

TREVO NXT 6MM X 37MM - US

Facility

$37,026.25

Service Code	HCPCS C1757
Hospital Charge Code	270689898
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$8,960.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,145.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 6X37+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689894
Hospital Revenue Code	278
Min. Negotiated Rate	$5,696.44
Max. Negotiated Rate	$9,190.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,354.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44

TREVO NXT 6X37+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689894
Hospital Revenue Code	278
Min. Negotiated Rate	$915.23
Max. Negotiated Rate	$18,988.12
Rate for Payer: Aetna Commercial	$14,430.98
Rate for Payer: Aetna Medicare Advantage	$11,392.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,683.94
Rate for Payer: Cigna Commercial	$18,988.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,354.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44
Rate for Payer: UnitedHealthcare Community & State	$915.23
Rate for Payer: Wellpoint Medicaid Managed Care	$1,006.37

TREXAN/50MG/TAB

Facility

$3.00

Hospital Charge Code	60634404
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

TREXAN/50MG/TAB

Facility

$3.00

Hospital Charge Code	60634404
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

TRIAL ADAPTER 12 14 4MM

Facility

$2,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270696891
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

TRIAL ADAPTER 12 14 4MM

Facility

$2,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270696891
Hospital Revenue Code	278
Min. Negotiated Rate	$48.20
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$48.20
Rate for Payer: Wellpoint Medicaid Managed Care	$53.00

TRIAL KIT SPECTRA PATIENT

Facility

$575.00

Hospital Charge Code	270673089
Hospital Revenue Code	272
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$218.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.50
Rate for Payer: Oxford Commercial	$115.00
Rate for Payer: Qualcare PPO/HMO/WC	$86.25
Rate for Payer: UnitedHealthcare Commercial	$115.00
Rate for Payer: UnitedHealthcare Community & State	$13.86
Rate for Payer: Wellpoint Medicaid Managed Care	$15.24

TRIAL KIT SPECTRA PATIENT

Facility

$575.00

Hospital Charge Code	270673089
Hospital Revenue Code	272
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$86.25
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

TRIAL LEAD KIT

Facility

$3,875.00

Hospital Charge Code	270705557
Hospital Revenue Code	279
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$581.25
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

TRIAL LEAD KIT

Facility

$3,875.00

Hospital Charge Code	270705557
Hospital Revenue Code	279
Min. Negotiated Rate	$93.39
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,472.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,162.50
Rate for Payer: Oxford Commercial	$775.00
Rate for Payer: Qualcare PPO/HMO/WC	$581.25
Rate for Payer: UnitedHealthcare Commercial	$775.00
Rate for Payer: UnitedHealthcare Community & State	$93.39
Rate for Payer: Wellpoint Medicaid Managed Care	$102.69

Know your out-of-pocket cost for care.

All Charges