Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

WIRE BD GUIDE PEG 28F 000731

Facility

$522.45

Hospital Charge Code	270612430
Hospital Revenue Code	278
Min. Negotiated Rate	$78.37
Max. Negotiated Rate	$126.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.94
Rate for Payer: Qualcare PPO/HMO/WC	$78.37

WIRE BMT GUIDE BALL 3.2 469060

Facility

$480.00

Hospital Charge Code	270610880
Hospital Revenue Code	278
Min. Negotiated Rate	$11.57
Max. Negotiated Rate	$240.00
Rate for Payer: Aetna Commercial	$182.40
Rate for Payer: Aetna Medicare Advantage	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.40
Rate for Payer: Cigna Commercial	$240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$105.60
Rate for Payer: Qualcare PPO/HMO/WC	$72.00
Rate for Payer: UnitedHealthcare Community & State	$11.57
Rate for Payer: Wellpoint Medicaid Managed Care	$12.72

WIRE BMT GUIDE BALL 3.2 469060

Facility

$480.00

Hospital Charge Code	270610880
Hospital Revenue Code	278
Min. Negotiated Rate	$72.00
Max. Negotiated Rate	$116.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$105.60
Rate for Payer: Qualcare PPO/HMO/WC	$72.00

WIRE BMW II ANGIOPLASTY

Facility

$75.00

Hospital Charge Code	270651828
Hospital Revenue Code	278
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$18.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

WIRE BMW II ANGIOPLASTY

Facility

$75.00

Hospital Charge Code	270651828
Hospital Revenue Code	278
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

WIRE BOLT LONG LRF 1.5X2.0MM

Facility

$594.75

Service Code	HCPCS A4649
Hospital Charge Code	270674289
Hospital Revenue Code	272
Min. Negotiated Rate	$14.33
Max. Negotiated Rate	$297.38
Rate for Payer: Aetna Commercial	$226.00
Rate for Payer: Aetna Medicare Advantage	$178.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.66
Rate for Payer: Cigna Commercial	$297.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.43
Rate for Payer: Oxford Commercial	$118.95
Rate for Payer: Qualcare PPO/HMO/WC	$89.21
Rate for Payer: UnitedHealthcare Commercial	$118.95
Rate for Payer: UnitedHealthcare Community & State	$14.33
Rate for Payer: Wellpoint Medicaid Managed Care	$15.76

WIRE BOLT LONG LRF 1.5X2.0MM

Facility

$594.75

Service Code	HCPCS A4649
Hospital Charge Code	270674289
Hospital Revenue Code	272
Min. Negotiated Rate	$89.21
Max. Negotiated Rate	$89.21
Rate for Payer: Qualcare PPO/HMO/WC	$89.21

WIRE BOLT MEDUIM LRF 1.5X2.0MM

Facility

$570.35

Service Code	HCPCS A4649
Hospital Charge Code	270699591
Hospital Revenue Code	272
Min. Negotiated Rate	$13.75
Max. Negotiated Rate	$285.18
Rate for Payer: Aetna Commercial	$216.73
Rate for Payer: Aetna Medicare Advantage	$171.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.44
Rate for Payer: Cigna Commercial	$285.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.10
Rate for Payer: Oxford Commercial	$114.07
Rate for Payer: Qualcare PPO/HMO/WC	$85.55
Rate for Payer: UnitedHealthcare Commercial	$114.07
Rate for Payer: UnitedHealthcare Community & State	$13.75
Rate for Payer: Wellpoint Medicaid Managed Care	$15.11

WIRE BOLT MEDUIM LRF 1.5X2.0MM

Facility

$570.35

Service Code	HCPCS A4649
Hospital Charge Code	270699591
Hospital Revenue Code	272
Min. Negotiated Rate	$85.55
Max. Negotiated Rate	$85.55
Rate for Payer: Qualcare PPO/HMO/WC	$85.55

WIRE BOLT OFFSET ADAPTER SHORT

Facility

$1,512.80

Service Code	HCPCS A4649
Hospital Charge Code	270674290
Hospital Revenue Code	272
Min. Negotiated Rate	$226.92
Max. Negotiated Rate	$226.92
Rate for Payer: Qualcare PPO/HMO/WC	$226.92

WIRE BOLT OFFSET ADAPTER SHORT

Facility

$1,512.80

Service Code	HCPCS A4649
Hospital Charge Code	270674290
Hospital Revenue Code	272
Min. Negotiated Rate	$36.46
Max. Negotiated Rate	$756.40
Rate for Payer: Aetna Commercial	$574.86
Rate for Payer: Aetna Medicare Advantage	$453.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$385.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$385.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$385.76
Rate for Payer: Cigna Commercial	$756.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.84
Rate for Payer: Oxford Commercial	$302.56
Rate for Payer: Qualcare PPO/HMO/WC	$226.92
Rate for Payer: UnitedHealthcare Commercial	$302.56
Rate for Payer: UnitedHealthcare Community & State	$36.46
Rate for Payer: Wellpoint Medicaid Managed Care	$40.09

WIRE BOLT SHORT LRF 1.5X2.0MM

Facility

$570.35

Service Code	HCPCS A4649
Hospital Charge Code	270699590
Hospital Revenue Code	272
Min. Negotiated Rate	$13.75
Max. Negotiated Rate	$285.18
Rate for Payer: Aetna Commercial	$216.73
Rate for Payer: Aetna Medicare Advantage	$171.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.44
Rate for Payer: Cigna Commercial	$285.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.10
Rate for Payer: Oxford Commercial	$114.07
Rate for Payer: Qualcare PPO/HMO/WC	$85.55
Rate for Payer: UnitedHealthcare Commercial	$114.07
Rate for Payer: UnitedHealthcare Community & State	$13.75
Rate for Payer: Wellpoint Medicaid Managed Care	$15.11

WIRE BOLT SHORT LRF 1.5X2.0MM

Facility

$570.35

Service Code	HCPCS A4649
Hospital Charge Code	270699590
Hospital Revenue Code	272
Min. Negotiated Rate	$85.55
Max. Negotiated Rate	$85.55
Rate for Payer: Qualcare PPO/HMO/WC	$85.55

WIRE BONE 2.4MMX100CM

Facility

$349.45

Service Code	HCPCS C1713
Hospital Charge Code	270625006
Hospital Revenue Code	278
Min. Negotiated Rate	$52.42
Max. Negotiated Rate	$84.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$76.88
Rate for Payer: Qualcare PPO/HMO/WC	$52.42

WIRE BONE 2.4MMX100CM

Facility

$349.45

Service Code	HCPCS C1713
Hospital Charge Code	270625006
Hospital Revenue Code	278
Min. Negotiated Rate	$8.42
Max. Negotiated Rate	$174.72
Rate for Payer: Aetna Commercial	$132.79
Rate for Payer: Aetna Medicare Advantage	$104.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.11
Rate for Payer: Cigna Commercial	$174.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$76.88
Rate for Payer: Qualcare PPO/HMO/WC	$52.42
Rate for Payer: UnitedHealthcare Community & State	$8.42
Rate for Payer: Wellpoint Medicaid Managed Care	$9.26

WIRE CALIBRATED MEASURED 1.1MM

Facility

$206.00

Hospital Charge Code	270703052
Hospital Revenue Code	278
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$103.00
Rate for Payer: Aetna Commercial	$78.28
Rate for Payer: Aetna Medicare Advantage	$61.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.53
Rate for Payer: Cigna Commercial	$103.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$45.32
Rate for Payer: Qualcare PPO/HMO/WC	$30.90
Rate for Payer: UnitedHealthcare Community & State	$4.96
Rate for Payer: Wellpoint Medicaid Managed Care	$5.46

WIRE CALIBRATED MEASURED 1.1MM

Facility

$206.00

Hospital Charge Code	270703052
Hospital Revenue Code	278
Min. Negotiated Rate	$30.90
Max. Negotiated Rate	$49.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$45.32
Rate for Payer: Qualcare PPO/HMO/WC	$30.90

WIRE CALIBRATED MEASURED 1.35T

Facility

$206.00

Hospital Charge Code	270703054
Hospital Revenue Code	278
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$103.00
Rate for Payer: Aetna Commercial	$78.28
Rate for Payer: Aetna Medicare Advantage	$61.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.53
Rate for Payer: Cigna Commercial	$103.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$45.32
Rate for Payer: Qualcare PPO/HMO/WC	$30.90
Rate for Payer: UnitedHealthcare Community & State	$4.96
Rate for Payer: Wellpoint Medicaid Managed Care	$5.46

WIRE CALIBRATED MEASURED 1.35T

Facility

$206.00

Hospital Charge Code	270703054
Hospital Revenue Code	278
Min. Negotiated Rate	$30.90
Max. Negotiated Rate	$49.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$45.32
Rate for Payer: Qualcare PPO/HMO/WC	$30.90

WIRE CD GUIDE .038 150CM 3MMJ

Facility

$270.50

Service Code	HCPCS C1769
Hospital Charge Code	270600708
Hospital Revenue Code	278
Min. Negotiated Rate	$6.52
Max. Negotiated Rate	$135.25
Rate for Payer: Aetna Commercial	$102.79
Rate for Payer: Aetna Medicare Advantage	$81.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.98
Rate for Payer: Cigna Commercial	$135.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$59.51
Rate for Payer: Qualcare PPO/HMO/WC	$40.58
Rate for Payer: UnitedHealthcare Community & State	$6.52
Rate for Payer: Wellpoint Medicaid Managed Care	$7.17

WIRE CD GUIDE .038 150CM 3MMJ

Facility

$270.50

Service Code	HCPCS C1769
Hospital Charge Code	270600708
Hospital Revenue Code	278
Min. Negotiated Rate	$40.58
Max. Negotiated Rate	$65.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$59.51
Rate for Payer: Qualcare PPO/HMO/WC	$40.58

WIRE CD GUIDE .038 150CM 3MMJ

Facility

$99.25

Hospital Charge Code	270600708C
Hospital Revenue Code	278
Min. Negotiated Rate	$2.39
Max. Negotiated Rate	$49.62
Rate for Payer: Aetna Commercial	$37.72
Rate for Payer: Aetna Medicare Advantage	$29.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.31
Rate for Payer: Cigna Commercial	$49.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$21.84
Rate for Payer: Qualcare PPO/HMO/WC	$14.89
Rate for Payer: UnitedHealthcare Community & State	$2.39
Rate for Payer: Wellpoint Medicaid Managed Care	$2.63

WIRE CD GUIDE .038 150CM 3MMJ

Facility

$99.25

Hospital Charge Code	270600708C
Hospital Revenue Code	278
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$24.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$21.84
Rate for Payer: Qualcare PPO/HMO/WC	$14.89

WIRE CERCLAGE 1.0MM COILS

Facility

$283.50

Hospital Charge Code	270676853
Hospital Revenue Code	272
Min. Negotiated Rate	$42.52
Max. Negotiated Rate	$42.52
Rate for Payer: Qualcare PPO/HMO/WC	$42.52

WIRE CERCLAGE 1.0MM COILS

Facility

$283.50

Hospital Charge Code	270676853
Hospital Revenue Code	272
Min. Negotiated Rate	$6.83
Max. Negotiated Rate	$141.75
Rate for Payer: Aetna Commercial	$107.73
Rate for Payer: Aetna Medicare Advantage	$85.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.29
Rate for Payer: Cigna Commercial	$141.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.05
Rate for Payer: Oxford Commercial	$56.70
Rate for Payer: Qualcare PPO/HMO/WC	$42.52
Rate for Payer: UnitedHealthcare Commercial	$56.70
Rate for Payer: UnitedHealthcare Community & State	$6.83
Rate for Payer: Wellpoint Medicaid Managed Care	$7.51

Know your out-of-pocket cost for care.

All Charges