Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

WIRE COMPR 15MM THD 150MM

Facility

$200.50

Hospital Charge Code	270675951
Hospital Revenue Code	272
Min. Negotiated Rate	$4.83
Max. Negotiated Rate	$100.25
Rate for Payer: Aetna Commercial	$76.19
Rate for Payer: Aetna Medicare Advantage	$60.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.13
Rate for Payer: Cigna Commercial	$100.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.15
Rate for Payer: Oxford Commercial	$40.10
Rate for Payer: Qualcare PPO/HMO/WC	$30.07
Rate for Payer: UnitedHealthcare Commercial	$40.10
Rate for Payer: UnitedHealthcare Community & State	$4.83
Rate for Payer: Wellpoint Medicaid Managed Care	$5.31

WIRE COMPR 1.6MM 30x150MM

Facility

$223.60

Hospital Charge Code	270677509
Hospital Revenue Code	272
Min. Negotiated Rate	$33.54
Max. Negotiated Rate	$33.54
Rate for Payer: Qualcare PPO/HMO/WC	$33.54

WIRE COMPR 1.6MM 30x150MM

Facility

$223.60

Hospital Charge Code	270677509
Hospital Revenue Code	272
Min. Negotiated Rate	$5.39
Max. Negotiated Rate	$111.80
Rate for Payer: Aetna Commercial	$84.97
Rate for Payer: Aetna Medicare Advantage	$67.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.02
Rate for Payer: Cigna Commercial	$111.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.08
Rate for Payer: Oxford Commercial	$44.72
Rate for Payer: Qualcare PPO/HMO/WC	$33.54
Rate for Payer: UnitedHealthcare Commercial	$44.72
Rate for Payer: UnitedHealthcare Community & State	$5.39
Rate for Payer: Wellpoint Medicaid Managed Care	$5.93

WIRE COMPR 20MM THD 1.6x150MM

Facility

$200.50

Hospital Charge Code	270675217
Hospital Revenue Code	272
Min. Negotiated Rate	$4.83
Max. Negotiated Rate	$100.25
Rate for Payer: Aetna Commercial	$76.19
Rate for Payer: Aetna Medicare Advantage	$60.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.13
Rate for Payer: Cigna Commercial	$100.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.15
Rate for Payer: Oxford Commercial	$40.10
Rate for Payer: Qualcare PPO/HMO/WC	$30.07
Rate for Payer: UnitedHealthcare Commercial	$40.10
Rate for Payer: UnitedHealthcare Community & State	$4.83
Rate for Payer: Wellpoint Medicaid Managed Care	$5.31

WIRE COMPR 20MM THD 1.6x150MM

Facility

$200.50

Hospital Charge Code	270675217
Hospital Revenue Code	272
Min. Negotiated Rate	$30.07
Max. Negotiated Rate	$30.07
Rate for Payer: Qualcare PPO/HMO/WC	$30.07

WIRE COMPR 25MM THD 1.6x150MM

Facility

$189.00

Hospital Charge Code	270676223
Hospital Revenue Code	272
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$94.50
Rate for Payer: Aetna Commercial	$71.82
Rate for Payer: Aetna Medicare Advantage	$56.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.20
Rate for Payer: Cigna Commercial	$94.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.70
Rate for Payer: Oxford Commercial	$37.80
Rate for Payer: Qualcare PPO/HMO/WC	$28.35
Rate for Payer: UnitedHealthcare Commercial	$37.80
Rate for Payer: UnitedHealthcare Community & State	$4.55
Rate for Payer: Wellpoint Medicaid Managed Care	$5.01

WIRE COMPR 25MM THD 1.6x150MM

Facility

$189.00

Hospital Charge Code	270676223
Hospital Revenue Code	272
Min. Negotiated Rate	$28.35
Max. Negotiated Rate	$28.35
Rate for Payer: Qualcare PPO/HMO/WC	$28.35

WIRE COMPRES 2.8x15mm/200mm

Facility

$253.00

Service Code	HCPCS C1713
Hospital Charge Code	270681462
Hospital Revenue Code	278
Min. Negotiated Rate	$37.95
Max. Negotiated Rate	$61.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.66
Rate for Payer: Qualcare PPO/HMO/WC	$37.95

WIRE COMPRES 2.8x15mm/200mm

Facility

$253.00

Service Code	HCPCS C1713
Hospital Charge Code	270681462
Hospital Revenue Code	278
Min. Negotiated Rate	$6.10
Max. Negotiated Rate	$126.50
Rate for Payer: Aetna Commercial	$96.14
Rate for Payer: Aetna Medicare Advantage	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.52
Rate for Payer: Cigna Commercial	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.66
Rate for Payer: Qualcare PPO/HMO/WC	$37.95
Rate for Payer: UnitedHealthcare Community & State	$6.10
Rate for Payer: Wellpoint Medicaid Managed Care	$6.70

WIRE COMPRES 2.8x25mm/200mm

Facility

$662.00

Service Code	HCPCS C1713
Hospital Charge Code	270681460
Hospital Revenue Code	278
Min. Negotiated Rate	$15.95
Max. Negotiated Rate	$331.00
Rate for Payer: Aetna Commercial	$251.56
Rate for Payer: Aetna Medicare Advantage	$198.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.81
Rate for Payer: Cigna Commercial	$331.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.64
Rate for Payer: Qualcare PPO/HMO/WC	$99.30
Rate for Payer: UnitedHealthcare Community & State	$15.95
Rate for Payer: Wellpoint Medicaid Managed Care	$17.54

WIRE COMPRES 2.8x25mm/200mm

Facility

$662.00

Service Code	HCPCS C1713
Hospital Charge Code	270681460
Hospital Revenue Code	278
Min. Negotiated Rate	$99.30
Max. Negotiated Rate	$160.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.64
Rate for Payer: Qualcare PPO/HMO/WC	$99.30

WIRE COMPRESSION ALPS SHORT

Facility

$165.00

Service Code	HCPCS C1713
Hospital Charge Code	270694040
Hospital Revenue Code	278
Min. Negotiated Rate	$3.98
Max. Negotiated Rate	$82.50
Rate for Payer: Aetna Commercial	$62.70
Rate for Payer: Aetna Medicare Advantage	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.08
Rate for Payer: Cigna Commercial	$82.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$24.75
Rate for Payer: UnitedHealthcare Community & State	$3.98
Rate for Payer: Wellpoint Medicaid Managed Care	$4.37

WIRE COMPRESSION ALPS SHORT

Facility

$165.00

Service Code	HCPCS C1713
Hospital Charge Code	270694040
Hospital Revenue Code	278
Min. Negotiated Rate	$24.75
Max. Negotiated Rate	$39.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$24.75

WIRE CONNORS J .035 260CM

Facility

$255.00

Hospital Charge Code	270677087
Hospital Revenue Code	272
Min. Negotiated Rate	$38.25
Max. Negotiated Rate	$38.25
Rate for Payer: Qualcare PPO/HMO/WC	$38.25

WIRE CONNORS J .035 260CM

Facility

$255.00

Hospital Charge Code	270677087
Hospital Revenue Code	272
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$127.50
Rate for Payer: Aetna Commercial	$96.90
Rate for Payer: Aetna Medicare Advantage	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.03
Rate for Payer: Cigna Commercial	$127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.50
Rate for Payer: Oxford Commercial	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.25
Rate for Payer: UnitedHealthcare Commercial	$51.00
Rate for Payer: UnitedHealthcare Community & State	$6.15
Rate for Payer: Wellpoint Medicaid Managed Care	$6.76

WIRE CRD GUIDE .035 ST 502555H

Facility

$67.25

Hospital Charge Code	270616498C
Hospital Revenue Code	278
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$33.62
Rate for Payer: Aetna Commercial	$25.55
Rate for Payer: Aetna Medicare Advantage	$20.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.15
Rate for Payer: Cigna Commercial	$33.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.79
Rate for Payer: Qualcare PPO/HMO/WC	$10.09
Rate for Payer: UnitedHealthcare Community & State	$1.62
Rate for Payer: Wellpoint Medicaid Managed Care	$1.78

WIRE CRD GUIDE .035 ST 502555H

Facility

$67.25

Hospital Charge Code	270616498C
Hospital Revenue Code	278
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$16.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.79
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

WIRE CRD GUIDE .038 420100

Facility

$77.65

Hospital Charge Code	270605414C
Hospital Revenue Code	278
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$38.83
Rate for Payer: Aetna Commercial	$29.51
Rate for Payer: Aetna Medicare Advantage	$23.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.80
Rate for Payer: Cigna Commercial	$38.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$17.08
Rate for Payer: Qualcare PPO/HMO/WC	$11.65
Rate for Payer: UnitedHealthcare Community & State	$1.87
Rate for Payer: Wellpoint Medicaid Managed Care	$2.06

WIRE CRD GUIDE .038 420100

Facility

$77.65

Hospital Charge Code	270605414C
Hospital Revenue Code	278
Min. Negotiated Rate	$11.65
Max. Negotiated Rate	$18.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$17.08
Rate for Payer: Qualcare PPO/HMO/WC	$11.65

WIRE DPY BAYONET 1.8MM 10420

Facility

$459.25

Hospital Charge Code	270621622
Hospital Revenue Code	278
Min. Negotiated Rate	$11.07
Max. Negotiated Rate	$229.62
Rate for Payer: Aetna Commercial	$174.51
Rate for Payer: Aetna Medicare Advantage	$137.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.11
Rate for Payer: Cigna Commercial	$229.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$101.03
Rate for Payer: Qualcare PPO/HMO/WC	$68.89
Rate for Payer: UnitedHealthcare Community & State	$11.07
Rate for Payer: Wellpoint Medicaid Managed Care	$12.17

WIRE DPY BAYONET 1.8MM 10420

Facility

$459.25

Hospital Charge Code	270621622
Hospital Revenue Code	278
Min. Negotiated Rate	$68.89
Max. Negotiated Rate	$111.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$101.03
Rate for Payer: Qualcare PPO/HMO/WC	$68.89

WIRE DPY BAYONET 1.8MM 10469

Facility

$408.85

Hospital Charge Code	270612438
Hospital Revenue Code	278
Min. Negotiated Rate	$61.33
Max. Negotiated Rate	$98.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$89.95
Rate for Payer: Qualcare PPO/HMO/WC	$61.33

WIRE DPY BAYONET 1.8MM 10469

Facility

$408.85

Hospital Charge Code	270612438
Hospital Revenue Code	278
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$204.43
Rate for Payer: Aetna Commercial	$155.36
Rate for Payer: Aetna Medicare Advantage	$122.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.26
Rate for Payer: Cigna Commercial	$204.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$89.95
Rate for Payer: Qualcare PPO/HMO/WC	$61.33
Rate for Payer: UnitedHealthcare Community & State	$9.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.83

WIRE DYNANTIE 1.6 DBL TIP

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270689953
Hospital Revenue Code	278
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

WIRE DYNANTIE 1.6 DBL TIP

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270689953
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

Know your out-of-pocket cost for care.

All Charges