Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

WIRE LUQUE CERCLAGE .97x20MM

Facility

$194.95

Hospital Charge Code	270677271
Hospital Revenue Code	272
Min. Negotiated Rate	$4.70
Max. Negotiated Rate	$97.47
Rate for Payer: Aetna Commercial	$74.08
Rate for Payer: Aetna Medicare Advantage	$58.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.71
Rate for Payer: Cigna Commercial	$97.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.48
Rate for Payer: Oxford Commercial	$38.99
Rate for Payer: Qualcare PPO/HMO/WC	$29.24
Rate for Payer: UnitedHealthcare Commercial	$38.99
Rate for Payer: UnitedHealthcare Community & State	$4.70
Rate for Payer: Wellpoint Medicaid Managed Care	$5.17

WIRE MCV GLIDE STR .025 5340

Facility

$3,214.45

Hospital Charge Code	270612717
Hospital Revenue Code	278
Min. Negotiated Rate	$77.47
Max. Negotiated Rate	$1,607.22
Rate for Payer: Aetna Commercial	$1,221.49
Rate for Payer: Aetna Medicare Advantage	$964.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$819.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$819.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$642.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$819.68
Rate for Payer: Cigna Commercial	$1,607.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$777.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$707.18
Rate for Payer: Qualcare PPO/HMO/WC	$482.17
Rate for Payer: UnitedHealthcare Community & State	$77.47
Rate for Payer: Wellpoint Medicaid Managed Care	$85.18

WIRE MCV GLIDE STR .025 5340

Facility

$3,214.45

Hospital Charge Code	270612717
Hospital Revenue Code	278
Min. Negotiated Rate	$482.17
Max. Negotiated Rate	$777.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$642.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$777.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$707.18
Rate for Payer: Qualcare PPO/HMO/WC	$482.17

WIRE MCV GLIDE STR .035 5193

Facility

$1,225.65

Hospital Charge Code	270601172
Hospital Revenue Code	278
Min. Negotiated Rate	$183.85
Max. Negotiated Rate	$296.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$245.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.64
Rate for Payer: Qualcare PPO/HMO/WC	$183.85

WIRE MCV GLIDE STR .035 5193

Facility

$1,225.65

Hospital Charge Code	270601172
Hospital Revenue Code	278
Min. Negotiated Rate	$29.54
Max. Negotiated Rate	$612.83
Rate for Payer: Aetna Commercial	$465.75
Rate for Payer: Aetna Medicare Advantage	$367.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$312.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$312.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$245.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$312.54
Rate for Payer: Cigna Commercial	$612.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.64
Rate for Payer: Qualcare PPO/HMO/WC	$183.85
Rate for Payer: UnitedHealthcare Community & State	$29.54
Rate for Payer: Wellpoint Medicaid Managed Care	$32.48

WIRE MCV GUIDE .025 610102

Facility

$75.00

Service Code	HCPCS C1769
Hospital Charge Code	270601263
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 MCV GUIDE .025 610102

Facility

$75.00

Service Code	HCPCS C1769
Hospital Charge Code	270601263
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 MCV GUIDE .028 620106

Facility

$136.85

Hospital Charge Code	270601270
Hospital Revenue Code	278
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$68.42
Rate for Payer: Aetna Commercial	$52.00
Rate for Payer: Aetna Medicare Advantage	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.90
Rate for Payer: Cigna Commercial	$68.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.11
Rate for Payer: Qualcare PPO/HMO/WC	$20.53
Rate for Payer: UnitedHealthcare Community & State	$3.30
Rate for Payer: Wellpoint Medicaid Managed Care	$3.63

WIRE MCV GUIDE .028 620106

Facility

$136.85

Hospital Charge Code	270601270
Hospital Revenue Code	278
Min. Negotiated Rate	$20.53
Max. Negotiated Rate	$33.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.11
Rate for Payer: Qualcare PPO/HMO/WC	$20.53

WIRE MCV GUIDE .035 620120

Facility

$100.85

Hospital Charge Code	270614930
Hospital Revenue Code	278
Min. Negotiated Rate	$2.43
Max. Negotiated Rate	$50.42
Rate for Payer: Aetna Commercial	$38.32
Rate for Payer: Aetna Medicare Advantage	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.72
Rate for Payer: Cigna Commercial	$50.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$22.19
Rate for Payer: Qualcare PPO/HMO/WC	$15.13
Rate for Payer: UnitedHealthcare Community & State	$2.43
Rate for Payer: Wellpoint Medicaid Managed Care	$2.67

WIRE MCV GUIDE .035 620120

Facility

$100.85

Hospital Charge Code	270614930
Hospital Revenue Code	278
Min. Negotiated Rate	$15.13
Max. Negotiated Rate	$24.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$22.19
Rate for Payer: Qualcare PPO/HMO/WC	$15.13

WIRE MCV GUIDE FXTIP .038 5170

Facility

$494.45

Hospital Charge Code	270600934
Hospital Revenue Code	278
Min. Negotiated Rate	$11.92
Max. Negotiated Rate	$247.22
Rate for Payer: Aetna Commercial	$187.89
Rate for Payer: Aetna Medicare Advantage	$148.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.08
Rate for Payer: Cigna Commercial	$247.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$108.78
Rate for Payer: Qualcare PPO/HMO/WC	$74.17
Rate for Payer: UnitedHealthcare Community & State	$11.92
Rate for Payer: Wellpoint Medicaid Managed Care	$13.10

WIRE MCV GUIDE FXTIP .038 5170

Facility

$494.45

Hospital Charge Code	270600934
Hospital Revenue Code	278
Min. Negotiated Rate	$74.17
Max. Negotiated Rate	$119.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$108.78
Rate for Payer: Qualcare PPO/HMO/WC	$74.17

WIRE MCV GUIDE JAG .025 5656

Facility

$657.50

Service Code	HCPCS C1769
Hospital Charge Code	270608080
Hospital Revenue Code	278
Min. Negotiated Rate	$15.85
Max. Negotiated Rate	$328.75
Rate for Payer: Aetna Commercial	$249.85
Rate for Payer: Aetna Medicare Advantage	$197.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.66
Rate for Payer: Cigna Commercial	$328.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$144.65
Rate for Payer: Qualcare PPO/HMO/WC	$98.62
Rate for Payer: UnitedHealthcare Community & State	$15.85
Rate for Payer: Wellpoint Medicaid Managed Care	$17.42

WIRE MCV GUIDE JAG .025 5656

Facility

$657.50

Service Code	HCPCS C1769
Hospital Charge Code	270608080
Hospital Revenue Code	278
Min. Negotiated Rate	$98.62
Max. Negotiated Rate	$159.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$144.65
Rate for Payer: Qualcare PPO/HMO/WC	$98.62

WIRE MCV GUIDE MVI 5009

Facility

$1,208.85

Hospital Charge Code	270611112
Hospital Revenue Code	278
Min. Negotiated Rate	$29.13
Max. Negotiated Rate	$604.42
Rate for Payer: Aetna Commercial	$459.36
Rate for Payer: Aetna Medicare Advantage	$362.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.26
Rate for Payer: Cigna Commercial	$604.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$265.95
Rate for Payer: Qualcare PPO/HMO/WC	$181.33
Rate for Payer: UnitedHealthcare Community & State	$29.13
Rate for Payer: Wellpoint Medicaid Managed Care	$32.03

WIRE MCV GUIDE MVI 5009

Facility

$1,208.85

Hospital Charge Code	270611112
Hospital Revenue Code	278
Min. Negotiated Rate	$181.33
Max. Negotiated Rate	$292.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$265.95
Rate for Payer: Qualcare PPO/HMO/WC	$181.33

WIRE MCV GUIDE TFL .025 620107

Facility

$124.85

Hospital Charge Code	270601264
Hospital Revenue Code	278
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.42
Rate for Payer: Aetna Commercial	$47.44
Rate for Payer: Aetna Medicare Advantage	$37.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.84
Rate for Payer: Cigna Commercial	$62.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.47
Rate for Payer: Qualcare PPO/HMO/WC	$18.73
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

WIRE MCV GUIDE TFL .025 620107

Facility

$124.85

Hospital Charge Code	270601264
Hospital Revenue Code	278
Min. Negotiated Rate	$18.73
Max. Negotiated Rate	$30.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.47
Rate for Payer: Qualcare PPO/HMO/WC	$18.73

WIRE MCV GUIDE TFL .038 620100

Facility

$65.00

Hospital Charge Code	270601257
Hospital Revenue Code	272
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

WIRE MCV GUIDE TFL .038 620100

Facility

$65.00

Hospital Charge Code	270601257
Hospital Revenue Code	272
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$32.50
Rate for Payer: Aetna Commercial	$24.70
Rate for Payer: Aetna Medicare Advantage	$19.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.57
Rate for Payer: Cigna Commercial	$32.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$13.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.75
Rate for Payer: UnitedHealthcare Commercial	$13.00
Rate for Payer: UnitedHealthcare Community & State	$1.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1.72

WIRE MCV ZEBRA 450CM 5156

Facility

$1,021.65

Hospital Charge Code	270604740
Hospital Revenue Code	278
Min. Negotiated Rate	$153.25
Max. Negotiated Rate	$247.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$224.76
Rate for Payer: Qualcare PPO/HMO/WC	$153.25

WIRE MCV ZEBRA 450CM 5156

Facility

$1,021.65

Hospital Charge Code	270604740
Hospital Revenue Code	278
Min. Negotiated Rate	$24.62
Max. Negotiated Rate	$510.82
Rate for Payer: Aetna Commercial	$388.23
Rate for Payer: Aetna Medicare Advantage	$306.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.52
Rate for Payer: Cigna Commercial	$510.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$224.76
Rate for Payer: Qualcare PPO/HMO/WC	$153.25
Rate for Payer: UnitedHealthcare Community & State	$24.62
Rate for Payer: Wellpoint Medicaid Managed Care	$27.07

WIRE MCV ZEBRA 450CM 5157

Facility

$1,021.65

Hospital Charge Code	270604745
Hospital Revenue Code	278
Min. Negotiated Rate	$153.25
Max. Negotiated Rate	$247.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$224.76
Rate for Payer: Qualcare PPO/HMO/WC	$153.25

WIRE MCV ZEBRA 450CM 5157

Facility

$1,021.65

Hospital Charge Code	270604745
Hospital Revenue Code	278
Min. Negotiated Rate	$24.62
Max. Negotiated Rate	$510.82
Rate for Payer: Aetna Commercial	$388.23
Rate for Payer: Aetna Medicare Advantage	$306.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.52
Rate for Payer: Cigna Commercial	$510.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$224.76
Rate for Payer: Qualcare PPO/HMO/WC	$153.25
Rate for Payer: UnitedHealthcare Community & State	$24.62
Rate for Payer: Wellpoint Medicaid Managed Care	$27.07

Know your out-of-pocket cost for care.

All Charges