Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

WIRE SPIDER FILTER RX 7.0X180

Facility

$6,000.00

Hospital Charge Code	270639496
Hospital Revenue Code	272
Min. Negotiated Rate	$144.60
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,800.00
Rate for Payer: Oxford Commercial	$1,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Commercial	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$159.00

WIRES STIFF HYDROPHILIC ANGLE

Facility

$280.00

Hospital Charge Code	270CH0069
Hospital Revenue Code	272
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$106.40
Rate for Payer: Aetna Medicare Advantage	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.40
Rate for Payer: Cigna Commercial	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.00
Rate for Payer: Oxford Commercial	$56.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Commercial	$56.00
Rate for Payer: UnitedHealthcare Community & State	$6.75
Rate for Payer: Wellpoint Medicaid Managed Care	$7.42

WIRES STIFF HYDROPHILIC ANGLE

Facility

$280.00

Hospital Charge Code	270CH0069
Hospital Revenue Code	272
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

WIRE STANDARD HYDROPHILIC STR

Facility

$1,400.00

Hospital Charge Code	270658354
Hospital Revenue Code	272
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

WIRE STANDARD HYDROPHILIC STR

Facility

$1,400.00

Hospital Charge Code	270658354
Hospital Revenue Code	272
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$210.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.00

WIRE STAND HYDRO ANGL 35X180

Facility

$250.00

Hospital Charge Code	270658357
Hospital Revenue Code	272
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.00
Rate for Payer: Oxford Commercial	$50.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$50.00
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

WIRE STAND HYDRO ANGL 35X180

Facility

$250.00

Hospital Charge Code	270658357
Hospital Revenue Code	272
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

WIRE STIFF 0.035/260C

Facility

$280.00

Service Code	HCPCS C1769
Hospital Charge Code	270662309N
Hospital Revenue Code	278
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$106.40
Rate for Payer: Aetna Medicare Advantage	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.40
Rate for Payer: Cigna Commercial	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.60
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Community & State	$6.75
Rate for Payer: Wellpoint Medicaid Managed Care	$7.42

WIRE STIFF 0.035/260C

Facility

$169.95

Service Code	HCPCS C1769
Hospital Charge Code	270662309
Hospital Revenue Code	278
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$84.97
Rate for Payer: Aetna Commercial	$64.58
Rate for Payer: Aetna Medicare Advantage	$50.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.34
Rate for Payer: Cigna Commercial	$84.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$37.39
Rate for Payer: Qualcare PPO/HMO/WC	$25.49
Rate for Payer: UnitedHealthcare Community & State	$4.10
Rate for Payer: Wellpoint Medicaid Managed Care	$4.50

WIRE STIFF 0.035/260C

Facility

$280.00

Service Code	HCPCS C1769
Hospital Charge Code	270662309N
Hospital Revenue Code	278
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$67.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.60
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

WIRE STIFF 0.035/260C

Facility

$169.95

Service Code	HCPCS C1769
Hospital Charge Code	270662309
Hospital Revenue Code	278
Min. Negotiated Rate	$25.49
Max. Negotiated Rate	$41.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$37.39
Rate for Payer: Qualcare PPO/HMO/WC	$25.49

WIRE STIFF 0.035/260C

Facility

$169.95

Service Code	HCPCS C1769
Hospital Charge Code	270662309S
Hospital Revenue Code	278
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$84.97
Rate for Payer: Aetna Commercial	$64.58
Rate for Payer: Aetna Medicare Advantage	$50.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.34
Rate for Payer: Cigna Commercial	$84.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$37.39
Rate for Payer: Qualcare PPO/HMO/WC	$25.49
Rate for Payer: UnitedHealthcare Community & State	$4.10
Rate for Payer: Wellpoint Medicaid Managed Care	$4.50

WIRE STIFF 0.035/260C

Facility

$169.95

Service Code	HCPCS C1769
Hospital Charge Code	270662309S
Hospital Revenue Code	278
Min. Negotiated Rate	$25.49
Max. Negotiated Rate	$41.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$37.39
Rate for Payer: Qualcare PPO/HMO/WC	$25.49

WIRE STRY K 3.2 150 12106450S

Facility

$341.65

Hospital Charge Code	270622042
Hospital Revenue Code	278
Min. Negotiated Rate	$51.25
Max. Negotiated Rate	$82.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$75.16
Rate for Payer: Qualcare PPO/HMO/WC	$51.25

WIRE STRY K 3.2 150 12106450S

Facility

$341.65

Hospital Charge Code	270622042
Hospital Revenue Code	278
Min. Negotiated Rate	$8.23
Max. Negotiated Rate	$170.82
Rate for Payer: Aetna Commercial	$129.83
Rate for Payer: Aetna Medicare Advantage	$102.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.12
Rate for Payer: Cigna Commercial	$170.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$75.16
Rate for Payer: Qualcare PPO/HMO/WC	$51.25
Rate for Payer: UnitedHealthcare Community & State	$8.23
Rate for Payer: Wellpoint Medicaid Managed Care	$9.05

WIRE SUPER STIFF .035 X 260 MM

Facility

$750.00

Service Code	HCPCS C1874
Hospital Charge Code	270688532
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

WIRE SUPER STIFF .035 X 260 MM

Facility

$750.00

Service Code	HCPCS C1874
Hospital Charge Code	270688532
Hospital Revenue Code	272
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$150.00
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

WIRE SWAN-GANZ WIRE .025 x 1

Facility

$40.50

Hospital Charge Code	270664783
Hospital Revenue Code	270
Min. Negotiated Rate	$6.08
Max. Negotiated Rate	$6.08
Rate for Payer: Qualcare PPO/HMO/WC	$6.08

WIRE SWAN-GANZ WIRE .025 x 1

Facility

$40.50

Hospital Charge Code	270664783
Hospital Revenue Code	270
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$20.25
Rate for Payer: Aetna Commercial	$15.39
Rate for Payer: Aetna Medicare Advantage	$12.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.33
Rate for Payer: Cigna Commercial	$20.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.15
Rate for Payer: Oxford Commercial	$8.10
Rate for Payer: Qualcare PPO/HMO/WC	$6.08
Rate for Payer: UnitedHealthcare Commercial	$8.10
Rate for Payer: UnitedHealthcare Community & State	$0.98
Rate for Payer: Wellpoint Medicaid Managed Care	$1.07

WIRE SYN GUIDE 1.25 150 292.62

Facility

$40.85

Hospital Charge Code	270622123
Hospital Revenue Code	278
Min. Negotiated Rate	$6.13
Max. Negotiated Rate	$9.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.99
Rate for Payer: Qualcare PPO/HMO/WC	$6.13

WIRE SYN GUIDE 1.25 150 292.62

Facility

$40.85

Hospital Charge Code	270622123
Hospital Revenue Code	278
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$20.43
Rate for Payer: Aetna Commercial	$15.52
Rate for Payer: Aetna Medicare Advantage	$12.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.42
Rate for Payer: Cigna Commercial	$20.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.99
Rate for Payer: Qualcare PPO/HMO/WC	$6.13
Rate for Payer: UnitedHealthcare Community & State	$0.98
Rate for Payer: Wellpoint Medicaid Managed Care	$1.08

WIRE SYN GUIDE 3.2 292.69

Facility

$362.50

Service Code	HCPCS C1769
Hospital Charge Code	270611969
Hospital Revenue Code	278
Min. Negotiated Rate	$54.38
Max. Negotiated Rate	$87.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$79.75
Rate for Payer: Qualcare PPO/HMO/WC	$54.38

WIRE SYN GUIDE 3.2 292.69

Facility

$362.50

Service Code	HCPCS C1769
Hospital Charge Code	270611969
Hospital Revenue Code	278
Min. Negotiated Rate	$8.74
Max. Negotiated Rate	$181.25
Rate for Payer: Aetna Commercial	$137.75
Rate for Payer: Aetna Medicare Advantage	$108.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.44
Rate for Payer: Cigna Commercial	$181.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$79.75
Rate for Payer: Qualcare PPO/HMO/WC	$54.38
Rate for Payer: UnitedHealthcare Community & State	$8.74
Rate for Payer: Wellpoint Medicaid Managed Care	$9.61

WIRE SYN K 0.6 70MM 292.46

Facility

$43.25

Hospital Charge Code	270604429
Hospital Revenue Code	272
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$6.49
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

WIRE SYN K 0.6 70MM 292.46

Facility

$43.25

Hospital Charge Code	270604429
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.62
Rate for Payer: Aetna Commercial	$16.43
Rate for Payer: Aetna Medicare Advantage	$12.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.03
Rate for Payer: Cigna Commercial	$21.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.97
Rate for Payer: Oxford Commercial	$8.65
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
Rate for Payer: UnitedHealthcare Commercial	$8.65
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.15

Know your out-of-pocket cost for care.

All Charges