Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CABLE BMT SS 2 750 350800

Facility

$1,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270627428
Hospital Revenue Code	278
Min. Negotiated Rate	$217.50
Max. Negotiated Rate	$350.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$319.00
Rate for Payer: Qualcare PPO/HMO/WC	$217.50

CABLE COCR 1.7MM W/CRIMP 750MM

Facility

$2,133.30

Hospital Charge Code	270668587
Hospital Revenue Code	272
Min. Negotiated Rate	$320.00
Max. Negotiated Rate	$320.00
Rate for Payer: Qualcare PPO/HMO/WC	$320.00

CABLE COCR 1.7MM W/CRIMP 750MM

Facility

$2,133.30

Hospital Charge Code	270668587
Hospital Revenue Code	272
Min. Negotiated Rate	$51.41
Max. Negotiated Rate	$1,066.65
Rate for Payer: Aetna Commercial	$810.65
Rate for Payer: Aetna Medicare Advantage	$639.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$543.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$543.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$543.99
Rate for Payer: Cigna Commercial	$1,066.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$639.99
Rate for Payer: Oxford Commercial	$426.66
Rate for Payer: Qualcare PPO/HMO/WC	$320.00
Rate for Payer: UnitedHealthcare Commercial	$426.66
Rate for Payer: UnitedHealthcare Community & State	$51.41
Rate for Payer: Wellpoint Medicaid Managed Care	$56.53

CABLE CONNECTOR

Facility

$2,465.00

Hospital Charge Code	270681171
Hospital Revenue Code	278
Min. Negotiated Rate	$59.41
Max. Negotiated Rate	$1,232.50
Rate for Payer: Aetna Commercial	$936.70
Rate for Payer: Aetna Medicare Advantage	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$628.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$628.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$493.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$628.58
Rate for Payer: Cigna Commercial	$1,232.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$596.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$542.30
Rate for Payer: Qualcare PPO/HMO/WC	$369.75
Rate for Payer: UnitedHealthcare Community & State	$59.41
Rate for Payer: Wellpoint Medicaid Managed Care	$65.32

CABLE CONNECTOR

Facility

$2,465.00

Hospital Charge Code	270681171
Hospital Revenue Code	278
Min. Negotiated Rate	$369.75
Max. Negotiated Rate	$596.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$493.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$596.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$542.30
Rate for Payer: Qualcare PPO/HMO/WC	$369.75

CABLE CONNECTOR ASSY MNTR

Facility

$2,465.00

Hospital Charge Code	270677391
Hospital Revenue Code	272
Min. Negotiated Rate	$369.75
Max. Negotiated Rate	$369.75
Rate for Payer: Qualcare PPO/HMO/WC	$369.75

CABLE CONNECTOR ASSY MNTR

Facility

$2,465.00

Hospital Charge Code	270677391
Hospital Revenue Code	272
Min. Negotiated Rate	$59.41
Max. Negotiated Rate	$1,232.50
Rate for Payer: Aetna Commercial	$936.70
Rate for Payer: Aetna Medicare Advantage	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$628.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$628.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$628.58
Rate for Payer: Cigna Commercial	$1,232.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$739.50
Rate for Payer: Oxford Commercial	$493.00
Rate for Payer: Qualcare PPO/HMO/WC	$369.75
Rate for Payer: UnitedHealthcare Commercial	$493.00
Rate for Payer: UnitedHealthcare Community & State	$59.41
Rate for Payer: Wellpoint Medicaid Managed Care	$65.32

CABLE CONNECTORS

Facility

$2,315.00

Service Code	HCPCS C1713
Hospital Charge Code	270690486
Hospital Revenue Code	278
Min. Negotiated Rate	$347.25
Max. Negotiated Rate	$560.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$463.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$560.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$509.30
Rate for Payer: Qualcare PPO/HMO/WC	$347.25

CABLE CONNECTORS

Facility

$2,315.00

Service Code	HCPCS C1713
Hospital Charge Code	270690486
Hospital Revenue Code	278
Min. Negotiated Rate	$55.79
Max. Negotiated Rate	$1,157.50
Rate for Payer: Aetna Commercial	$879.70
Rate for Payer: Aetna Medicare Advantage	$694.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$590.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$590.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$463.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$590.33
Rate for Payer: Cigna Commercial	$1,157.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$560.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$509.30
Rate for Payer: Qualcare PPO/HMO/WC	$347.25
Rate for Payer: UnitedHealthcare Community & State	$55.79
Rate for Payer: Wellpoint Medicaid Managed Care	$61.35

CABLE DISPOSABLE W/TUBING KIT

Facility

$269.50

Hospital Charge Code	270692060
Hospital Revenue Code	272
Min. Negotiated Rate	$40.42
Max. Negotiated Rate	$40.42
Rate for Payer: Qualcare PPO/HMO/WC	$40.42

CABLE DISPOSABLE W/TUBING KIT

Facility

$269.50

Hospital Charge Code	270692060
Hospital Revenue Code	272
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$134.75
Rate for Payer: Aetna Commercial	$102.41
Rate for Payer: Aetna Medicare Advantage	$80.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.72
Rate for Payer: Cigna Commercial	$134.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.85
Rate for Payer: Oxford Commercial	$53.90
Rate for Payer: Qualcare PPO/HMO/WC	$40.42
Rate for Payer: UnitedHealthcare Commercial	$53.90
Rate for Payer: UnitedHealthcare Community & State	$6.49
Rate for Payer: Wellpoint Medicaid Managed Care	$7.14

CABLEELECTRCLIPONLEADWIREDISP

Facility

$2,700.00

Hospital Charge Code	270694862
Hospital Revenue Code	272
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$405.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00

CABLEELECTRCLIPONLEADWIREDISP

Facility

$2,700.00

Hospital Charge Code	270694862
Hospital Revenue Code	272
Min. Negotiated Rate	$65.07
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$1,026.00
Rate for Payer: Aetna Medicare Advantage	$810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$688.50
Rate for Payer: Cigna Commercial	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$810.00
Rate for Payer: Oxford Commercial	$540.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00
Rate for Payer: UnitedHealthcare Commercial	$540.00
Rate for Payer: UnitedHealthcare Community & State	$65.07
Rate for Payer: Wellpoint Medicaid Managed Care	$71.55

CABLE FIBER OPTIC 5MM X 10FT

Facility

$3,150.00

Hospital Charge Code	270662669
Hospital Revenue Code	278
Min. Negotiated Rate	$75.92
Max. Negotiated Rate	$1,575.00
Rate for Payer: Aetna Commercial	$1,197.00
Rate for Payer: Aetna Medicare Advantage	$945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$803.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$803.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$803.25
Rate for Payer: Cigna Commercial	$1,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$762.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$693.00
Rate for Payer: Qualcare PPO/HMO/WC	$472.50
Rate for Payer: UnitedHealthcare Community & State	$75.92
Rate for Payer: Wellpoint Medicaid Managed Care	$83.47

CABLE FIBER OPTIC 5MM X 10FT

Facility

$3,150.00

Hospital Charge Code	270662669
Hospital Revenue Code	278
Min. Negotiated Rate	$472.50
Max. Negotiated Rate	$762.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$630.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$762.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$693.00
Rate for Payer: Qualcare PPO/HMO/WC	$472.50

CABLE GRIP SYS 1.8MM X635M

Facility

$2,860.00

Service Code	HCPCS C1713
Hospital Charge Code	270679952
Hospital Revenue Code	278
Min. Negotiated Rate	$68.93
Max. Negotiated Rate	$1,430.00
Rate for Payer: Aetna Commercial	$1,086.80
Rate for Payer: Aetna Medicare Advantage	$858.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$729.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$729.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$729.30
Rate for Payer: Cigna Commercial	$1,430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$692.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$629.20
Rate for Payer: Qualcare PPO/HMO/WC	$429.00
Rate for Payer: UnitedHealthcare Community & State	$68.93
Rate for Payer: Wellpoint Medicaid Managed Care	$75.79

CABLE GRIP SYS 1.8MM X635M

Facility

$2,860.00

Service Code	HCPCS C1713
Hospital Charge Code	270679952
Hospital Revenue Code	278
Min. Negotiated Rate	$429.00
Max. Negotiated Rate	$692.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$692.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$629.20
Rate for Payer: Qualcare PPO/HMO/WC	$429.00

CABLE INTEGRAL LNG 23X121 MM

Facility

$875.00

Hospital Charge Code	270690881
Hospital Revenue Code	272
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

CABLE INTEGRAL LNG 23X121 MM

Facility

$875.00

Hospital Charge Code	270690881
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

CABLE INTERFACE IBF

Facility

$365.00

Hospital Charge Code	270665867
Hospital Revenue Code	270
Min. Negotiated Rate	$54.75
Max. Negotiated Rate	$54.75
Rate for Payer: Qualcare PPO/HMO/WC	$54.75

CABLE INTERFACE IBF

Facility

$365.00

Hospital Charge Code	270665867
Hospital Revenue Code	270
Min. Negotiated Rate	$8.80
Max. Negotiated Rate	$182.50
Rate for Payer: Aetna Commercial	$138.70
Rate for Payer: Aetna Medicare Advantage	$109.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.08
Rate for Payer: Cigna Commercial	$182.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.50
Rate for Payer: Oxford Commercial	$73.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.75
Rate for Payer: UnitedHealthcare Commercial	$73.00
Rate for Payer: UnitedHealthcare Community & State	$8.80
Rate for Payer: Wellpoint Medicaid Managed Care	$9.67

CABLE INTRAUTERINE PRESS

Facility

$903.25

Hospital Charge Code	270600587
Hospital Revenue Code	270
Min. Negotiated Rate	$135.49
Max. Negotiated Rate	$135.49
Rate for Payer: Qualcare PPO/HMO/WC	$135.49

CABLE INTRAUTERINE PRESS

Facility

$903.25

Hospital Charge Code	270600587
Hospital Revenue Code	270
Min. Negotiated Rate	$21.77
Max. Negotiated Rate	$451.62
Rate for Payer: Aetna Commercial	$343.24
Rate for Payer: Aetna Medicare Advantage	$270.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.33
Rate for Payer: Cigna Commercial	$451.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.98
Rate for Payer: Oxford Commercial	$180.65
Rate for Payer: Qualcare PPO/HMO/WC	$135.49
Rate for Payer: UnitedHealthcare Commercial	$180.65
Rate for Payer: UnitedHealthcare Community & State	$21.77
Rate for Payer: Wellpoint Medicaid Managed Care	$23.94

CABLE MONITOR

Facility

$492.75

Hospital Charge Code	270661179
Hospital Revenue Code	270
Min. Negotiated Rate	$11.88
Max. Negotiated Rate	$246.38
Rate for Payer: Aetna Commercial	$187.25
Rate for Payer: Aetna Medicare Advantage	$147.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.65
Rate for Payer: Cigna Commercial	$246.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.82
Rate for Payer: Oxford Commercial	$98.55
Rate for Payer: Qualcare PPO/HMO/WC	$73.91
Rate for Payer: UnitedHealthcare Commercial	$98.55
Rate for Payer: UnitedHealthcare Community & State	$11.88
Rate for Payer: Wellpoint Medicaid Managed Care	$13.06

CABLE MONITOR

Facility

$492.75

Hospital Charge Code	270661179
Hospital Revenue Code	270
Min. Negotiated Rate	$73.91
Max. Negotiated Rate	$73.91
Rate for Payer: Qualcare PPO/HMO/WC	$73.91

Know your out-of-pocket cost for care.

All Charges