Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR ATHERECTOMY, PTA

Facility

$4,665.90

Hospital Charge Code	2101155
Hospital Revenue Code	320
Min. Negotiated Rate	$699.88
Max. Negotiated Rate	$699.88
Rate for Payer: Qualcare PPO/HMO/WC	$699.88

IR ATHERECTOMY, PTA EACH ADDL

Facility

$4,665.90

Hospital Charge Code	2101157
Hospital Revenue Code	320
Min. Negotiated Rate	$112.45
Max. Negotiated Rate	$2,332.95
Rate for Payer: Aetna Commercial	$1,773.04
Rate for Payer: Aetna Medicare Advantage	$1,399.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,189.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,189.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,189.80
Rate for Payer: Cigna Commercial	$2,332.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,399.77
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$699.88
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$112.45
Rate for Payer: Wellpoint Medicaid Managed Care	$123.65

IR ATHERECTOMY, PTA EACH ADDL

Facility

$4,665.90

Hospital Charge Code	2101157
Hospital Revenue Code	320
Min. Negotiated Rate	$699.88
Max. Negotiated Rate	$699.88
Rate for Payer: Qualcare PPO/HMO/WC	$699.88

IR ATHERECTOMY RENAL

Facility

$3,084.40

Hospital Charge Code	2600046
Hospital Revenue Code	320
Min. Negotiated Rate	$74.33
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$1,172.07
Rate for Payer: Aetna Medicare Advantage	$925.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$786.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$786.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$786.52
Rate for Payer: Cigna Commercial	$1,542.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$925.32
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$462.66
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$74.33
Rate for Payer: Wellpoint Medicaid Managed Care	$81.74

IR ATHERECTOMY RENAL

Facility

$3,084.40

Hospital Charge Code	2600046
Hospital Revenue Code	320
Min. Negotiated Rate	$462.66
Max. Negotiated Rate	$462.66
Rate for Payer: Qualcare PPO/HMO/WC	$462.66

IR-ATHERECTOMY-TIBIOP-BIL

Facility

$8,231.00

Service Code	HCPCS 3722950
Hospital Charge Code	2690545
Hospital Revenue Code	361
Min. Negotiated Rate	$198.37
Max. Negotiated Rate	$4,115.50
Rate for Payer: Aetna Commercial	$3,127.78
Rate for Payer: Aetna Medicare Advantage	$2,469.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,098.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,098.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,098.91
Rate for Payer: Cigna Commercial	$4,115.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,469.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,234.65
Rate for Payer: UnitedHealthcare Community & State	$198.37
Rate for Payer: Wellpoint Medicaid Managed Care	$218.12

IR-ATHERECTOMY-TIBIOP-BIL

Facility

$8,231.00

Service Code	HCPCS 3722950
Hospital Charge Code	2690545
Hospital Revenue Code	361
Min. Negotiated Rate	$1,234.65
Max. Negotiated Rate	$1,234.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,234.65

IR-ATHERECTOMY-TIBIOP-BIL

Facility

$93,917.89

Service Code	HCPCS 3722950
Hospital Charge Code	7411808
Hospital Revenue Code	361
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$46,958.94
Rate for Payer: Aetna Commercial	$35,688.80
Rate for Payer: Aetna Medicare Advantage	$28,175.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,949.06
Rate for Payer: Cigna Commercial	$46,958.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28,175.37
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68
Rate for Payer: UnitedHealthcare Community & State	$2,263.42
Rate for Payer: Wellpoint Medicaid Managed Care	$2,488.82

IR-ATHERECTOMY-TIBIOP-BIL

Facility

$93,917.89

Service Code	HCPCS 3722950
Hospital Charge Code	7411808
Hospital Revenue Code	361
Min. Negotiated Rate	$14,087.68
Max. Negotiated Rate	$14,087.68
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-ATHERECTOMY-TIBIOP-LT

Facility

$93,917.89

Service Code	HCPCS 37229LT
Hospital Charge Code	366837229L
Hospital Revenue Code	361
Min. Negotiated Rate	$14,087.68
Max. Negotiated Rate	$14,087.68
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-ATHERECTOMY-TIBIOP-LT

Facility

$93,917.89

Service Code	HCPCS 37229LT
Hospital Charge Code	7411936
Hospital Revenue Code	361
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$46,958.94
Rate for Payer: Aetna Commercial	$35,688.80
Rate for Payer: Aetna Medicare Advantage	$28,175.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,949.06
Rate for Payer: Cigna Commercial	$46,958.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28,175.37
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68
Rate for Payer: UnitedHealthcare Community & State	$2,263.42
Rate for Payer: Wellpoint Medicaid Managed Care	$2,488.82

IR-ATHERECTOMY-TIBIOP-LT

Facility

$93,917.89

Service Code	HCPCS 37229LT
Hospital Charge Code	2691420
Hospital Revenue Code	361
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$46,958.94
Rate for Payer: Aetna Commercial	$35,688.80
Rate for Payer: Aetna Medicare Advantage	$28,175.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,949.06
Rate for Payer: Cigna Commercial	$46,958.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28,175.37
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68
Rate for Payer: UnitedHealthcare Community & State	$2,263.42
Rate for Payer: Wellpoint Medicaid Managed Care	$2,488.82

IR-ATHERECTOMY-TIBIOP-LT

Facility

$93,917.89

Service Code	HCPCS 37229LT
Hospital Charge Code	7411936
Hospital Revenue Code	361
Min. Negotiated Rate	$14,087.68
Max. Negotiated Rate	$14,087.68
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-ATHERECTOMY-TIBIOP-LT

Facility

$93,917.89

Service Code	HCPCS 37229LT
Hospital Charge Code	366837229L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$46,958.94
Rate for Payer: Aetna Commercial	$35,688.80
Rate for Payer: Aetna Medicare Advantage	$28,175.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,949.06
Rate for Payer: Cigna Commercial	$46,958.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28,175.37
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68
Rate for Payer: UnitedHealthcare Community & State	$2,263.42
Rate for Payer: Wellpoint Medicaid Managed Care	$2,488.82

IR-ATHERECTOMY-TIBIOP-LT

Facility

$93,917.89

Service Code	HCPCS 37229LT
Hospital Charge Code	321037229L
Hospital Revenue Code	361
Min. Negotiated Rate	$14,087.68
Max. Negotiated Rate	$14,087.68
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-ATHERECTOMY-TIBIOP-LT

Facility

$93,917.89

Service Code	HCPCS 37229LT
Hospital Charge Code	321037229L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$46,958.94
Rate for Payer: Aetna Commercial	$35,688.80
Rate for Payer: Aetna Medicare Advantage	$28,175.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,949.06
Rate for Payer: Cigna Commercial	$46,958.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28,175.37
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68
Rate for Payer: UnitedHealthcare Community & State	$2,263.42
Rate for Payer: Wellpoint Medicaid Managed Care	$2,488.82

IR-ATHERECTOMY-TIBIOP-LT

Facility

$93,917.89

Service Code	HCPCS 37229LT
Hospital Charge Code	2691420
Hospital Revenue Code	361
Min. Negotiated Rate	$14,087.68
Max. Negotiated Rate	$14,087.68
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-ATHERECTOMY-TIBIOP-RT

Facility

$93,917.89

Service Code	HCPCS 37229RT
Hospital Charge Code	411037229R
Hospital Revenue Code	361
Min. Negotiated Rate	$14,087.68
Max. Negotiated Rate	$14,087.68
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-ATHERECTOMY-TIBIOP-RT

Facility

$93,917.89

Service Code	HCPCS 37229RT
Hospital Charge Code	411037229R
Hospital Revenue Code	361
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$46,958.94
Rate for Payer: Aetna Commercial	$35,688.80
Rate for Payer: Aetna Medicare Advantage	$28,175.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,949.06
Rate for Payer: Cigna Commercial	$46,958.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28,175.37
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68
Rate for Payer: UnitedHealthcare Community & State	$2,263.42
Rate for Payer: Wellpoint Medicaid Managed Care	$2,488.82

IR-ATHERECTOMY-TIBIOP-RT

Facility

$93,917.89

Service Code	HCPCS 37229RT
Hospital Charge Code	2691425
Hospital Revenue Code	361
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$46,958.94
Rate for Payer: Aetna Commercial	$35,688.80
Rate for Payer: Aetna Medicare Advantage	$28,175.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,949.06
Rate for Payer: Cigna Commercial	$46,958.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28,175.37
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68
Rate for Payer: UnitedHealthcare Community & State	$2,263.42
Rate for Payer: Wellpoint Medicaid Managed Care	$2,488.82

IR-ATHERECTOMY-TIBIOP-RT

Facility

$93,917.89

Service Code	HCPCS 37229RT
Hospital Charge Code	2691425
Hospital Revenue Code	361
Min. Negotiated Rate	$14,087.68
Max. Negotiated Rate	$14,087.68
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-ATHERECTOMY-TIBIOP-RT

Facility

$93,917.89

Service Code	HCPCS 37229RT
Hospital Charge Code	366837229R
Hospital Revenue Code	361
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$46,958.94
Rate for Payer: Aetna Commercial	$35,688.80
Rate for Payer: Aetna Medicare Advantage	$28,175.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,949.06
Rate for Payer: Cigna Commercial	$46,958.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28,175.37
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68
Rate for Payer: UnitedHealthcare Community & State	$2,263.42
Rate for Payer: Wellpoint Medicaid Managed Care	$2,488.82

IR-ATHERECTOMY-TIBIOP-RT

Facility

$93,917.89

Service Code	HCPCS 37229RT
Hospital Charge Code	321037229R
Hospital Revenue Code	361
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$46,958.94
Rate for Payer: Aetna Commercial	$35,688.80
Rate for Payer: Aetna Medicare Advantage	$28,175.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,949.06
Rate for Payer: Cigna Commercial	$46,958.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28,175.37
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68
Rate for Payer: UnitedHealthcare Community & State	$2,263.42
Rate for Payer: Wellpoint Medicaid Managed Care	$2,488.82

IR-ATHERECTOMY-TIBIOP-RT

Facility

$93,917.89

Service Code	HCPCS 37229RT
Hospital Charge Code	321037229R
Hospital Revenue Code	361
Min. Negotiated Rate	$14,087.68
Max. Negotiated Rate	$14,087.68
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-ATHERECTOMY-TIBIOP-RT

Facility

$8,231.00

Service Code	HCPCS 37229RT
Hospital Charge Code	7411937
Hospital Revenue Code	361
Min. Negotiated Rate	$198.37
Max. Negotiated Rate	$4,115.50
Rate for Payer: Aetna Commercial	$3,127.78
Rate for Payer: Aetna Medicare Advantage	$2,469.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,098.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,098.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,098.91
Rate for Payer: Cigna Commercial	$4,115.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,469.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,234.65
Rate for Payer: UnitedHealthcare Community & State	$198.37
Rate for Payer: Wellpoint Medicaid Managed Care	$218.12

Know your out-of-pocket cost for care.

All Charges