Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR TIB/PER REVASC ADD-ON

Facility

$47,642.70

Service Code	HCPCS 37232
Hospital Charge Code	7411522
Hospital Revenue Code	361
Min. Negotiated Rate	$7,146.40
Max. Negotiated Rate	$7,146.40
Rate for Payer: Qualcare PPO/HMO/WC	$7,146.40

IR TIB/PER REVASC ADD-ON

Facility

$15,877.00

Service Code	HCPCS 37281
Hospital Charge Code	411037232
Hospital Revenue Code	361
Min. Negotiated Rate	$2,381.55
Max. Negotiated Rate	$2,381.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

IR TIB/PER REVASC ADD-ON

Facility

$15,877.00

Service Code	HCPCS 37281
Hospital Charge Code	411037232
Hospital Revenue Code	361
Min. Negotiated Rate	$382.64
Max. Negotiated Rate	$7,938.50
Rate for Payer: Aetna Commercial	$6,033.26
Rate for Payer: Aetna Medicare Advantage	$4,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,048.64
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	$4,048.64
Rate for Payer: Cigna Commercial	$7,938.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,763.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55
Rate for Payer: UnitedHealthcare Community & State	$382.64
Rate for Payer: Wellpoint Medicaid Managed Care	$420.74

IR TIB/PER REVASC STENT & ATHE

Facility

$131,167.45

Service Code	HCPCS 37231
Hospital Charge Code	5600212
Hospital Revenue Code	361
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$65,583.73
Rate for Payer: Aetna Commercial	$49,843.63
Rate for Payer: Aetna Medicare Advantage	$39,350.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33,447.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33,447.70
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	$33,447.70
Rate for Payer: Cigna Commercial	$65,583.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39,350.24
Rate for Payer: Oxford Commercial	$11,667.00
Rate for Payer: Qualcare PPO/HMO/WC	$19,675.12
Rate for Payer: UnitedHealthcare Commercial	$20,074.00
Rate for Payer: UnitedHealthcare Community & State	$3,161.14
Rate for Payer: Wellpoint Medicaid Managed Care	$3,475.94

IR TIB/PER REVASC STENT & ATHE

Facility

$131,167.45

Service Code	HCPCS 37231
Hospital Charge Code	7411521
Hospital Revenue Code	361
Min. Negotiated Rate	$19,675.12
Max. Negotiated Rate	$19,675.12
Rate for Payer: Qualcare PPO/HMO/WC	$19,675.12

IR TIB/PER REVASC STENT & ATHE

Facility

$131,167.45

Service Code	HCPCS 37231
Hospital Charge Code	7411521
Hospital Revenue Code	361
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$65,583.73
Rate for Payer: Aetna Commercial	$49,843.63
Rate for Payer: Aetna Medicare Advantage	$39,350.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33,447.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33,447.70
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	$33,447.70
Rate for Payer: Cigna Commercial	$65,583.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39,350.24
Rate for Payer: Oxford Commercial	$11,667.00
Rate for Payer: Qualcare PPO/HMO/WC	$19,675.12
Rate for Payer: UnitedHealthcare Commercial	$20,074.00
Rate for Payer: UnitedHealthcare Community & State	$3,161.14
Rate for Payer: Wellpoint Medicaid Managed Care	$3,475.94

IR TIB/PER REVASC STENT & ATHE

Facility

$131,167.45

Service Code	HCPCS 37231
Hospital Charge Code	5600212
Hospital Revenue Code	361
Min. Negotiated Rate	$19,675.12
Max. Negotiated Rate	$19,675.12
Rate for Payer: Qualcare PPO/HMO/WC	$19,675.12

IR TIB/PER REVASC STNT & ATHER

Facility

$22,441.40

Service Code	HCPCS 37235
Hospital Charge Code	5600216
Hospital Revenue Code	361
Min. Negotiated Rate	$540.84
Max. Negotiated Rate	$14,834.00
Rate for Payer: Aetna Commercial	$8,527.73
Rate for Payer: Aetna Medicare Advantage	$6,732.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.56
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	$5,722.56
Rate for Payer: Cigna Commercial	$11,220.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,732.42
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$540.84
Rate for Payer: Wellpoint Medicaid Managed Care	$594.70

IR TIB/PER REVASC STNT & ATHER

Facility

$22,441.40

Service Code	HCPCS 37293
Hospital Charge Code	7411525
Hospital Revenue Code	361
Min. Negotiated Rate	$3,366.21
Max. Negotiated Rate	$3,366.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21

IR TIB/PER REVASC STNT & ATHER

Facility

$22,441.40

Service Code	HCPCS 37293
Hospital Charge Code	7411525
Hospital Revenue Code	361
Min. Negotiated Rate	$540.84
Max. Negotiated Rate	$11,220.70
Rate for Payer: Aetna Commercial	$8,527.73
Rate for Payer: Aetna Medicare Advantage	$6,732.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.56
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	$5,722.56
Rate for Payer: Cigna Commercial	$11,220.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,732.42
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21
Rate for Payer: UnitedHealthcare Community & State	$540.84
Rate for Payer: Wellpoint Medicaid Managed Care	$594.70

IR TIB/PER REVASC STNT & ATHER

Facility

$22,441.40

Service Code	HCPCS 37235
Hospital Charge Code	5600216
Hospital Revenue Code	361
Min. Negotiated Rate	$3,366.21
Max. Negotiated Rate	$3,366.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21

IR TIB/PER REVASC W/ATHER

Facility

$89,914.40

Service Code	HCPCS 37229
Hospital Charge Code	5600210
Hospital Revenue Code	361
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$44,957.20
Rate for Payer: Aetna Commercial	$34,167.47
Rate for Payer: Aetna Medicare Advantage	$26,974.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,928.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,928.17
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	$22,928.17
Rate for Payer: Cigna Commercial	$44,957.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26,974.32
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.16
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$2,166.94
Rate for Payer: Wellpoint Medicaid Managed Care	$2,382.73

IR TIB/PER REVASC W/ATHER

Facility

$80,096.45

Service Code	HCPCS 37229
Hospital Charge Code	366837229
Hospital Revenue Code	361
Min. Negotiated Rate	$12,014.47
Max. Negotiated Rate	$12,014.47
Rate for Payer: Qualcare PPO/HMO/WC	$12,014.47

IR TIB/PER REVASC W/ATHER

Facility

$89,914.40

Service Code	HCPCS 37229
Hospital Charge Code	321037229
Hospital Revenue Code	361
Min. Negotiated Rate	$13,487.16
Max. Negotiated Rate	$13,487.16
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.16

IR TIB/PER REVASC W/ATHER

Facility

$89,914.40

Service Code	HCPCS 37229
Hospital Charge Code	321037229
Hospital Revenue Code	361
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$44,957.20
Rate for Payer: Aetna Commercial	$34,167.47
Rate for Payer: Aetna Medicare Advantage	$26,974.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,928.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,928.17
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	$22,928.17
Rate for Payer: Cigna Commercial	$44,957.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26,974.32
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.16
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$2,166.94
Rate for Payer: Wellpoint Medicaid Managed Care	$2,382.73

IR TIB/PER REVASC W/ATHER

Facility

$80,096.45

Service Code	HCPCS 37288
Hospital Charge Code	411037229
Hospital Revenue Code	361
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$78,613.74
Rate for Payer: Aetna Commercial	$59,237.44
Rate for Payer: Aetna Medicare Advantage	$70,562.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78,613.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78,613.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,778.47
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	$78,613.74
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: Cigna Medicare Advantage	$21,778.47
Rate for Payer: Clover Medicare Advantage	$20,689.55
Rate for Payer: EmblemHealth Commercial	$65,335.41
Rate for Payer: Humana Medicare Advantage	$22,431.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,778.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24,028.94
Rate for Payer: Qualcare PPO/HMO/WC	$12,014.47
Rate for Payer: UnitedHealthcare Community & State	$1,930.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,778.47
Rate for Payer: Wellcare Medicare Advantage	$21,778.47
Rate for Payer: Wellpoint Medicaid Managed Care	$2,122.56

IR TIB/PER REVASC W/ATHER

Facility

$89,914.00

Service Code	HCPCS 37229
Hospital Charge Code	1600000746
Hospital Revenue Code	360
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$44,957.00
Rate for Payer: Aetna Commercial	$34,167.32
Rate for Payer: Aetna Medicare Advantage	$26,974.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,928.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,928.07
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	$22,928.07
Rate for Payer: Cigna Commercial	$44,957.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26,974.20
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.10
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$2,166.93
Rate for Payer: Wellpoint Medicaid Managed Care	$2,382.72

IR TIB/PER REVASC W/ATHER

Facility

$47,642.70

Service Code	HCPCS 37229
Hospital Charge Code	7411519
Hospital Revenue Code	361
Min. Negotiated Rate	$7,146.40
Max. Negotiated Rate	$7,146.40
Rate for Payer: Qualcare PPO/HMO/WC	$7,146.40

IR TIB/PER REVASC W/ATHER

Facility

$47,642.70

Service Code	HCPCS 37229
Hospital Charge Code	7411519
Hospital Revenue Code	361
Min. Negotiated Rate	$1,148.19
Max. Negotiated Rate	$23,821.35
Rate for Payer: Aetna Commercial	$18,104.23
Rate for Payer: Aetna Medicare Advantage	$14,292.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,148.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,148.89
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	$12,148.89
Rate for Payer: Cigna Commercial	$23,821.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,292.81
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,146.40
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,148.19
Rate for Payer: Wellpoint Medicaid Managed Care	$1,262.53

IR TIB/PER REVASC W/ATHER

Facility

$89,914.40

Service Code	HCPCS 37229
Hospital Charge Code	5600210
Hospital Revenue Code	361
Min. Negotiated Rate	$13,487.16
Max. Negotiated Rate	$13,487.16
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.16

IR TIB/PER REVASC W/ATHER

Facility

$89,914.00

Service Code	HCPCS 37229
Hospital Charge Code	1600000746
Hospital Revenue Code	360
Min. Negotiated Rate	$13,487.10
Max. Negotiated Rate	$13,487.10
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.10

IR TIB/PER REVASC W/ATHER

Facility

$80,096.45

Service Code	HCPCS 37229
Hospital Charge Code	366837229
Hospital Revenue Code	361
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$40,048.22
Rate for Payer: Aetna Commercial	$30,436.65
Rate for Payer: Aetna Medicare Advantage	$24,028.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20,424.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20,424.59
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	$20,424.59
Rate for Payer: Cigna Commercial	$40,048.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24,028.94
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$12,014.47
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,930.32
Rate for Payer: Wellpoint Medicaid Managed Care	$2,122.56

IR TIB/PER REVASC W/ATHER

Facility

$80,096.45

Service Code	HCPCS 37288
Hospital Charge Code	411037229
Hospital Revenue Code	361
Min. Negotiated Rate	$12,014.47
Max. Negotiated Rate	$12,014.47
Rate for Payer: Qualcare PPO/HMO/WC	$12,014.47

IR TIBPER REVASC W/ATHER ADD-O

Facility

$47,642.70

Service Code	HCPCS 37233
Hospital Charge Code	5600214
Hospital Revenue Code	361
Min. Negotiated Rate	$7,146.40
Max. Negotiated Rate	$7,146.40
Rate for Payer: Qualcare PPO/HMO/WC	$7,146.40

IR TIBPER REVASC W/ATHER ADD-O

Facility

$47,642.70

Service Code	HCPCS 37233
Hospital Charge Code	7411523
Hospital Revenue Code	361
Min. Negotiated Rate	$1,148.19
Max. Negotiated Rate	$23,821.35
Rate for Payer: Aetna Commercial	$18,104.23
Rate for Payer: Aetna Medicare Advantage	$14,292.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,148.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,148.89
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	$12,148.89
Rate for Payer: Cigna Commercial	$23,821.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,292.81
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,146.40
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,148.19
Rate for Payer: Wellpoint Medicaid Managed Care	$1,262.53

Know your out-of-pocket cost for care.

All Charges