Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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	$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	5600214
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/STENT

Facility

$80,096.45

Service Code	HCPCS 37230
Hospital Charge Code	366837230
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/STENT

Facility

$89,914.40

Service Code	HCPCS 37230
Hospital Charge Code	5600211
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/STENT

Facility

$80,096.45

Service Code	HCPCS 37284
Hospital Charge Code	411037230
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/STENT

Facility

$89,914.40

Service Code	HCPCS 37230
Hospital Charge Code	5600211
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/STENT

Facility

$89,914.40

Service Code	HCPCS 37230
Hospital Charge Code	321037230
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/STENT

Facility

$89,914.40

Service Code	HCPCS 37230
Hospital Charge Code	321037230
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/STENT

Facility

$80,096.45

Service Code	HCPCS 37230
Hospital Charge Code	366837230
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/STENT

Facility

$47,642.70

Service Code	HCPCS 37230
Hospital Charge Code	7411520
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/STENT

Facility

$47,642.70

Service Code	HCPCS 37230
Hospital Charge Code	7411520
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/STENT

Facility

$80,096.45

Service Code	HCPCS 37284
Hospital Charge Code	411037230
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/TLA

Facility

$22,441.40

Service Code	HCPCS 37228
Hospital Charge Code	7411518
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 W/TLA

Facility

$22,441.40

Service Code	HCPCS 37228
Hospital Charge Code	7411518
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/TLA

Facility

$52,548.60

Service Code	HCPCS 37280
Hospital Charge Code	411037228
Hospital Revenue Code	361
Min. Negotiated Rate	$1,266.42
Max. Negotiated Rate	$49,506.31
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
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	$49,506.31
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,764.58
Rate for Payer: Qualcare PPO/HMO/WC	$7,882.29
Rate for Payer: UnitedHealthcare Community & State	$1,266.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1,392.54

IR TIB/PER REVASC W/TLA

Facility

$56,620.95

Service Code	HCPCS 37228
Hospital Charge Code	321037228
Hospital Revenue Code	361
Min. Negotiated Rate	$1,364.56
Max. Negotiated Rate	$28,310.47
Rate for Payer: Aetna Commercial	$21,515.96
Rate for Payer: Aetna Medicare Advantage	$16,986.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,438.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,438.34
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	$14,438.34
Rate for Payer: Cigna Commercial	$28,310.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,986.28
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,364.56
Rate for Payer: Wellpoint Medicaid Managed Care	$1,500.46

IR TIB/PER REVASC W/TLA

Facility

$52,548.60

Service Code	HCPCS 37228
Hospital Charge Code	366837228
Hospital Revenue Code	361
Min. Negotiated Rate	$7,882.29
Max. Negotiated Rate	$7,882.29
Rate for Payer: Qualcare PPO/HMO/WC	$7,882.29

IR TIB/PER REVASC W/TLA

Facility

$52,548.60

Service Code	HCPCS 37228
Hospital Charge Code	366837228
Hospital Revenue Code	361
Min. Negotiated Rate	$1,266.42
Max. Negotiated Rate	$26,274.30
Rate for Payer: Aetna Commercial	$19,968.47
Rate for Payer: Aetna Medicare Advantage	$15,764.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,399.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,399.89
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	$13,399.89
Rate for Payer: Cigna Commercial	$26,274.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,764.58
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,882.29
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,266.42
Rate for Payer: Wellpoint Medicaid Managed Care	$1,392.54

IR TIB/PER REVASC W/TLA

Facility

$56,620.95

Service Code	HCPCS 37228
Hospital Charge Code	5600209
Hospital Revenue Code	361
Min. Negotiated Rate	$1,364.56
Max. Negotiated Rate	$28,310.47
Rate for Payer: Aetna Commercial	$21,515.96
Rate for Payer: Aetna Medicare Advantage	$16,986.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,438.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,438.34
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	$14,438.34
Rate for Payer: Cigna Commercial	$28,310.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,986.28
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,364.56
Rate for Payer: Wellpoint Medicaid Managed Care	$1,500.46

IR TIB/PER REVASC W/TLA

Facility

$56,620.95

Service Code	HCPCS 37228
Hospital Charge Code	321037228
Hospital Revenue Code	361
Min. Negotiated Rate	$8,493.14
Max. Negotiated Rate	$8,493.14
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14

IR TIB/PER REVASC W/TLA

Facility

$56,620.95

Service Code	HCPCS 37228
Hospital Charge Code	5600209
Hospital Revenue Code	361
Min. Negotiated Rate	$8,493.14
Max. Negotiated Rate	$8,493.14
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14

IR TIB/PER REVASC W/TLA

Facility

$52,548.60

Service Code	HCPCS 37280
Hospital Charge Code	411037228
Hospital Revenue Code	361
Min. Negotiated Rate	$7,882.29
Max. Negotiated Rate	$7,882.29
Rate for Payer: Qualcare PPO/HMO/WC	$7,882.29

IR TL ANGIOPLSTY TIBIOPERONEAL

Facility

$9,403.75

Hospital Charge Code	2600170
Hospital Revenue Code	323
Min. Negotiated Rate	$1,410.56
Max. Negotiated Rate	$1,410.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,410.56

IR TL ANGIOPLSTY TIBIOPERONEAL

Facility

$9,403.75

Hospital Charge Code	2600170
Hospital Revenue Code	323
Min. Negotiated Rate	$226.63
Max. Negotiated Rate	$4,701.88
Rate for Payer: Aetna Commercial	$3,573.43
Rate for Payer: Aetna Medicare Advantage	$2,821.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,397.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,397.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,397.96
Rate for Payer: Cigna Commercial	$4,701.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,821.12
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,410.56
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$226.63
Rate for Payer: Wellpoint Medicaid Managed Care	$249.20

IR-TRANCATH RETRIEVAL

Facility

$3,724.00

Hospital Charge Code	2690105
Hospital Revenue Code	761
Min. Negotiated Rate	$558.60
Max. Negotiated Rate	$558.60
Rate for Payer: Qualcare PPO/HMO/WC	$558.60

Know your out-of-pocket cost for care.

All Charges