Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

OPENGASRESTRICT REV OFSUBCUTPT

Facility

$15,874.30

Service Code	HCPCS 43886
Hospital Charge Code	1700176
Hospital Revenue Code	361
Min. Negotiated Rate	$382.57
Max. Negotiated Rate	$15,196.98
Rate for Payer: Aetna Commercial	$11,451.31
Rate for Payer: Aetna Medicare Advantage	$13,640.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,196.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,196.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,210.04
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	$15,196.98
Rate for Payer: Cigna Commercial	$8,439.01
Rate for Payer: Cigna Medicare Advantage	$4,210.04
Rate for Payer: Clover Medicare Advantage	$3,999.54
Rate for Payer: EmblemHealth Commercial	$12,630.12
Rate for Payer: Humana Medicare Advantage	$4,336.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,210.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,762.29
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.14
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$382.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,210.04
Rate for Payer: Wellcare Medicare Advantage	$4,210.04
Rate for Payer: Wellpoint Medicaid Managed Care	$420.67

OPENGASRESTRICT REV OFSUBCUTPT

Facility

$15,874.30

Service Code	HCPCS 43886
Hospital Charge Code	1700176
Hospital Revenue Code	361
Min. Negotiated Rate	$2,381.14
Max. Negotiated Rate	$2,381.14
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.14

OPEN - INCIS BREAST BX

Facility

$23,857.69

Service Code	HCPCS 19101
Hospital Charge Code	16000314
Hospital Revenue Code	360
Min. Negotiated Rate	$574.97
Max. Negotiated Rate	$16,791.02
Rate for Payer: Aetna Commercial	$12,652.46
Rate for Payer: Aetna Medicare Advantage	$15,071.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,791.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,791.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,651.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16,791.02
Rate for Payer: Cigna Commercial	$9,324.19
Rate for Payer: Cigna Medicare Advantage	$4,651.64
Rate for Payer: Clover Medicare Advantage	$4,419.06
Rate for Payer: EmblemHealth Commercial	$13,954.92
Rate for Payer: Humana Medicare Advantage	$4,791.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,651.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,157.31
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,578.65
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$574.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,651.64
Rate for Payer: Wellcare Medicare Advantage	$4,651.64
Rate for Payer: Wellpoint Medicaid Managed Care	$632.23

OPEN - INCIS BREAST BX

Facility

$23,857.69

Service Code	HCPCS 19101
Hospital Charge Code	16000314
Hospital Revenue Code	360
Min. Negotiated Rate	$3,578.65
Max. Negotiated Rate	$3,578.65
Rate for Payer: Qualcare PPO/HMO/WC	$3,578.65

OPEN LAT RETINA RELEASE

Facility

$30,595.00

Service Code	HCPCS 27425
Hospital Charge Code	16000509
Hospital Revenue Code	360
Min. Negotiated Rate	$4,589.25
Max. Negotiated Rate	$4,589.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25

OPEN LAT RETINA RELEASE

Facility

$30,595.00

Service Code	HCPCS 27425
Hospital Charge Code	16000509
Hospital Revenue Code	360
Min. Negotiated Rate	$737.34
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,178.50
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$737.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$810.77

OPEN/PERQ PLACE STENT 1ST

Facility

$52,548.60

Service Code	HCPCS 37236
Hospital Charge Code	411037236
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

OPEN/PERQ PLACE STENT 1ST

Facility

$52,548.60

Service Code	HCPCS 37236
Hospital Charge Code	411037236
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: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,882.29
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
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

OPEN/PERQ PLACE STENT 1ST

Facility

$52,548.60

Service Code	HCPCS 37236
Hospital Charge Code	366837236
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: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,882.29
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
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

OPEN/PERQ PLACE STENT 1ST

Facility

$42,041.84

Service Code	HCPCS 37236
Hospital Charge Code	1600000351
Hospital Revenue Code	360
Min. Negotiated Rate	$1,013.21
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	$12,612.55
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,306.28
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,013.21
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	$1,114.11

OPEN/PERQ PLACE STENT 1ST

Facility

$42,041.84

Service Code	HCPCS 37236
Hospital Charge Code	1600000351
Hospital Revenue Code	360
Min. Negotiated Rate	$6,306.28
Max. Negotiated Rate	$6,306.28
Rate for Payer: Qualcare PPO/HMO/WC	$6,306.28

OPEN/PERQ PLACE STENT 1ST

Facility

$52,548.60

Service Code	HCPCS 37236
Hospital Charge Code	366837236
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

OPEN/PERQ PLACE STENT EA ADD

Facility

$15,615.00

Service Code	HCPCS 37237
Hospital Charge Code	366837237
Hospital Revenue Code	361
Min. Negotiated Rate	$2,342.25
Max. Negotiated Rate	$2,342.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,342.25

OPEN/PERQ PLACE STENT EA ADD

Facility

$15,615.00

Service Code	HCPCS 37237
Hospital Charge Code	366837237
Hospital Revenue Code	361
Min. Negotiated Rate	$376.32
Max. Negotiated Rate	$14,834.00
Rate for Payer: Aetna Commercial	$5,933.70
Rate for Payer: Aetna Medicare Advantage	$4,684.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,981.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,981.82
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	$3,981.82
Rate for Payer: Cigna Commercial	$7,807.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,684.50
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,342.25
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$376.32
Rate for Payer: Wellpoint Medicaid Managed Care	$413.80

OPEN/PERQ PLACE STENT EA ADD

Facility

$26,192.10

Service Code	HCPCS 37239
Hospital Charge Code	366837239
Hospital Revenue Code	361
Min. Negotiated Rate	$631.23
Max. Negotiated Rate	$14,834.00
Rate for Payer: Aetna Commercial	$9,953.00
Rate for Payer: Aetna Medicare Advantage	$7,857.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,678.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,678.99
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	$6,678.99
Rate for Payer: Cigna Commercial	$13,096.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,857.63
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,928.82
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$631.23
Rate for Payer: Wellpoint Medicaid Managed Care	$694.09

OPEN/PERQ PLACE STENT EA ADD

Facility

$26,192.10

Service Code	HCPCS 37239
Hospital Charge Code	366837239
Hospital Revenue Code	361
Min. Negotiated Rate	$3,928.82
Max. Negotiated Rate	$3,928.82
Rate for Payer: Qualcare PPO/HMO/WC	$3,928.82

OPEN/PERQ PLACE STENT EA ADD

Facility

$26,192.10

Service Code	HCPCS 37239
Hospital Charge Code	5700319
Hospital Revenue Code	361
Min. Negotiated Rate	$631.23
Max. Negotiated Rate	$14,834.00
Rate for Payer: Aetna Commercial	$9,953.00
Rate for Payer: Aetna Medicare Advantage	$7,857.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,678.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,678.99
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	$6,678.99
Rate for Payer: Cigna Commercial	$13,096.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,857.63
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,928.82
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$631.23
Rate for Payer: Wellpoint Medicaid Managed Care	$694.09

OPEN/PERQ PLACE STENT EA ADD

Facility

$15,615.00

Service Code	HCPCS 37237
Hospital Charge Code	411037237
Hospital Revenue Code	361
Min. Negotiated Rate	$376.32
Max. Negotiated Rate	$14,834.00
Rate for Payer: Aetna Commercial	$5,933.70
Rate for Payer: Aetna Medicare Advantage	$4,684.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,981.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,981.82
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	$3,981.82
Rate for Payer: Cigna Commercial	$7,807.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,684.50
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,342.25
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$376.32
Rate for Payer: Wellpoint Medicaid Managed Care	$413.80

OPEN/PERQ PLACE STENT EA ADD

Facility

$26,192.10

Service Code	HCPCS 37239
Hospital Charge Code	411037239
Hospital Revenue Code	361
Min. Negotiated Rate	$631.23
Max. Negotiated Rate	$14,834.00
Rate for Payer: Aetna Commercial	$9,953.00
Rate for Payer: Aetna Medicare Advantage	$7,857.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,678.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,678.99
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	$6,678.99
Rate for Payer: Cigna Commercial	$13,096.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,857.63
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,928.82
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$631.23
Rate for Payer: Wellpoint Medicaid Managed Care	$694.09

OPEN/PERQ PLACE STENT EA ADD

Facility

$26,192.10

Service Code	HCPCS 37239
Hospital Charge Code	321037239
Hospital Revenue Code	361
Min. Negotiated Rate	$631.23
Max. Negotiated Rate	$14,834.00
Rate for Payer: Aetna Commercial	$9,953.00
Rate for Payer: Aetna Medicare Advantage	$7,857.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,678.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,678.99
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	$6,678.99
Rate for Payer: Cigna Commercial	$13,096.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,857.63
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,928.82
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$631.23
Rate for Payer: Wellpoint Medicaid Managed Care	$694.09

OPEN/PERQ PLACE STENT EA ADD

Facility

$26,192.10

Service Code	HCPCS 37239
Hospital Charge Code	7411527
Hospital Revenue Code	361
Min. Negotiated Rate	$3,928.82
Max. Negotiated Rate	$3,928.82
Rate for Payer: Qualcare PPO/HMO/WC	$3,928.82

OPEN/PERQ PLACE STENT EA ADD

Facility

$26,192.10

Service Code	HCPCS 37239
Hospital Charge Code	7411527
Hospital Revenue Code	361
Min. Negotiated Rate	$631.23
Max. Negotiated Rate	$14,834.00
Rate for Payer: Aetna Commercial	$9,953.00
Rate for Payer: Aetna Medicare Advantage	$7,857.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,678.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,678.99
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	$6,678.99
Rate for Payer: Cigna Commercial	$13,096.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,857.63
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,928.82
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$631.23
Rate for Payer: Wellpoint Medicaid Managed Care	$694.09

OPEN/PERQ PLACE STENT EA ADD

Facility

$26,192.10

Service Code	HCPCS 37239
Hospital Charge Code	321037239
Hospital Revenue Code	361
Min. Negotiated Rate	$3,928.82
Max. Negotiated Rate	$3,928.82
Rate for Payer: Qualcare PPO/HMO/WC	$3,928.82

OPEN/PERQ PLACE STENT EA ADD

Facility

$26,192.10

Service Code	HCPCS 37239
Hospital Charge Code	5700319
Hospital Revenue Code	361
Min. Negotiated Rate	$3,928.82
Max. Negotiated Rate	$3,928.82
Rate for Payer: Qualcare PPO/HMO/WC	$3,928.82

OPEN/PERQ PLACE STENT EA ADD

Facility

$15,615.00

Service Code	HCPCS 37237
Hospital Charge Code	411037237
Hospital Revenue Code	361
Min. Negotiated Rate	$2,342.25
Max. Negotiated Rate	$2,342.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,342.25

Know your out-of-pocket cost for care.

All Charges