Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC

Facility

$108,527.23

Service Code	MSDRG 274
Min. Negotiated Rate	$33,045.15
Max. Negotiated Rate	$108,527.23
Rate for Payer: Aetna Commercial	$74,827.90
Rate for Payer: Aetna Medicare Advantage	$108,527.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75,365.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75,365.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34,784.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75,365.64
Rate for Payer: Cigna Commercial	$61,600.87
Rate for Payer: Cigna Medicare Advantage	$34,784.37
Rate for Payer: Clover Medicare Advantage	$33,045.15
Rate for Payer: EmblemHealth Commercial	$104,353.11
Rate for Payer: Humana Medicare Advantage	$35,827.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34,784.37
Rate for Payer: Oxford Commercial	$44,273.36
Rate for Payer: UnitedHealthcare Commercial	$77,634.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$34,784.37
Rate for Payer: Wellcare Medicare Advantage	$34,784.37

PERCUTANEOUS CARDIAC INTERVENTION WITH AMI

Facility

$24,611.13

Service Code	APR-DRG 1741
Min. Negotiated Rate	$24,128.56
Max. Negotiated Rate	$24,611.13
Rate for Payer: UnitedHealthcare Community & State	$24,128.56
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,611.13
Rate for Payer: Wellpoint Medicaid Managed Care	$24,128.56

PERCUTANEOUS CARDIAC INTERVENTION WITH AMI

Facility

$33,075.72

Service Code	APR-DRG 1743
Min. Negotiated Rate	$32,427.18
Max. Negotiated Rate	$33,075.72
Rate for Payer: UnitedHealthcare Community & State	$32,427.18
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$33,075.72
Rate for Payer: Wellpoint Medicaid Managed Care	$32,427.18

PERCUTANEOUS CARDIAC INTERVENTION WITH AMI

Facility

$26,567.03

Service Code	APR-DRG 1742
Min. Negotiated Rate	$26,046.11
Max. Negotiated Rate	$26,567.03
Rate for Payer: UnitedHealthcare Community & State	$26,046.11
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$26,567.03
Rate for Payer: Wellpoint Medicaid Managed Care	$26,046.11

PERCUTANEOUS CARDIAC INTERVENTION WITH AMI

Facility

$47,483.37

Service Code	APR-DRG 1744
Min. Negotiated Rate	$46,552.32
Max. Negotiated Rate	$47,483.37
Rate for Payer: UnitedHealthcare Community & State	$46,552.32
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$47,483.37
Rate for Payer: Wellpoint Medicaid Managed Care	$46,552.32

PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI

Facility

$25,170.34

Service Code	APR-DRG 1751
Min. Negotiated Rate	$24,676.80
Max. Negotiated Rate	$25,170.34
Rate for Payer: UnitedHealthcare Community & State	$24,676.80
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$25,170.34
Rate for Payer: Wellpoint Medicaid Managed Care	$24,676.80

PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI

Facility

$52,840.43

Service Code	APR-DRG 1754
Min. Negotiated Rate	$51,804.34
Max. Negotiated Rate	$52,840.43
Rate for Payer: UnitedHealthcare Community & State	$51,804.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$52,840.43
Rate for Payer: Wellpoint Medicaid Managed Care	$51,804.34

PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI

Facility

$35,258.87

Service Code	APR-DRG 1753
Min. Negotiated Rate	$34,567.52
Max. Negotiated Rate	$35,258.87
Rate for Payer: UnitedHealthcare Community & State	$34,567.52
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$35,258.87
Rate for Payer: Wellpoint Medicaid Managed Care	$34,567.52

PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI

Facility

$28,281.64

Service Code	APR-DRG 1752
Min. Negotiated Rate	$27,727.10
Max. Negotiated Rate	$28,281.64
Rate for Payer: UnitedHealthcare Community & State	$27,727.10
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$28,281.64
Rate for Payer: Wellpoint Medicaid Managed Care	$27,727.10

PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES

Facility

$90,074.84

Service Code	MSDRG 321
Min. Negotiated Rate	$27,426.63
Max. Negotiated Rate	$90,074.84
Rate for Payer: Aetna Commercial	$62,149.00
Rate for Payer: Aetna Medicare Advantage	$90,074.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$28,870.14
Rate for Payer: Cigna Commercial	$50,917.05
Rate for Payer: Cigna Medicare Advantage	$28,870.14
Rate for Payer: Clover Medicare Advantage	$27,426.63
Rate for Payer: EmblemHealth Commercial	$86,610.42
Rate for Payer: Humana Medicare Advantage	$29,736.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$28,870.14
Rate for Payer: Oxford Commercial	$36,594.76
Rate for Payer: UnitedHealthcare Commercial	$64,170.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$28,870.14
Rate for Payer: Wellcare Medicare Advantage	$28,870.14

PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC

Facility

$59,117.14

Service Code	MSDRG 322
Min. Negotiated Rate	$18,000.41
Max. Negotiated Rate	$59,117.14
Rate for Payer: Aetna Commercial	$40,877.55
Rate for Payer: Aetna Medicare Advantage	$59,117.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18,947.80
Rate for Payer: Cigna Commercial	$32,992.78
Rate for Payer: Cigna Medicare Advantage	$18,947.80
Rate for Payer: Clover Medicare Advantage	$18,000.41
Rate for Payer: EmblemHealth Commercial	$56,843.40
Rate for Payer: Humana Medicare Advantage	$19,516.23
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18,947.80
Rate for Payer: Oxford Commercial	$23,712.35
Rate for Payer: UnitedHealthcare Commercial	$41,580.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$18,947.80
Rate for Payer: Wellcare Medicare Advantage	$18,947.80

PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT CORONARY ARTERY STENT WITH MCC

Facility

$72,676.03

Service Code	MSDRG 250
Min. Negotiated Rate	$22,128.92
Max. Negotiated Rate	$72,676.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54,663.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54,663.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54,663.35

PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT CORONARY ARTERY STENT WITHOUT MCC

Facility

$50,438.76

Service Code	MSDRG 251
Min. Negotiated Rate	$15,357.96
Max. Negotiated Rate	$50,438.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36,984.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36,984.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36,984.99

PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC

Facility

$72,676.03

Service Code	MSDRG 250
Min. Negotiated Rate	$22,128.92
Max. Negotiated Rate	$72,676.03
Rate for Payer: Aetna Commercial	$50,194.04
Rate for Payer: Aetna Medicare Advantage	$72,676.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23,293.60
Rate for Payer: Cigna Commercial	$40,843.31
Rate for Payer: Cigna Medicare Advantage	$23,293.60
Rate for Payer: Clover Medicare Advantage	$22,128.92
Rate for Payer: EmblemHealth Commercial	$69,880.80
Rate for Payer: Humana Medicare Advantage	$23,992.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23,293.60
Rate for Payer: Oxford Commercial	$29,354.62
Rate for Payer: UnitedHealthcare Commercial	$51,474.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$23,293.60
Rate for Payer: Wellcare Medicare Advantage	$23,293.60

PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC

Facility

$50,438.76

Service Code	MSDRG 251
Min. Negotiated Rate	$15,357.96
Max. Negotiated Rate	$50,438.76
Rate for Payer: Aetna Commercial	$34,914.50
Rate for Payer: Aetna Medicare Advantage	$50,438.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,166.27
Rate for Payer: Cigna Commercial	$27,968.07
Rate for Payer: Cigna Medicare Advantage	$16,166.27
Rate for Payer: Clover Medicare Advantage	$15,357.96
Rate for Payer: EmblemHealth Commercial	$48,498.81
Rate for Payer: Humana Medicare Advantage	$16,651.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,166.27
Rate for Payer: Oxford Commercial	$20,101.03
Rate for Payer: UnitedHealthcare Commercial	$35,247.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,166.27
Rate for Payer: Wellcare Medicare Advantage	$16,166.27

PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITH MCC

Facility

$113,275.31

Service Code	MSDRG 359
Min. Negotiated Rate	$34,490.88
Max. Negotiated Rate	$113,275.31
Rate for Payer: Aetna Commercial	$78,090.36
Rate for Payer: Aetna Medicare Advantage	$113,275.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$36,306.19
Rate for Payer: Cigna Commercial	$64,349.96
Rate for Payer: Cigna Medicare Advantage	$36,306.19
Rate for Payer: Clover Medicare Advantage	$34,490.88
Rate for Payer: EmblemHealth Commercial	$108,918.57
Rate for Payer: Humana Medicare Advantage	$37,395.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$36,306.19
Rate for Payer: Oxford Commercial	$46,249.17
Rate for Payer: UnitedHealthcare Commercial	$81,099.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$36,306.19
Rate for Payer: Wellcare Medicare Advantage	$36,306.19

PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITHOUT MCC

Facility

$80,168.21

Service Code	MSDRG 360
Min. Negotiated Rate	$24,410.19
Max. Negotiated Rate	$80,168.21
Rate for Payer: Aetna Commercial	$55,342.02
Rate for Payer: Aetna Medicare Advantage	$80,168.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25,694.94
Rate for Payer: Cigna Commercial	$45,181.21
Rate for Payer: Cigna Medicare Advantage	$25,694.94
Rate for Payer: Clover Medicare Advantage	$24,410.19
Rate for Payer: EmblemHealth Commercial	$77,084.82
Rate for Payer: Humana Medicare Advantage	$26,465.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25,694.94
Rate for Payer: Oxford Commercial	$32,472.33
Rate for Payer: UnitedHealthcare Commercial	$56,941.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$25,694.94
Rate for Payer: Wellcare Medicare Advantage	$25,694.94

PERCUTANEOUS CORONARY ATHERECTOMY WITHOUT INTRALUMINAL DEVICE

Facility

$80,423.58

Service Code	MSDRG 318
Min. Negotiated Rate	$24,487.95
Max. Negotiated Rate	$80,423.58
Rate for Payer: Aetna Commercial	$55,517.49
Rate for Payer: Aetna Medicare Advantage	$80,423.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25,776.79
Rate for Payer: Cigna Commercial	$45,329.05
Rate for Payer: Cigna Medicare Advantage	$25,776.79
Rate for Payer: Clover Medicare Advantage	$24,487.95
Rate for Payer: EmblemHealth Commercial	$77,330.37
Rate for Payer: Humana Medicare Advantage	$26,550.09
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25,776.79
Rate for Payer: Oxford Commercial	$32,578.59
Rate for Payer: UnitedHealthcare Commercial	$57,127.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$25,776.79
Rate for Payer: Wellcare Medicare Advantage	$25,776.79

PERCUTANEOUS DISKECTOMY

Facility

$21,704.79

Service Code	HCPCS 62887
Hospital Charge Code	1600000400
Hospital Revenue Code	360
Min. Negotiated Rate	$523.09
Max. Negotiated Rate	$10,852.40
Rate for Payer: Aetna Commercial	$8,247.82
Rate for Payer: Aetna Medicare Advantage	$6,511.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,534.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,534.72
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	$5,534.72
Rate for Payer: Cigna Commercial	$10,852.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,511.44
Rate for Payer: Qualcare PPO/HMO/WC	$3,255.72
Rate for Payer: UnitedHealthcare Community & State	$523.09
Rate for Payer: Wellpoint Medicaid Managed Care	$575.18

PERCUTANEOUS DISKECTOMY

Facility

$21,704.79

Service Code	HCPCS 62887
Hospital Charge Code	1600000400
Hospital Revenue Code	360
Min. Negotiated Rate	$3,255.72
Max. Negotiated Rate	$3,255.72
Rate for Payer: Qualcare PPO/HMO/WC	$3,255.72

PERCUTANEOUS DISKECTOMY

Facility

$21,704.79

Service Code	HCPCS 62287
Hospital Charge Code	1600000268
Hospital Revenue Code	360
Min. Negotiated Rate	$3,255.72
Max. Negotiated Rate	$3,255.72
Rate for Payer: Qualcare PPO/HMO/WC	$3,255.72

PERCUTANEOUS DISKECTOMY

Facility

$21,704.79

Service Code	HCPCS 62287
Hospital Charge Code	1600000268
Hospital Revenue Code	360
Min. Negotiated Rate	$523.09
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$6,310.10
Rate for Payer: Aetna Medicare Advantage	$7,516.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,374.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,374.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,319.89
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	$8,374.11
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: Cigna Medicare Advantage	$2,319.89
Rate for Payer: Clover Medicare Advantage	$2,203.90
Rate for Payer: EmblemHealth Commercial	$6,959.67
Rate for Payer: Humana Medicare Advantage	$2,389.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,319.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,511.44
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,255.72
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$523.09
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,319.89
Rate for Payer: Wellcare Medicare Advantage	$2,319.89
Rate for Payer: Wellpoint Medicaid Managed Care	$575.18

PERCUTANEOUS DISKECTOMY-

Facility

$16,003.26

Service Code	HCPCS 62380
Hospital Charge Code	16000768
Hospital Revenue Code	360
Min. Negotiated Rate	$385.68
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,800.98
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.49
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$385.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$424.09

PERCUTANEOUS DISKECTOMY-

Facility

$16,003.26

Service Code	HCPCS 62380
Hospital Charge Code	16000768
Hospital Revenue Code	360
Min. Negotiated Rate	$2,400.49
Max. Negotiated Rate	$2,400.49
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.49

PERCUTANEOUS INSERTION KIT

Facility

$1,395.00

Hospital Charge Code	270675965
Hospital Revenue Code	272
Min. Negotiated Rate	$209.25
Max. Negotiated Rate	$209.25
Rate for Payer: Qualcare PPO/HMO/WC	$209.25

Know your out-of-pocket cost for care.

All Charges