Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLACE CATH XTRNL CAROTID

Facility

$13,077.63

Service Code	HCPCS 36227
Hospital Charge Code	7411429
Hospital Revenue Code	361
Min. Negotiated Rate	$1,961.64
Max. Negotiated Rate	$1,961.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,961.64

PLACE CATH XTRNL CAROTID

Facility

$13,077.63

Service Code	HCPCS 36227
Hospital Charge Code	7411429
Hospital Revenue Code	361
Min. Negotiated Rate	$315.17
Max. Negotiated Rate	$6,538.81
Rate for Payer: Aetna Commercial	$4,969.50
Rate for Payer: Aetna Medicare Advantage	$3,923.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,334.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,334.80
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	$3,334.80
Rate for Payer: Cigna Commercial	$6,538.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,923.29
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,961.64
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$315.17
Rate for Payer: Wellpoint Medicaid Managed Care	$346.56

PLACE CATH XTRNL CAROTID

Facility

$13,077.63

Service Code	HCPCS 36227
Hospital Charge Code	5600227
Hospital Revenue Code	361
Min. Negotiated Rate	$1,961.64
Max. Negotiated Rate	$1,961.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,961.64

PLACE CATH XTRNL CAROTID

Facility

$2,919.00

Service Code	HCPCS 36227
Hospital Charge Code	366836227
Hospital Revenue Code	361
Min. Negotiated Rate	$437.85
Max. Negotiated Rate	$437.85
Rate for Payer: Qualcare PPO/HMO/WC	$437.85

PLACE CATH XTRNL CAROTID BI

Facility

$2,919.00

Service Code	HCPCS 3622750
Hospital Charge Code	411036227B
Hospital Revenue Code	361
Min. Negotiated Rate	$70.35
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$1,109.22
Rate for Payer: Aetna Medicare Advantage	$875.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$744.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$744.35
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	$744.35
Rate for Payer: Cigna Commercial	$1,459.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$875.70
Rate for Payer: Qualcare PPO/HMO/WC	$437.85
Rate for Payer: UnitedHealthcare Community & State	$70.35
Rate for Payer: Wellpoint Medicaid Managed Care	$77.35

PLACE CATH XTRNL CAROTID BI

Facility

$2,919.00

Service Code	HCPCS 36227
Hospital Charge Code	366836227B
Hospital Revenue Code	361
Min. Negotiated Rate	$70.35
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,109.22
Rate for Payer: Aetna Medicare Advantage	$875.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$744.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$744.35
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	$744.35
Rate for Payer: Cigna Commercial	$1,459.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$875.70
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$437.85
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$70.35
Rate for Payer: Wellpoint Medicaid Managed Care	$77.35

PLACE CATH XTRNL CAROTID BI

Facility

$2,919.00

Service Code	HCPCS 3622750
Hospital Charge Code	411036227B
Hospital Revenue Code	361
Min. Negotiated Rate	$437.85
Max. Negotiated Rate	$437.85
Rate for Payer: Qualcare PPO/HMO/WC	$437.85

PLACE CATH XTRNL CAROTID BI

Facility

$2,919.00

Service Code	HCPCS 36227
Hospital Charge Code	366836227B
Hospital Revenue Code	361
Min. Negotiated Rate	$437.85
Max. Negotiated Rate	$437.85
Rate for Payer: Qualcare PPO/HMO/WC	$437.85

PLACE DUOD/JEJ TUBE PERC

Facility

$15,699.70

Service Code	HCPCS 49441
Hospital Charge Code	1600000298
Hospital Revenue Code	360
Min. Negotiated Rate	$378.36
Max. Negotiated Rate	$8,229.07
Rate for Payer: Aetna Commercial	$6,200.81
Rate for Payer: Aetna Medicare Advantage	$7,386.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,229.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,229.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,279.71
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	$8,229.07
Rate for Payer: Cigna Commercial	$4,569.67
Rate for Payer: Cigna Medicare Advantage	$2,279.71
Rate for Payer: Clover Medicare Advantage	$2,165.72
Rate for Payer: EmblemHealth Commercial	$6,839.13
Rate for Payer: Humana Medicare Advantage	$2,348.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,279.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,709.91
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,354.95
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$378.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,279.71
Rate for Payer: Wellcare Medicare Advantage	$2,279.71
Rate for Payer: Wellpoint Medicaid Managed Care	$416.04

PLACE DUOD/JEJ TUBE PERC

Facility

$15,699.70

Service Code	HCPCS 49441
Hospital Charge Code	1600000298
Hospital Revenue Code	360
Min. Negotiated Rate	$2,354.95
Max. Negotiated Rate	$2,354.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,354.95

PLACE GASTROSTOMY TUBE

Facility

$28,383.60

Service Code	HCPCS 43830
Hospital Charge Code	1600000857
Hospital Revenue Code	360
Min. Negotiated Rate	$4,257.54
Max. Negotiated Rate	$4,257.54
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.54

PLACE GASTROSTOMY TUBE

Facility

$28,383.60

Service Code	HCPCS 43830
Hospital Charge Code	1600000857
Hospital Revenue Code	360
Min. Negotiated Rate	$684.04
Max. Negotiated Rate	$8,515.08
Rate for Payer: Aetna Commercial	$6,200.81
Rate for Payer: Aetna Medicare Advantage	$7,386.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,229.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,229.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,279.71
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	$8,229.07
Rate for Payer: Cigna Commercial	$4,569.67
Rate for Payer: Cigna Medicare Advantage	$2,279.71
Rate for Payer: Clover Medicare Advantage	$2,165.72
Rate for Payer: EmblemHealth Commercial	$6,839.13
Rate for Payer: Humana Medicare Advantage	$2,348.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,279.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,515.08
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.54
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$684.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,279.71
Rate for Payer: Wellcare Medicare Advantage	$2,279.71
Rate for Payer: Wellpoint Medicaid Managed Care	$752.17

PLACEMENT BARE METAL STENT ADD

Facility

$25,000.00

Hospital Charge Code	5100044
Hospital Revenue Code	481
Min. Negotiated Rate	$602.50
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$9,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,500.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00
Rate for Payer: UnitedHealthcare Community & State	$602.50
Rate for Payer: Wellpoint Medicaid Managed Care	$662.50

PLACEMENT BARE METAL STENT ADD

Facility

$25,000.00

Hospital Charge Code	5100044
Hospital Revenue Code	481
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$3,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

PLACEMENT BARE METAL STENT ADD

Facility

$25,000.00

Hospital Charge Code	74110008
Hospital Revenue Code	481
Min. Negotiated Rate	$602.50
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$9,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,500.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00
Rate for Payer: UnitedHealthcare Community & State	$602.50
Rate for Payer: Wellpoint Medicaid Managed Care	$662.50

PLACEMENT BARE METAL STENT ADD

Facility

$25,000.00

Hospital Charge Code	74110008
Hospital Revenue Code	481
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$3,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

PLACEMENT BARE METAL STENT SGL

Facility

$32,000.00

Hospital Charge Code	5100043
Hospital Revenue Code	481
Min. Negotiated Rate	$4,800.00
Max. Negotiated Rate	$4,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00

PLACEMENT BARE METAL STENT SGL

Facility

$32,000.00

Hospital Charge Code	74110007
Hospital Revenue Code	481
Min. Negotiated Rate	$771.20
Max. Negotiated Rate	$16,000.00
Rate for Payer: Aetna Commercial	$12,160.00
Rate for Payer: Aetna Medicare Advantage	$9,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,160.00
Rate for Payer: Cigna Commercial	$16,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,600.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00
Rate for Payer: UnitedHealthcare Community & State	$771.20
Rate for Payer: Wellpoint Medicaid Managed Care	$848.00

PLACEMENT BARE METAL STENT SGL

Facility

$32,000.00

Hospital Charge Code	5100043
Hospital Revenue Code	481
Min. Negotiated Rate	$771.20
Max. Negotiated Rate	$16,000.00
Rate for Payer: Aetna Commercial	$12,160.00
Rate for Payer: Aetna Medicare Advantage	$9,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,160.00
Rate for Payer: Cigna Commercial	$16,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,600.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00
Rate for Payer: UnitedHealthcare Community & State	$771.20
Rate for Payer: Wellpoint Medicaid Managed Care	$848.00

PLACEMENT BARE METAL STENT SGL

Facility

$32,000.00

Hospital Charge Code	74110007
Hospital Revenue Code	481
Min. Negotiated Rate	$4,800.00
Max. Negotiated Rate	$4,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00

PLACEMENT DRUG ELUD STENT ADDL

Facility

$39,742.37

Hospital Charge Code	74110006
Hospital Revenue Code	481
Min. Negotiated Rate	$5,961.36
Max. Negotiated Rate	$5,961.36
Rate for Payer: Qualcare PPO/HMO/WC	$5,961.36

PLACEMENT DRUG ELUD STENT ADDL

Facility

$39,742.37

Hospital Charge Code	5100042
Hospital Revenue Code	481
Min. Negotiated Rate	$957.79
Max. Negotiated Rate	$19,871.19
Rate for Payer: Aetna Commercial	$15,102.10
Rate for Payer: Aetna Medicare Advantage	$11,922.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,134.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,134.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,134.30
Rate for Payer: Cigna Commercial	$19,871.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,922.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,961.36
Rate for Payer: UnitedHealthcare Community & State	$957.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1,053.17

PLACEMENT DRUG ELUD STENT ADDL

Facility

$39,742.37

Hospital Charge Code	74110006
Hospital Revenue Code	481
Min. Negotiated Rate	$957.79
Max. Negotiated Rate	$19,871.19
Rate for Payer: Aetna Commercial	$15,102.10
Rate for Payer: Aetna Medicare Advantage	$11,922.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,134.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,134.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,134.30
Rate for Payer: Cigna Commercial	$19,871.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,922.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,961.36
Rate for Payer: UnitedHealthcare Community & State	$957.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1,053.17

PLACEMENT DRUG ELUD STENT ADDL

Facility

$39,742.37

Hospital Charge Code	5100042
Hospital Revenue Code	481
Min. Negotiated Rate	$5,961.36
Max. Negotiated Rate	$5,961.36
Rate for Payer: Qualcare PPO/HMO/WC	$5,961.36

PLACEMENT DRUG ELUD STENT SING

Facility

$50,870.23

Hospital Charge Code	74110005
Hospital Revenue Code	481
Min. Negotiated Rate	$1,225.97
Max. Negotiated Rate	$25,435.12
Rate for Payer: Aetna Commercial	$19,330.69
Rate for Payer: Aetna Medicare Advantage	$15,261.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,971.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,971.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,971.91
Rate for Payer: Cigna Commercial	$25,435.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,261.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,630.53
Rate for Payer: UnitedHealthcare Community & State	$1,225.97
Rate for Payer: Wellpoint Medicaid Managed Care	$1,348.06

Know your out-of-pocket cost for care.

All Charges