Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PRQ CARDIAC ANGIOPLAT 1 ART

Facility

$23,700.99

Service Code	HCPCS 92920
Hospital Charge Code	5100786
Hospital Revenue Code	481
Min. Negotiated Rate	$571.19
Max. Negotiated Rate	$24,407.82
Rate for Payer: Aetna Commercial	$18,391.91
Rate for Payer: Aetna Medicare Advantage	$21,908.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,407.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,407.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,761.73
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	$24,407.82
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: Cigna Medicare Advantage	$6,761.73
Rate for Payer: Clover Medicare Advantage	$6,423.64
Rate for Payer: EmblemHealth Commercial	$20,285.19
Rate for Payer: Humana Medicare Advantage	$6,964.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,761.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,110.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,555.15
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$571.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,761.73
Rate for Payer: Wellcare Medicare Advantage	$6,761.73
Rate for Payer: Wellpoint Medicaid Managed Care	$628.08

PRQ CARDIAC ANGIOPLAT 1 ART

Facility

$23,700.99

Service Code	HCPCS 92920
Hospital Charge Code	366892920
Hospital Revenue Code	481
Min. Negotiated Rate	$3,555.15
Max. Negotiated Rate	$3,555.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,555.15

PRQ CARDIAC ANGIOPLAT 1 ART

Facility

$23,700.99

Service Code	HCPCS 92920
Hospital Charge Code	74110079
Hospital Revenue Code	481
Min. Negotiated Rate	$571.19
Max. Negotiated Rate	$24,407.82
Rate for Payer: Aetna Commercial	$18,391.91
Rate for Payer: Aetna Medicare Advantage	$21,908.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,407.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,407.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,761.73
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	$24,407.82
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: Cigna Medicare Advantage	$6,761.73
Rate for Payer: Clover Medicare Advantage	$6,423.64
Rate for Payer: EmblemHealth Commercial	$20,285.19
Rate for Payer: Humana Medicare Advantage	$6,964.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,761.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,110.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,555.15
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$571.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,761.73
Rate for Payer: Wellcare Medicare Advantage	$6,761.73
Rate for Payer: Wellpoint Medicaid Managed Care	$628.08

PRQ CARDI ANGIO/ATHRECT 1 ART

Facility

$45,193.22

Service Code	HCPCS 92924
Hospital Charge Code	74110081
Hospital Revenue Code	481
Min. Negotiated Rate	$1,089.16
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	$3,194.00
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	$13,557.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,778.98
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,089.16
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	$1,197.62

PRQ CARDI ANGIO/ATHRECT 1 ART

Facility

$45,193.22

Service Code	HCPCS 92924
Hospital Charge Code	5100788
Hospital Revenue Code	481
Min. Negotiated Rate	$6,778.98
Max. Negotiated Rate	$6,778.98
Rate for Payer: Qualcare PPO/HMO/WC	$6,778.98

PRQ CARDI ANGIO/ATHRECT 1 ART

Facility

$45,193.22

Service Code	HCPCS 92924
Hospital Charge Code	74110081
Hospital Revenue Code	481
Min. Negotiated Rate	$6,778.98
Max. Negotiated Rate	$6,778.98
Rate for Payer: Qualcare PPO/HMO/WC	$6,778.98

PRQ CARDI ANGIO/ATHRECT 1 ART

Facility

$45,193.22

Service Code	HCPCS 92924
Hospital Charge Code	5100788
Hospital Revenue Code	481
Min. Negotiated Rate	$1,089.16
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	$3,194.00
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	$13,557.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,778.98
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,089.16
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	$1,197.62

PRQ CARDI ANGIO/ATHRECT ADDL

Facility

$92,925.00

Service Code	HCPCS 92925
Hospital Charge Code	5100789
Hospital Revenue Code	481
Min. Negotiated Rate	$2,239.49
Max. Negotiated Rate	$46,462.50
Rate for Payer: Aetna Commercial	$35,311.50
Rate for Payer: Aetna Medicare Advantage	$27,877.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,695.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,695.88
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	$23,695.88
Rate for Payer: Cigna Commercial	$46,462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27,877.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,938.75
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$2,239.49
Rate for Payer: Wellpoint Medicaid Managed Care	$2,462.51

PRQ CARDI ANGIO/ATHRECT ADDL

Facility

$92,925.00

Service Code	HCPCS 92925
Hospital Charge Code	5100789
Hospital Revenue Code	481
Min. Negotiated Rate	$13,938.75
Max. Negotiated Rate	$13,938.75
Rate for Payer: Qualcare PPO/HMO/WC	$13,938.75

PRQ CARDI ANGIO/ATHRECT ADDL

Facility

$35,998.44

Service Code	HCPCS 92925
Hospital Charge Code	74110082
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PRQ CARDI ANGIO/ATHRECT ADDL

Facility

$35,998.44

Service Code	HCPCS 92925
Hospital Charge Code	74110082
Hospital Revenue Code	481
Min. Negotiated Rate	$867.56
Max. Negotiated Rate	$17,999.22
Rate for Payer: Aetna Commercial	$13,679.41
Rate for Payer: Aetna Medicare Advantage	$10,799.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,179.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,179.60
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	$9,179.60
Rate for Payer: Cigna Commercial	$17,999.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,799.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$867.56
Rate for Payer: Wellpoint Medicaid Managed Care	$953.96

PRQ CARDI STENT/ATH/ANGIO

Facility

$35,998.44

Service Code	HCPCS 92933
Hospital Charge Code	5100792
Hospital Revenue Code	481
Min. Negotiated Rate	$867.56
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	$3,194.00
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	$10,799.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$867.56
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	$953.96

PRQ CARDI STENT/ATH/ANGIO

Facility

$35,998.44

Service Code	HCPCS 92933
Hospital Charge Code	5100792
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PRQ CARDI STENT/ATH/ANGIO

Facility

$35,998.44

Service Code	HCPCS 92934
Hospital Charge Code	74110086
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PRQ CARDI STENT/ATH/ANGIO

Facility

$35,998.44

Service Code	HCPCS 92934
Hospital Charge Code	74110086
Hospital Revenue Code	481
Min. Negotiated Rate	$867.56
Max. Negotiated Rate	$17,999.22
Rate for Payer: Aetna Commercial	$13,679.41
Rate for Payer: Aetna Medicare Advantage	$10,799.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,179.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,179.60
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	$9,179.60
Rate for Payer: Cigna Commercial	$17,999.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,799.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$867.56
Rate for Payer: Wellpoint Medicaid Managed Care	$953.96

PRQ CARDI STENT/ATH/ANGIO

Facility

$35,998.44

Service Code	HCPCS 92933
Hospital Charge Code	74110085
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PRQ CARDI STENT/ATH/ANGIO

Facility

$35,998.44

Service Code	HCPCS 92933
Hospital Charge Code	74110085
Hospital Revenue Code	481
Min. Negotiated Rate	$867.56
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	$3,194.00
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	$10,799.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$867.56
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	$953.96

PRQ CARDI STENT/ATH/ANGIO

Facility

$35,998.44

Service Code	HCPCS 92934
Hospital Charge Code	5100793
Hospital Revenue Code	481
Min. Negotiated Rate	$867.56
Max. Negotiated Rate	$17,999.22
Rate for Payer: Aetna Commercial	$13,679.41
Rate for Payer: Aetna Medicare Advantage	$10,799.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,179.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,179.60
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	$9,179.60
Rate for Payer: Cigna Commercial	$17,999.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,799.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$867.56
Rate for Payer: Wellpoint Medicaid Managed Care	$953.96

PRQ CARDI STENT/ATH/ANGIO

Facility

$35,998.44

Service Code	HCPCS 92934
Hospital Charge Code	5100793
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PRQ CARDI STENT W/ANGIO 1 VSL

Facility

$35,998.44

Service Code	HCPCS 92928
Hospital Charge Code	5100790
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PRQ CARDI STENT W/ANGIO 1 VSL

Facility

$35,998.44

Service Code	HCPCS 92928
Hospital Charge Code	74110083
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PRQ CARDI STENT W/ANGIO 1 VSL

Facility

$35,998.44

Service Code	HCPCS 92928
Hospital Charge Code	74110083
Hospital Revenue Code	481
Min. Negotiated Rate	$867.56
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	$3,194.00
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	$10,799.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$867.56
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	$953.96

PRQ CARDI STENT W/ANGIO 1 VSL

Facility

$35,998.44

Service Code	HCPCS 92928
Hospital Charge Code	5100790
Hospital Revenue Code	481
Min. Negotiated Rate	$867.56
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	$3,194.00
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	$10,799.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$867.56
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	$953.96

PRQ CARDI STENT W/ANGIO ADDL

Facility

$35,998.44

Service Code	HCPCS 92928
Hospital Charge Code	74110084
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PRQ CARDI STENT W/ANGIO ADDL

Facility

$35,998.44

Service Code	HCPCS 92928
Hospital Charge Code	5100791
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

Know your out-of-pocket cost for care.

All Charges