Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PTCA DRU ELU STEN 1VES-LC

Facility

$28,383.00

Hospital Charge Code	7411271
Hospital Revenue Code	481
Min. Negotiated Rate	$684.03
Max. Negotiated Rate	$14,191.50
Rate for Payer: Aetna Commercial	$10,785.54
Rate for Payer: Aetna Medicare Advantage	$8,514.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,237.66
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	$7,237.66
Rate for Payer: Cigna Commercial	$14,191.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,514.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45
Rate for Payer: UnitedHealthcare Community & State	$684.03
Rate for Payer: Wellpoint Medicaid Managed Care	$752.15

PTCA DRU ELU STEN 1VES-LC

Facility

$28,383.00

Hospital Charge Code	7411271
Hospital Revenue Code	481
Min. Negotiated Rate	$4,257.45
Max. Negotiated Rate	$4,257.45
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA DRU ELU STEN 1VES-LD

Facility

$28,383.00

Hospital Charge Code	7411277
Hospital Revenue Code	481
Min. Negotiated Rate	$4,257.45
Max. Negotiated Rate	$4,257.45
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA DRU ELU STEN 1VES-LD

Facility

$28,383.00

Hospital Charge Code	7411277
Hospital Revenue Code	481
Min. Negotiated Rate	$684.03
Max. Negotiated Rate	$14,191.50
Rate for Payer: Aetna Commercial	$10,785.54
Rate for Payer: Aetna Medicare Advantage	$8,514.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,237.66
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	$7,237.66
Rate for Payer: Cigna Commercial	$14,191.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,514.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45
Rate for Payer: UnitedHealthcare Community & State	$684.03
Rate for Payer: Wellpoint Medicaid Managed Care	$752.15

PTCA DRU ELU STEN 1VES-RC

Facility

$28,383.00

Hospital Charge Code	7411273
Hospital Revenue Code	481
Min. Negotiated Rate	$684.03
Max. Negotiated Rate	$14,191.50
Rate for Payer: Aetna Commercial	$10,785.54
Rate for Payer: Aetna Medicare Advantage	$8,514.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,237.66
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	$7,237.66
Rate for Payer: Cigna Commercial	$14,191.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,514.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45
Rate for Payer: UnitedHealthcare Community & State	$684.03
Rate for Payer: Wellpoint Medicaid Managed Care	$752.15

PTCA DRU ELU STEN 1VES-RC

Facility

$28,383.00

Hospital Charge Code	7411273
Hospital Revenue Code	481
Min. Negotiated Rate	$4,257.45
Max. Negotiated Rate	$4,257.45
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA-EA ADDTL VESSEL-LC

Facility

$14,507.00

Service Code	HCPCS 92984LC
Hospital Charge Code	7411205
Hospital Revenue Code	481
Min. Negotiated Rate	$2,176.05
Max. Negotiated Rate	$2,176.05
Rate for Payer: Qualcare PPO/HMO/WC	$2,176.05

PTCA-EA ADDTL VESSEL-LC

Facility

$14,507.00

Service Code	HCPCS 92984LC
Hospital Charge Code	7411205
Hospital Revenue Code	481
Min. Negotiated Rate	$349.62
Max. Negotiated Rate	$7,253.50
Rate for Payer: Aetna Commercial	$5,512.66
Rate for Payer: Aetna Medicare Advantage	$4,352.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,699.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,699.28
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	$3,699.28
Rate for Payer: Cigna Commercial	$7,253.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,352.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,176.05
Rate for Payer: UnitedHealthcare Community & State	$349.62
Rate for Payer: Wellpoint Medicaid Managed Care	$384.44

PTCA-EA ADDTL VESSEL-LD

Facility

$14,507.00

Service Code	HCPCS 92984LD
Hospital Charge Code	7411207
Hospital Revenue Code	481
Min. Negotiated Rate	$2,176.05
Max. Negotiated Rate	$2,176.05
Rate for Payer: Qualcare PPO/HMO/WC	$2,176.05

PTCA-EA ADDTL VESSEL-LD

Facility

$14,507.00

Service Code	HCPCS 92984LD
Hospital Charge Code	7411207
Hospital Revenue Code	481
Min. Negotiated Rate	$349.62
Max. Negotiated Rate	$7,253.50
Rate for Payer: Aetna Commercial	$5,512.66
Rate for Payer: Aetna Medicare Advantage	$4,352.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,699.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,699.28
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	$3,699.28
Rate for Payer: Cigna Commercial	$7,253.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,352.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,176.05
Rate for Payer: UnitedHealthcare Community & State	$349.62
Rate for Payer: Wellpoint Medicaid Managed Care	$384.44

PTCA-EA ADDTL VESSEL-RC

Facility

$14,507.00

Service Code	HCPCS 92984RC
Hospital Charge Code	7411209
Hospital Revenue Code	481
Min. Negotiated Rate	$2,176.05
Max. Negotiated Rate	$2,176.05
Rate for Payer: Qualcare PPO/HMO/WC	$2,176.05

PTCA-EA ADDTL VESSEL-RC

Facility

$14,507.00

Service Code	HCPCS 92984RC
Hospital Charge Code	7411209
Hospital Revenue Code	481
Min. Negotiated Rate	$349.62
Max. Negotiated Rate	$7,253.50
Rate for Payer: Aetna Commercial	$5,512.66
Rate for Payer: Aetna Medicare Advantage	$4,352.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,699.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,699.28
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	$3,699.28
Rate for Payer: Cigna Commercial	$7,253.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,352.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,176.05
Rate for Payer: UnitedHealthcare Community & State	$349.62
Rate for Payer: Wellpoint Medicaid Managed Care	$384.44

PTCA NDRC ELU STEN 1VE-LD

Facility

$28,383.00

Hospital Charge Code	7411281
Hospital Revenue Code	481
Min. Negotiated Rate	$684.03
Max. Negotiated Rate	$14,191.50
Rate for Payer: Aetna Commercial	$10,785.54
Rate for Payer: Aetna Medicare Advantage	$8,514.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,237.66
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	$7,237.66
Rate for Payer: Cigna Commercial	$14,191.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,514.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45
Rate for Payer: UnitedHealthcare Community & State	$684.03
Rate for Payer: Wellpoint Medicaid Managed Care	$752.15

PTCA NDRC ELU STEN 1VE-LD

Facility

$28,383.00

Service Code	HCPCS 92928LD
Hospital Charge Code	7411189
Hospital Revenue Code	481
Min. Negotiated Rate	$4,257.45
Max. Negotiated Rate	$4,257.45
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA NDRC ELU STEN 1VE-LD

Facility

$28,383.00

Service Code	HCPCS 92928LD
Hospital Charge Code	7411189
Hospital Revenue Code	481
Min. Negotiated Rate	$684.03
Max. Negotiated Rate	$14,191.50
Rate for Payer: Aetna Commercial	$10,785.54
Rate for Payer: Aetna Medicare Advantage	$8,514.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,237.66
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	$7,237.66
Rate for Payer: Cigna Commercial	$14,191.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,514.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45
Rate for Payer: UnitedHealthcare Community & State	$684.03
Rate for Payer: Wellpoint Medicaid Managed Care	$752.15

PTCA NDRC ELU STEN 1VE-LD

Facility

$28,383.00

Hospital Charge Code	7411281
Hospital Revenue Code	481
Min. Negotiated Rate	$4,257.45
Max. Negotiated Rate	$4,257.45
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA NDRU EL STE AD/VE-LC

Facility

$28,383.00

Hospital Charge Code	7411285
Hospital Revenue Code	481
Min. Negotiated Rate	$684.03
Max. Negotiated Rate	$14,191.50
Rate for Payer: Aetna Commercial	$10,785.54
Rate for Payer: Aetna Medicare Advantage	$8,514.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,237.66
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	$7,237.66
Rate for Payer: Cigna Commercial	$14,191.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,514.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45
Rate for Payer: UnitedHealthcare Community & State	$684.03
Rate for Payer: Wellpoint Medicaid Managed Care	$752.15

PTCA NDRU EL STE AD/VE-LC

Facility

$28,383.00

Hospital Charge Code	7411285
Hospital Revenue Code	481
Min. Negotiated Rate	$4,257.45
Max. Negotiated Rate	$4,257.45
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA NDRU EL STE AD/VE-LC

Facility

$28,383.00

Service Code	HCPCS 92981LC
Hospital Charge Code	7411193
Hospital Revenue Code	481
Min. Negotiated Rate	$684.03
Max. Negotiated Rate	$14,191.50
Rate for Payer: Aetna Commercial	$10,785.54
Rate for Payer: Aetna Medicare Advantage	$8,514.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,237.66
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	$7,237.66
Rate for Payer: Cigna Commercial	$14,191.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,514.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45
Rate for Payer: UnitedHealthcare Community & State	$684.03
Rate for Payer: Wellpoint Medicaid Managed Care	$752.15

PTCA NDRU EL STE AD/VE-LC

Facility

$28,383.00

Service Code	HCPCS 92981LC
Hospital Charge Code	7411193
Hospital Revenue Code	481
Min. Negotiated Rate	$4,257.45
Max. Negotiated Rate	$4,257.45
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA NDRU EL STE AD/VE-LD

Facility

$28,383.00

Service Code	HCPCS 92981LD
Hospital Charge Code	7411197
Hospital Revenue Code	481
Min. Negotiated Rate	$4,257.45
Max. Negotiated Rate	$4,257.45
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA NDRU EL STE AD/VE-LD

Facility

$28,383.00

Service Code	HCPCS 92981LD
Hospital Charge Code	7411197
Hospital Revenue Code	481
Min. Negotiated Rate	$684.03
Max. Negotiated Rate	$14,191.50
Rate for Payer: Aetna Commercial	$10,785.54
Rate for Payer: Aetna Medicare Advantage	$8,514.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,237.66
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	$7,237.66
Rate for Payer: Cigna Commercial	$14,191.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,514.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45
Rate for Payer: UnitedHealthcare Community & State	$684.03
Rate for Payer: Wellpoint Medicaid Managed Care	$752.15

PTCA NDRU EL STE AD/VE-LD

Facility

$28,383.00

Hospital Charge Code	7411295
Hospital Revenue Code	481
Min. Negotiated Rate	$684.03
Max. Negotiated Rate	$14,191.50
Rate for Payer: Aetna Commercial	$10,785.54
Rate for Payer: Aetna Medicare Advantage	$8,514.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,237.66
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	$7,237.66
Rate for Payer: Cigna Commercial	$14,191.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,514.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45
Rate for Payer: UnitedHealthcare Community & State	$684.03
Rate for Payer: Wellpoint Medicaid Managed Care	$752.15

PTCA NDRU EL STE AD/VE-LD

Facility

$28,383.00

Hospital Charge Code	7411295
Hospital Revenue Code	481
Min. Negotiated Rate	$4,257.45
Max. Negotiated Rate	$4,257.45
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA NDRU EL STE AD/VE-RC

Facility

$28,383.00

Service Code	HCPCS 92981RC
Hospital Charge Code	7411195
Hospital Revenue Code	481
Min. Negotiated Rate	$684.03
Max. Negotiated Rate	$14,191.50
Rate for Payer: Aetna Commercial	$10,785.54
Rate for Payer: Aetna Medicare Advantage	$8,514.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,237.66
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	$7,237.66
Rate for Payer: Cigna Commercial	$14,191.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,514.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45
Rate for Payer: UnitedHealthcare Community & State	$684.03
Rate for Payer: Wellpoint Medicaid Managed Care	$752.15

Know your out-of-pocket cost for care.

All Charges