Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PTCA NDRU EL STE AD/VE-RC

Facility

$28,383.00

Hospital Charge Code	7411287
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

Hospital Charge Code	7411287
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-RC

Facility

$28,383.00

Service Code	HCPCS 92981RC
Hospital Charge Code	7411195
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 ELU STEN 1VE-LC

Facility

$28,383.00

Service Code	HCPCS 92980LC
Hospital Charge Code	7411191
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 ELU STEN 1VE-LC

Facility

$28,383.00

Hospital Charge Code	7411283
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 ELU STEN 1VE-LC

Facility

$28,383.00

Hospital Charge Code	7411283
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 ELU STEN 1VE-LC

Facility

$28,383.00

Service Code	HCPCS 92980LC
Hospital Charge Code	7411191
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 ELU STEN 1VE-RC

Facility

$28,383.00

Service Code	HCPCS 92980RC
Hospital Charge Code	7411187
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 ELU STEN 1VE-RC

Facility

$28,383.00

Hospital Charge Code	7411279
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 ELU STEN 1VE-RC

Facility

$28,383.00

Service Code	HCPCS 92980RC
Hospital Charge Code	7411187
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 ELU STEN 1VE-RC

Facility

$28,383.00

Hospital Charge Code	7411279
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-SINGLE VESSEL-LC

Facility

$14,507.00

Service Code	HCPCS 92982
Hospital Charge Code	7411199
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-SINGLE VESSEL-LC

Facility

$14,507.00

Service Code	HCPCS 92982
Hospital Charge Code	7411199
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-SINGLE VESSEL-LD

Facility

$14,507.00

Hospital Charge Code	7411201
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-SINGLE VESSEL-LD

Facility

$14,507.00

Hospital Charge Code	7411201
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-SINGLE VESSEL-RC

Facility

$14,507.00

Service Code	HCPCS 92982RC
Hospital Charge Code	7411203
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-SINGLE VESSEL-RC

Facility

$14,507.00

Service Code	HCPCS 92982RC
Hospital Charge Code	7411203
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

PT CASTING/STRAPPING UNLSTD PR

Facility

$869.79

Service Code	HCPCS 29799GP
Hospital Charge Code	422529799
Hospital Revenue Code	420
Min. Negotiated Rate	$20.96
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$330.52
Rate for Payer: Aetna Medicare Advantage	$260.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221.80
Rate for Payer: Cigna Commercial	$434.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.94
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$130.47
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$20.96
Rate for Payer: Wellpoint Medicaid Managed Care	$23.05

PT CASTING/STRAPPING UNLSTD PR

Facility

$869.79

Service Code	HCPCS 29799GP
Hospital Charge Code	422529799
Hospital Revenue Code	420
Min. Negotiated Rate	$130.47
Max. Negotiated Rate	$130.47
Rate for Payer: Qualcare PPO/HMO/WC	$130.47

PTCA UNSUCESSFUL

Facility

$34,486.68

Hospital Charge Code	1
Hospital Revenue Code	481
Min. Negotiated Rate	$831.13
Max. Negotiated Rate	$17,243.34
Rate for Payer: Aetna Commercial	$13,104.94
Rate for Payer: Aetna Medicare Advantage	$10,346.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,794.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,794.10
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	$8,794.10
Rate for Payer: Cigna Commercial	$17,243.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,346.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,173.00
Rate for Payer: UnitedHealthcare Community & State	$831.13
Rate for Payer: Wellpoint Medicaid Managed Care	$913.90

PTCA UNSUCESSFUL

Facility

$61,620.70

Service Code	HCPCS C9600
Hospital Charge Code	5100621U
Hospital Revenue Code	480
Min. Negotiated Rate	$1,485.06
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) 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	$18,486.21
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,243.10
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$1,485.06
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	$1,632.95

PTCA UNSUCESSFUL

Facility

$61,620.70

Service Code	HCPCS C9600
Hospital Charge Code	5100621U
Hospital Revenue Code	480
Min. Negotiated Rate	$9,243.10
Max. Negotiated Rate	$9,243.10
Rate for Payer: Qualcare PPO/HMO/WC	$9,243.10

PTCA UNSUCESSFUL

Facility

$61,620.70

Service Code	HCPCS C9600
Hospital Charge Code	411039600
Hospital Revenue Code	361
Min. Negotiated Rate	$9,243.10
Max. Negotiated Rate	$9,243.10
Rate for Payer: Qualcare PPO/HMO/WC	$9,243.10

PTCA UNSUCESSFUL

Facility

$61,620.70

Service Code	HCPCS C9600
Hospital Charge Code	3668C9600
Hospital Revenue Code	361
Min. Negotiated Rate	$1,485.06
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	$18,486.21
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,243.10
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,485.06
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	$1,632.95

PTCA UNSUCESSFUL

Facility

$61,620.70

Service Code	HCPCS C9600
Hospital Charge Code	3668C9600
Hospital Revenue Code	361
Min. Negotiated Rate	$9,243.10
Max. Negotiated Rate	$9,243.10
Rate for Payer: Qualcare PPO/HMO/WC	$9,243.10

Know your out-of-pocket cost for care.

All Charges