Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SHTH PINNCLE II INTROD 7FRX6

Facility

$29.70

Service Code	HCPCS C1766
Hospital Charge Code	270658252N
Hospital Revenue Code	278
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$7.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6.53
Rate for Payer: Qualcare PPO/HMO/WC	$4.46

SHTH PINNCLE II INTROD 7FRX6

Facility

$29.70

Service Code	HCPCS C1766
Hospital Charge Code	270658252N
Hospital Revenue Code	278
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$14.85
Rate for Payer: Aetna Commercial	$11.29
Rate for Payer: Aetna Medicare Advantage	$8.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.57
Rate for Payer: Cigna Commercial	$14.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6.53
Rate for Payer: Qualcare PPO/HMO/WC	$4.46
Rate for Payer: UnitedHealthcare Community & State	$0.72
Rate for Payer: Wellpoint Medicaid Managed Care	$0.79

SHTH PINNCLE II INTROD 7FRX6

Facility

$148.50

Service Code	HCPCS C1766
Hospital Charge Code	270658252S
Hospital Revenue Code	278
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$35.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$22.27

SHTH PINNCLE II INTROD 7FRX6

Facility

$148.50

Service Code	HCPCS C1766
Hospital Charge Code	270658252S
Hospital Revenue Code	278
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$74.25
Rate for Payer: Aetna Commercial	$56.43
Rate for Payer: Aetna Medicare Advantage	$44.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.87
Rate for Payer: Cigna Commercial	$74.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$22.27
Rate for Payer: UnitedHealthcare Community & State	$3.58
Rate for Payer: Wellpoint Medicaid Managed Care	$3.94

SHTH PINNCLE II INTROD 7FRX6

Facility

$148.50

Service Code	HCPCS C1766
Hospital Charge Code	270658252
Hospital Revenue Code	278
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$35.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$22.27

SHTH PINNCLE II INTROD 7FRX6

Facility

$148.50

Service Code	HCPCS C1766
Hospital Charge Code	270658252
Hospital Revenue Code	278
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$74.25
Rate for Payer: Aetna Commercial	$56.43
Rate for Payer: Aetna Medicare Advantage	$44.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.87
Rate for Payer: Cigna Commercial	$74.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$22.27
Rate for Payer: UnitedHealthcare Community & State	$3.58
Rate for Payer: Wellpoint Medicaid Managed Care	$3.94

SHUNT ARGYLE CAROTID ARTERY

Facility

$288.40

Service Code	HCPCS C1729
Hospital Charge Code	270657594
Hospital Revenue Code	278
Min. Negotiated Rate	$6.95
Max. Negotiated Rate	$144.20
Rate for Payer: Aetna Commercial	$109.59
Rate for Payer: Aetna Medicare Advantage	$86.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.54
Rate for Payer: Cigna Commercial	$144.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$63.45
Rate for Payer: Qualcare PPO/HMO/WC	$43.26
Rate for Payer: UnitedHealthcare Community & State	$6.95
Rate for Payer: Wellpoint Medicaid Managed Care	$7.64

SHUNT ARGYLE CAROTID ARTERY

Facility

$288.40

Service Code	HCPCS C1729
Hospital Charge Code	270657594
Hospital Revenue Code	278
Min. Negotiated Rate	$43.26
Max. Negotiated Rate	$69.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$63.45
Rate for Payer: Qualcare PPO/HMO/WC	$43.26

SHUNT BYPASS JAVID CAROTID

Facility

$5,925.00

Hospital Charge Code	270656013
Hospital Revenue Code	278
Min. Negotiated Rate	$888.75
Max. Negotiated Rate	$1,433.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,433.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,303.50
Rate for Payer: Qualcare PPO/HMO/WC	$888.75

SHUNT BYPASS JAVID CAROTID

Facility

$5,925.00

Hospital Charge Code	270656013
Hospital Revenue Code	278
Min. Negotiated Rate	$142.79
Max. Negotiated Rate	$2,962.50
Rate for Payer: Aetna Commercial	$2,251.50
Rate for Payer: Aetna Medicare Advantage	$1,777.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,510.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,510.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,185.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,510.88
Rate for Payer: Cigna Commercial	$2,962.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,433.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,303.50
Rate for Payer: Qualcare PPO/HMO/WC	$888.75
Rate for Payer: UnitedHealthcare Community & State	$142.79
Rate for Payer: Wellpoint Medicaid Managed Care	$157.01

SHUNT CAROTD BYPASS 14F 007755

Facility

$445.75

Service Code	HCPCS C1729
Hospital Charge Code	270629730
Hospital Revenue Code	278
Min. Negotiated Rate	$10.74
Max. Negotiated Rate	$222.88
Rate for Payer: Aetna Commercial	$169.38
Rate for Payer: Aetna Medicare Advantage	$133.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$89.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.67
Rate for Payer: Cigna Commercial	$222.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$98.06
Rate for Payer: Qualcare PPO/HMO/WC	$66.86
Rate for Payer: UnitedHealthcare Community & State	$10.74
Rate for Payer: Wellpoint Medicaid Managed Care	$11.81

SHUNT CAROTD BYPASS 14F 007755

Facility

$445.75

Service Code	HCPCS C1729
Hospital Charge Code	270629730
Hospital Revenue Code	278
Min. Negotiated Rate	$66.86
Max. Negotiated Rate	$107.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$89.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$98.06
Rate for Payer: Qualcare PPO/HMO/WC	$66.86

SHUNT CAROTID ARTERY 6

Facility

$179.25

Service Code	HCPCS C1729
Hospital Charge Code	270600281
Hospital Revenue Code	278
Min. Negotiated Rate	$4.32
Max. Negotiated Rate	$89.62
Rate for Payer: Aetna Commercial	$68.11
Rate for Payer: Aetna Medicare Advantage	$53.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.71
Rate for Payer: Cigna Commercial	$89.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$39.44
Rate for Payer: Qualcare PPO/HMO/WC	$26.89
Rate for Payer: UnitedHealthcare Community & State	$4.32
Rate for Payer: Wellpoint Medicaid Managed Care	$4.75

SHUNT CAROTID ARTERY 6

Facility

$179.25

Service Code	HCPCS C1729
Hospital Charge Code	270600281
Hospital Revenue Code	278
Min. Negotiated Rate	$26.89
Max. Negotiated Rate	$43.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$39.44
Rate for Payer: Qualcare PPO/HMO/WC	$26.89

SHUNT CAROTID BYPASS JAVID

Facility

$284.00

Hospital Charge Code	270331545
Hospital Revenue Code	278
Min. Negotiated Rate	$6.84
Max. Negotiated Rate	$142.00
Rate for Payer: Aetna Commercial	$107.92
Rate for Payer: Aetna Medicare Advantage	$85.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.42
Rate for Payer: Cigna Commercial	$142.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$62.48
Rate for Payer: Qualcare PPO/HMO/WC	$42.60
Rate for Payer: UnitedHealthcare Community & State	$6.84
Rate for Payer: Wellpoint Medicaid Managed Care	$7.53

SHUNT CAROTID BYPASS JAVID

Facility

$284.00

Hospital Charge Code	270331545
Hospital Revenue Code	278
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$68.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$62.48
Rate for Payer: Qualcare PPO/HMO/WC	$42.60

SHUNT CAROTID JAVID 007714

Facility

$411.25

Hospital Charge Code	270624964
Hospital Revenue Code	278
Min. Negotiated Rate	$9.91
Max. Negotiated Rate	$205.62
Rate for Payer: Aetna Commercial	$156.28
Rate for Payer: Aetna Medicare Advantage	$123.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.87
Rate for Payer: Cigna Commercial	$205.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$90.47
Rate for Payer: Qualcare PPO/HMO/WC	$61.69
Rate for Payer: UnitedHealthcare Community & State	$9.91
Rate for Payer: Wellpoint Medicaid Managed Care	$10.90

SHUNT CAROTID JAVID 007714

Facility

$411.25

Hospital Charge Code	270624964
Hospital Revenue Code	278
Min. Negotiated Rate	$61.69
Max. Negotiated Rate	$99.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$90.47
Rate for Payer: Qualcare PPO/HMO/WC	$61.69

SHUNT CAROTID LS1408

Facility

$1,250.00

Service Code	HCPCS C1729
Hospital Charge Code	270640873
Hospital Revenue Code	278
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

SHUNT CAROTID LS1408

Facility

$1,250.00

Service Code	HCPCS C1729
Hospital Charge Code	270640873
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SHUNT CAROTID PRUIT INHARA T

Facility

$883.25

Hospital Charge Code	270600283
Hospital Revenue Code	278
Min. Negotiated Rate	$21.29
Max. Negotiated Rate	$441.62
Rate for Payer: Aetna Commercial	$335.63
Rate for Payer: Aetna Medicare Advantage	$264.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$225.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$225.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$225.23
Rate for Payer: Cigna Commercial	$441.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$194.31
Rate for Payer: Qualcare PPO/HMO/WC	$132.49
Rate for Payer: UnitedHealthcare Community & State	$21.29
Rate for Payer: Wellpoint Medicaid Managed Care	$23.41

SHUNT CAROTID PRUIT INHARA T

Facility

$883.25

Hospital Charge Code	270600283
Hospital Revenue Code	278
Min. Negotiated Rate	$132.49
Max. Negotiated Rate	$213.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$194.31
Rate for Payer: Qualcare PPO/HMO/WC	$132.49

SHUNT CAROTID PRUITT T

Facility

$460.00

Hospital Charge Code	270601222
Hospital Revenue Code	272
Min. Negotiated Rate	$11.09
Max. Negotiated Rate	$230.00
Rate for Payer: Aetna Commercial	$174.80
Rate for Payer: Aetna Medicare Advantage	$138.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.30
Rate for Payer: Cigna Commercial	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.00
Rate for Payer: Oxford Commercial	$92.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.00
Rate for Payer: UnitedHealthcare Commercial	$92.00
Rate for Payer: UnitedHealthcare Community & State	$11.09
Rate for Payer: Wellpoint Medicaid Managed Care	$12.19

SHUNT CAROTID PRUITT T

Facility

$460.00

Hospital Charge Code	270601222
Hospital Revenue Code	272
Min. Negotiated Rate	$69.00
Max. Negotiated Rate	$69.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.00

SHUNT CARTID BYPASS 14f 007755

Facility

$421.65

Hospital Charge Code	270629720
Hospital Revenue Code	278
Min. Negotiated Rate	$63.25
Max. Negotiated Rate	$102.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$92.76
Rate for Payer: Qualcare PPO/HMO/WC	$63.25

Know your out-of-pocket cost for care.

All Charges