Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STENT ABS 6X60 135cm1010564-60

Facility

$6,200.00

Hospital Charge Code	270635611
Hospital Revenue Code	278
Min. Negotiated Rate	$930.00
Max. Negotiated Rate	$1,500.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,364.00
Rate for Payer: Qualcare PPO/HMO/WC	$930.00

STENT ABS 6X60 135cm1010564-60

Facility

$6,200.00

Hospital Charge Code	270635611V
Hospital Revenue Code	278
Min. Negotiated Rate	$930.00
Max. Negotiated Rate	$1,500.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,364.00
Rate for Payer: Qualcare PPO/HMO/WC	$930.00

STENT ABS 6X60 135cm1010564-60

Facility

$6,200.00

Hospital Charge Code	270635611V
Hospital Revenue Code	278
Min. Negotiated Rate	$149.42
Max. Negotiated Rate	$3,100.00
Rate for Payer: Aetna Commercial	$2,356.00
Rate for Payer: Aetna Medicare Advantage	$1,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,581.00
Rate for Payer: Cigna Commercial	$3,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,364.00
Rate for Payer: Qualcare PPO/HMO/WC	$930.00
Rate for Payer: UnitedHealthcare Community & State	$149.42
Rate for Payer: Wellpoint Medicaid Managed Care	$164.30

STENT ABS 7x100x135 1010565100

Facility

$6,448.00

Hospital Charge Code	270633921V
Hospital Revenue Code	278
Min. Negotiated Rate	$155.40
Max. Negotiated Rate	$3,224.00
Rate for Payer: Aetna Commercial	$2,450.24
Rate for Payer: Aetna Medicare Advantage	$1,934.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,289.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,644.24
Rate for Payer: Cigna Commercial	$3,224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,418.56
Rate for Payer: Qualcare PPO/HMO/WC	$967.20
Rate for Payer: UnitedHealthcare Community & State	$155.40
Rate for Payer: Wellpoint Medicaid Managed Care	$170.87

STENT ABS 7x100x135 1010565100

Facility

$6,448.00

Hospital Charge Code	270633921V
Hospital Revenue Code	278
Min. Negotiated Rate	$967.20
Max. Negotiated Rate	$1,560.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,289.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,418.56
Rate for Payer: Qualcare PPO/HMO/WC	$967.20

STENT ABS 7x100x135 1010565100

Facility

$6,448.00

Hospital Charge Code	270633921
Hospital Revenue Code	278
Min. Negotiated Rate	$155.40
Max. Negotiated Rate	$3,224.00
Rate for Payer: Aetna Commercial	$2,450.24
Rate for Payer: Aetna Medicare Advantage	$1,934.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,289.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,644.24
Rate for Payer: Cigna Commercial	$3,224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,418.56
Rate for Payer: Qualcare PPO/HMO/WC	$967.20
Rate for Payer: UnitedHealthcare Community & State	$155.40
Rate for Payer: Wellpoint Medicaid Managed Care	$170.87

STENT ABS 7x100x135 1010565100

Facility

$6,448.00

Hospital Charge Code	270633921
Hospital Revenue Code	278
Min. Negotiated Rate	$967.20
Max. Negotiated Rate	$1,560.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,289.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,418.56
Rate for Payer: Qualcare PPO/HMO/WC	$967.20

STENT ABS 7x80 135cm 101056580

Facility

$6,448.00

Hospital Charge Code	270635165
Hospital Revenue Code	278
Min. Negotiated Rate	$155.40
Max. Negotiated Rate	$3,224.00
Rate for Payer: Aetna Commercial	$2,450.24
Rate for Payer: Aetna Medicare Advantage	$1,934.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,289.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,644.24
Rate for Payer: Cigna Commercial	$3,224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,418.56
Rate for Payer: Qualcare PPO/HMO/WC	$967.20
Rate for Payer: UnitedHealthcare Community & State	$155.40
Rate for Payer: Wellpoint Medicaid Managed Care	$170.87

STENT ABS 7x80 135cm 101056580

Facility

$6,448.00

Hospital Charge Code	270635165
Hospital Revenue Code	278
Min. Negotiated Rate	$967.20
Max. Negotiated Rate	$1,560.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,289.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,418.56
Rate for Payer: Qualcare PPO/HMO/WC	$967.20

STENT ABS 7x80 135cm 101056580

Facility

$6,448.00

Hospital Charge Code	270635165V
Hospital Revenue Code	278
Min. Negotiated Rate	$155.40
Max. Negotiated Rate	$3,224.00
Rate for Payer: Aetna Commercial	$2,450.24
Rate for Payer: Aetna Medicare Advantage	$1,934.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,289.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,644.24
Rate for Payer: Cigna Commercial	$3,224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,418.56
Rate for Payer: Qualcare PPO/HMO/WC	$967.20
Rate for Payer: UnitedHealthcare Community & State	$155.40
Rate for Payer: Wellpoint Medicaid Managed Care	$170.87

STENT ABS 7x80 135cm 101056580

Facility

$6,448.00

Hospital Charge Code	270635165V
Hospital Revenue Code	278
Min. Negotiated Rate	$967.20
Max. Negotiated Rate	$1,560.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,289.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,418.56
Rate for Payer: Qualcare PPO/HMO/WC	$967.20

STENT ABS 8x100x035 1010565100

Facility

$6,200.00

Hospital Charge Code	270632869
Hospital Revenue Code	278
Min. Negotiated Rate	$930.00
Max. Negotiated Rate	$1,500.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,364.00
Rate for Payer: Qualcare PPO/HMO/WC	$930.00

STENT ABS 8x100x035 1010565100

Facility

$6,200.00

Hospital Charge Code	270632869V
Hospital Revenue Code	278
Min. Negotiated Rate	$149.42
Max. Negotiated Rate	$3,100.00
Rate for Payer: Aetna Commercial	$2,356.00
Rate for Payer: Aetna Medicare Advantage	$1,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,581.00
Rate for Payer: Cigna Commercial	$3,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,364.00
Rate for Payer: Qualcare PPO/HMO/WC	$930.00
Rate for Payer: UnitedHealthcare Community & State	$149.42
Rate for Payer: Wellpoint Medicaid Managed Care	$164.30

STENT ABS 8x100x035 1010565100

Facility

$6,200.00

Hospital Charge Code	270632869V
Hospital Revenue Code	278
Min. Negotiated Rate	$930.00
Max. Negotiated Rate	$1,500.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,364.00
Rate for Payer: Qualcare PPO/HMO/WC	$930.00

STENT ABS 8x100x035 1010565100

Facility

$6,200.00

Hospital Charge Code	270632869
Hospital Revenue Code	278
Min. Negotiated Rate	$149.42
Max. Negotiated Rate	$3,100.00
Rate for Payer: Aetna Commercial	$2,356.00
Rate for Payer: Aetna Medicare Advantage	$1,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,581.00
Rate for Payer: Cigna Commercial	$3,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,364.00
Rate for Payer: Qualcare PPO/HMO/WC	$930.00
Rate for Payer: UnitedHealthcare Community & State	$149.42
Rate for Payer: Wellpoint Medicaid Managed Care	$164.30

STENT ABSOL 6x80x135 101056480

Facility

$6,448.00

Hospital Charge Code	270635238
Hospital Revenue Code	278
Min. Negotiated Rate	$155.40
Max. Negotiated Rate	$3,224.00
Rate for Payer: Aetna Commercial	$2,450.24
Rate for Payer: Aetna Medicare Advantage	$1,934.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,289.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,644.24
Rate for Payer: Cigna Commercial	$3,224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,418.56
Rate for Payer: Qualcare PPO/HMO/WC	$967.20
Rate for Payer: UnitedHealthcare Community & State	$155.40
Rate for Payer: Wellpoint Medicaid Managed Care	$170.87

STENT ABSOL 6x80x135 101056480

Facility

$6,448.00

Hospital Charge Code	270635238V
Hospital Revenue Code	278
Min. Negotiated Rate	$967.20
Max. Negotiated Rate	$1,560.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,289.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,418.56
Rate for Payer: Qualcare PPO/HMO/WC	$967.20

STENT ABSOL 6x80x135 101056480

Facility

$6,448.00

Hospital Charge Code	270635238
Hospital Revenue Code	278
Min. Negotiated Rate	$967.20
Max. Negotiated Rate	$1,560.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,289.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,418.56
Rate for Payer: Qualcare PPO/HMO/WC	$967.20

STENT ABSOL 6x80x135 101056480

Facility

$6,448.00

Hospital Charge Code	270635238V
Hospital Revenue Code	278
Min. Negotiated Rate	$155.40
Max. Negotiated Rate	$3,224.00
Rate for Payer: Aetna Commercial	$2,450.24
Rate for Payer: Aetna Medicare Advantage	$1,934.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,289.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,644.24
Rate for Payer: Cigna Commercial	$3,224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,418.56
Rate for Payer: Qualcare PPO/HMO/WC	$967.20
Rate for Payer: UnitedHealthcare Community & State	$155.40
Rate for Payer: Wellpoint Medicaid Managed Care	$170.87

STENT ABSOL 8x80x035 101056680

Facility

$6,448.00

Hospital Charge Code	270633678V
Hospital Revenue Code	278
Min. Negotiated Rate	$155.40
Max. Negotiated Rate	$3,224.00
Rate for Payer: Aetna Commercial	$2,450.24
Rate for Payer: Aetna Medicare Advantage	$1,934.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,289.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,644.24
Rate for Payer: Cigna Commercial	$3,224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,418.56
Rate for Payer: Qualcare PPO/HMO/WC	$967.20
Rate for Payer: UnitedHealthcare Community & State	$155.40
Rate for Payer: Wellpoint Medicaid Managed Care	$170.87

STENT ABSOL 8x80x035 101056680

Facility

$6,448.00

Hospital Charge Code	270633678
Hospital Revenue Code	278
Min. Negotiated Rate	$155.40
Max. Negotiated Rate	$3,224.00
Rate for Payer: Aetna Commercial	$2,450.24
Rate for Payer: Aetna Medicare Advantage	$1,934.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,289.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,644.24
Rate for Payer: Cigna Commercial	$3,224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,418.56
Rate for Payer: Qualcare PPO/HMO/WC	$967.20
Rate for Payer: UnitedHealthcare Community & State	$155.40
Rate for Payer: Wellpoint Medicaid Managed Care	$170.87

STENT ABSOL 8x80x035 101056680

Facility

$6,448.00

Hospital Charge Code	270633678V
Hospital Revenue Code	278
Min. Negotiated Rate	$967.20
Max. Negotiated Rate	$1,560.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,289.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,418.56
Rate for Payer: Qualcare PPO/HMO/WC	$967.20

STENT ABSOL 8x80x035 101056680

Facility

$6,448.00

Hospital Charge Code	270633678
Hospital Revenue Code	278
Min. Negotiated Rate	$967.20
Max. Negotiated Rate	$1,560.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,289.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,418.56
Rate for Payer: Qualcare PPO/HMO/WC	$967.20

STENT ABSOLUTE 6x60mm 135cm

Facility

$3,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270647807
Hospital Revenue Code	278
Min. Negotiated Rate	$93.39
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,472.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$852.50
Rate for Payer: Qualcare PPO/HMO/WC	$581.25
Rate for Payer: UnitedHealthcare Community & State	$93.39
Rate for Payer: Wellpoint Medicaid Managed Care	$102.69

STENT ABSOLUTE 6x60mm 135cm

Facility

$3,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270647807
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$937.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$852.50
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

Know your out-of-pocket cost for care.

All Charges