Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STENT BILIARY 10FR X 12CM 4563

Facility

$580.40

Hospital Charge Code	270630047
Hospital Revenue Code	278
Min. Negotiated Rate	$13.99
Max. Negotiated Rate	$290.20
Rate for Payer: Aetna Commercial	$220.55
Rate for Payer: Aetna Medicare Advantage	$174.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.00
Rate for Payer: Cigna Commercial	$290.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.69
Rate for Payer: Qualcare PPO/HMO/WC	$87.06
Rate for Payer: UnitedHealthcare Community & State	$13.99
Rate for Payer: Wellpoint Medicaid Managed Care	$15.38

STENT BILIARY 10FR X 12CM 4563

Facility

$580.40

Hospital Charge Code	270630047
Hospital Revenue Code	278
Min. Negotiated Rate	$87.06
Max. Negotiated Rate	$140.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.69
Rate for Payer: Qualcare PPO/HMO/WC	$87.06

STENT BILIARY 8 5Fx10cm 4567

Facility

$580.40

Hospital Charge Code	270628071
Hospital Revenue Code	278
Min. Negotiated Rate	$13.99
Max. Negotiated Rate	$290.20
Rate for Payer: Aetna Commercial	$220.55
Rate for Payer: Aetna Medicare Advantage	$174.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.00
Rate for Payer: Cigna Commercial	$290.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.69
Rate for Payer: Qualcare PPO/HMO/WC	$87.06
Rate for Payer: UnitedHealthcare Community & State	$13.99
Rate for Payer: Wellpoint Medicaid Managed Care	$15.38

STENT BILIARY 8 5Fx10cm 4567

Facility

$580.40

Hospital Charge Code	270628071
Hospital Revenue Code	278
Min. Negotiated Rate	$87.06
Max. Negotiated Rate	$140.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.69
Rate for Payer: Qualcare PPO/HMO/WC	$87.06

STENT BILIARY COTTON CLBS-07-5

Facility

$1,032.85

Hospital Charge Code	270600992
Hospital Revenue Code	278
Min. Negotiated Rate	$24.89
Max. Negotiated Rate	$516.42
Rate for Payer: Aetna Commercial	$392.48
Rate for Payer: Aetna Medicare Advantage	$309.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.38
Rate for Payer: Cigna Commercial	$516.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$227.23
Rate for Payer: Qualcare PPO/HMO/WC	$154.93
Rate for Payer: UnitedHealthcare Community & State	$24.89
Rate for Payer: Wellpoint Medicaid Managed Care	$27.37

STENT BILIARY COTTON CLBS-07-5

Facility

$1,032.85

Hospital Charge Code	270600992
Hospital Revenue Code	278
Min. Negotiated Rate	$154.93
Max. Negotiated Rate	$249.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$227.23
Rate for Payer: Qualcare PPO/HMO/WC	$154.93

STENT BILIARY COTTON CLBS-07-7

Facility

$971.25

Hospital Charge Code	270600973
Hospital Revenue Code	278
Min. Negotiated Rate	$145.69
Max. Negotiated Rate	$235.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$213.68
Rate for Payer: Qualcare PPO/HMO/WC	$145.69

STENT BILIARY COTTON CLBS-07-7

Facility

$971.25

Hospital Charge Code	270600973
Hospital Revenue Code	278
Min. Negotiated Rate	$23.41
Max. Negotiated Rate	$485.62
Rate for Payer: Aetna Commercial	$369.07
Rate for Payer: Aetna Medicare Advantage	$291.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.67
Rate for Payer: Cigna Commercial	$485.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$213.68
Rate for Payer: Qualcare PPO/HMO/WC	$145.69
Rate for Payer: UnitedHealthcare Community & State	$23.41
Rate for Payer: Wellpoint Medicaid Managed Care	$25.74

STENT BILIARY COTTON CLBS-07-9

Facility

$1,032.85

Hospital Charge Code	270607996
Hospital Revenue Code	278
Min. Negotiated Rate	$154.93
Max. Negotiated Rate	$249.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$227.23
Rate for Payer: Qualcare PPO/HMO/WC	$154.93

STENT BILIARY COTTON CLBS-07-9

Facility

$1,032.85

Hospital Charge Code	270607996
Hospital Revenue Code	278
Min. Negotiated Rate	$24.89
Max. Negotiated Rate	$516.42
Rate for Payer: Aetna Commercial	$392.48
Rate for Payer: Aetna Medicare Advantage	$309.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.38
Rate for Payer: Cigna Commercial	$516.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$227.23
Rate for Payer: Qualcare PPO/HMO/WC	$154.93
Rate for Payer: UnitedHealthcare Community & State	$24.89
Rate for Payer: Wellpoint Medicaid Managed Care	$27.37

STENT BILIARY COTTON CLBS-1010

Facility

$1,021.65

Hospital Charge Code	270609566
Hospital Revenue Code	278
Min. Negotiated Rate	$153.25
Max. Negotiated Rate	$247.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$224.76
Rate for Payer: Qualcare PPO/HMO/WC	$153.25

STENT BILIARY COTTON CLBS-1010

Facility

$1,021.65

Hospital Charge Code	270609566
Hospital Revenue Code	278
Min. Negotiated Rate	$24.62
Max. Negotiated Rate	$510.82
Rate for Payer: Aetna Commercial	$388.23
Rate for Payer: Aetna Medicare Advantage	$306.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.52
Rate for Payer: Cigna Commercial	$510.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$224.76
Rate for Payer: Qualcare PPO/HMO/WC	$153.25
Rate for Payer: UnitedHealthcare Community & State	$24.62
Rate for Payer: Wellpoint Medicaid Managed Care	$27.07

STENT BILIARY COTTON CLBS-1012

Facility

$929.65

Hospital Charge Code	270609868
Hospital Revenue Code	278
Min. Negotiated Rate	$22.40
Max. Negotiated Rate	$464.82
Rate for Payer: Aetna Commercial	$353.27
Rate for Payer: Aetna Medicare Advantage	$278.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.06
Rate for Payer: Cigna Commercial	$464.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$204.52
Rate for Payer: Qualcare PPO/HMO/WC	$139.45
Rate for Payer: UnitedHealthcare Community & State	$22.40
Rate for Payer: Wellpoint Medicaid Managed Care	$24.64

STENT BILIARY COTTON CLBS-1012

Facility

$929.65

Hospital Charge Code	270609868
Hospital Revenue Code	278
Min. Negotiated Rate	$139.45
Max. Negotiated Rate	$224.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$204.52
Rate for Payer: Qualcare PPO/HMO/WC	$139.45

STENT BILIARY COTTON CLBS-10-5

Facility

$1,032.85

Hospital Charge Code	270600989
Hospital Revenue Code	278
Min. Negotiated Rate	$24.89
Max. Negotiated Rate	$516.42
Rate for Payer: Aetna Commercial	$392.48
Rate for Payer: Aetna Medicare Advantage	$309.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.38
Rate for Payer: Cigna Commercial	$516.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$227.23
Rate for Payer: Qualcare PPO/HMO/WC	$154.93
Rate for Payer: UnitedHealthcare Community & State	$24.89
Rate for Payer: Wellpoint Medicaid Managed Care	$27.37

STENT BILIARY COTTON CLBS-10-5

Facility

$1,032.85

Hospital Charge Code	270600989
Hospital Revenue Code	278
Min. Negotiated Rate	$154.93
Max. Negotiated Rate	$249.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$227.23
Rate for Payer: Qualcare PPO/HMO/WC	$154.93

STENT BILIARY COTTON CLBS-10-7

Facility

$1,032.85

Hospital Charge Code	270601175
Hospital Revenue Code	278
Min. Negotiated Rate	$154.93
Max. Negotiated Rate	$249.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$227.23
Rate for Payer: Qualcare PPO/HMO/WC	$154.93

STENT BILIARY COTTON CLBS-10-7

Facility

$1,032.85

Hospital Charge Code	270601175
Hospital Revenue Code	278
Min. Negotiated Rate	$24.89
Max. Negotiated Rate	$516.42
Rate for Payer: Aetna Commercial	$392.48
Rate for Payer: Aetna Medicare Advantage	$309.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.38
Rate for Payer: Cigna Commercial	$516.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$227.23
Rate for Payer: Qualcare PPO/HMO/WC	$154.93
Rate for Payer: UnitedHealthcare Community & State	$24.89
Rate for Payer: Wellpoint Medicaid Managed Care	$27.37

STENT BILIARY COTTON CLBS-10-9

Facility

$1,032.85

Hospital Charge Code	270600979
Hospital Revenue Code	278
Min. Negotiated Rate	$24.89
Max. Negotiated Rate	$516.42
Rate for Payer: Aetna Commercial	$392.48
Rate for Payer: Aetna Medicare Advantage	$309.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.38
Rate for Payer: Cigna Commercial	$516.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$227.23
Rate for Payer: Qualcare PPO/HMO/WC	$154.93
Rate for Payer: UnitedHealthcare Community & State	$24.89
Rate for Payer: Wellpoint Medicaid Managed Care	$27.37

STENT BILIARY COTTON CLBS-10-9

Facility

$1,032.85

Hospital Charge Code	270600979
Hospital Revenue Code	278
Min. Negotiated Rate	$154.93
Max. Negotiated Rate	$249.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$227.23
Rate for Payer: Qualcare PPO/HMO/WC	$154.93

STENT BILIARY COTTON CLBS-7-12

Facility

$466.45

Hospital Charge Code	270619606
Hospital Revenue Code	278
Min. Negotiated Rate	$69.97
Max. Negotiated Rate	$112.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$102.62
Rate for Payer: Qualcare PPO/HMO/WC	$69.97

STENT BILIARY COTTON CLBS-7-12

Facility

$466.45

Hospital Charge Code	270619606
Hospital Revenue Code	278
Min. Negotiated Rate	$11.24
Max. Negotiated Rate	$233.22
Rate for Payer: Aetna Commercial	$177.25
Rate for Payer: Aetna Medicare Advantage	$139.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.94
Rate for Payer: Cigna Commercial	$233.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$102.62
Rate for Payer: Qualcare PPO/HMO/WC	$69.97
Rate for Payer: UnitedHealthcare Community & State	$11.24
Rate for Payer: Wellpoint Medicaid Managed Care	$12.36

STENT BILIARY MCV 10Fx10c 4562

Facility

$580.40

Hospital Charge Code	270628068
Hospital Revenue Code	278
Min. Negotiated Rate	$13.99
Max. Negotiated Rate	$290.20
Rate for Payer: Aetna Commercial	$220.55
Rate for Payer: Aetna Medicare Advantage	$174.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.00
Rate for Payer: Cigna Commercial	$290.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.69
Rate for Payer: Qualcare PPO/HMO/WC	$87.06
Rate for Payer: UnitedHealthcare Community & State	$13.99
Rate for Payer: Wellpoint Medicaid Managed Care	$15.38

STENT BILIARY MCV 10Fx10c 4562

Facility

$580.40

Hospital Charge Code	270628068
Hospital Revenue Code	278
Min. Negotiated Rate	$87.06
Max. Negotiated Rate	$140.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.69
Rate for Payer: Qualcare PPO/HMO/WC	$87.06

STENT BILIARY MCV 10Fx7c 5461

Facility

$640.00

Service Code	HCPCS C2625
Hospital Charge Code	270628066
Hospital Revenue Code	278
Min. Negotiated Rate	$15.42
Max. Negotiated Rate	$320.00
Rate for Payer: Aetna Commercial	$243.20
Rate for Payer: Aetna Medicare Advantage	$192.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.20
Rate for Payer: Cigna Commercial	$320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$140.80
Rate for Payer: Qualcare PPO/HMO/WC	$96.00
Rate for Payer: UnitedHealthcare Community & State	$15.42
Rate for Payer: Wellpoint Medicaid Managed Care	$16.96

Know your out-of-pocket cost for care.

All Charges