Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STENT EX BL 9x25x75 3804692075

Facility

$6,423.25

Hospital Charge Code	270630471
Hospital Revenue Code	278
Min. Negotiated Rate	$963.49
Max. Negotiated Rate	$1,554.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,284.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,554.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,413.12
Rate for Payer: Qualcare PPO/HMO/WC	$963.49

STENT EX BL 9x25x75 3804692075

Facility

$6,475.00

Hospital Charge Code	270630471V
Hospital Revenue Code	278
Min. Negotiated Rate	$156.05
Max. Negotiated Rate	$3,237.50
Rate for Payer: Aetna Commercial	$2,460.50
Rate for Payer: Aetna Medicare Advantage	$1,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.12
Rate for Payer: Cigna Commercial	$3,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,424.50
Rate for Payer: Qualcare PPO/HMO/WC	$971.25
Rate for Payer: UnitedHealthcare Community & State	$156.05
Rate for Payer: Wellpoint Medicaid Managed Care	$171.59

STENT EX BL 9x25x75 3804692075

Facility

$6,475.00

Hospital Charge Code	270630471V
Hospital Revenue Code	278
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$1,566.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,424.50
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

STENT EX BL 9x25x75 3804692075

Facility

$6,423.25

Hospital Charge Code	270630471
Hospital Revenue Code	278
Min. Negotiated Rate	$154.80
Max. Negotiated Rate	$3,211.62
Rate for Payer: Aetna Commercial	$2,440.84
Rate for Payer: Aetna Medicare Advantage	$1,926.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,637.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,637.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,284.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,637.93
Rate for Payer: Cigna Commercial	$3,211.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,554.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,413.12
Rate for Payer: Qualcare PPO/HMO/WC	$963.49
Rate for Payer: UnitedHealthcare Community & State	$154.80
Rate for Payer: Wellpoint Medicaid Managed Care	$170.22

STENT EXCLUDER

Facility

$23,695.00

Hospital Charge Code	270681917
Hospital Revenue Code	278
Min. Negotiated Rate	$571.05
Max. Negotiated Rate	$11,847.50
Rate for Payer: Aetna Commercial	$9,004.10
Rate for Payer: Aetna Medicare Advantage	$7,108.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,042.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,042.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,739.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,042.23
Rate for Payer: Cigna Commercial	$11,847.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,734.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,212.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,554.25
Rate for Payer: UnitedHealthcare Community & State	$571.05
Rate for Payer: Wellpoint Medicaid Managed Care	$627.92

STENT EXCLUDER

Facility

$23,695.00

Hospital Charge Code	270681917
Hospital Revenue Code	278
Min. Negotiated Rate	$3,554.25
Max. Negotiated Rate	$5,734.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,739.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,734.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,212.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,554.25

STENT EXCLUDER 16MM 16 9.5CM

Facility

$23,695.00

Hospital Charge Code	270682803
Hospital Revenue Code	278
Min. Negotiated Rate	$3,554.25
Max. Negotiated Rate	$5,734.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,739.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,734.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,212.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,554.25

STENT EXCLUDER 16MM 16 9.5CM

Facility

$23,695.00

Hospital Charge Code	270682803
Hospital Revenue Code	278
Min. Negotiated Rate	$571.05
Max. Negotiated Rate	$11,847.50
Rate for Payer: Aetna Commercial	$9,004.10
Rate for Payer: Aetna Medicare Advantage	$7,108.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,042.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,042.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,739.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,042.23
Rate for Payer: Cigna Commercial	$11,847.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,734.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,212.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,554.25
Rate for Payer: UnitedHealthcare Community & State	$571.05
Rate for Payer: Wellpoint Medicaid Managed Care	$627.92

STENT EXCLUDER 16MM16x13.5CM

Facility

$23,695.00

Hospital Charge Code	270682804
Hospital Revenue Code	278
Min. Negotiated Rate	$571.05
Max. Negotiated Rate	$11,847.50
Rate for Payer: Aetna Commercial	$9,004.10
Rate for Payer: Aetna Medicare Advantage	$7,108.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,042.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,042.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,739.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,042.23
Rate for Payer: Cigna Commercial	$11,847.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,734.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,212.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,554.25
Rate for Payer: UnitedHealthcare Community & State	$571.05
Rate for Payer: Wellpoint Medicaid Managed Care	$627.92

STENT EXCLUDER 16MM16x13.5CM

Facility

$23,695.00

Hospital Charge Code	270682804
Hospital Revenue Code	278
Min. Negotiated Rate	$3,554.25
Max. Negotiated Rate	$5,734.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,739.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,734.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,212.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,554.25

STENT EXCLUDER 31MM 14.5 13CM

Facility

$57,785.00

Hospital Charge Code	270682805
Hospital Revenue Code	278
Min. Negotiated Rate	$8,667.75
Max. Negotiated Rate	$13,983.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,557.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,983.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12,712.70
Rate for Payer: Qualcare PPO/HMO/WC	$8,667.75

STENT EXCLUDER 31MM 14.5 13CM

Facility

$57,785.00

Hospital Charge Code	270682805
Hospital Revenue Code	278
Min. Negotiated Rate	$1,392.62
Max. Negotiated Rate	$28,892.50
Rate for Payer: Aetna Commercial	$21,958.30
Rate for Payer: Aetna Medicare Advantage	$17,335.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,735.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,735.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,557.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,735.17
Rate for Payer: Cigna Commercial	$28,892.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,983.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12,712.70
Rate for Payer: Qualcare PPO/HMO/WC	$8,667.75
Rate for Payer: UnitedHealthcare Community & State	$1,392.62
Rate for Payer: Wellpoint Medicaid Managed Care	$1,531.30

STENT EXCLUDER AAA16MM 23 14CM

Facility

$23,695.00

Hospital Charge Code	270682800
Hospital Revenue Code	278
Min. Negotiated Rate	$571.05
Max. Negotiated Rate	$11,847.50
Rate for Payer: Aetna Commercial	$9,004.10
Rate for Payer: Aetna Medicare Advantage	$7,108.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,042.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,042.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,739.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,042.23
Rate for Payer: Cigna Commercial	$11,847.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,734.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,212.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,554.25
Rate for Payer: UnitedHealthcare Community & State	$571.05
Rate for Payer: Wellpoint Medicaid Managed Care	$627.92

STENT EXCLUDER AAA16MM 23 14CM

Facility

$23,695.00

Hospital Charge Code	270682800
Hospital Revenue Code	278
Min. Negotiated Rate	$3,554.25
Max. Negotiated Rate	$5,734.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,739.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,734.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,212.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,554.25

STENT EXCLUDER AAA32MM 4.5CM

Facility

$16,675.00

Hospital Charge Code	270682802
Hospital Revenue Code	278
Min. Negotiated Rate	$2,501.25
Max. Negotiated Rate	$4,035.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,035.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,668.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,501.25

STENT EXCLUDER AAA32MM 4.5CM

Facility

$16,675.00

Hospital Charge Code	270682802
Hospital Revenue Code	278
Min. Negotiated Rate	$401.87
Max. Negotiated Rate	$8,337.50
Rate for Payer: Aetna Commercial	$6,336.50
Rate for Payer: Aetna Medicare Advantage	$5,002.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,252.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,252.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,335.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,252.12
Rate for Payer: Cigna Commercial	$8,337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,035.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,668.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,501.25
Rate for Payer: UnitedHealthcare Community & State	$401.87
Rate for Payer: Wellpoint Medicaid Managed Care	$441.89

STENT EXP 2 2.5X20 350502025

Facility

$4,375.00

Hospital Charge Code	270639376
Hospital Revenue Code	278
Min. Negotiated Rate	$105.44
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,662.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25
Rate for Payer: UnitedHealthcare Community & State	$105.44
Rate for Payer: Wellpoint Medicaid Managed Care	$115.94

STENT EXP 2 2.5X20 350502025

Facility

$4,375.00

Hospital Charge Code	270639376
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,058.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

STENT EXP MONO 2.5X8 350500825

Facility

$4,375.00

Hospital Charge Code	270638558C
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,058.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

STENT EXP MONO 2.5X8 350500825

Facility

$4,375.00

Hospital Charge Code	270638558C
Hospital Revenue Code	278
Min. Negotiated Rate	$105.44
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,662.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25
Rate for Payer: UnitedHealthcare Community & State	$105.44
Rate for Payer: Wellpoint Medicaid Managed Care	$115.94

STENT EXPR 2 2.5X12M35050-1225

Facility

$4,375.00

Hospital Charge Code	270642469C
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,058.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

STENT EXPR 2 2.5X12M35050-1225

Facility

$4,375.00

Hospital Charge Code	270642469C
Hospital Revenue Code	278
Min. Negotiated Rate	$105.44
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,662.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25
Rate for Payer: UnitedHealthcare Community & State	$105.44
Rate for Payer: Wellpoint Medicaid Managed Care	$115.94

STENT EXPR 2 2.5X16 350501625

Facility

$4,375.00

Hospital Charge Code	270638811C
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,058.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

STENT EXPR 2 2.5X16 350501625

Facility

$4,375.00

Hospital Charge Code	270638811C
Hospital Revenue Code	278
Min. Negotiated Rate	$105.44
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,662.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25
Rate for Payer: UnitedHealthcare Community & State	$105.44
Rate for Payer: Wellpoint Medicaid Managed Care	$115.94

STENT EXPR 2 2.5X8 350500825

Facility

$4,375.00

Hospital Charge Code	270638812
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,058.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

Know your out-of-pocket cost for care.

All Charges