Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STENT GENISIS CRD PG2990BPS

Facility

$6,944.00

Hospital Charge Code	270625965
Hospital Revenue Code	278
Min. Negotiated Rate	$167.35
Max. Negotiated Rate	$3,472.00
Rate for Payer: Aetna Commercial	$2,638.72
Rate for Payer: Aetna Medicare Advantage	$2,083.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,770.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,770.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,770.72
Rate for Payer: Cigna Commercial	$3,472.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,680.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,527.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.60
Rate for Payer: UnitedHealthcare Community & State	$167.35
Rate for Payer: Wellpoint Medicaid Managed Care	$184.02

STENT GENISIS CRD PG2990BPS

Facility

$6,944.00

Hospital Charge Code	270625965V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.60
Max. Negotiated Rate	$1,680.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,680.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,527.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.60

STENT GENISIS CRD PG2990BPS

Facility

$6,944.00

Hospital Charge Code	270625965V
Hospital Revenue Code	278
Min. Negotiated Rate	$167.35
Max. Negotiated Rate	$3,472.00
Rate for Payer: Aetna Commercial	$2,638.72
Rate for Payer: Aetna Medicare Advantage	$2,083.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,770.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,770.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,770.72
Rate for Payer: Cigna Commercial	$3,472.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,680.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,527.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.60
Rate for Payer: UnitedHealthcare Community & State	$167.35
Rate for Payer: Wellpoint Medicaid Managed Care	$184.02

STENT GENISIS CRD PG2990BPS

Facility

$6,944.00

Hospital Charge Code	270625965
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.60
Max. Negotiated Rate	$1,680.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,680.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,527.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.60

STENT GENSIS BILIARY PG1560BSS

Facility

$6,944.00

Hospital Charge Code	270625650
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.60
Max. Negotiated Rate	$1,680.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,680.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,527.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.60

STENT GENSIS BILIARY PG1560BSS

Facility

$6,944.00

Hospital Charge Code	270625650
Hospital Revenue Code	278
Min. Negotiated Rate	$167.35
Max. Negotiated Rate	$3,472.00
Rate for Payer: Aetna Commercial	$2,638.72
Rate for Payer: Aetna Medicare Advantage	$2,083.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,770.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,770.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,770.72
Rate for Payer: Cigna Commercial	$3,472.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,680.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,527.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.60
Rate for Payer: UnitedHealthcare Community & State	$167.35
Rate for Payer: Wellpoint Medicaid Managed Care	$184.02

STENT GENSIS BILIARY PG1560BSS

Facility

$6,944.00

Hospital Charge Code	270625650V
Hospital Revenue Code	278
Min. Negotiated Rate	$167.35
Max. Negotiated Rate	$3,472.00
Rate for Payer: Aetna Commercial	$2,638.72
Rate for Payer: Aetna Medicare Advantage	$2,083.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,770.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,770.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,770.72
Rate for Payer: Cigna Commercial	$3,472.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,680.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,527.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.60
Rate for Payer: UnitedHealthcare Community & State	$167.35
Rate for Payer: Wellpoint Medicaid Managed Care	$184.02

STENT GENSIS BILIARY PG1560BSS

Facility

$6,944.00

Hospital Charge Code	270625650V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.60
Max. Negotiated Rate	$1,680.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,680.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,527.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.60

STENT GLIDEX 8FR 26CM

Facility

$618.00

Hospital Charge Code	270665950
Hospital Revenue Code	278
Min. Negotiated Rate	$92.70
Max. Negotiated Rate	$149.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.96
Rate for Payer: Qualcare PPO/HMO/WC	$92.70

STENT GLIDEX 8FR 26CM

Facility

$618.00

Hospital Charge Code	270665950
Hospital Revenue Code	278
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$309.00
Rate for Payer: Aetna Commercial	$234.84
Rate for Payer: Aetna Medicare Advantage	$185.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.59
Rate for Payer: Cigna Commercial	$309.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.96
Rate for Payer: Qualcare PPO/HMO/WC	$92.70
Rate for Payer: UnitedHealthcare Community & State	$14.89
Rate for Payer: Wellpoint Medicaid Managed Care	$16.38

STENT GNEN PANCRTIC 5x5 GEPD55

Facility

$567.75

Hospital Charge Code	270632939
Hospital Revenue Code	278
Min. Negotiated Rate	$85.16
Max. Negotiated Rate	$137.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$124.91
Rate for Payer: Qualcare PPO/HMO/WC	$85.16

STENT GNEN PANCRTIC 5x5 GEPD55

Facility

$567.75

Hospital Charge Code	270632939
Hospital Revenue Code	278
Min. Negotiated Rate	$13.68
Max. Negotiated Rate	$283.88
Rate for Payer: Aetna Commercial	$215.75
Rate for Payer: Aetna Medicare Advantage	$170.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.78
Rate for Payer: Cigna Commercial	$283.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$124.91
Rate for Payer: Qualcare PPO/HMO/WC	$85.16
Rate for Payer: UnitedHealthcare Community & State	$13.68
Rate for Payer: Wellpoint Medicaid Managed Care	$15.05

STENT GORE TEX GRAFT 6MMX 30MM

Facility

$1,785.00

Service Code	HCPCS C1768
Hospital Charge Code	270688611
Hospital Revenue Code	278
Min. Negotiated Rate	$267.75
Max. Negotiated Rate	$431.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$357.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$431.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$392.70
Rate for Payer: Qualcare PPO/HMO/WC	$267.75

STENT GORE TEX GRAFT 6MMX 30MM

Facility

$1,785.00

Service Code	HCPCS C1768
Hospital Charge Code	270688611
Hospital Revenue Code	278
Min. Negotiated Rate	$43.02
Max. Negotiated Rate	$892.50
Rate for Payer: Aetna Commercial	$678.30
Rate for Payer: Aetna Medicare Advantage	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$455.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$455.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$455.18
Rate for Payer: Cigna Commercial	$892.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$431.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$392.70
Rate for Payer: Qualcare PPO/HMO/WC	$267.75
Rate for Payer: UnitedHealthcare Community & State	$43.02
Rate for Payer: Wellpoint Medicaid Managed Care	$47.30

STENT GPS 12MMx40MM, 80CM

Facility

$4,500.00

Service Code	HCPCS C1876
Hospital Charge Code	270636998
Hospital Revenue Code	278
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

STENT GPS 12MMx40MM, 80CM

Facility

$4,500.00

Service Code	HCPCS C1876
Hospital Charge Code	270636998S
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

STENT GPS 12MMx40MM, 80CM

Facility

$4,500.00

Service Code	HCPCS C1876
Hospital Charge Code	270636998
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

STENT GPS 12MMx40MM, 80CM

Facility

$4,500.00

Service Code	HCPCS C1876
Hospital Charge Code	270636998S
Hospital Revenue Code	278
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

STENT GPS 12MMx60MM, 80CM

Facility

$6,624.80

Service Code	HCPCS C1876
Hospital Charge Code	270636999
Hospital Revenue Code	278
Min. Negotiated Rate	$159.66
Max. Negotiated Rate	$3,312.40
Rate for Payer: Aetna Commercial	$2,517.42
Rate for Payer: Aetna Medicare Advantage	$1,987.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,689.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,689.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,324.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,689.32
Rate for Payer: Cigna Commercial	$3,312.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,603.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,457.46
Rate for Payer: Qualcare PPO/HMO/WC	$993.72
Rate for Payer: UnitedHealthcare Community & State	$159.66
Rate for Payer: Wellpoint Medicaid Managed Care	$175.56

STENT GPS 12MMx60MM, 80CM

Facility

$6,624.80

Service Code	HCPCS C1876
Hospital Charge Code	270636999
Hospital Revenue Code	278
Min. Negotiated Rate	$993.72
Max. Negotiated Rate	$1,603.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,324.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,603.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,457.46
Rate for Payer: Qualcare PPO/HMO/WC	$993.72

STENT GPS 14MMx30MM, 120CM

Facility

$4,500.00

Hospital Charge Code	270643090
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

STENT GPS 14MMx30MM, 120CM

Facility

$4,500.00

Hospital Charge Code	270643090
Hospital Revenue Code	278
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

STENT GPS 9MMx40MM, 80CM

Facility

$4,500.00

Hospital Charge Code	270637012
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

STENT GPS 9MMx40MM, 80CM

Facility

$4,500.00

Hospital Charge Code	270637012
Hospital Revenue Code	278
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

STENT GRAFT 10FR 11MM X 10CM

Facility

$20,450.00

Service Code	HCPCS C1874
Hospital Charge Code	270692118
Hospital Revenue Code	278
Min. Negotiated Rate	$492.85
Max. Negotiated Rate	$10,225.00
Rate for Payer: Aetna Commercial	$7,771.00
Rate for Payer: Aetna Medicare Advantage	$6,135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,214.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,214.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,090.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,214.75
Rate for Payer: Cigna Commercial	$10,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,948.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,499.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,067.50
Rate for Payer: UnitedHealthcare Community & State	$492.85
Rate for Payer: Wellpoint Medicaid Managed Care	$541.92

Know your out-of-pocket cost for care.

All Charges