Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STENT I CAST 5MMX16MMX120CM

Facility

$12,100.00

Hospital Charge Code	270647292C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,815.00
Max. Negotiated Rate	$2,928.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00

STENT I CAST 6MMX22MMX120CM

Facility

$12,100.00

Hospital Charge Code	270647293C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,815.00
Max. Negotiated Rate	$2,928.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00

STENT I CAST 6MMX22MMX120CM

Facility

$12,100.00

Hospital Charge Code	270647293C
Hospital Revenue Code	278
Min. Negotiated Rate	$291.61
Max. Negotiated Rate	$6,050.00
Rate for Payer: Aetna Commercial	$4,598.00
Rate for Payer: Aetna Medicare Advantage	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,085.50
Rate for Payer: Cigna Commercial	$6,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00
Rate for Payer: UnitedHealthcare Community & State	$291.61
Rate for Payer: Wellpoint Medicaid Managed Care	$320.65

STENT I-CAST 6x22MM 120CM

Facility

$12,575.00

Service Code	HCPCS C1874
Hospital Charge Code	270647293
Hospital Revenue Code	278
Min. Negotiated Rate	$303.06
Max. Negotiated Rate	$6,287.50
Rate for Payer: Aetna Commercial	$4,778.50
Rate for Payer: Aetna Medicare Advantage	$3,772.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,206.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,206.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,515.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,206.62
Rate for Payer: Cigna Commercial	$6,287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,043.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,766.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,886.25
Rate for Payer: UnitedHealthcare Community & State	$303.06
Rate for Payer: Wellpoint Medicaid Managed Care	$333.24

STENT I-CAST 6x22MM 120CM

Facility

$12,575.00

Service Code	HCPCS C1874
Hospital Charge Code	270647293
Hospital Revenue Code	278
Min. Negotiated Rate	$1,886.25
Max. Negotiated Rate	$3,043.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,515.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,043.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,766.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,886.25

STENT I-CAST 6x22MM 80CM

Facility

$12,575.00

Hospital Charge Code	270678107
Hospital Revenue Code	278
Min. Negotiated Rate	$303.06
Max. Negotiated Rate	$6,287.50
Rate for Payer: Aetna Commercial	$4,778.50
Rate for Payer: Aetna Medicare Advantage	$3,772.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,206.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,206.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,515.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,206.62
Rate for Payer: Cigna Commercial	$6,287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,043.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,766.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,886.25
Rate for Payer: UnitedHealthcare Community & State	$303.06
Rate for Payer: Wellpoint Medicaid Managed Care	$333.24

STENT I-CAST 6x22MM 80CM

Facility

$12,575.00

Hospital Charge Code	270678107
Hospital Revenue Code	278
Min. Negotiated Rate	$1,886.25
Max. Negotiated Rate	$3,043.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,515.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,043.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,766.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,886.25

STENT I CAST 7MMX38MMX120CM

Facility

$12,100.00

Hospital Charge Code	270647294C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,815.00
Max. Negotiated Rate	$2,928.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00

STENT I CAST 7MMX38MMX120CM

Facility

$12,100.00

Hospital Charge Code	270647294C
Hospital Revenue Code	278
Min. Negotiated Rate	$291.61
Max. Negotiated Rate	$6,050.00
Rate for Payer: Aetna Commercial	$4,598.00
Rate for Payer: Aetna Medicare Advantage	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,085.50
Rate for Payer: Cigna Commercial	$6,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00
Rate for Payer: UnitedHealthcare Community & State	$291.61
Rate for Payer: Wellpoint Medicaid Managed Care	$320.65

STENT I CAST 8MMX59MX80CM

Facility

$13,875.00

Hospital Charge Code	270634582C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,081.25
Max. Negotiated Rate	$3,357.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,357.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,052.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,081.25

STENT I CAST 8MMX59MX80CM

Facility

$13,875.00

Hospital Charge Code	270634582C
Hospital Revenue Code	278
Min. Negotiated Rate	$334.39
Max. Negotiated Rate	$6,937.50
Rate for Payer: Aetna Commercial	$5,272.50
Rate for Payer: Aetna Medicare Advantage	$4,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,538.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,538.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,538.12
Rate for Payer: Cigna Commercial	$6,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,357.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,052.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,081.25
Rate for Payer: UnitedHealthcare Community & State	$334.39
Rate for Payer: Wellpoint Medicaid Managed Care	$367.69

STENT ICAST COV 6MMx38MMx80CM

Facility

$13,875.00

Hospital Charge Code	270653399
Hospital Revenue Code	278
Min. Negotiated Rate	$2,081.25
Max. Negotiated Rate	$3,357.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,357.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,052.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,081.25

STENT ICAST COV 6MMx38MMx80CM

Facility

$13,875.00

Hospital Charge Code	270653399
Hospital Revenue Code	278
Min. Negotiated Rate	$334.39
Max. Negotiated Rate	$6,937.50
Rate for Payer: Aetna Commercial	$5,272.50
Rate for Payer: Aetna Medicare Advantage	$4,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,538.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,538.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,538.12
Rate for Payer: Cigna Commercial	$6,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,357.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,052.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,081.25
Rate for Payer: UnitedHealthcare Community & State	$334.39
Rate for Payer: Wellpoint Medicaid Managed Care	$367.69

STENT ICAST COV 7MMx59MMx80CM

Facility

$13,875.00

Service Code	HCPCS C1874
Hospital Charge Code	270653401
Hospital Revenue Code	278
Min. Negotiated Rate	$2,081.25
Max. Negotiated Rate	$3,357.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,357.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,052.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,081.25

STENT ICAST COV 7MMx59MMx80CM

Facility

$13,875.00

Service Code	HCPCS C1874
Hospital Charge Code	270653401
Hospital Revenue Code	278
Min. Negotiated Rate	$334.39
Max. Negotiated Rate	$6,937.50
Rate for Payer: Aetna Commercial	$5,272.50
Rate for Payer: Aetna Medicare Advantage	$4,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,538.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,538.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,538.12
Rate for Payer: Cigna Commercial	$6,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,357.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,052.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,081.25
Rate for Payer: UnitedHealthcare Community & State	$334.39
Rate for Payer: Wellpoint Medicaid Managed Care	$367.69

STENT ICAST COVERED 5MMX38MM

Facility

$12,875.00

Service Code	HCPCS C1874
Hospital Charge Code	270659855
Hospital Revenue Code	278
Min. Negotiated Rate	$1,931.25
Max. Negotiated Rate	$3,115.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,115.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,832.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,931.25

STENT ICAST COVERED 5MMX38MM

Facility

$12,875.00

Service Code	HCPCS C1874
Hospital Charge Code	270659855N
Hospital Revenue Code	278
Min. Negotiated Rate	$310.29
Max. Negotiated Rate	$6,437.50
Rate for Payer: Aetna Commercial	$4,892.50
Rate for Payer: Aetna Medicare Advantage	$3,862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,283.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,283.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,283.12
Rate for Payer: Cigna Commercial	$6,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,115.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,832.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,931.25
Rate for Payer: UnitedHealthcare Community & State	$310.29
Rate for Payer: Wellpoint Medicaid Managed Care	$341.19

STENT ICAST COVERED 5MMX38MM

Facility

$12,875.00

Service Code	HCPCS C1874
Hospital Charge Code	270659855N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,931.25
Max. Negotiated Rate	$3,115.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,115.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,832.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,931.25

STENT ICAST COVERED 5MMX38MM

Facility

$12,875.00

Service Code	HCPCS C1874
Hospital Charge Code	270659855
Hospital Revenue Code	278
Min. Negotiated Rate	$310.29
Max. Negotiated Rate	$6,437.50
Rate for Payer: Aetna Commercial	$4,892.50
Rate for Payer: Aetna Medicare Advantage	$3,862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,283.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,283.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,283.12
Rate for Payer: Cigna Commercial	$6,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,115.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,832.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,931.25
Rate for Payer: UnitedHealthcare Community & State	$310.29
Rate for Payer: Wellpoint Medicaid Managed Care	$341.19

STENT ILIAC LEG G55245

Facility

$15,425.00

Hospital Charge Code	270647930C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,313.75
Max. Negotiated Rate	$3,732.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,085.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,732.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,393.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,313.75

STENT ILIAC LEG G55245

Facility

$15,425.00

Hospital Charge Code	270647930C
Hospital Revenue Code	278
Min. Negotiated Rate	$371.74
Max. Negotiated Rate	$7,712.50
Rate for Payer: Aetna Commercial	$5,861.50
Rate for Payer: Aetna Medicare Advantage	$4,627.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,933.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,933.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,085.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,933.38
Rate for Payer: Cigna Commercial	$7,712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,732.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,393.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,313.75
Rate for Payer: UnitedHealthcare Community & State	$371.74
Rate for Payer: Wellpoint Medicaid Managed Care	$408.76

STENT ILIAC LEG G55247

Facility

$15,425.00

Hospital Charge Code	270647929C
Hospital Revenue Code	278
Min. Negotiated Rate	$371.74
Max. Negotiated Rate	$7,712.50
Rate for Payer: Aetna Commercial	$5,861.50
Rate for Payer: Aetna Medicare Advantage	$4,627.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,933.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,933.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,085.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,933.38
Rate for Payer: Cigna Commercial	$7,712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,732.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,393.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,313.75
Rate for Payer: UnitedHealthcare Community & State	$371.74
Rate for Payer: Wellpoint Medicaid Managed Care	$408.76

STENT ILIAC LEG G55247

Facility

$15,425.00

Hospital Charge Code	270647929C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,313.75
Max. Negotiated Rate	$3,732.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,085.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,732.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,393.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,313.75

STENT ILIAC SMRT 8/40 C08040SB

Facility

$8,159.25

Hospital Charge Code	270628376
Hospital Revenue Code	278
Min. Negotiated Rate	$196.64
Max. Negotiated Rate	$4,079.62
Rate for Payer: Aetna Commercial	$3,100.51
Rate for Payer: Aetna Medicare Advantage	$2,447.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,080.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,080.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,631.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,080.61
Rate for Payer: Cigna Commercial	$4,079.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,974.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,795.04
Rate for Payer: Qualcare PPO/HMO/WC	$1,223.89
Rate for Payer: UnitedHealthcare Community & State	$196.64
Rate for Payer: Wellpoint Medicaid Managed Care	$216.22

STENT ILIAC SMRT 8/40 C08040SB

Facility

$8,225.00

Hospital Charge Code	270628376V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,233.75
Max. Negotiated Rate	$1,990.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,990.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,809.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,233.75

Know your out-of-pocket cost for care.

All Charges