Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STENT ILIAC SMRT 8/40 C08040SB

Facility

$8,225.00

Hospital Charge Code	270628376V
Hospital Revenue Code	278
Min. Negotiated Rate	$198.22
Max. Negotiated Rate	$4,112.50
Rate for Payer: Aetna Commercial	$3,125.50
Rate for Payer: Aetna Medicare Advantage	$2,467.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,097.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,097.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,645.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,097.38
Rate for Payer: Cigna Commercial	$4,112.50
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
Rate for Payer: UnitedHealthcare Community & State	$198.22
Rate for Payer: Wellpoint Medicaid Managed Care	$217.96

STENT ILIAC SMRT 8/40 C08040SB

Facility

$8,159.25

Hospital Charge Code	270628376
Hospital Revenue Code	278
Min. Negotiated Rate	$1,223.89
Max. Negotiated Rate	$1,974.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,631.85
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

Stent INLAY 6 FR 22-32 cm

Facility

$295.00

Service Code	HCPCS C1725
Hospital Charge Code	270626655
Hospital Revenue Code	278
Min. Negotiated Rate	$44.25
Max. Negotiated Rate	$71.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$64.90
Rate for Payer: Qualcare PPO/HMO/WC	$44.25

Stent INLAY 6 FR 22-32 cm

Facility

$295.00

Service Code	HCPCS C1725
Hospital Charge Code	270626655
Hospital Revenue Code	278
Min. Negotiated Rate	$7.11
Max. Negotiated Rate	$147.50
Rate for Payer: Aetna Commercial	$112.10
Rate for Payer: Aetna Medicare Advantage	$88.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.22
Rate for Payer: Cigna Commercial	$147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$64.90
Rate for Payer: Qualcare PPO/HMO/WC	$44.25
Rate for Payer: UnitedHealthcare Community & State	$7.11
Rate for Payer: Wellpoint Medicaid Managed Care	$7.82

STENT INLAY 7FR 22-32CM

Facility

$295.00

Hospital Charge Code	270682457
Hospital Revenue Code	278
Min. Negotiated Rate	$7.11
Max. Negotiated Rate	$147.50
Rate for Payer: Aetna Commercial	$112.10
Rate for Payer: Aetna Medicare Advantage	$88.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.22
Rate for Payer: Cigna Commercial	$147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$64.90
Rate for Payer: Qualcare PPO/HMO/WC	$44.25
Rate for Payer: UnitedHealthcare Community & State	$7.11
Rate for Payer: Wellpoint Medicaid Managed Care	$7.82

STENT INLAY 7FR 22-32CM

Facility

$295.00

Hospital Charge Code	270682457
Hospital Revenue Code	278
Min. Negotiated Rate	$44.25
Max. Negotiated Rate	$71.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$64.90
Rate for Payer: Qualcare PPO/HMO/WC	$44.25

STENT INLAY 7 FR 22 CM

Facility

$295.00

Hospital Charge Code	270682458
Hospital Revenue Code	278
Min. Negotiated Rate	$44.25
Max. Negotiated Rate	$71.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$64.90
Rate for Payer: Qualcare PPO/HMO/WC	$44.25

STENT INLAY 7 FR 22 CM

Facility

$295.00

Hospital Charge Code	270682458
Hospital Revenue Code	278
Min. Negotiated Rate	$7.11
Max. Negotiated Rate	$147.50
Rate for Payer: Aetna Commercial	$112.10
Rate for Payer: Aetna Medicare Advantage	$88.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.22
Rate for Payer: Cigna Commercial	$147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$64.90
Rate for Payer: Qualcare PPO/HMO/WC	$44.25
Rate for Payer: UnitedHealthcare Community & State	$7.11
Rate for Payer: Wellpoint Medicaid Managed Care	$7.82

STENT INLAY 7 FR 24 CM

Facility

$295.00

Hospital Charge Code	270682459
Hospital Revenue Code	278
Min. Negotiated Rate	$7.11
Max. Negotiated Rate	$147.50
Rate for Payer: Aetna Commercial	$112.10
Rate for Payer: Aetna Medicare Advantage	$88.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.22
Rate for Payer: Cigna Commercial	$147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$64.90
Rate for Payer: Qualcare PPO/HMO/WC	$44.25
Rate for Payer: UnitedHealthcare Community & State	$7.11
Rate for Payer: Wellpoint Medicaid Managed Care	$7.82

STENT INLAY 7 FR 24 CM

Facility

$295.00

Hospital Charge Code	270682459
Hospital Revenue Code	278
Min. Negotiated Rate	$44.25
Max. Negotiated Rate	$71.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$64.90
Rate for Payer: Qualcare PPO/HMO/WC	$44.25

STENT INLAY 7 FR 26 CM

Facility

$295.00

Hospital Charge Code	270682460
Hospital Revenue Code	278
Min. Negotiated Rate	$7.11
Max. Negotiated Rate	$147.50
Rate for Payer: Aetna Commercial	$112.10
Rate for Payer: Aetna Medicare Advantage	$88.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.22
Rate for Payer: Cigna Commercial	$147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$64.90
Rate for Payer: Qualcare PPO/HMO/WC	$44.25
Rate for Payer: UnitedHealthcare Community & State	$7.11
Rate for Payer: Wellpoint Medicaid Managed Care	$7.82

STENT INLAY 7 FR 26 CM

Facility

$295.00

Hospital Charge Code	270682460
Hospital Revenue Code	278
Min. Negotiated Rate	$44.25
Max. Negotiated Rate	$71.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$64.90
Rate for Payer: Qualcare PPO/HMO/WC	$44.25

STENT INLAY 8 FR 22-32 CM

Facility

$295.00

Hospital Charge Code	270682471
Hospital Revenue Code	278
Min. Negotiated Rate	$7.11
Max. Negotiated Rate	$147.50
Rate for Payer: Aetna Commercial	$112.10
Rate for Payer: Aetna Medicare Advantage	$88.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.22
Rate for Payer: Cigna Commercial	$147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$64.90
Rate for Payer: Qualcare PPO/HMO/WC	$44.25
Rate for Payer: UnitedHealthcare Community & State	$7.11
Rate for Payer: Wellpoint Medicaid Managed Care	$7.82

STENT INLAY 8 FR 22-32 CM

Facility

$295.00

Hospital Charge Code	270682471
Hospital Revenue Code	278
Min. Negotiated Rate	$44.25
Max. Negotiated Rate	$71.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$64.90
Rate for Payer: Qualcare PPO/HMO/WC	$44.25

STENT INLAY 8FR 22 CM

Facility

$295.00

Hospital Charge Code	270682461
Hospital Revenue Code	278
Min. Negotiated Rate	$7.11
Max. Negotiated Rate	$147.50
Rate for Payer: Aetna Commercial	$112.10
Rate for Payer: Aetna Medicare Advantage	$88.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.22
Rate for Payer: Cigna Commercial	$147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$64.90
Rate for Payer: Qualcare PPO/HMO/WC	$44.25
Rate for Payer: UnitedHealthcare Community & State	$7.11
Rate for Payer: Wellpoint Medicaid Managed Care	$7.82

STENT INLAY 8FR 22 CM

Facility

$295.00

Hospital Charge Code	270682461
Hospital Revenue Code	278
Min. Negotiated Rate	$44.25
Max. Negotiated Rate	$71.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$64.90
Rate for Payer: Qualcare PPO/HMO/WC	$44.25

STENT INLAY 8 FR 24 CM

Facility

$295.00

Hospital Charge Code	270682466
Hospital Revenue Code	278
Min. Negotiated Rate	$7.11
Max. Negotiated Rate	$147.50
Rate for Payer: Aetna Commercial	$112.10
Rate for Payer: Aetna Medicare Advantage	$88.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.22
Rate for Payer: Cigna Commercial	$147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$64.90
Rate for Payer: Qualcare PPO/HMO/WC	$44.25
Rate for Payer: UnitedHealthcare Community & State	$7.11
Rate for Payer: Wellpoint Medicaid Managed Care	$7.82

STENT INLAY 8 FR 24 CM

Facility

$295.00

Hospital Charge Code	270682466
Hospital Revenue Code	278
Min. Negotiated Rate	$44.25
Max. Negotiated Rate	$71.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$64.90
Rate for Payer: Qualcare PPO/HMO/WC	$44.25

STENT INLAY 8FR 26 CM

Facility

$295.00

Hospital Charge Code	270682467
Hospital Revenue Code	278
Min. Negotiated Rate	$44.25
Max. Negotiated Rate	$71.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$64.90
Rate for Payer: Qualcare PPO/HMO/WC	$44.25

STENT INLAY 8FR 26 CM

Facility

$295.00

Hospital Charge Code	270682467
Hospital Revenue Code	278
Min. Negotiated Rate	$7.11
Max. Negotiated Rate	$147.50
Rate for Payer: Aetna Commercial	$112.10
Rate for Payer: Aetna Medicare Advantage	$88.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.22
Rate for Payer: Cigna Commercial	$147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$64.90
Rate for Payer: Qualcare PPO/HMO/WC	$44.25
Rate for Payer: UnitedHealthcare Community & State	$7.11
Rate for Payer: Wellpoint Medicaid Managed Care	$7.82

STENT INLAY OPTIMA 6F 22-32CM

Facility

$449.45

Service Code	HCPCS C1769
Hospital Charge Code	270700237
Hospital Revenue Code	278
Min. Negotiated Rate	$67.42
Max. Negotiated Rate	$108.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$89.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$98.88
Rate for Payer: Qualcare PPO/HMO/WC	$67.42

STENT INLAY OPTIMA 6F 22-32CM

Facility

$449.45

Service Code	HCPCS C1769
Hospital Charge Code	270700237
Hospital Revenue Code	278
Min. Negotiated Rate	$10.83
Max. Negotiated Rate	$224.72
Rate for Payer: Aetna Commercial	$170.79
Rate for Payer: Aetna Medicare Advantage	$134.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$89.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.61
Rate for Payer: Cigna Commercial	$224.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$98.88
Rate for Payer: Qualcare PPO/HMO/WC	$67.42
Rate for Payer: UnitedHealthcare Community & State	$10.83
Rate for Payer: Wellpoint Medicaid Managed Care	$11.91

STENTINLAYURETGDWIRE 6F 22-32

Facility

$930.00

Service Code	HCPCS C2617
Hospital Charge Code	270696861
Hospital Revenue Code	278
Min. Negotiated Rate	$22.41
Max. Negotiated Rate	$465.00
Rate for Payer: Aetna Commercial	$353.40
Rate for Payer: Aetna Medicare Advantage	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.15
Rate for Payer: Cigna Commercial	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$204.60
Rate for Payer: Qualcare PPO/HMO/WC	$139.50
Rate for Payer: UnitedHealthcare Community & State	$22.41
Rate for Payer: Wellpoint Medicaid Managed Care	$24.64

STENTINLAYURETGDWIRE 6F 22-32

Facility

$930.00

Service Code	HCPCS C2617
Hospital Charge Code	270696861
Hospital Revenue Code	278
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$225.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$204.60
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

STENT INNOVA 5mmx150mmx130cm

Facility

$9,250.00

Service Code	HCPCS C1876
Hospital Charge Code	270678939
Hospital Revenue Code	278
Min. Negotiated Rate	$222.93
Max. Negotiated Rate	$4,625.00
Rate for Payer: Aetna Commercial	$3,515.00
Rate for Payer: Aetna Medicare Advantage	$2,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,358.75
Rate for Payer: Cigna Commercial	$4,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,035.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50
Rate for Payer: UnitedHealthcare Community & State	$222.93
Rate for Payer: Wellpoint Medicaid Managed Care	$245.12

Know your out-of-pocket cost for care.

All Charges