Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STENT LIB OTW 2.7X16 389351627

Facility

$4,375.00

Hospital Charge Code	270637192C
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 LIB OTW 2.7X16 389351627

Facility

$4,375.00

Hospital Charge Code	270637192C
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 LIB OTW 3 5X16 389351635

Facility

$4,375.00

Hospital Charge Code	270637375C
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 LIB OTW 3 5X16 389351635

Facility

$4,375.00

Hospital Charge Code	270637375C
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 LIFE 6MMx60MMx130CM

Facility

$9,375.00

Hospital Charge Code	270671188
Hospital Revenue Code	278
Min. Negotiated Rate	$225.94
Max. Negotiated Rate	$4,687.50
Rate for Payer: Aetna Commercial	$3,562.50
Rate for Payer: Aetna Medicare Advantage	$2,812.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,390.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,390.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,390.62
Rate for Payer: Cigna Commercial	$4,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,268.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,062.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,406.25
Rate for Payer: UnitedHealthcare Community & State	$225.94
Rate for Payer: Wellpoint Medicaid Managed Care	$248.44

STENT LIFE 6MMx60MMx130CM

Facility

$9,375.00

Hospital Charge Code	270671188
Hospital Revenue Code	278
Min. Negotiated Rate	$1,406.25
Max. Negotiated Rate	$2,268.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,268.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,062.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,406.25

STENT LIFESTAR 10 X 40 X 80

Facility

$4,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270688130
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

STENT LIFESTAR 10 X 40 X 80

Facility

$4,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270688130
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

STENT LUMINEXX 10x40 LXM10040

Facility

$7,440.00

Hospital Charge Code	270629417
Hospital Revenue Code	278
Min. Negotiated Rate	$1,116.00
Max. Negotiated Rate	$1,800.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,488.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,800.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,636.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,116.00

STENT LUMINEXX 10x40 LXM10040

Facility

$7,440.00

Hospital Charge Code	270629417
Hospital Revenue Code	278
Min. Negotiated Rate	$179.30
Max. Negotiated Rate	$3,720.00
Rate for Payer: Aetna Commercial	$2,827.20
Rate for Payer: Aetna Medicare Advantage	$2,232.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,897.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,897.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,488.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,897.20
Rate for Payer: Cigna Commercial	$3,720.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,800.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,636.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,116.00
Rate for Payer: UnitedHealthcare Community & State	$179.30
Rate for Payer: Wellpoint Medicaid Managed Care	$197.16

STENT LUMINEXX 10x60 LXM10060

Facility

$7,911.25

Hospital Charge Code	270631049
Hospital Revenue Code	278
Min. Negotiated Rate	$1,186.69
Max. Negotiated Rate	$1,914.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,582.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,914.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,740.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,186.69

STENT LUMINEXX 10x60 LXM10060

Facility

$7,911.25

Hospital Charge Code	270631049V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,186.69
Max. Negotiated Rate	$1,914.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,582.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,914.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,740.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,186.69

STENT LUMINEXX 10x60 LXM10060

Facility

$7,911.25

Hospital Charge Code	270631049V
Hospital Revenue Code	278
Min. Negotiated Rate	$190.66
Max. Negotiated Rate	$3,955.62
Rate for Payer: Aetna Commercial	$3,006.28
Rate for Payer: Aetna Medicare Advantage	$2,373.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,017.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,017.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,582.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,017.37
Rate for Payer: Cigna Commercial	$3,955.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,914.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,740.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,186.69
Rate for Payer: UnitedHealthcare Community & State	$190.66
Rate for Payer: Wellpoint Medicaid Managed Care	$209.65

STENT LUMINEXX 10x60 LXM10060

Facility

$7,911.25

Hospital Charge Code	270631049
Hospital Revenue Code	278
Min. Negotiated Rate	$190.66
Max. Negotiated Rate	$3,955.62
Rate for Payer: Aetna Commercial	$3,006.28
Rate for Payer: Aetna Medicare Advantage	$2,373.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,017.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,017.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,582.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,017.37
Rate for Payer: Cigna Commercial	$3,955.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,914.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,740.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,186.69
Rate for Payer: UnitedHealthcare Community & State	$190.66
Rate for Payer: Wellpoint Medicaid Managed Care	$209.65

STENT LUMINEXX 12x40 LXM12040

Facility

$8,159.25

Hospital Charge Code	270635338V
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 LUMINEXX 12x40 LXM12040

Facility

$8,159.25

Hospital Charge Code	270635338
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 LUMINEXX 12x40 LXM12040

Facility

$8,159.25

Hospital Charge Code	270635338
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 LUMINEXX 12x40 LXM12040

Facility

$8,159.25

Hospital Charge Code	270635338V
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 LUMINEXX 8x40 LXM08040

Facility

$7,688.00

Hospital Charge Code	270631050
Hospital Revenue Code	278
Min. Negotiated Rate	$185.28
Max. Negotiated Rate	$3,844.00
Rate for Payer: Aetna Commercial	$2,921.44
Rate for Payer: Aetna Medicare Advantage	$2,306.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,960.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,960.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,537.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,960.44
Rate for Payer: Cigna Commercial	$3,844.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,860.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,691.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,153.20
Rate for Payer: UnitedHealthcare Community & State	$185.28
Rate for Payer: Wellpoint Medicaid Managed Care	$203.73

STENT LUMINEXX 8x40 LXM08040

Facility

$7,688.00

Hospital Charge Code	270631050
Hospital Revenue Code	278
Min. Negotiated Rate	$1,153.20
Max. Negotiated Rate	$1,860.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,537.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,860.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,691.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,153.20

STENT LUXINEXX 8x60 LXL08060

Facility

$7,911.25

Hospital Charge Code	270630609
Hospital Revenue Code	278
Min. Negotiated Rate	$1,186.69
Max. Negotiated Rate	$1,914.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,582.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,914.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,740.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,186.69

STENT LUXINEXX 8x60 LXL08060

Facility

$7,911.25

Hospital Charge Code	270630609
Hospital Revenue Code	278
Min. Negotiated Rate	$190.66
Max. Negotiated Rate	$3,955.62
Rate for Payer: Aetna Commercial	$3,006.28
Rate for Payer: Aetna Medicare Advantage	$2,373.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,017.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,017.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,582.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,017.37
Rate for Payer: Cigna Commercial	$3,955.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,914.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,740.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,186.69
Rate for Payer: UnitedHealthcare Community & State	$190.66
Rate for Payer: Wellpoint Medicaid Managed Care	$209.65

STENT LUXINEXX 8x60 LXL08060

Facility

$7,911.25

Hospital Charge Code	270630609V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,186.69
Max. Negotiated Rate	$1,914.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,582.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,914.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,740.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,186.69

STENT LUXINEXX 8x60 LXL08060

Facility

$7,911.25

Hospital Charge Code	270630609V
Hospital Revenue Code	278
Min. Negotiated Rate	$190.66
Max. Negotiated Rate	$3,955.62
Rate for Payer: Aetna Commercial	$3,006.28
Rate for Payer: Aetna Medicare Advantage	$2,373.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,017.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,017.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,582.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,017.37
Rate for Payer: Cigna Commercial	$3,955.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,914.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,740.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,186.69
Rate for Payer: UnitedHealthcare Community & State	$190.66
Rate for Payer: Wellpoint Medicaid Managed Care	$209.65

STENT MCV BILI 10.0F 10CM 3932

Facility

$760.00

Service Code	HCPCS C2625
Hospital Charge Code	270617759
Hospital Revenue Code	278
Min. Negotiated Rate	$114.00
Max. Negotiated Rate	$183.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$152.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$167.20
Rate for Payer: Qualcare PPO/HMO/WC	$114.00

Know your out-of-pocket cost for care.

All Charges