Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STENT MCV PERC 7 24 175-272

Facility

$693.65

Hospital Charge Code	270626138
Hospital Revenue Code	278
Min. Negotiated Rate	$104.05
Max. Negotiated Rate	$167.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$152.60
Rate for Payer: Qualcare PPO/HMO/WC	$104.05

STENT MCV PERC 7 24 175-272

Facility

$693.65

Hospital Charge Code	270626138
Hospital Revenue Code	278
Min. Negotiated Rate	$16.72
Max. Negotiated Rate	$346.82
Rate for Payer: Aetna Commercial	$263.59
Rate for Payer: Aetna Medicare Advantage	$208.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$176.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$176.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$176.88
Rate for Payer: Cigna Commercial	$346.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$152.60
Rate for Payer: Qualcare PPO/HMO/WC	$104.05
Rate for Payer: UnitedHealthcare Community & State	$16.72
Rate for Payer: Wellpoint Medicaid Managed Care	$18.38

STENT MCV WALL 10 22 60 6558

Facility

$9,135.25

Hospital Charge Code	270629356
Hospital Revenue Code	278
Min. Negotiated Rate	$220.16
Max. Negotiated Rate	$4,567.62
Rate for Payer: Aetna Commercial	$3,471.39
Rate for Payer: Aetna Medicare Advantage	$2,740.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,329.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,329.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,827.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,329.49
Rate for Payer: Cigna Commercial	$4,567.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,210.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,009.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,370.29
Rate for Payer: UnitedHealthcare Community & State	$220.16
Rate for Payer: Wellpoint Medicaid Managed Care	$242.08

STENT MCV WALL 10 22 60 6558

Facility

$9,135.25

Hospital Charge Code	270629356
Hospital Revenue Code	278
Min. Negotiated Rate	$1,370.29
Max. Negotiated Rate	$2,210.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,827.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,210.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,009.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,370.29

STENT MDT FEM ILIAC YR1R1485

Facility

$8,971.25

Hospital Charge Code	270623301
Hospital Revenue Code	278
Min. Negotiated Rate	$216.21
Max. Negotiated Rate	$4,485.62
Rate for Payer: Aetna Commercial	$3,409.07
Rate for Payer: Aetna Medicare Advantage	$2,691.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,287.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,287.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,794.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,287.67
Rate for Payer: Cigna Commercial	$4,485.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,171.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,973.67
Rate for Payer: Qualcare PPO/HMO/WC	$1,345.69
Rate for Payer: UnitedHealthcare Community & State	$216.21
Rate for Payer: Wellpoint Medicaid Managed Care	$237.74

STENT MDT FEM ILIAC YR1R1485

Facility

$8,971.25

Hospital Charge Code	270623301
Hospital Revenue Code	278
Min. Negotiated Rate	$1,345.69
Max. Negotiated Rate	$2,171.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,794.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,171.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,973.67
Rate for Payer: Qualcare PPO/HMO/WC	$1,345.69

STENT MDT FEM ILIAC YRIR14115

Facility

$9,777.65

Hospital Charge Code	270623300
Hospital Revenue Code	278
Min. Negotiated Rate	$1,466.65
Max. Negotiated Rate	$2,366.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,955.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,366.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,151.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,466.65

STENT MDT FEM ILIAC YRIR14115

Facility

$9,777.65

Hospital Charge Code	270623300
Hospital Revenue Code	278
Min. Negotiated Rate	$235.64
Max. Negotiated Rate	$4,888.82
Rate for Payer: Aetna Commercial	$3,715.51
Rate for Payer: Aetna Medicare Advantage	$2,933.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,493.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,493.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,955.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,493.30
Rate for Payer: Cigna Commercial	$4,888.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,366.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,151.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,466.65
Rate for Payer: UnitedHealthcare Community & State	$235.64
Rate for Payer: Wellpoint Medicaid Managed Care	$259.11

STENT MEDT ILIAC 16 11.5 16115

Facility

$12,842.45

Hospital Charge Code	270629597V
Hospital Revenue Code	278
Min. Negotiated Rate	$309.50
Max. Negotiated Rate	$6,421.23
Rate for Payer: Aetna Commercial	$4,880.13
Rate for Payer: Aetna Medicare Advantage	$3,852.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,274.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,274.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,568.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,274.82
Rate for Payer: Cigna Commercial	$6,421.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,107.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,825.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,926.37
Rate for Payer: UnitedHealthcare Community & State	$309.50
Rate for Payer: Wellpoint Medicaid Managed Care	$340.32

STENT MEDT ILIAC 16 11.5 16115

Facility

$12,842.45

Hospital Charge Code	270629597
Hospital Revenue Code	278
Min. Negotiated Rate	$309.50
Max. Negotiated Rate	$6,421.23
Rate for Payer: Aetna Commercial	$4,880.13
Rate for Payer: Aetna Medicare Advantage	$3,852.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,274.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,274.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,568.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,274.82
Rate for Payer: Cigna Commercial	$6,421.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,107.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,825.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,926.37
Rate for Payer: UnitedHealthcare Community & State	$309.50
Rate for Payer: Wellpoint Medicaid Managed Care	$340.32

STENT MEDT ILIAC 16 11.5 16115

Facility

$12,842.45

Hospital Charge Code	270629597V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,926.37
Max. Negotiated Rate	$3,107.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,568.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,107.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,825.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,926.37

STENT MEDT ILIAC 16 11.5 16115

Facility

$12,842.45

Hospital Charge Code	270629597
Hospital Revenue Code	278
Min. Negotiated Rate	$1,926.37
Max. Negotiated Rate	$3,107.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,568.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,107.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,825.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,926.37

STENT METALLIC URETERAL 20CM

Facility

$4,770.00

Hospital Charge Code	270674320
Hospital Revenue Code	278
Min. Negotiated Rate	$715.50
Max. Negotiated Rate	$1,154.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$954.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,154.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,049.40
Rate for Payer: Qualcare PPO/HMO/WC	$715.50

STENT METALLIC URETERAL 20CM

Facility

$4,770.00

Hospital Charge Code	270674320
Hospital Revenue Code	278
Min. Negotiated Rate	$114.96
Max. Negotiated Rate	$2,385.00
Rate for Payer: Aetna Commercial	$1,812.60
Rate for Payer: Aetna Medicare Advantage	$1,431.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,216.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,216.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$954.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,216.35
Rate for Payer: Cigna Commercial	$2,385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,154.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,049.40
Rate for Payer: Qualcare PPO/HMO/WC	$715.50
Rate for Payer: UnitedHealthcare Community & State	$114.96
Rate for Payer: Wellpoint Medicaid Managed Care	$126.41

STENT METALLIC URETERAL 22CM

Facility

$4,770.00

Service Code	HCPCS C2617
Hospital Charge Code	270674321
Hospital Revenue Code	278
Min. Negotiated Rate	$715.50
Max. Negotiated Rate	$1,154.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$954.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,154.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,049.40
Rate for Payer: Qualcare PPO/HMO/WC	$715.50

STENT METALLIC URETERAL 22CM

Facility

$4,770.00

Service Code	HCPCS C2617
Hospital Charge Code	270674321
Hospital Revenue Code	278
Min. Negotiated Rate	$114.96
Max. Negotiated Rate	$2,385.00
Rate for Payer: Aetna Commercial	$1,812.60
Rate for Payer: Aetna Medicare Advantage	$1,431.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,216.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,216.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$954.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,216.35
Rate for Payer: Cigna Commercial	$2,385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,154.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,049.40
Rate for Payer: Qualcare PPO/HMO/WC	$715.50
Rate for Payer: UnitedHealthcare Community & State	$114.96
Rate for Payer: Wellpoint Medicaid Managed Care	$126.41

STENT METALLIC URETERAL 24CM

Facility

$4,770.00

Service Code	HCPCS C2617
Hospital Charge Code	270674322
Hospital Revenue Code	278
Min. Negotiated Rate	$114.96
Max. Negotiated Rate	$2,385.00
Rate for Payer: Aetna Commercial	$1,812.60
Rate for Payer: Aetna Medicare Advantage	$1,431.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,216.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,216.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$954.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,216.35
Rate for Payer: Cigna Commercial	$2,385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,154.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,049.40
Rate for Payer: Qualcare PPO/HMO/WC	$715.50
Rate for Payer: UnitedHealthcare Community & State	$114.96
Rate for Payer: Wellpoint Medicaid Managed Care	$126.41

STENT METALLIC URETERAL 24CM

Facility

$4,770.00

Service Code	HCPCS C2617
Hospital Charge Code	270674322
Hospital Revenue Code	278
Min. Negotiated Rate	$715.50
Max. Negotiated Rate	$1,154.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$954.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,154.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,049.40
Rate for Payer: Qualcare PPO/HMO/WC	$715.50

STENT METALLIC URETERAL 26CM

Facility

$4,770.00

Service Code	HCPCS C2617
Hospital Charge Code	270674323
Hospital Revenue Code	278
Min. Negotiated Rate	$715.50
Max. Negotiated Rate	$1,154.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$954.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,154.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,049.40
Rate for Payer: Qualcare PPO/HMO/WC	$715.50

STENT METALLIC URETERAL 26CM

Facility

$4,770.00

Service Code	HCPCS C2617
Hospital Charge Code	270674323
Hospital Revenue Code	278
Min. Negotiated Rate	$114.96
Max. Negotiated Rate	$2,385.00
Rate for Payer: Aetna Commercial	$1,812.60
Rate for Payer: Aetna Medicare Advantage	$1,431.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,216.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,216.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$954.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,216.35
Rate for Payer: Cigna Commercial	$2,385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,154.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,049.40
Rate for Payer: Qualcare PPO/HMO/WC	$715.50
Rate for Payer: UnitedHealthcare Community & State	$114.96
Rate for Payer: Wellpoint Medicaid Managed Care	$126.41

STENT METALLIC URETERAL 28CM

Facility

$4,770.00

Service Code	HCPCS C2617
Hospital Charge Code	270674324
Hospital Revenue Code	278
Min. Negotiated Rate	$715.50
Max. Negotiated Rate	$1,154.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$954.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,154.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,049.40
Rate for Payer: Qualcare PPO/HMO/WC	$715.50

STENT METALLIC URETERAL 28CM

Facility

$4,770.00

Service Code	HCPCS C2617
Hospital Charge Code	270674324
Hospital Revenue Code	278
Min. Negotiated Rate	$114.96
Max. Negotiated Rate	$2,385.00
Rate for Payer: Aetna Commercial	$1,812.60
Rate for Payer: Aetna Medicare Advantage	$1,431.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,216.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,216.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$954.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,216.35
Rate for Payer: Cigna Commercial	$2,385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,154.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,049.40
Rate for Payer: Qualcare PPO/HMO/WC	$715.50
Rate for Payer: UnitedHealthcare Community & State	$114.96
Rate for Payer: Wellpoint Medicaid Managed Care	$126.41

STENT METALLIC URETERAL 30CM

Facility

$4,770.00

Hospital Charge Code	270674325
Hospital Revenue Code	278
Min. Negotiated Rate	$114.96
Max. Negotiated Rate	$2,385.00
Rate for Payer: Aetna Commercial	$1,812.60
Rate for Payer: Aetna Medicare Advantage	$1,431.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,216.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,216.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$954.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,216.35
Rate for Payer: Cigna Commercial	$2,385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,154.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,049.40
Rate for Payer: Qualcare PPO/HMO/WC	$715.50
Rate for Payer: UnitedHealthcare Community & State	$114.96
Rate for Payer: Wellpoint Medicaid Managed Care	$126.41

STENT METALLIC URETERAL 30CM

Facility

$4,770.00

Hospital Charge Code	270674325
Hospital Revenue Code	278
Min. Negotiated Rate	$715.50
Max. Negotiated Rate	$1,154.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$954.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,154.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,049.40
Rate for Payer: Qualcare PPO/HMO/WC	$715.50

STENT MINI MONOKA

Facility

$291.67

Hospital Charge Code	270673867
Hospital Revenue Code	278
Min. Negotiated Rate	$7.03
Max. Negotiated Rate	$145.84
Rate for Payer: Aetna Commercial	$110.83
Rate for Payer: Aetna Medicare Advantage	$87.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.38
Rate for Payer: Cigna Commercial	$145.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$64.17
Rate for Payer: Qualcare PPO/HMO/WC	$43.75
Rate for Payer: UnitedHealthcare Community & State	$7.03
Rate for Payer: Wellpoint Medicaid Managed Care	$7.73

Know your out-of-pocket cost for care.

All Charges