Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STENT MT UST/7-4/5/75 14-436

Facility

$1,296.85

Hospital Charge Code	270623796
Hospital Revenue Code	278
Min. Negotiated Rate	$31.25
Max. Negotiated Rate	$648.42
Rate for Payer: Aetna Commercial	$492.80
Rate for Payer: Aetna Medicare Advantage	$389.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.70
Rate for Payer: Cigna Commercial	$648.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$285.31
Rate for Payer: Qualcare PPO/HMO/WC	$194.53
Rate for Payer: UnitedHealthcare Community & State	$31.25
Rate for Payer: Wellpoint Medicaid Managed Care	$34.37

STENT MT WALL 10 42 75 71-134

Facility

$5,148.00

Hospital Charge Code	270627351V
Hospital Revenue Code	278
Min. Negotiated Rate	$772.20
Max. Negotiated Rate	$1,245.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,029.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,245.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,132.56
Rate for Payer: Qualcare PPO/HMO/WC	$772.20

STENT MT WALL 10 42 75 71-134

Facility

$5,148.00

Hospital Charge Code	270627351V
Hospital Revenue Code	278
Min. Negotiated Rate	$124.07
Max. Negotiated Rate	$2,574.00
Rate for Payer: Aetna Commercial	$1,956.24
Rate for Payer: Aetna Medicare Advantage	$1,544.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,312.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,312.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,029.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,312.74
Rate for Payer: Cigna Commercial	$2,574.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,245.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,132.56
Rate for Payer: Qualcare PPO/HMO/WC	$772.20
Rate for Payer: UnitedHealthcare Community & State	$124.07
Rate for Payer: Wellpoint Medicaid Managed Care	$136.42

STENT MT WALL 80 60 75 71-128

Facility

$5,148.00

Hospital Charge Code	270627332V
Hospital Revenue Code	278
Min. Negotiated Rate	$124.07
Max. Negotiated Rate	$2,574.00
Rate for Payer: Aetna Commercial	$1,956.24
Rate for Payer: Aetna Medicare Advantage	$1,544.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,312.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,312.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,029.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,312.74
Rate for Payer: Cigna Commercial	$2,574.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,245.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,132.56
Rate for Payer: Qualcare PPO/HMO/WC	$772.20
Rate for Payer: UnitedHealthcare Community & State	$124.07
Rate for Payer: Wellpoint Medicaid Managed Care	$136.42

STENT MT WALL 80 60 75 71-128

Facility

$5,148.00

Hospital Charge Code	270627332V
Hospital Revenue Code	278
Min. Negotiated Rate	$772.20
Max. Negotiated Rate	$1,245.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,029.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,245.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,132.56
Rate for Payer: Qualcare PPO/HMO/WC	$772.20

STENT MT WS 10F 18 40 40411

Facility

$5,712.85

Hospital Charge Code	270626884
Hospital Revenue Code	278
Min. Negotiated Rate	$137.68
Max. Negotiated Rate	$2,856.43
Rate for Payer: Aetna Commercial	$2,170.88
Rate for Payer: Aetna Medicare Advantage	$1,713.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,456.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,456.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,142.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,456.78
Rate for Payer: Cigna Commercial	$2,856.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,382.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,256.83
Rate for Payer: Qualcare PPO/HMO/WC	$856.93
Rate for Payer: UnitedHealthcare Community & State	$137.68
Rate for Payer: Wellpoint Medicaid Managed Care	$151.39

STENT MT WS 10F 18 40 40411

Facility

$5,712.85

Hospital Charge Code	270626884
Hospital Revenue Code	278
Min. Negotiated Rate	$856.93
Max. Negotiated Rate	$1,382.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,142.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,382.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,256.83
Rate for Payer: Qualcare PPO/HMO/WC	$856.93

STENT MT WS 9F 12 90 40213

Facility

$8,823.20

Hospital Charge Code	270627567V
Hospital Revenue Code	278
Min. Negotiated Rate	$212.64
Max. Negotiated Rate	$4,411.60
Rate for Payer: Aetna Commercial	$3,352.82
Rate for Payer: Aetna Medicare Advantage	$2,646.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,249.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,249.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,764.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,249.92
Rate for Payer: Cigna Commercial	$4,411.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,135.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,941.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,323.48
Rate for Payer: UnitedHealthcare Community & State	$212.64
Rate for Payer: Wellpoint Medicaid Managed Care	$233.81

STENT MT WS 9F 12 90 40213

Facility

$8,823.20

Hospital Charge Code	270627567V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,323.48
Max. Negotiated Rate	$2,135.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,764.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,135.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,941.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,323.48

STENT MULI-LINK MINI 2.0X12MM

Facility

$4,875.00

Hospital Charge Code	270643599C
Hospital Revenue Code	278
Min. Negotiated Rate	$117.49
Max. Negotiated Rate	$2,437.50
Rate for Payer: Aetna Commercial	$1,852.50
Rate for Payer: Aetna Medicare Advantage	$1,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,243.12
Rate for Payer: Cigna Commercial	$2,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,072.50
Rate for Payer: Qualcare PPO/HMO/WC	$731.25
Rate for Payer: UnitedHealthcare Community & State	$117.49
Rate for Payer: Wellpoint Medicaid Managed Care	$129.19

STENT MULI-LINK MINI 2.0X12MM

Facility

$4,875.00

Hospital Charge Code	270643599C
Hospital Revenue Code	278
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$1,179.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,072.50
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

STENT MUL MIN 2.0x23 100782123

Facility

$4,875.00

Hospital Charge Code	270643361V
Hospital Revenue Code	278
Min. Negotiated Rate	$117.49
Max. Negotiated Rate	$2,437.50
Rate for Payer: Aetna Commercial	$1,852.50
Rate for Payer: Aetna Medicare Advantage	$1,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,243.12
Rate for Payer: Cigna Commercial	$2,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,072.50
Rate for Payer: Qualcare PPO/HMO/WC	$731.25
Rate for Payer: UnitedHealthcare Community & State	$117.49
Rate for Payer: Wellpoint Medicaid Managed Care	$129.19

STENT MUL MIN 2.0x23 100782123

Facility

$4,875.00

Hospital Charge Code	270643361V
Hospital Revenue Code	278
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$1,179.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,072.50
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

STENT MUL MIN 2.0X23 100782123

Facility

$4,875.00

Hospital Charge Code	270643361C
Hospital Revenue Code	278
Min. Negotiated Rate	$117.49
Max. Negotiated Rate	$2,437.50
Rate for Payer: Aetna Commercial	$1,852.50
Rate for Payer: Aetna Medicare Advantage	$1,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,243.12
Rate for Payer: Cigna Commercial	$2,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,072.50
Rate for Payer: Qualcare PPO/HMO/WC	$731.25
Rate for Payer: UnitedHealthcare Community & State	$117.49
Rate for Payer: Wellpoint Medicaid Managed Care	$129.19

STENT MUL MIN 2.0X23 100782123

Facility

$4,875.00

Hospital Charge Code	270643361C
Hospital Revenue Code	278
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$1,179.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,072.50
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

STENT MUL RX 2.75X12 100782123

Facility

$3,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270643292
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

STENT MUL RX 2.75X12 100782123

Facility

$3,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270643292
Hospital Revenue Code	278
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

STENT MUL RX 2.75X18 100787418

Facility

$3,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270643416C
Hospital Revenue Code	278
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

STENT MUL RX 2.75X18 100787418

Facility

$3,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270643416C
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

STENT MUL RX 2.75X23 100784723

Facility

$3,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270643611C
Hospital Revenue Code	278
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

STENT MUL RX 2.75X23 100784723

Facility

$3,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270643611C
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

STENT MULTI 2 75x18 100784718

Facility

$3,000.00

Hospital Charge Code	270643416
Hospital Revenue Code	278
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

STENT MULTI 2 75x18 100784718

Facility

$3,000.00

Hospital Charge Code	270643416
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

STENT MULTILENGH 3.7Fx21-32

Facility

$618.05

Hospital Charge Code	270673817
Hospital Revenue Code	278
Min. Negotiated Rate	$92.71
Max. Negotiated Rate	$149.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.97
Rate for Payer: Qualcare PPO/HMO/WC	$92.71

STENT MULTILENGH 3.7Fx21-32

Facility

$618.05

Hospital Charge Code	270673817
Hospital Revenue Code	278
Min. Negotiated Rate	$14.90
Max. Negotiated Rate	$309.02
Rate for Payer: Aetna Commercial	$234.86
Rate for Payer: Aetna Medicare Advantage	$185.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.60
Rate for Payer: Cigna Commercial	$309.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.97
Rate for Payer: Qualcare PPO/HMO/WC	$92.71
Rate for Payer: UnitedHealthcare Community & State	$14.90
Rate for Payer: Wellpoint Medicaid Managed Care	$16.38

Know your out-of-pocket cost for care.

All Charges