Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STENT PLACEMT ANTE CAROTID

Facility

$4,328.00

Service Code	HCPCS 37218
Hospital Charge Code	366837218
Hospital Revenue Code	361
Min. Negotiated Rate	$104.30
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$1,644.64
Rate for Payer: Aetna Medicare Advantage	$1,298.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,103.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,103.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,103.64
Rate for Payer: Cigna Commercial	$2,164.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,298.40
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$649.20
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$104.30
Rate for Payer: Wellpoint Medicaid Managed Care	$114.69

STENT PLACEMT ANTE CAROTID

Facility

$4,328.00

Service Code	HCPCS 37218
Hospital Charge Code	411037218
Hospital Revenue Code	361
Min. Negotiated Rate	$104.30
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$1,644.64
Rate for Payer: Aetna Medicare Advantage	$1,298.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,103.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,103.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,103.64
Rate for Payer: Cigna Commercial	$2,164.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,298.40
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$649.20
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$104.30
Rate for Payer: Wellpoint Medicaid Managed Care	$114.69

STENT PLACEMT ANTE CAROTID

Facility

$4,328.00

Service Code	HCPCS 37218
Hospital Charge Code	411037218
Hospital Revenue Code	361
Min. Negotiated Rate	$649.20
Max. Negotiated Rate	$649.20
Rate for Payer: Qualcare PPO/HMO/WC	$649.20

STENT PLACEMT RETRO CAROTID

Facility

$20,000.00

Service Code	HCPCS 37217
Hospital Charge Code	411037217
Hospital Revenue Code	360
Min. Negotiated Rate	$482.00
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$7,600.00
Rate for Payer: Aetna Medicare Advantage	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,100.00
Rate for Payer: Cigna Commercial	$10,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,000.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$482.00
Rate for Payer: Wellpoint Medicaid Managed Care	$530.00

STENT PLACEMT RETRO CAROTID

Facility

$20,000.00

Service Code	HCPCS 37217
Hospital Charge Code	411037217
Hospital Revenue Code	360
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

STENT PLASTIC 7 X12

Facility

$670.00

Service Code	HCPCS C2625
Hospital Charge Code	270663632
Hospital Revenue Code	278
Min. Negotiated Rate	$16.15
Max. Negotiated Rate	$335.00
Rate for Payer: Aetna Commercial	$254.60
Rate for Payer: Aetna Medicare Advantage	$201.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.85
Rate for Payer: Cigna Commercial	$335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.40
Rate for Payer: Qualcare PPO/HMO/WC	$100.50
Rate for Payer: UnitedHealthcare Community & State	$16.15
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

STENT PLASTIC 7 X12

Facility

$670.00

Service Code	HCPCS C2625
Hospital Charge Code	270663632
Hospital Revenue Code	278
Min. Negotiated Rate	$100.50
Max. Negotiated Rate	$162.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.40
Rate for Payer: Qualcare PPO/HMO/WC	$100.50

STENT PM RX 2.75x12 100954012B

Facility

$10,250.00

Hospital Charge Code	270642159C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$2,480.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,255.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

STENT PM RX 2.75x12 100954012B

Facility

$10,250.00

Hospital Charge Code	270642159C
Hospital Revenue Code	278
Min. Negotiated Rate	$247.03
Max. Negotiated Rate	$5,125.00
Rate for Payer: Aetna Commercial	$3,895.00
Rate for Payer: Aetna Medicare Advantage	$3,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,613.75
Rate for Payer: Cigna Commercial	$5,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,255.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50
Rate for Payer: UnitedHealthcare Community & State	$247.03
Rate for Payer: Wellpoint Medicaid Managed Care	$271.62

STENT PR 6F 8X60 SERB650860120

Facility

$6,000.00

Hospital Charge Code	270636798V
Hospital Revenue Code	278
Min. Negotiated Rate	$144.60
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$159.00

STENT PR 6F 8X60 SERB650860120

Facility

$6,000.00

Hospital Charge Code	270636798V
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

STENT PRECISE BILI 6x30 N630SB

Facility

$9,750.00

Hospital Charge Code	270628402V
Hospital Revenue Code	278
Min. Negotiated Rate	$234.97
Max. Negotiated Rate	$4,875.00
Rate for Payer: Aetna Commercial	$3,705.00
Rate for Payer: Aetna Medicare Advantage	$2,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,486.25
Rate for Payer: Cigna Commercial	$4,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,145.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50
Rate for Payer: UnitedHealthcare Community & State	$234.97
Rate for Payer: Wellpoint Medicaid Managed Care	$258.38

STENT PRECISE BILI 6x30 N630SB

Facility

$9,672.00

Hospital Charge Code	270628402
Hospital Revenue Code	278
Min. Negotiated Rate	$233.10
Max. Negotiated Rate	$4,836.00
Rate for Payer: Aetna Commercial	$3,675.36
Rate for Payer: Aetna Medicare Advantage	$2,901.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,466.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,466.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,934.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,466.36
Rate for Payer: Cigna Commercial	$4,836.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,340.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,127.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,450.80
Rate for Payer: UnitedHealthcare Community & State	$233.10
Rate for Payer: Wellpoint Medicaid Managed Care	$256.31

STENT PRECISE BILI 6x30 N630SB

Facility

$9,672.00

Hospital Charge Code	270628402
Hospital Revenue Code	278
Min. Negotiated Rate	$1,450.80
Max. Negotiated Rate	$2,340.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,934.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,340.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,127.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,450.80

STENT PRECISE BILI 6x30 N630SB

Facility

$9,750.00

Hospital Charge Code	270628402V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,462.50
Max. Negotiated Rate	$2,359.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,145.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50

STENT PRECISE BILI 6x40 N640SB

Facility

$9,750.00

Hospital Charge Code	270626426V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,462.50
Max. Negotiated Rate	$2,359.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,145.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50

STENT PRECISE BILI 6x40 N640SB

Facility

$9,750.00

Hospital Charge Code	270626426V
Hospital Revenue Code	278
Min. Negotiated Rate	$234.97
Max. Negotiated Rate	$4,875.00
Rate for Payer: Aetna Commercial	$3,705.00
Rate for Payer: Aetna Medicare Advantage	$2,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,486.25
Rate for Payer: Cigna Commercial	$4,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,145.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50
Rate for Payer: UnitedHealthcare Community & State	$234.97
Rate for Payer: Wellpoint Medicaid Managed Care	$258.38

STENT PRECISE BILI 6x40 N640SB

Facility

$9,672.00

Hospital Charge Code	270626426
Hospital Revenue Code	278
Min. Negotiated Rate	$233.10
Max. Negotiated Rate	$4,836.00
Rate for Payer: Aetna Commercial	$3,675.36
Rate for Payer: Aetna Medicare Advantage	$2,901.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,466.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,466.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,934.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,466.36
Rate for Payer: Cigna Commercial	$4,836.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,340.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,127.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,450.80
Rate for Payer: UnitedHealthcare Community & State	$233.10
Rate for Payer: Wellpoint Medicaid Managed Care	$256.31

STENT PRECISE BILI 6x40 N640SB

Facility

$9,672.00

Hospital Charge Code	270626426
Hospital Revenue Code	278
Min. Negotiated Rate	$1,450.80
Max. Negotiated Rate	$2,340.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,934.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,340.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,127.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,450.80

STENT PRECISE PRO RX 7X40 MM 1

Facility

$10,590.00

Service Code	HCPCS C1876
Hospital Charge Code	270689712
Hospital Revenue Code	278
Min. Negotiated Rate	$1,588.50
Max. Negotiated Rate	$2,562.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,118.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,562.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,329.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,588.50

STENT PRECISE PRO RX 7X40 MM 1

Facility

$10,590.00

Service Code	HCPCS C1876
Hospital Charge Code	270689712
Hospital Revenue Code	278
Min. Negotiated Rate	$255.22
Max. Negotiated Rate	$5,295.00
Rate for Payer: Aetna Commercial	$4,024.20
Rate for Payer: Aetna Medicare Advantage	$3,177.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,700.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,700.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,118.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,700.45
Rate for Payer: Cigna Commercial	$5,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,562.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,329.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,588.50
Rate for Payer: UnitedHealthcare Community & State	$255.22
Rate for Payer: Wellpoint Medicaid Managed Care	$280.63

STENT PRECISE PRO RX 8X40 MM 1

Facility

$10,590.00

Service Code	HCPCS C1876
Hospital Charge Code	270689711
Hospital Revenue Code	278
Min. Negotiated Rate	$255.22
Max. Negotiated Rate	$5,295.00
Rate for Payer: Aetna Commercial	$4,024.20
Rate for Payer: Aetna Medicare Advantage	$3,177.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,700.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,700.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,118.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,700.45
Rate for Payer: Cigna Commercial	$5,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,562.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,329.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,588.50
Rate for Payer: UnitedHealthcare Community & State	$255.22
Rate for Payer: Wellpoint Medicaid Managed Care	$280.63

STENT PRECISE PRO RX 8X40 MM 1

Facility

$10,590.00

Service Code	HCPCS C1876
Hospital Charge Code	270689711
Hospital Revenue Code	278
Min. Negotiated Rate	$1,588.50
Max. Negotiated Rate	$2,562.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,118.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,562.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,329.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,588.50

STENT PRECISE RX 5x40 6FR

Facility

$10,725.00

Hospital Charge Code	270638606
Hospital Revenue Code	278
Min. Negotiated Rate	$1,608.75
Max. Negotiated Rate	$2,595.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,595.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,359.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,608.75

STENT PRECISE RX 5x40 6FR

Facility

$10,725.00

Hospital Charge Code	270638606
Hospital Revenue Code	278
Min. Negotiated Rate	$258.47
Max. Negotiated Rate	$5,362.50
Rate for Payer: Aetna Commercial	$4,075.50
Rate for Payer: Aetna Medicare Advantage	$3,217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,734.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,734.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,734.88
Rate for Payer: Cigna Commercial	$5,362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,595.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,359.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,608.75
Rate for Payer: UnitedHealthcare Community & State	$258.47
Rate for Payer: Wellpoint Medicaid Managed Care	$284.21

Know your out-of-pocket cost for care.

All Charges