Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STENT SENTINOL 7X78m

Facility

$7,415.25

Hospital Charge Code	270635573
Hospital Revenue Code	278
Min. Negotiated Rate	$1,112.29
Max. Negotiated Rate	$1,794.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,483.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,794.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,631.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,112.29

STENT SENTINOL 7X78m

Facility

$7,415.25

Hospital Charge Code	270635573
Hospital Revenue Code	278
Min. Negotiated Rate	$178.71
Max. Negotiated Rate	$3,707.62
Rate for Payer: Aetna Commercial	$2,817.80
Rate for Payer: Aetna Medicare Advantage	$2,224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,890.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,890.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,483.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,890.89
Rate for Payer: Cigna Commercial	$3,707.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,794.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,631.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,112.29
Rate for Payer: UnitedHealthcare Community & State	$178.71
Rate for Payer: Wellpoint Medicaid Managed Care	$196.50

STENT SENTINOL 7X78m

Facility

$7,475.00

Hospital Charge Code	270635573V
Hospital Revenue Code	278
Min. Negotiated Rate	$180.15
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,644.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Community & State	$180.15
Rate for Payer: Wellpoint Medicaid Managed Care	$198.09

STENT SENTINOL 7X78m

Facility

$7,475.00

Hospital Charge Code	270635573V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,644.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

STENT SENTINOL 8x60 135cm

Facility

$7,415.25

Hospital Charge Code	270636397
Hospital Revenue Code	278
Min. Negotiated Rate	$1,112.29
Max. Negotiated Rate	$1,794.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,483.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,794.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,631.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,112.29

STENT SENTINOL 8x60 135cm

Facility

$7,475.00

Hospital Charge Code	270636397V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,644.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

STENT SENTINOL 8x60 135cm

Facility

$7,415.25

Hospital Charge Code	270636397
Hospital Revenue Code	278
Min. Negotiated Rate	$178.71
Max. Negotiated Rate	$3,707.62
Rate for Payer: Aetna Commercial	$2,817.80
Rate for Payer: Aetna Medicare Advantage	$2,224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,890.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,890.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,483.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,890.89
Rate for Payer: Cigna Commercial	$3,707.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,794.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,631.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,112.29
Rate for Payer: UnitedHealthcare Community & State	$178.71
Rate for Payer: Wellpoint Medicaid Managed Care	$196.50

STENT SENTINOL 8x60 135cm

Facility

$7,475.00

Hospital Charge Code	270636397V
Hospital Revenue Code	278
Min. Negotiated Rate	$180.15
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,644.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Community & State	$180.15
Rate for Payer: Wellpoint Medicaid Managed Care	$198.09

STENT SINGLE PIGTAIL 5FR 5 CM

Facility

$850.00

Service Code	HCPCS C2625
Hospital Charge Code	270679127
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

STENT SINGLE PIGTAIL 5FR 5 CM

Facility

$850.00

Service Code	HCPCS C2625
Hospital Charge Code	270679127
Hospital Revenue Code	278
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Community & State	$20.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.52

STENT SINGLE PIGTAIL 5FR 7CM

Facility

$850.00

Service Code	HCPCS C2625
Hospital Charge Code	270679124
Hospital Revenue Code	278
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Community & State	$20.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.52

STENT SINGLE PIGTAIL 5FR 7CM

Facility

$850.00

Service Code	HCPCS C2625
Hospital Charge Code	270679124
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

STENT SLF 10x60x120 NT3510602D

Facility

$8,375.00

Hospital Charge Code	270637053V
Hospital Revenue Code	278
Min. Negotiated Rate	$201.84
Max. Negotiated Rate	$4,187.50
Rate for Payer: Aetna Commercial	$3,182.50
Rate for Payer: Aetna Medicare Advantage	$2,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,135.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,135.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,135.62
Rate for Payer: Cigna Commercial	$4,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,026.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,842.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,256.25
Rate for Payer: UnitedHealthcare Community & State	$201.84
Rate for Payer: Wellpoint Medicaid Managed Care	$221.94

STENT SLF 10x60x120 NT3510602D

Facility

$8,375.00

Hospital Charge Code	270637053V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,256.25
Max. Negotiated Rate	$2,026.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,026.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,842.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,256.25

STENT SLF 10x60x120 NT3510602D

Facility

$8,375.00

Hospital Charge Code	270637053
Hospital Revenue Code	278
Min. Negotiated Rate	$201.84
Max. Negotiated Rate	$4,187.50
Rate for Payer: Aetna Commercial	$3,182.50
Rate for Payer: Aetna Medicare Advantage	$2,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,135.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,135.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,135.62
Rate for Payer: Cigna Commercial	$4,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,026.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,842.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,256.25
Rate for Payer: UnitedHealthcare Community & State	$201.84
Rate for Payer: Wellpoint Medicaid Managed Care	$221.94

STENT SLF 10x60x120 NT3510602D

Facility

$8,375.00

Hospital Charge Code	270637053
Hospital Revenue Code	278
Min. Negotiated Rate	$1,256.25
Max. Negotiated Rate	$2,026.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,026.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,842.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,256.25

STENT SMART 6X40 6FR C06040SL

Facility

$8,225.00

Hospital Charge Code	270638422V
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 SMART 6X40 6FR C06040SL

Facility

$8,225.00

Hospital Charge Code	270638422V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,233.75
Max. Negotiated Rate	$1,990.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,645.00
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

STENT - SMART STENT #N840BBR

Facility

$5,815.00

Hospital Charge Code	5100515
Hospital Revenue Code	278
Min. Negotiated Rate	$140.14
Max. Negotiated Rate	$2,907.50
Rate for Payer: Aetna Commercial	$2,209.70
Rate for Payer: Aetna Medicare Advantage	$1,744.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,482.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,482.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,163.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,482.83
Rate for Payer: Cigna Commercial	$2,907.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,407.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,279.30
Rate for Payer: Qualcare PPO/HMO/WC	$872.25
Rate for Payer: UnitedHealthcare Community & State	$140.14
Rate for Payer: Wellpoint Medicaid Managed Care	$154.10

STENT - SMART STENT #N840BBR

Facility

$5,815.00

Hospital Charge Code	5100515
Hospital Revenue Code	278
Min. Negotiated Rate	$872.25
Max. Negotiated Rate	$1,407.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,163.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,407.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,279.30
Rate for Payer: Qualcare PPO/HMO/WC	$872.25

STENT SM BILIRY 10X60 N1060ABR

Facility

$7,624.00

Hospital Charge Code	270626107
Hospital Revenue Code	272
Min. Negotiated Rate	$183.74
Max. Negotiated Rate	$3,812.00
Rate for Payer: Aetna Commercial	$2,897.12
Rate for Payer: Aetna Medicare Advantage	$2,287.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,944.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,944.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,944.12
Rate for Payer: Cigna Commercial	$3,812.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,287.20
Rate for Payer: Oxford Commercial	$1,524.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,143.60
Rate for Payer: UnitedHealthcare Commercial	$1,524.80
Rate for Payer: UnitedHealthcare Community & State	$183.74
Rate for Payer: Wellpoint Medicaid Managed Care	$202.04

STENT SM BILIRY 10X60 N1060ABR

Facility

$7,624.00

Hospital Charge Code	270626107
Hospital Revenue Code	272
Min. Negotiated Rate	$1,143.60
Max. Negotiated Rate	$1,143.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,143.60

STENT SMRT BILI 10x20 C10020SB

Facility

$7,425.00

Hospital Charge Code	270630175V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,113.75
Max. Negotiated Rate	$1,796.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,796.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,113.75

STENT SMRT BILI 10x20 C10020SB

Facility

$7,425.00

Hospital Charge Code	270630175V
Hospital Revenue Code	278
Min. Negotiated Rate	$178.94
Max. Negotiated Rate	$3,712.50
Rate for Payer: Aetna Commercial	$2,821.50
Rate for Payer: Aetna Medicare Advantage	$2,227.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,893.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,893.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,893.38
Rate for Payer: Cigna Commercial	$3,712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,796.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,113.75
Rate for Payer: UnitedHealthcare Community & State	$178.94
Rate for Payer: Wellpoint Medicaid Managed Care	$196.76

STENT SMRT BILI 10x20 C10020SB

Facility

$7,365.65

Hospital Charge Code	270630175
Hospital Revenue Code	278
Min. Negotiated Rate	$177.51
Max. Negotiated Rate	$3,682.82
Rate for Payer: Aetna Commercial	$2,798.95
Rate for Payer: Aetna Medicare Advantage	$2,209.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,878.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,878.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,473.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,878.24
Rate for Payer: Cigna Commercial	$3,682.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,782.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,620.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,104.85
Rate for Payer: UnitedHealthcare Community & State	$177.51
Rate for Payer: Wellpoint Medicaid Managed Care	$195.19

Know your out-of-pocket cost for care.

All Charges