Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STENT SMRT BILI 10x20 C10020SB

Facility

$7,365.65

Hospital Charge Code	270630175
Hospital Revenue Code	278
Min. Negotiated Rate	$1,104.85
Max. Negotiated Rate	$1,782.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,473.13
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

STENT SMRT BILI 12x60 N1260AB

Facility

$7,638.45

Hospital Charge Code	270629405
Hospital Revenue Code	278
Min. Negotiated Rate	$184.09
Max. Negotiated Rate	$3,819.22
Rate for Payer: Aetna Commercial	$2,902.61
Rate for Payer: Aetna Medicare Advantage	$2,291.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,947.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,947.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,527.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,947.80
Rate for Payer: Cigna Commercial	$3,819.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,848.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,680.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,145.77
Rate for Payer: UnitedHealthcare Community & State	$184.09
Rate for Payer: Wellpoint Medicaid Managed Care	$202.42

STENT SMRT BILI 12x60 N1260AB

Facility

$7,638.45

Hospital Charge Code	270629405V
Hospital Revenue Code	278
Min. Negotiated Rate	$184.09
Max. Negotiated Rate	$3,819.22
Rate for Payer: Aetna Commercial	$2,902.61
Rate for Payer: Aetna Medicare Advantage	$2,291.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,947.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,947.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,527.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,947.80
Rate for Payer: Cigna Commercial	$3,819.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,848.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,680.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,145.77
Rate for Payer: UnitedHealthcare Community & State	$184.09
Rate for Payer: Wellpoint Medicaid Managed Care	$202.42

STENT SMRT BILI 12x60 N1260AB

Facility

$7,638.45

Hospital Charge Code	270629405
Hospital Revenue Code	278
Min. Negotiated Rate	$1,145.77
Max. Negotiated Rate	$1,848.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,527.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,848.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,680.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,145.77

STENT SMRT BILI 12x60 N1260AB

Facility

$7,638.45

Hospital Charge Code	270629405V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,145.77
Max. Negotiated Rate	$1,848.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,527.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,848.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,680.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,145.77

STENT SMT BIL 8x60 6F 8060SB

Facility

$8,159.25

Hospital Charge Code	270629647
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 SMT BIL 8x60 6F 8060SB

Facility

$8,225.00

Hospital Charge Code	270629647V
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 SMT BIL 8x60 6F 8060SB

Facility

$8,225.00

Hospital Charge Code	270629647V
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 SMT BIL 8x60 6F 8060SB

Facility

$8,159.25

Hospital Charge Code	270629647
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

STENTS ORSIRO 2.75/9

Facility

$2,250.00

Service Code	HCPCS C1874
Hospital Charge Code	270700911S
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

STENTS ORSIRO 2.75/9

Facility

$2,250.00

Service Code	HCPCS C1874
Hospital Charge Code	270700911
Hospital Revenue Code	278
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

STENTS ORSIRO 2.75/9

Facility

$2,250.00

Service Code	HCPCS C1874
Hospital Charge Code	270700911S
Hospital Revenue Code	278
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

STENTS ORSIRO 2.75/9

Facility

$2,250.00

Service Code	HCPCS C1874
Hospital Charge Code	270700911
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

STENT SPUR 3.0 x 65x 135

Facility

$19,975.00

Hospital Charge Code	270705364
Hospital Revenue Code	279
Min. Negotiated Rate	$2,996.25
Max. Negotiated Rate	$2,996.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25

STENT SPUR 3.0 x 65x 135

Facility

$19,975.00

Hospital Charge Code	270705364
Hospital Revenue Code	279
Min. Negotiated Rate	$481.40
Max. Negotiated Rate	$9,987.50
Rate for Payer: Aetna Commercial	$7,590.50
Rate for Payer: Aetna Medicare Advantage	$5,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,093.62
Rate for Payer: Cigna Commercial	$9,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,992.50
Rate for Payer: Oxford Commercial	$3,995.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25
Rate for Payer: UnitedHealthcare Commercial	$3,995.00
Rate for Payer: UnitedHealthcare Community & State	$481.40
Rate for Payer: Wellpoint Medicaid Managed Care	$529.34

STENT SPUR 4.0x60x135

Facility

$19,975.00

Hospital Charge Code	270705365
Hospital Revenue Code	279
Min. Negotiated Rate	$481.40
Max. Negotiated Rate	$9,987.50
Rate for Payer: Aetna Commercial	$7,590.50
Rate for Payer: Aetna Medicare Advantage	$5,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,093.62
Rate for Payer: Cigna Commercial	$9,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,992.50
Rate for Payer: Oxford Commercial	$3,995.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25
Rate for Payer: UnitedHealthcare Commercial	$3,995.00
Rate for Payer: UnitedHealthcare Community & State	$481.40
Rate for Payer: Wellpoint Medicaid Managed Care	$529.34

STENT SPUR 4.0x60x135

Facility

$19,975.00

Hospital Charge Code	270705365
Hospital Revenue Code	279
Min. Negotiated Rate	$2,996.25
Max. Negotiated Rate	$2,996.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25

STENT ST BIL 10x40x80 C10040SB

Facility

$8,225.00

Hospital Charge Code	270628011V
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 ST BIL 10x40x80 C10040SB

Facility

$8,159.25

Hospital Charge Code	270628011
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 ST BIL 10x40x80 C10040SB

Facility

$8,225.00

Hospital Charge Code	270628011V
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 ST BIL 10x40x80 C10040SB

Facility

$8,159.25

Hospital Charge Code	270628011
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 ST BIL 7x40x120 C07040MB

Facility

$8,159.25

Hospital Charge Code	270632501
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 ST BIL 7x40x120 C07040MB

Facility

$8,159.25

Hospital Charge Code	270632501
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 ST BIL 7x40x120 C07040MB

Facility

$8,225.00

Hospital Charge Code	270632501V
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 ST BIL 7x40x120 C07040MB

Facility

$8,225.00

Hospital Charge Code	270632501V
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

Know your out-of-pocket cost for care.

All Charges