Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STENT TAX EXP 2.75X16

Facility

$13,625.00

Hospital Charge Code	270637435
Hospital Revenue Code	278
Min. Negotiated Rate	$328.36
Max. Negotiated Rate	$6,812.50
Rate for Payer: Aetna Commercial	$5,177.50
Rate for Payer: Aetna Medicare Advantage	$4,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,474.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,474.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,474.38
Rate for Payer: Cigna Commercial	$6,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,297.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,997.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,043.75
Rate for Payer: UnitedHealthcare Community & State	$328.36
Rate for Payer: Wellpoint Medicaid Managed Care	$361.06

STENT TAX EXP 3 0X16 389701630

Facility

$13,625.00

Hospital Charge Code	270638231C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,043.75
Max. Negotiated Rate	$3,297.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,297.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,997.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,043.75

STENT TAX EXP 3 0X16 389701630

Facility

$13,625.00

Hospital Charge Code	270638231C
Hospital Revenue Code	278
Min. Negotiated Rate	$328.36
Max. Negotiated Rate	$6,812.50
Rate for Payer: Aetna Commercial	$5,177.50
Rate for Payer: Aetna Medicare Advantage	$4,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,474.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,474.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,474.38
Rate for Payer: Cigna Commercial	$6,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,297.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,997.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,043.75
Rate for Payer: UnitedHealthcare Community & State	$328.36
Rate for Payer: Wellpoint Medicaid Managed Care	$361.06

STENT TAX EXP 3 0X24 389682430

Facility

$13,516.00

Hospital Charge Code	270636598
Hospital Revenue Code	278
Min. Negotiated Rate	$325.74
Max. Negotiated Rate	$6,758.00
Rate for Payer: Aetna Commercial	$5,136.08
Rate for Payer: Aetna Medicare Advantage	$4,054.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,446.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,446.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,703.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,446.58
Rate for Payer: Cigna Commercial	$6,758.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,270.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,973.52
Rate for Payer: Qualcare PPO/HMO/WC	$2,027.40
Rate for Payer: UnitedHealthcare Community & State	$325.74
Rate for Payer: Wellpoint Medicaid Managed Care	$358.17

STENT TAX EXP 3 0X24 389682430

Facility

$13,516.00

Hospital Charge Code	270636598
Hospital Revenue Code	278
Min. Negotiated Rate	$2,027.40
Max. Negotiated Rate	$3,270.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,703.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,270.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,973.52
Rate for Payer: Qualcare PPO/HMO/WC	$2,027.40

STENT TAX EXP 3 0X24 389702430

Facility

$13,625.00

Hospital Charge Code	270637364
Hospital Revenue Code	278
Min. Negotiated Rate	$328.36
Max. Negotiated Rate	$6,812.50
Rate for Payer: Aetna Commercial	$5,177.50
Rate for Payer: Aetna Medicare Advantage	$4,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,474.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,474.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,474.38
Rate for Payer: Cigna Commercial	$6,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,297.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,997.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,043.75
Rate for Payer: UnitedHealthcare Community & State	$328.36
Rate for Payer: Wellpoint Medicaid Managed Care	$361.06

STENT TAX EXP 3 0X24 389702430

Facility

$13,625.00

Hospital Charge Code	270637364
Hospital Revenue Code	278
Min. Negotiated Rate	$2,043.75
Max. Negotiated Rate	$3,297.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,297.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,997.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,043.75

STENT TAX EXP 3 0X32 389703230

Facility

$13,625.00

Hospital Charge Code	270637331
Hospital Revenue Code	278
Min. Negotiated Rate	$2,043.75
Max. Negotiated Rate	$3,297.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,297.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,997.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,043.75

STENT TAX EXP 3 0X32 389703230

Facility

$13,625.00

Hospital Charge Code	270637331
Hospital Revenue Code	278
Min. Negotiated Rate	$328.36
Max. Negotiated Rate	$6,812.50
Rate for Payer: Aetna Commercial	$5,177.50
Rate for Payer: Aetna Medicare Advantage	$4,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,474.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,474.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,474.38
Rate for Payer: Cigna Commercial	$6,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,297.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,997.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,043.75
Rate for Payer: UnitedHealthcare Community & State	$328.36
Rate for Payer: Wellpoint Medicaid Managed Care	$361.06

STENT TAX EXP 3 5X1 389681235

Facility

$13,625.00

Hospital Charge Code	270637309
Hospital Revenue Code	278
Min. Negotiated Rate	$2,043.75
Max. Negotiated Rate	$3,297.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,297.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,997.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,043.75

STENT TAX EXP 3 5X1 389681235

Facility

$13,625.00

Hospital Charge Code	270637309
Hospital Revenue Code	278
Min. Negotiated Rate	$328.36
Max. Negotiated Rate	$6,812.50
Rate for Payer: Aetna Commercial	$5,177.50
Rate for Payer: Aetna Medicare Advantage	$4,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,474.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,474.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,474.38
Rate for Payer: Cigna Commercial	$6,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,297.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,997.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,043.75
Rate for Payer: UnitedHealthcare Community & State	$328.36
Rate for Payer: Wellpoint Medicaid Managed Care	$361.06

STENT TAX EXP 3 5X16 389681635

Facility

$13,625.00

Hospital Charge Code	270637305
Hospital Revenue Code	278
Min. Negotiated Rate	$2,043.75
Max. Negotiated Rate	$3,297.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,297.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,997.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,043.75

STENT TAX EXP 3 5X16 389681635

Facility

$13,625.00

Hospital Charge Code	270637305
Hospital Revenue Code	278
Min. Negotiated Rate	$328.36
Max. Negotiated Rate	$6,812.50
Rate for Payer: Aetna Commercial	$5,177.50
Rate for Payer: Aetna Medicare Advantage	$4,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,474.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,474.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,474.38
Rate for Payer: Cigna Commercial	$6,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,297.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,997.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,043.75
Rate for Payer: UnitedHealthcare Community & State	$328.36
Rate for Payer: Wellpoint Medicaid Managed Care	$361.06

STENT TAX EXP 3X16 389701630

Facility

$13,625.00

Hospital Charge Code	270638231
Hospital Revenue Code	278
Min. Negotiated Rate	$328.36
Max. Negotiated Rate	$6,812.50
Rate for Payer: Aetna Commercial	$5,177.50
Rate for Payer: Aetna Medicare Advantage	$4,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,474.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,474.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,474.38
Rate for Payer: Cigna Commercial	$6,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,297.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,997.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,043.75
Rate for Payer: UnitedHealthcare Community & State	$328.36
Rate for Payer: Wellpoint Medicaid Managed Care	$361.06

STENT TAX EXP 3X16 389701630

Facility

$13,625.00

Hospital Charge Code	270638231
Hospital Revenue Code	278
Min. Negotiated Rate	$2,043.75
Max. Negotiated Rate	$3,297.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,297.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,997.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,043.75

STENT TAXUS 2 5X24 389682425

Facility

$21,118.75

Hospital Charge Code	270636965
Hospital Revenue Code	278
Min. Negotiated Rate	$3,167.81
Max. Negotiated Rate	$5,110.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,223.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,110.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,646.12
Rate for Payer: Qualcare PPO/HMO/WC	$3,167.81

STENT TAXUS 2 5X24 389682425

Facility

$21,118.75

Hospital Charge Code	270636965
Hospital Revenue Code	278
Min. Negotiated Rate	$508.96
Max. Negotiated Rate	$10,559.38
Rate for Payer: Aetna Commercial	$8,025.12
Rate for Payer: Aetna Medicare Advantage	$6,335.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,385.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,385.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,223.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,385.28
Rate for Payer: Cigna Commercial	$10,559.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,110.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,646.12
Rate for Payer: Qualcare PPO/HMO/WC	$3,167.81
Rate for Payer: UnitedHealthcare Community & State	$508.96
Rate for Payer: Wellpoint Medicaid Managed Care	$559.65

STENT TAXUS EXPRESS 2.75x24mm

Facility

$13,625.00

Hospital Charge Code	270637404
Hospital Revenue Code	278
Min. Negotiated Rate	$328.36
Max. Negotiated Rate	$6,812.50
Rate for Payer: Aetna Commercial	$5,177.50
Rate for Payer: Aetna Medicare Advantage	$4,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,474.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,474.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,474.38
Rate for Payer: Cigna Commercial	$6,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,297.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,997.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,043.75
Rate for Payer: UnitedHealthcare Community & State	$328.36
Rate for Payer: Wellpoint Medicaid Managed Care	$361.06

STENT TAXUS EXPRESS 2.75x24mm

Facility

$13,625.00

Hospital Charge Code	270637404
Hospital Revenue Code	278
Min. Negotiated Rate	$2,043.75
Max. Negotiated Rate	$3,297.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,297.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,997.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,043.75

STENT TRACH CVRD 17FR 12x30mm

Facility

$15,000.00

Service Code	HCPCS C1874
Hospital Charge Code	270673159
Hospital Revenue Code	278
Min. Negotiated Rate	$361.50
Max. Negotiated Rate	$7,500.00
Rate for Payer: Aetna Commercial	$5,700.00
Rate for Payer: Aetna Medicare Advantage	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,825.00
Rate for Payer: Cigna Commercial	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00
Rate for Payer: UnitedHealthcare Community & State	$361.50
Rate for Payer: Wellpoint Medicaid Managed Care	$397.50

STENT TRACH CVRD 17FR 12x30mm

Facility

$15,000.00

Service Code	HCPCS C1874
Hospital Charge Code	270673159
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

STENT TRACH CVRD 18FR 14x60mm

Facility

$15,000.00

Hospital Charge Code	270676650
Hospital Revenue Code	278
Min. Negotiated Rate	$361.50
Max. Negotiated Rate	$7,500.00
Rate for Payer: Aetna Commercial	$5,700.00
Rate for Payer: Aetna Medicare Advantage	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,825.00
Rate for Payer: Cigna Commercial	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00
Rate for Payer: UnitedHealthcare Community & State	$361.50
Rate for Payer: Wellpoint Medicaid Managed Care	$397.50

STENT TRACH CVRD 18FR 14x60mm

Facility

$15,000.00

Hospital Charge Code	270676650
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

STENT TRACH CVRD 1FR 14x30mm

Facility

$15,000.00

Hospital Charge Code	270676649
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

STENT TRACH CVRD 1FR 14x30mm

Facility

$15,000.00

Hospital Charge Code	270676649
Hospital Revenue Code	278
Min. Negotiated Rate	$361.50
Max. Negotiated Rate	$7,500.00
Rate for Payer: Aetna Commercial	$5,700.00
Rate for Payer: Aetna Medicare Advantage	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,825.00
Rate for Payer: Cigna Commercial	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00
Rate for Payer: UnitedHealthcare Community & State	$361.50
Rate for Payer: Wellpoint Medicaid Managed Care	$397.50

Know your out-of-pocket cost for care.

All Charges