Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STENT VARIABLE LENGTH 7FR

Facility

$700.00

Hospital Charge Code	270650850
Hospital Revenue Code	278
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

STENT VARIABLE LENGTH 7FR

Facility

$700.00

Hospital Charge Code	270650850
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

STENT VASCULAR FREDX21 3X13MM

Facility

$86,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270700648S
Hospital Revenue Code	278
Min. Negotiated Rate	$12,990.00
Max. Negotiated Rate	$20,957.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20,957.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19,052.00
Rate for Payer: Qualcare PPO/HMO/WC	$12,990.00

STENT VASCULAR FREDX21 3X13MM

Facility

$86,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270700648S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,087.06
Max. Negotiated Rate	$43,300.00
Rate for Payer: Aetna Commercial	$32,908.00
Rate for Payer: Aetna Medicare Advantage	$25,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,083.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,083.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,083.00
Rate for Payer: Cigna Commercial	$43,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20,957.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19,052.00
Rate for Payer: Qualcare PPO/HMO/WC	$12,990.00
Rate for Payer: UnitedHealthcare Community & State	$2,087.06
Rate for Payer: Wellpoint Medicaid Managed Care	$2,294.90

STENT VASCULAR ZILVER 518

Facility

$8,250.00

Service Code	HCPCS C1876
Hospital Charge Code	270662856
Hospital Revenue Code	278
Min. Negotiated Rate	$1,237.50
Max. Negotiated Rate	$1,996.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50

STENT VASCULAR ZILVER 518

Facility

$8,250.00

Service Code	HCPCS C1876
Hospital Charge Code	270662856
Hospital Revenue Code	278
Min. Negotiated Rate	$198.82
Max. Negotiated Rate	$4,125.00
Rate for Payer: Aetna Commercial	$3,135.00
Rate for Payer: Aetna Medicare Advantage	$2,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,103.75
Rate for Payer: Cigna Commercial	$4,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50
Rate for Payer: UnitedHealthcare Community & State	$198.82
Rate for Payer: Wellpoint Medicaid Managed Care	$218.62

STENT VBX ENDOPROS 11 X 79 CM

Facility

$17,095.00

Service Code	HCPCS C1874
Hospital Charge Code	270683406
Hospital Revenue Code	278
Min. Negotiated Rate	$411.99
Max. Negotiated Rate	$8,547.50
Rate for Payer: Aetna Commercial	$6,496.10
Rate for Payer: Aetna Medicare Advantage	$5,128.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,359.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,359.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,419.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,359.23
Rate for Payer: Cigna Commercial	$8,547.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,136.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,760.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,564.25
Rate for Payer: UnitedHealthcare Community & State	$411.99
Rate for Payer: Wellpoint Medicaid Managed Care	$453.02

STENT VBX ENDOPROS 11 X 79 CM

Facility

$17,095.00

Service Code	HCPCS C1874
Hospital Charge Code	270683406
Hospital Revenue Code	278
Min. Negotiated Rate	$2,564.25
Max. Negotiated Rate	$4,136.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,419.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,136.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,760.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,564.25

STENT VERIFLEX 12mm 3.50

Facility

$6,250.00

Hospital Charge Code	270638315
Hospital Revenue Code	278
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

STENT VERIFLEX 12mm 3.50

Facility

$6,250.00

Hospital Charge Code	270638315
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

STENT VERIFLEX 12mm 4.00

Facility

$6,250.00

Hospital Charge Code	270638226
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

STENT VERIFLEX 12mm 4.00

Facility

$6,250.00

Hospital Charge Code	270638226
Hospital Revenue Code	278
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

STENT VERIFLEX 24mm 3.00

Facility

$6,250.00

Hospital Charge Code	270659110
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

STENT VERIFLEX 24mm 3.00

Facility

$6,250.00

Hospital Charge Code	270659110
Hospital Revenue Code	278
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

STENT VERIFLEX 32mm 4.00

Facility

$6,250.00

Hospital Charge Code	270CH0081
Hospital Revenue Code	278
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

STENT VERIFLEX 32mm 4.00

Facility

$6,250.00

Hospital Charge Code	270CH0081
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

STENT VERIFLEX 32mm 4.50

Facility

$6,250.00

Hospital Charge Code	270CH0082
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

STENT VERIFLEX 32mm 4.50

Facility

$6,250.00

Hospital Charge Code	270CH0082
Hospital Revenue Code	278
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

STENT VERIFLEX 8mm 2.75

Facility

$6,250.00

Hospital Charge Code	270638260
Hospital Revenue Code	278
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

STENT VERIFLEX 8mm 2.75

Facility

$6,250.00

Hospital Charge Code	270638260
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

STENT VERIFLX 4 0X32 389343240

Facility

$6,250.00

Hospital Charge Code	270661689
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

STENT VERIFLX 4 0X32 389343240

Facility

$6,250.00

Hospital Charge Code	270661689
Hospital Revenue Code	278
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

STENT VI 8F 7X10 120 VBH071002

Facility

$15,250.00

Hospital Charge Code	270640342C
Hospital Revenue Code	278
Min. Negotiated Rate	$367.52
Max. Negotiated Rate	$7,625.00
Rate for Payer: Aetna Commercial	$5,795.00
Rate for Payer: Aetna Medicare Advantage	$4,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,888.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,888.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,888.75
Rate for Payer: Cigna Commercial	$7,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,690.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,355.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,287.50
Rate for Payer: UnitedHealthcare Community & State	$367.52
Rate for Payer: Wellpoint Medicaid Managed Care	$404.12

STENT VI 8F 7X10 120 VBH071002

Facility

$15,250.00

Hospital Charge Code	270640342C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,287.50
Max. Negotiated Rate	$3,690.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,690.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,355.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,287.50

STENT VIABAH 13x10x75 VB131001

Facility

$12,152.00

Hospital Charge Code	270635161
Hospital Revenue Code	278
Min. Negotiated Rate	$292.86
Max. Negotiated Rate	$6,076.00
Rate for Payer: Aetna Commercial	$4,617.76
Rate for Payer: Aetna Medicare Advantage	$3,645.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,098.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,098.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,430.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,098.76
Rate for Payer: Cigna Commercial	$6,076.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,940.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,673.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,822.80
Rate for Payer: UnitedHealthcare Community & State	$292.86
Rate for Payer: Wellpoint Medicaid Managed Care	$322.03

Know your out-of-pocket cost for care.

All Charges