Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STENT WALLGRAFT 12x50

Facility

$10,265.00

Hospital Charge Code	270623518
Hospital Revenue Code	278
Min. Negotiated Rate	$1,539.75
Max. Negotiated Rate	$2,484.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,053.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,484.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,258.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,539.75

STENT WALLGRAFT 8x50

Facility

$10,265.00

Hospital Charge Code	270623516
Hospital Revenue Code	278
Min. Negotiated Rate	$1,539.75
Max. Negotiated Rate	$2,484.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,053.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,484.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,258.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,539.75

STENT WALLGRAFT 8x50

Facility

$10,265.00

Hospital Charge Code	270623516
Hospital Revenue Code	278
Min. Negotiated Rate	$247.39
Max. Negotiated Rate	$5,132.50
Rate for Payer: Aetna Commercial	$3,900.70
Rate for Payer: Aetna Medicare Advantage	$3,079.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,617.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,617.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,053.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,617.57
Rate for Payer: Cigna Commercial	$5,132.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,484.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,258.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,539.75
Rate for Payer: UnitedHealthcare Community & State	$247.39
Rate for Payer: Wellpoint Medicaid Managed Care	$272.02

STENT WALL RAPID EXCHANGE 6971

Facility

$7,936.00

Hospital Charge Code	270630294
Hospital Revenue Code	278
Min. Negotiated Rate	$191.26
Max. Negotiated Rate	$3,968.00
Rate for Payer: Aetna Commercial	$3,015.68
Rate for Payer: Aetna Medicare Advantage	$2,380.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,023.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,023.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,587.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,023.68
Rate for Payer: Cigna Commercial	$3,968.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,920.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,745.92
Rate for Payer: Qualcare PPO/HMO/WC	$1,190.40
Rate for Payer: UnitedHealthcare Community & State	$191.26
Rate for Payer: Wellpoint Medicaid Managed Care	$210.30

STENT WALL RAPID EXCHANGE 6971

Facility

$7,936.00

Hospital Charge Code	270630294
Hospital Revenue Code	278
Min. Negotiated Rate	$1,190.40
Max. Negotiated Rate	$1,920.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,587.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,920.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,745.92
Rate for Payer: Qualcare PPO/HMO/WC	$1,190.40

STENT WALLSTENT 8F 100cm 4021

Facility

$5,193.40

Hospital Charge Code	270624175V
Hospital Revenue Code	278
Min. Negotiated Rate	$125.16
Max. Negotiated Rate	$2,596.70
Rate for Payer: Aetna Commercial	$1,973.49
Rate for Payer: Aetna Medicare Advantage	$1,558.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,324.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,324.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,038.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,324.32
Rate for Payer: Cigna Commercial	$2,596.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,256.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,142.55
Rate for Payer: Qualcare PPO/HMO/WC	$779.01
Rate for Payer: UnitedHealthcare Community & State	$125.16
Rate for Payer: Wellpoint Medicaid Managed Care	$137.63

STENT WALLSTENT 8F 100cm 4021

Facility

$5,193.40

Hospital Charge Code	270624175V
Hospital Revenue Code	278
Min. Negotiated Rate	$779.01
Max. Negotiated Rate	$1,256.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,038.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,256.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,142.55
Rate for Payer: Qualcare PPO/HMO/WC	$779.01

STENT WALLSTENT 8F 100cm 40211

Facility

$5,152.00

Hospital Charge Code	270624175
Hospital Revenue Code	278
Min. Negotiated Rate	$772.80
Max. Negotiated Rate	$1,246.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,030.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,246.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,133.44
Rate for Payer: Qualcare PPO/HMO/WC	$772.80

STENT WALLSTENT 8F 100cm 40211

Facility

$5,152.00

Hospital Charge Code	270624175
Hospital Revenue Code	278
Min. Negotiated Rate	$124.16
Max. Negotiated Rate	$2,576.00
Rate for Payer: Aetna Commercial	$1,957.76
Rate for Payer: Aetna Medicare Advantage	$1,545.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,313.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,313.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,030.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,313.76
Rate for Payer: Cigna Commercial	$2,576.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,246.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,133.44
Rate for Payer: Qualcare PPO/HMO/WC	$772.80
Rate for Payer: UnitedHealthcare Community & State	$124.16
Rate for Payer: Wellpoint Medicaid Managed Care	$136.53

STENT WALL WPERLUME 10x80 6972

Facility

$7,675.00

Hospital Charge Code	270637764
Hospital Revenue Code	278
Min. Negotiated Rate	$184.97
Max. Negotiated Rate	$3,837.50
Rate for Payer: Aetna Commercial	$2,916.50
Rate for Payer: Aetna Medicare Advantage	$2,302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,957.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,957.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,535.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,957.12
Rate for Payer: Cigna Commercial	$3,837.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,857.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,688.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,151.25
Rate for Payer: UnitedHealthcare Community & State	$184.97
Rate for Payer: Wellpoint Medicaid Managed Care	$203.39

STENT WALL WPERLUME 10x80 6972

Facility

$7,675.00

Hospital Charge Code	270637764
Hospital Revenue Code	278
Min. Negotiated Rate	$1,151.25
Max. Negotiated Rate	$1,857.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,535.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,857.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,688.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,151.25

STENT WAVEMAX 8x28mm 14549-01

Facility

$4,960.00

Hospital Charge Code	270635420
Hospital Revenue Code	278
Min. Negotiated Rate	$744.00
Max. Negotiated Rate	$1,200.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$992.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,200.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,091.20
Rate for Payer: Qualcare PPO/HMO/WC	$744.00

STENT WAVEMAX 8x28mm 14549-01

Facility

$4,960.00

Hospital Charge Code	270635420V
Hospital Revenue Code	278
Min. Negotiated Rate	$744.00
Max. Negotiated Rate	$1,200.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$992.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,200.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,091.20
Rate for Payer: Qualcare PPO/HMO/WC	$744.00

STENT WAVEMAX 8x28mm 14549-01

Facility

$4,960.00

Hospital Charge Code	270635420
Hospital Revenue Code	278
Min. Negotiated Rate	$119.54
Max. Negotiated Rate	$2,480.00
Rate for Payer: Aetna Commercial	$1,884.80
Rate for Payer: Aetna Medicare Advantage	$1,488.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,264.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,264.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$992.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,264.80
Rate for Payer: Cigna Commercial	$2,480.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,200.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,091.20
Rate for Payer: Qualcare PPO/HMO/WC	$744.00
Rate for Payer: UnitedHealthcare Community & State	$119.54
Rate for Payer: Wellpoint Medicaid Managed Care	$131.44

STENT WAVEMAX 8x28mm 14549-01

Facility

$4,960.00

Hospital Charge Code	270635420V
Hospital Revenue Code	278
Min. Negotiated Rate	$119.54
Max. Negotiated Rate	$2,480.00
Rate for Payer: Aetna Commercial	$1,884.80
Rate for Payer: Aetna Medicare Advantage	$1,488.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,264.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,264.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$992.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,264.80
Rate for Payer: Cigna Commercial	$2,480.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,200.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,091.20
Rate for Payer: Qualcare PPO/HMO/WC	$744.00
Rate for Payer: UnitedHealthcare Community & State	$119.54
Rate for Payer: Wellpoint Medicaid Managed Care	$131.44

STENT WAVEMAX 9x28x75 1455001

Facility

$4,960.00

Hospital Charge Code	270634995V
Hospital Revenue Code	278
Min. Negotiated Rate	$119.54
Max. Negotiated Rate	$2,480.00
Rate for Payer: Aetna Commercial	$1,884.80
Rate for Payer: Aetna Medicare Advantage	$1,488.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,264.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,264.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$992.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,264.80
Rate for Payer: Cigna Commercial	$2,480.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,200.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,091.20
Rate for Payer: Qualcare PPO/HMO/WC	$744.00
Rate for Payer: UnitedHealthcare Community & State	$119.54
Rate for Payer: Wellpoint Medicaid Managed Care	$131.44

STENT WAVEMAX 9x28x75 1455001

Facility

$4,960.00

Hospital Charge Code	270634995V
Hospital Revenue Code	278
Min. Negotiated Rate	$744.00
Max. Negotiated Rate	$1,200.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$992.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,200.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,091.20
Rate for Payer: Qualcare PPO/HMO/WC	$744.00

STENT WAVEMAX 9x28x75 1455001

Facility

$4,960.00

Hospital Charge Code	270634995
Hospital Revenue Code	278
Min. Negotiated Rate	$119.54
Max. Negotiated Rate	$2,480.00
Rate for Payer: Aetna Commercial	$1,884.80
Rate for Payer: Aetna Medicare Advantage	$1,488.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,264.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,264.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$992.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,264.80
Rate for Payer: Cigna Commercial	$2,480.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,200.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,091.20
Rate for Payer: Qualcare PPO/HMO/WC	$744.00
Rate for Payer: UnitedHealthcare Community & State	$119.54
Rate for Payer: Wellpoint Medicaid Managed Care	$131.44

STENT WAVEMAX 9x28x75 1455001

Facility

$4,960.00

Hospital Charge Code	270634995
Hospital Revenue Code	278
Min. Negotiated Rate	$744.00
Max. Negotiated Rate	$1,200.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$992.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,200.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,091.20
Rate for Payer: Qualcare PPO/HMO/WC	$744.00

STENT WSRP 10x20 6FR 75 71132

Facility

$5,151.95

Hospital Charge Code	270633054V
Hospital Revenue Code	278
Min. Negotiated Rate	$772.79
Max. Negotiated Rate	$1,246.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,030.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,246.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,133.43
Rate for Payer: Qualcare PPO/HMO/WC	$772.79

STENT WSRP 10x20 6FR 75 71132

Facility

$5,151.95

Hospital Charge Code	270633054V
Hospital Revenue Code	278
Min. Negotiated Rate	$124.16
Max. Negotiated Rate	$2,575.97
Rate for Payer: Aetna Commercial	$1,957.74
Rate for Payer: Aetna Medicare Advantage	$1,545.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,313.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,313.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,030.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,313.75
Rate for Payer: Cigna Commercial	$2,575.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,246.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,133.43
Rate for Payer: Qualcare PPO/HMO/WC	$772.79
Rate for Payer: UnitedHealthcare Community & State	$124.16
Rate for Payer: Wellpoint Medicaid Managed Care	$136.53

STENT WSRP 6FR 10x20 75cm

Facility

$5,250.00

Hospital Charge Code	270633054
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,155.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

STENT WSRP 6FR 10x20 75cm

Facility

$5,250.00

Hospital Charge Code	270633054
Hospital Revenue Code	278
Min. Negotiated Rate	$126.53
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,995.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,155.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Community & State	$126.53
Rate for Payer: Wellpoint Medicaid Managed Care	$139.12

STENT WSRP 6FR 10x49 75cm

Facility

$5,250.00

Hospital Charge Code	270640708
Hospital Revenue Code	278
Min. Negotiated Rate	$126.53
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,995.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,155.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Community & State	$126.53
Rate for Payer: Wellpoint Medicaid Managed Care	$139.12

STENT WSRP 6FR 10x49 75cm

Facility

$5,250.00

Hospital Charge Code	270640708
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,155.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

Know your out-of-pocket cost for care.

All Charges