Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STENT WSRP 6FR 10X49 75CM

Facility

$5,401.15

Hospital Charge Code	270640708C
Hospital Revenue Code	278
Min. Negotiated Rate	$130.17
Max. Negotiated Rate	$2,700.57
Rate for Payer: Aetna Commercial	$2,052.44
Rate for Payer: Aetna Medicare Advantage	$1,620.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.29
Rate for Payer: Cigna Commercial	$2,700.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,307.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,188.25
Rate for Payer: Qualcare PPO/HMO/WC	$810.17
Rate for Payer: UnitedHealthcare Community & State	$130.17
Rate for Payer: Wellpoint Medicaid Managed Care	$143.13

STENT WSRP 6FR 10X49 75CM

Facility

$5,401.15

Hospital Charge Code	270640708C
Hospital Revenue Code	278
Min. Negotiated Rate	$810.17
Max. Negotiated Rate	$1,307.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,307.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,188.25
Rate for Payer: Qualcare PPO/HMO/WC	$810.17

STENT WSRP 6FR 8x20 75cm

Facility

$5,250.00

Hospital Charge Code	270633141
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 8x20 75cm

Facility

$5,250.00

Hospital Charge Code	270633141
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 8x38 75cm

Facility

$5,250.00

Hospital Charge Code	270643005
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 8x38 75cm

Facility

$5,250.00

Hospital Charge Code	270643005
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 8x40 75cm

Facility

$5,250.00

Hospital Charge Code	270626876
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 8x40 75cm

Facility

$5,250.00

Hospital Charge Code	270626876
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 8x47 75cm

Facility

$5,250.00

Hospital Charge Code	270623271
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 8x47 75cm

Facility

$5,250.00

Hospital Charge Code	270623271
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 8x60 75cm

Facility

$5,250.00

Hospital Charge Code	270627332
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 8x60 75cm

Facility

$5,250.00

Hospital Charge Code	270627332
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 7FR 10x42 75cm

Facility

$5,250.00

Hospital Charge Code	270627351
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 7FR 10x42 75cm

Facility

$5,250.00

Hospital Charge Code	270627351
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 7FR 10x68 75cm

Facility

$5,250.00

Hospital Charge Code	270623270
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 7FR 10x68 75cm

Facility

$5,250.00

Hospital Charge Code	270623270
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 8x20 6FR 75cm 71124

Facility

$5,535.45

Hospital Charge Code	270633141V
Hospital Revenue Code	278
Min. Negotiated Rate	$133.40
Max. Negotiated Rate	$2,767.72
Rate for Payer: Aetna Commercial	$2,103.47
Rate for Payer: Aetna Medicare Advantage	$1,660.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,411.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,411.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,107.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,411.54
Rate for Payer: Cigna Commercial	$2,767.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,339.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,217.80
Rate for Payer: Qualcare PPO/HMO/WC	$830.32
Rate for Payer: UnitedHealthcare Community & State	$133.40
Rate for Payer: Wellpoint Medicaid Managed Care	$146.69

STENT WSRP 8x20 6FR 75cm 71124

Facility

$5,535.45

Hospital Charge Code	270633141V
Hospital Revenue Code	278
Min. Negotiated Rate	$830.32
Max. Negotiated Rate	$1,339.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,107.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,339.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,217.80
Rate for Payer: Qualcare PPO/HMO/WC	$830.32

STENT XACT CAR 10-8X40 8209601

Facility

$10,250.00

Service Code	HCPCS C1876
Hospital Charge Code	270643629C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$2,480.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,255.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

STENT XACT CAR 10-8X40 8209601

Facility

$10,250.00

Service Code	HCPCS C1876
Hospital Charge Code	270643629C
Hospital Revenue Code	278
Min. Negotiated Rate	$247.03
Max. Negotiated Rate	$5,125.00
Rate for Payer: Aetna Commercial	$3,895.00
Rate for Payer: Aetna Medicare Advantage	$3,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,613.75
Rate for Payer: Cigna Commercial	$5,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,255.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50
Rate for Payer: UnitedHealthcare Community & State	$247.03
Rate for Payer: Wellpoint Medicaid Managed Care	$271.62

STENT XACT CAROTD 8X30 8209201

Facility

$12,225.00

Service Code	HCPCS C1876
Hospital Charge Code	270643628C
Hospital Revenue Code	278
Min. Negotiated Rate	$294.62
Max. Negotiated Rate	$6,112.50
Rate for Payer: Aetna Commercial	$4,645.50
Rate for Payer: Aetna Medicare Advantage	$3,667.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,117.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,117.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,117.38
Rate for Payer: Cigna Commercial	$6,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,958.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,689.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,833.75
Rate for Payer: UnitedHealthcare Community & State	$294.62
Rate for Payer: Wellpoint Medicaid Managed Care	$323.96

STENT XACT CAROTD 8X30 8209201

Facility

$12,225.00

Service Code	HCPCS C1876
Hospital Charge Code	270643628C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,833.75
Max. Negotiated Rate	$2,958.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,445.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,958.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,689.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,833.75

STENT XACT CAROTID 10-10 30MM

Facility

$10,250.00

Hospital Charge Code	270644530C
Hospital Revenue Code	278
Min. Negotiated Rate	$247.03
Max. Negotiated Rate	$5,125.00
Rate for Payer: Aetna Commercial	$3,895.00
Rate for Payer: Aetna Medicare Advantage	$3,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,613.75
Rate for Payer: Cigna Commercial	$5,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,255.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50
Rate for Payer: UnitedHealthcare Community & State	$247.03
Rate for Payer: Wellpoint Medicaid Managed Care	$271.62

STENT XACT CAROTID 10-10 30MM

Facility

$10,250.00

Hospital Charge Code	270644530C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$2,480.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,255.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

STENT XACT CAROTID 10-8 30MM

Facility

$10,250.00

Hospital Charge Code	270644100C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$2,480.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,255.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

Know your out-of-pocket cost for care.

All Charges