Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STENT XIENCE NANO 2.25X18MM

Facility

$7,750.00

Hospital Charge Code	270645875C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,162.50
Max. Negotiated Rate	$1,875.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,705.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.50

STENT XIENCE NANO 2.25X23MM

Facility

$7,750.00

Hospital Charge Code	270645876C
Hospital Revenue Code	278
Min. Negotiated Rate	$186.78
Max. Negotiated Rate	$3,875.00
Rate for Payer: Aetna Commercial	$2,945.00
Rate for Payer: Aetna Medicare Advantage	$2,325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,976.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,976.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,976.25
Rate for Payer: Cigna Commercial	$3,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,705.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.50
Rate for Payer: UnitedHealthcare Community & State	$186.78
Rate for Payer: Wellpoint Medicaid Managed Care	$205.38

STENT XIENCE NANO 2.25X23MM

Facility

$7,750.00

Hospital Charge Code	270645876C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,162.50
Max. Negotiated Rate	$1,875.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,705.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.50

STENT XIENCE NANO 2.25X28MM

Facility

$7,750.00

Hospital Charge Code	270645877C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,162.50
Max. Negotiated Rate	$1,875.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,705.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.50

STENT XIENCE NANO 2.25X28MM

Facility

$7,750.00

Hospital Charge Code	270645877C
Hospital Revenue Code	278
Min. Negotiated Rate	$186.78
Max. Negotiated Rate	$3,875.00
Rate for Payer: Aetna Commercial	$2,945.00
Rate for Payer: Aetna Medicare Advantage	$2,325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,976.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,976.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,976.25
Rate for Payer: Cigna Commercial	$3,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,705.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.50
Rate for Payer: UnitedHealthcare Community & State	$186.78
Rate for Payer: Wellpoint Medicaid Managed Care	$205.38

STENT XIENCE NANO 2.25X8MM

Facility

$7,750.00

Hospital Charge Code	270645872C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,162.50
Max. Negotiated Rate	$1,875.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,705.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.50

STENT XIENCE NANO 2.25X8MM

Facility

$7,750.00

Hospital Charge Code	270645872C
Hospital Revenue Code	278
Min. Negotiated Rate	$186.78
Max. Negotiated Rate	$3,875.00
Rate for Payer: Aetna Commercial	$2,945.00
Rate for Payer: Aetna Medicare Advantage	$2,325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,976.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,976.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,976.25
Rate for Payer: Cigna Commercial	$3,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,705.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.50
Rate for Payer: UnitedHealthcare Community & State	$186.78
Rate for Payer: Wellpoint Medicaid Managed Care	$205.38

STENT XIENCE PRIME 1011734-33

Facility

$16,294.37

Hospital Charge Code	270647336C
Hospital Revenue Code	278
Min. Negotiated Rate	$392.69
Max. Negotiated Rate	$8,147.19
Rate for Payer: Aetna Commercial	$6,191.86
Rate for Payer: Aetna Medicare Advantage	$4,888.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,155.06
Rate for Payer: Cigna Commercial	$8,147.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,584.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16
Rate for Payer: UnitedHealthcare Community & State	$392.69
Rate for Payer: Wellpoint Medicaid Managed Care	$431.80

STENT XIENCE PRIME 1011734-33

Facility

$16,294.37

Hospital Charge Code	270647336C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$3,943.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,584.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE PRIME 2.25x28mm

Facility

$7,975.00

Hospital Charge Code	270647325
Hospital Revenue Code	278
Min. Negotiated Rate	$1,196.25
Max. Negotiated Rate	$1,929.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,754.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25

STENT XIENCE PRIME 2.25x28mm

Facility

$7,975.00

Hospital Charge Code	270647325
Hospital Revenue Code	278
Min. Negotiated Rate	$192.20
Max. Negotiated Rate	$3,987.50
Rate for Payer: Aetna Commercial	$3,030.50
Rate for Payer: Aetna Medicare Advantage	$2,392.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,033.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,033.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,033.62
Rate for Payer: Cigna Commercial	$3,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,754.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25
Rate for Payer: UnitedHealthcare Community & State	$192.20
Rate for Payer: Wellpoint Medicaid Managed Care	$211.34

STENT XIENCE PRIME 2.5MMX33MM

Facility

$16,294.37

Hospital Charge Code	270647327C
Hospital Revenue Code	278
Min. Negotiated Rate	$392.69
Max. Negotiated Rate	$8,147.19
Rate for Payer: Aetna Commercial	$6,191.86
Rate for Payer: Aetna Medicare Advantage	$4,888.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,155.06
Rate for Payer: Cigna Commercial	$8,147.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,584.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16
Rate for Payer: UnitedHealthcare Community & State	$392.69
Rate for Payer: Wellpoint Medicaid Managed Care	$431.80

STENT XIENCE PRIME 2.5MMX33MM

Facility

$16,294.37

Hospital Charge Code	270647327C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$3,943.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,584.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE PRIME 2.5MMX38MM

Facility

$16,294.37

Hospital Charge Code	270647328C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$3,943.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,584.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE PRIME 2.5MMX38MM

Facility

$16,294.37

Hospital Charge Code	270647328C
Hospital Revenue Code	278
Min. Negotiated Rate	$392.69
Max. Negotiated Rate	$8,147.19
Rate for Payer: Aetna Commercial	$6,191.86
Rate for Payer: Aetna Medicare Advantage	$4,888.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,155.06
Rate for Payer: Cigna Commercial	$8,147.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,584.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16
Rate for Payer: UnitedHealthcare Community & State	$392.69
Rate for Payer: Wellpoint Medicaid Managed Care	$431.80

STENT XIENCE PRIME 2.5x28mm

Facility

$7,975.00

Hospital Charge Code	270647326
Hospital Revenue Code	278
Min. Negotiated Rate	$192.20
Max. Negotiated Rate	$3,987.50
Rate for Payer: Aetna Commercial	$3,030.50
Rate for Payer: Aetna Medicare Advantage	$2,392.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,033.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,033.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,033.62
Rate for Payer: Cigna Commercial	$3,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,754.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25
Rate for Payer: UnitedHealthcare Community & State	$192.20
Rate for Payer: Wellpoint Medicaid Managed Care	$211.34

STENT XIENCE PRIME 2.5x28mm

Facility

$7,975.00

Hospital Charge Code	270647326
Hospital Revenue Code	278
Min. Negotiated Rate	$1,196.25
Max. Negotiated Rate	$1,929.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,754.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25

STENT XIENCE PRIME 2.75*38MM

Facility

$16,294.37

Hospital Charge Code	270647331C
Hospital Revenue Code	278
Min. Negotiated Rate	$392.69
Max. Negotiated Rate	$8,147.19
Rate for Payer: Aetna Commercial	$6,191.86
Rate for Payer: Aetna Medicare Advantage	$4,888.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,155.06
Rate for Payer: Cigna Commercial	$8,147.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,584.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16
Rate for Payer: UnitedHealthcare Community & State	$392.69
Rate for Payer: Wellpoint Medicaid Managed Care	$431.80

STENT XIENCE PRIME 2.75*38MM

Facility

$16,294.37

Hospital Charge Code	270647331C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$3,943.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,584.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE PRIME 2.75MMX33MM

Facility

$16,294.37

Hospital Charge Code	270647330C
Hospital Revenue Code	278
Min. Negotiated Rate	$392.69
Max. Negotiated Rate	$8,147.19
Rate for Payer: Aetna Commercial	$6,191.86
Rate for Payer: Aetna Medicare Advantage	$4,888.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,155.06
Rate for Payer: Cigna Commercial	$8,147.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,584.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16
Rate for Payer: UnitedHealthcare Community & State	$392.69
Rate for Payer: Wellpoint Medicaid Managed Care	$431.80

STENT XIENCE PRIME 2.75MMX33MM

Facility

$16,294.37

Hospital Charge Code	270647330C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$3,943.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,584.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE PRIME 2.75x28mm

Facility

$7,975.00

Hospital Charge Code	270647329
Hospital Revenue Code	278
Min. Negotiated Rate	$1,196.25
Max. Negotiated Rate	$1,929.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,754.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25

STENT XIENCE PRIME 2.75x28mm

Facility

$7,975.00

Hospital Charge Code	270647329
Hospital Revenue Code	278
Min. Negotiated Rate	$192.20
Max. Negotiated Rate	$3,987.50
Rate for Payer: Aetna Commercial	$3,030.50
Rate for Payer: Aetna Medicare Advantage	$2,392.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,033.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,033.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,033.62
Rate for Payer: Cigna Commercial	$3,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,754.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25
Rate for Payer: UnitedHealthcare Community & State	$192.20
Rate for Payer: Wellpoint Medicaid Managed Care	$211.34

STENT XIENCE PRIME 3.0MMX33MM

Facility

$16,294.37

Hospital Charge Code	270647333C
Hospital Revenue Code	278
Min. Negotiated Rate	$392.69
Max. Negotiated Rate	$8,147.19
Rate for Payer: Aetna Commercial	$6,191.86
Rate for Payer: Aetna Medicare Advantage	$4,888.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,155.06
Rate for Payer: Cigna Commercial	$8,147.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,584.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16
Rate for Payer: UnitedHealthcare Community & State	$392.69
Rate for Payer: Wellpoint Medicaid Managed Care	$431.80

STENT XIENCE PRIME 3.0MMX33MM

Facility

$16,294.37

Hospital Charge Code	270647333C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$3,943.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,584.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

Know your out-of-pocket cost for care.

All Charges