Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STENT XPERT 4X20X135MM

Facility

$8,625.00

Hospital Charge Code	270644526C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,897.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 4X20X135MM

Facility

$8,625.00

Hospital Charge Code	270644526C
Hospital Revenue Code	278
Min. Negotiated Rate	$207.86
Max. Negotiated Rate	$4,312.50
Rate for Payer: Aetna Commercial	$3,277.50
Rate for Payer: Aetna Medicare Advantage	$2,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,199.38
Rate for Payer: Cigna Commercial	$4,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,897.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75
Rate for Payer: UnitedHealthcare Community & State	$207.86
Rate for Payer: Wellpoint Medicaid Managed Care	$228.56

STENT XPERT 4X40X135MM

Facility

$8,625.00

Hospital Charge Code	270644527C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,897.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 4X40X135MM

Facility

$8,625.00

Hospital Charge Code	270644527C
Hospital Revenue Code	278
Min. Negotiated Rate	$207.86
Max. Negotiated Rate	$4,312.50
Rate for Payer: Aetna Commercial	$3,277.50
Rate for Payer: Aetna Medicare Advantage	$2,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,199.38
Rate for Payer: Cigna Commercial	$4,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,897.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75
Rate for Payer: UnitedHealthcare Community & State	$207.86
Rate for Payer: Wellpoint Medicaid Managed Care	$228.56

STENT XPERT 4X60 82141-01

Facility

$8,625.00

Hospital Charge Code	270644131C
Hospital Revenue Code	278
Min. Negotiated Rate	$207.86
Max. Negotiated Rate	$4,312.50
Rate for Payer: Aetna Commercial	$3,277.50
Rate for Payer: Aetna Medicare Advantage	$2,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,199.38
Rate for Payer: Cigna Commercial	$4,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,897.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75
Rate for Payer: UnitedHealthcare Community & State	$207.86
Rate for Payer: Wellpoint Medicaid Managed Care	$228.56

STENT XPERT 4X60 82141-01

Facility

$8,625.00

Hospital Charge Code	270644131C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,897.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 5X40X120MM

Facility

$8,625.00

Hospital Charge Code	270644522C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,897.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 5X40X120MM

Facility

$8,625.00

Hospital Charge Code	270644522C
Hospital Revenue Code	278
Min. Negotiated Rate	$207.86
Max. Negotiated Rate	$4,312.50
Rate for Payer: Aetna Commercial	$3,277.50
Rate for Payer: Aetna Medicare Advantage	$2,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,199.38
Rate for Payer: Cigna Commercial	$4,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,897.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75
Rate for Payer: UnitedHealthcare Community & State	$207.86
Rate for Payer: Wellpoint Medicaid Managed Care	$228.56

STENT XPERT 5X60X120MM

Facility

$8,625.00

Hospital Charge Code	270644523C
Hospital Revenue Code	278
Min. Negotiated Rate	$207.86
Max. Negotiated Rate	$4,312.50
Rate for Payer: Aetna Commercial	$3,277.50
Rate for Payer: Aetna Medicare Advantage	$2,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,199.38
Rate for Payer: Cigna Commercial	$4,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,897.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75
Rate for Payer: UnitedHealthcare Community & State	$207.86
Rate for Payer: Wellpoint Medicaid Managed Care	$228.56

STENT XPERT 5X60X120MM

Facility

$8,625.00

Hospital Charge Code	270644523C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,897.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 6MM 40MM 1457801

Facility

$8,625.00

Hospital Charge Code	270635237C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,897.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 6MM 40MM 1457801

Facility

$8,625.00

Hospital Charge Code	270635237C
Hospital Revenue Code	278
Min. Negotiated Rate	$207.86
Max. Negotiated Rate	$4,312.50
Rate for Payer: Aetna Commercial	$3,277.50
Rate for Payer: Aetna Medicare Advantage	$2,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,199.38
Rate for Payer: Cigna Commercial	$4,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,897.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75
Rate for Payer: UnitedHealthcare Community & State	$207.86
Rate for Payer: Wellpoint Medicaid Managed Care	$228.56

STENT XPERT 6X60X120MM

Facility

$8,625.00

Hospital Charge Code	270644528C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,897.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 6X60X120MM

Facility

$8,625.00

Hospital Charge Code	270644528C
Hospital Revenue Code	278
Min. Negotiated Rate	$207.86
Max. Negotiated Rate	$4,312.50
Rate for Payer: Aetna Commercial	$3,277.50
Rate for Payer: Aetna Medicare Advantage	$2,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,199.38
Rate for Payer: Cigna Commercial	$4,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,897.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75
Rate for Payer: UnitedHealthcare Community & State	$207.86
Rate for Payer: Wellpoint Medicaid Managed Care	$228.56

STENT XPERT 8x60x120mm

Facility

$8,625.00

Hospital Charge Code	270644259
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,897.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 8x60x120mm

Facility

$8,625.00

Hospital Charge Code	270644259
Hospital Revenue Code	278
Min. Negotiated Rate	$207.86
Max. Negotiated Rate	$4,312.50
Rate for Payer: Aetna Commercial	$3,277.50
Rate for Payer: Aetna Medicare Advantage	$2,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,199.38
Rate for Payer: Cigna Commercial	$4,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,897.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75
Rate for Payer: UnitedHealthcare Community & State	$207.86
Rate for Payer: Wellpoint Medicaid Managed Care	$228.56

STENT XPERT 8X60X120MM

Facility

$8,625.00

Hospital Charge Code	270644529C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,897.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 8X60X120MM

Facility

$8,625.00

Hospital Charge Code	270644529C
Hospital Revenue Code	278
Min. Negotiated Rate	$207.86
Max. Negotiated Rate	$4,312.50
Rate for Payer: Aetna Commercial	$3,277.50
Rate for Payer: Aetna Medicare Advantage	$2,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,199.38
Rate for Payer: Cigna Commercial	$4,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,897.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75
Rate for Payer: UnitedHealthcare Community & State	$207.86
Rate for Payer: Wellpoint Medicaid Managed Care	$228.56

STENT ZILVER BILI 10x60 265218

Facility

$6,423.25

Hospital Charge Code	270631797V
Hospital Revenue Code	278
Min. Negotiated Rate	$154.80
Max. Negotiated Rate	$3,211.62
Rate for Payer: Aetna Commercial	$2,440.84
Rate for Payer: Aetna Medicare Advantage	$1,926.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,637.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,637.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,284.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,637.93
Rate for Payer: Cigna Commercial	$3,211.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,554.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,413.12
Rate for Payer: Qualcare PPO/HMO/WC	$963.49
Rate for Payer: UnitedHealthcare Community & State	$154.80
Rate for Payer: Wellpoint Medicaid Managed Care	$170.22

STENT ZILVER BILI 10x60 265218

Facility

$6,423.25

Hospital Charge Code	270631797
Hospital Revenue Code	278
Min. Negotiated Rate	$963.49
Max. Negotiated Rate	$1,554.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,284.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,554.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,413.12
Rate for Payer: Qualcare PPO/HMO/WC	$963.49

STENT ZILVER BILI 10x60 265218

Facility

$6,423.25

Hospital Charge Code	270631797V
Hospital Revenue Code	278
Min. Negotiated Rate	$963.49
Max. Negotiated Rate	$1,554.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,284.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,554.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,413.12
Rate for Payer: Qualcare PPO/HMO/WC	$963.49

STENT ZILVER BILI 10x60 265218

Facility

$6,423.25

Hospital Charge Code	270631797
Hospital Revenue Code	278
Min. Negotiated Rate	$154.80
Max. Negotiated Rate	$3,211.62
Rate for Payer: Aetna Commercial	$2,440.84
Rate for Payer: Aetna Medicare Advantage	$1,926.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,637.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,637.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,284.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,637.93
Rate for Payer: Cigna Commercial	$3,211.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,554.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,413.12
Rate for Payer: Qualcare PPO/HMO/WC	$963.49
Rate for Payer: UnitedHealthcare Community & State	$154.80
Rate for Payer: Wellpoint Medicaid Managed Care	$170.22

STENT ZILVER DES PTX 6MM X 140

Facility

$11,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270683859N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,796.25
Max. Negotiated Rate	$2,897.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,634.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25

STENT ZILVER DES PTX 6MM X 140

Facility

$11,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270683859
Hospital Revenue Code	278
Min. Negotiated Rate	$1,796.25
Max. Negotiated Rate	$2,897.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,634.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25

STENT ZILVER DES PTX 6MM X 140

Facility

$11,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270683859
Hospital Revenue Code	278
Min. Negotiated Rate	$288.60
Max. Negotiated Rate	$5,987.50
Rate for Payer: Aetna Commercial	$4,550.50
Rate for Payer: Aetna Medicare Advantage	$3,592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,053.62
Rate for Payer: Cigna Commercial	$5,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,634.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25
Rate for Payer: UnitedHealthcare Community & State	$288.60
Rate for Payer: Wellpoint Medicaid Managed Care	$317.34

Know your out-of-pocket cost for care.

All Charges