Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TRANSCATH OCCLUSION NON-CNS

Facility

$61,616.39

Service Code	HCPCS 61626
Hospital Charge Code	411061626
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

TRANSCATH OCCLUSION NON-CNS

Facility

$61,616.39

Service Code	HCPCS 61626
Hospital Charge Code	411061626
Hospital Revenue Code	361
Min. Negotiated Rate	$1,484.95
Max. Negotiated Rate	$49,506.31
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49,506.31
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18,484.92
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,484.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1,632.83

TRANSCATH OCCLUSION NON-CNS

Facility

$61,616.39

Service Code	HCPCS 61626
Hospital Charge Code	366861626
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

TRANSCATH OCCLUSION NON-CNS

Facility

$61,616.39

Service Code	HCPCS 61626
Hospital Charge Code	366861626
Hospital Revenue Code	361
Min. Negotiated Rate	$1,484.95
Max. Negotiated Rate	$49,506.31
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49,506.31
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18,484.92
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,484.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1,632.83

TRANSCATH OCCULSION

Facility

$26,293.00

Hospital Charge Code	7411131
Hospital Revenue Code	361
Min. Negotiated Rate	$3,943.95
Max. Negotiated Rate	$3,943.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,943.95

TRANSCATH OCCULSION

Facility

$26,293.00

Hospital Charge Code	7411131
Hospital Revenue Code	361
Min. Negotiated Rate	$633.66
Max. Negotiated Rate	$13,146.50
Rate for Payer: Aetna Commercial	$9,991.34
Rate for Payer: Aetna Medicare Advantage	$7,887.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,704.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,704.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,704.72
Rate for Payer: Cigna Commercial	$13,146.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,887.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,943.95
Rate for Payer: UnitedHealthcare Community & State	$633.66
Rate for Payer: Wellpoint Medicaid Managed Care	$696.76

TRANSCATH STENT CCA W/EPS

Facility

$25,076.30

Service Code	HCPCS 37215
Hospital Charge Code	366837215
Hospital Revenue Code	361
Min. Negotiated Rate	$3,761.45
Max. Negotiated Rate	$3,761.45
Rate for Payer: Qualcare PPO/HMO/WC	$3,761.45

TRANSCATH STENT CCA W/EPS

Facility

$25,076.30

Service Code	HCPCS 37215
Hospital Charge Code	366837215
Hospital Revenue Code	361
Min. Negotiated Rate	$604.34
Max. Negotiated Rate	$12,538.15
Rate for Payer: Aetna Commercial	$9,528.99
Rate for Payer: Aetna Medicare Advantage	$7,522.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,394.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,394.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,394.46
Rate for Payer: Cigna Commercial	$12,538.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,522.89
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,761.45
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$604.34
Rate for Payer: Wellpoint Medicaid Managed Care	$664.52

TRANSCATH THERAPY

Facility

$4,582.00

Service Code	HCPCS 37201
Hospital Charge Code	7411129
Hospital Revenue Code	361
Min. Negotiated Rate	$687.30
Max. Negotiated Rate	$687.30
Rate for Payer: Qualcare PPO/HMO/WC	$687.30

TRANSCATH THERAPY

Facility

$4,582.00

Hospital Charge Code	5790110
Hospital Revenue Code	450
Min. Negotiated Rate	$121.42
Max. Negotiated Rate	$2,291.00
Rate for Payer: Aetna Commercial	$1,741.16
Rate for Payer: Aetna Medicare Advantage	$1,374.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,168.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,168.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,168.41
Rate for Payer: Cigna Commercial	$2,291.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,374.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$687.30
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$121.42

TRANSCATH THERAPY

Facility

$4,582.00

Hospital Charge Code	5790110
Hospital Revenue Code	450
Min. Negotiated Rate	$687.30
Max. Negotiated Rate	$687.30
Rate for Payer: Qualcare PPO/HMO/WC	$687.30

TRANSCATH THERAPY

Facility

$4,582.00

Service Code	HCPCS 37201
Hospital Charge Code	7411129
Hospital Revenue Code	361
Min. Negotiated Rate	$110.43
Max. Negotiated Rate	$2,291.00
Rate for Payer: Aetna Commercial	$1,741.16
Rate for Payer: Aetna Medicare Advantage	$1,374.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,168.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,168.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,168.41
Rate for Payer: Cigna Commercial	$2,291.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,374.60
Rate for Payer: Qualcare PPO/HMO/WC	$687.30
Rate for Payer: UnitedHealthcare Community & State	$110.43
Rate for Payer: Wellpoint Medicaid Managed Care	$121.42

TRANSCATH THERAPY INFUSION***

Facility

$1,713.00

Service Code	HCPCS 75896
Hospital Charge Code	5100552
Hospital Revenue Code	320
Min. Negotiated Rate	$256.95
Max. Negotiated Rate	$256.95
Rate for Payer: Qualcare PPO/HMO/WC	$256.95

TRANSCATH THERAPY INFUSION***

Facility

$1,713.00

Service Code	HCPCS 75896
Hospital Charge Code	5100552
Hospital Revenue Code	320
Min. Negotiated Rate	$41.28
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$650.94
Rate for Payer: Aetna Medicare Advantage	$513.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$436.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$436.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$436.81
Rate for Payer: Cigna Commercial	$856.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$513.90
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$256.95
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$41.28
Rate for Payer: Wellpoint Medicaid Managed Care	$45.39

TRANSCAT PLACE PRPH STENT OPEN

Facility

$41,896.20

Hospital Charge Code	5100337
Hospital Revenue Code	361
Min. Negotiated Rate	$1,009.70
Max. Negotiated Rate	$20,948.10
Rate for Payer: Aetna Commercial	$15,920.56
Rate for Payer: Aetna Medicare Advantage	$12,568.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,683.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,683.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,683.53
Rate for Payer: Cigna Commercial	$20,948.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,568.86
Rate for Payer: Qualcare PPO/HMO/WC	$6,284.43
Rate for Payer: UnitedHealthcare Community & State	$1,009.70
Rate for Payer: Wellpoint Medicaid Managed Care	$1,110.25

TRANSCAT PLACE PRPH STENT OPEN

Facility

$41,896.20

Hospital Charge Code	74110041
Hospital Revenue Code	361
Min. Negotiated Rate	$6,284.43
Max. Negotiated Rate	$6,284.43
Rate for Payer: Qualcare PPO/HMO/WC	$6,284.43

TRANSCAT PLACE PRPH STENT OPEN

Facility

$41,896.20

Hospital Charge Code	74110041
Hospital Revenue Code	361
Min. Negotiated Rate	$1,009.70
Max. Negotiated Rate	$20,948.10
Rate for Payer: Aetna Commercial	$15,920.56
Rate for Payer: Aetna Medicare Advantage	$12,568.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,683.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,683.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,683.53
Rate for Payer: Cigna Commercial	$20,948.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,568.86
Rate for Payer: Qualcare PPO/HMO/WC	$6,284.43
Rate for Payer: UnitedHealthcare Community & State	$1,009.70
Rate for Payer: Wellpoint Medicaid Managed Care	$1,110.25

TRANSCAT PLACE PRPH STENT OPEN

Facility

$41,896.20

Hospital Charge Code	5100337
Hospital Revenue Code	361
Min. Negotiated Rate	$6,284.43
Max. Negotiated Rate	$6,284.43
Rate for Payer: Qualcare PPO/HMO/WC	$6,284.43

TRANSCAT PLACE STENT EA ADDL

Facility

$41,896.20

Service Code	HCPCS 37237
Hospital Charge Code	5100336
Hospital Revenue Code	361
Min. Negotiated Rate	$6,284.43
Max. Negotiated Rate	$6,284.43
Rate for Payer: Qualcare PPO/HMO/WC	$6,284.43

TRANSCAT PLACE STENT EA ADDL

Facility

$41,896.20

Service Code	HCPCS 37237
Hospital Charge Code	5100336
Hospital Revenue Code	361
Min. Negotiated Rate	$1,009.70
Max. Negotiated Rate	$20,948.10
Rate for Payer: Aetna Commercial	$15,920.56
Rate for Payer: Aetna Medicare Advantage	$12,568.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,683.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,683.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,683.53
Rate for Payer: Cigna Commercial	$20,948.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,568.86
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,284.43
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,009.70
Rate for Payer: Wellpoint Medicaid Managed Care	$1,110.25

TRANSCAT PLACE STENT EA ADDL

Facility

$41,896.20

Service Code	HCPCS 37237
Hospital Charge Code	74110040
Hospital Revenue Code	361
Min. Negotiated Rate	$1,009.70
Max. Negotiated Rate	$20,948.10
Rate for Payer: Aetna Commercial	$15,920.56
Rate for Payer: Aetna Medicare Advantage	$12,568.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,683.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,683.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,683.53
Rate for Payer: Cigna Commercial	$20,948.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,568.86
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,284.43
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,009.70
Rate for Payer: Wellpoint Medicaid Managed Care	$1,110.25

TRANSCAT PLACE STENT EA ADDL

Facility

$41,896.20

Service Code	HCPCS 37237
Hospital Charge Code	74110040
Hospital Revenue Code	361
Min. Negotiated Rate	$6,284.43
Max. Negotiated Rate	$6,284.43
Rate for Payer: Qualcare PPO/HMO/WC	$6,284.43

TRANSCAT PLACE STENT OPEN ADDL

Facility

$41,896.20

Hospital Charge Code	5100338
Hospital Revenue Code	361
Min. Negotiated Rate	$6,284.43
Max. Negotiated Rate	$6,284.43
Rate for Payer: Qualcare PPO/HMO/WC	$6,284.43

TRANSCAT PLACE STENT OPEN ADDL

Facility

$41,896.20

Hospital Charge Code	74110042
Hospital Revenue Code	361
Min. Negotiated Rate	$1,009.70
Max. Negotiated Rate	$20,948.10
Rate for Payer: Aetna Commercial	$15,920.56
Rate for Payer: Aetna Medicare Advantage	$12,568.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,683.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,683.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,683.53
Rate for Payer: Cigna Commercial	$20,948.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,568.86
Rate for Payer: Qualcare PPO/HMO/WC	$6,284.43
Rate for Payer: UnitedHealthcare Community & State	$1,009.70
Rate for Payer: Wellpoint Medicaid Managed Care	$1,110.25

TRANSCAT PLACE STENT OPEN ADDL

Facility

$41,896.20

Hospital Charge Code	5100338
Hospital Revenue Code	361
Min. Negotiated Rate	$1,009.70
Max. Negotiated Rate	$20,948.10
Rate for Payer: Aetna Commercial	$15,920.56
Rate for Payer: Aetna Medicare Advantage	$12,568.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,683.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,683.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,683.53
Rate for Payer: Cigna Commercial	$20,948.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,568.86
Rate for Payer: Qualcare PPO/HMO/WC	$6,284.43
Rate for Payer: UnitedHealthcare Community & State	$1,009.70
Rate for Payer: Wellpoint Medicaid Managed Care	$1,110.25

Know your out-of-pocket cost for care.

All Charges