Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CORONARY SVG ANGIO ONLY

Facility

$12,026.00

Service Code	HCPCS 93455
Hospital Charge Code	7411225
Hospital Revenue Code	481
Min. Negotiated Rate	$289.83
Max. Negotiated Rate	$13,902.76
Rate for Payer: Aetna Commercial	$10,476.08
Rate for Payer: Aetna Medicare Advantage	$12,478.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,851.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,902.76
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: Cigna Medicare Advantage	$3,851.50
Rate for Payer: Clover Medicare Advantage	$3,658.93
Rate for Payer: EmblemHealth Commercial	$11,554.50
Rate for Payer: Humana Medicare Advantage	$3,967.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,851.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,607.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,803.90
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$289.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,851.50
Rate for Payer: Wellcare Medicare Advantage	$3,851.50
Rate for Payer: Wellpoint Medicaid Managed Care	$318.69

CORONARY SVG ANGIO ONLY

Facility

$12,026.00

Service Code	HCPCS 93455
Hospital Charge Code	7411225
Hospital Revenue Code	481
Min. Negotiated Rate	$1,803.90
Max. Negotiated Rate	$1,803.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,803.90

CORPECTOMY CAGE 12X14X28MM 6D

Facility

$39,975.00

Service Code	HCPCS C1776
Hospital Charge Code	270695757
Hospital Revenue Code	278
Min. Negotiated Rate	$963.40
Max. Negotiated Rate	$19,987.50
Rate for Payer: Aetna Commercial	$15,190.50
Rate for Payer: Aetna Medicare Advantage	$11,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,193.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,193.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,193.62
Rate for Payer: Cigna Commercial	$19,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,673.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,794.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,996.25
Rate for Payer: UnitedHealthcare Community & State	$963.40
Rate for Payer: Wellpoint Medicaid Managed Care	$1,059.34

CORPECTOMY CAGE 12X14X28MM 6D

Facility

$39,975.00

Service Code	HCPCS C1776
Hospital Charge Code	270695757
Hospital Revenue Code	278
Min. Negotiated Rate	$5,996.25
Max. Negotiated Rate	$9,673.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,673.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,794.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,996.25

CORPECTOMY MATRIXX 15X23MM 12D

Facility

$39,975.00

Service Code	HCPCS C1889
Hospital Charge Code	270694188
Hospital Revenue Code	278
Min. Negotiated Rate	$5,996.25
Max. Negotiated Rate	$9,673.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,673.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,794.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,996.25

CORPECTOMY MATRIXX 15X23MM 12D

Facility

$39,975.00

Service Code	HCPCS C1889
Hospital Charge Code	270694188
Hospital Revenue Code	278
Min. Negotiated Rate	$963.40
Max. Negotiated Rate	$19,987.50
Rate for Payer: Aetna Commercial	$15,190.50
Rate for Payer: Aetna Medicare Advantage	$11,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,193.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,193.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,193.62
Rate for Payer: Cigna Commercial	$19,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,673.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,794.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,996.25
Rate for Payer: UnitedHealthcare Community & State	$963.40
Rate for Payer: Wellpoint Medicaid Managed Care	$1,059.34

CORRECTION HALLUX VALGUS

Facility

$12,289.64

Service Code	HCPCS 28295
Hospital Charge Code	16000482
Hospital Revenue Code	360
Min. Negotiated Rate	$1,843.45
Max. Negotiated Rate	$1,843.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,843.45

CORRECTION HALLUX VALGUS

Facility

$12,289.64

Service Code	HCPCS 28295
Hospital Charge Code	16000482
Hospital Revenue Code	360
Min. Negotiated Rate	$296.18
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
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	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,686.89
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,843.45
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$296.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$325.68

CORRECTION OF BUNION-LT

Facility

$46,489.60

Service Code	HCPCS 28298
Hospital Charge Code	16000365
Hospital Revenue Code	360
Min. Negotiated Rate	$1,120.40
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,946.88
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,973.44
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$1,120.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1,231.97

CORRECTION OF BUNION-LT

Facility

$46,489.60

Service Code	HCPCS 28298
Hospital Charge Code	16000365
Hospital Revenue Code	360
Min. Negotiated Rate	$6,973.44
Max. Negotiated Rate	$6,973.44
Rate for Payer: Qualcare PPO/HMO/WC	$6,973.44

CORRECTION OF BUNION RT

Facility

$46,489.60

Service Code	HCPCS 28297
Hospital Charge Code	16000244
Hospital Revenue Code	360
Min. Negotiated Rate	$6,973.44
Max. Negotiated Rate	$6,973.44
Rate for Payer: Qualcare PPO/HMO/WC	$6,973.44

CORRECTION OF BUNION RT

Facility

$46,489.60

Service Code	HCPCS 28297
Hospital Charge Code	16000244
Hospital Revenue Code	360
Min. Negotiated Rate	$1,120.40
Max. Negotiated Rate	$55,057.64
Rate for Payer: Aetna Commercial	$41,487.32
Rate for Payer: Aetna Medicare Advantage	$49,418.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55,057.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55,057.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,252.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55,057.64
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: Cigna Medicare Advantage	$15,252.69
Rate for Payer: Clover Medicare Advantage	$14,490.06
Rate for Payer: EmblemHealth Commercial	$45,758.07
Rate for Payer: Humana Medicare Advantage	$15,710.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,252.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,946.88
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,973.44
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$1,120.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,252.69
Rate for Payer: Wellcare Medicare Advantage	$15,252.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1,231.97

CORSET LUMBAR

Facility

$224.95

Hospital Charge Code	270647303
Hospital Revenue Code	271
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.47
Rate for Payer: Aetna Commercial	$85.48
Rate for Payer: Aetna Medicare Advantage	$67.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.36
Rate for Payer: Cigna Commercial	$112.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.48
Rate for Payer: Oxford Commercial	$44.99
Rate for Payer: Qualcare PPO/HMO/WC	$33.74
Rate for Payer: UnitedHealthcare Commercial	$44.99
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

CORSET LUMBAR

Facility

$224.95

Hospital Charge Code	270647303
Hospital Revenue Code	271
Min. Negotiated Rate	$33.74
Max. Negotiated Rate	$33.74
Rate for Payer: Qualcare PPO/HMO/WC	$33.74

CORSET LUMBAR CUSTOM

Facility

$550.45

Hospital Charge Code	270612782
Hospital Revenue Code	274
Min. Negotiated Rate	$13.27
Max. Negotiated Rate	$275.23
Rate for Payer: Aetna Commercial	$209.17
Rate for Payer: Aetna Medicare Advantage	$165.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.36
Rate for Payer: Cigna Commercial	$275.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.57
Rate for Payer: UnitedHealthcare Community & State	$13.27
Rate for Payer: Wellpoint Medicaid Managed Care	$14.59

CORSET LUMBAR CUSTOM

Facility

$550.45

Hospital Charge Code	270612782
Hospital Revenue Code	274
Min. Negotiated Rate	$82.57
Max. Negotiated Rate	$133.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.57

CORSET STEEL

Facility

$490.00

Hospital Charge Code	270645189
Hospital Revenue Code	271
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$73.50
Rate for Payer: Qualcare PPO/HMO/WC	$73.50

CORSET STEEL

Facility

$490.00

Hospital Charge Code	270645189
Hospital Revenue Code	271
Min. Negotiated Rate	$11.81
Max. Negotiated Rate	$245.00
Rate for Payer: Aetna Commercial	$186.20
Rate for Payer: Aetna Medicare Advantage	$147.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.95
Rate for Payer: Cigna Commercial	$245.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.00
Rate for Payer: Oxford Commercial	$98.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.50
Rate for Payer: UnitedHealthcare Commercial	$98.00
Rate for Payer: UnitedHealthcare Community & State	$11.81
Rate for Payer: Wellpoint Medicaid Managed Care	$12.98

CORSET XL 4S

Facility

$199.95

Hospital Charge Code	270648112
Hospital Revenue Code	271
Min. Negotiated Rate	$29.99
Max. Negotiated Rate	$29.99
Rate for Payer: Qualcare PPO/HMO/WC	$29.99

CORSET XL 4S

Facility

$199.95

Hospital Charge Code	270648112
Hospital Revenue Code	271
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$99.97
Rate for Payer: Aetna Commercial	$75.98
Rate for Payer: Aetna Medicare Advantage	$59.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.99
Rate for Payer: Cigna Commercial	$99.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.98
Rate for Payer: Oxford Commercial	$39.99
Rate for Payer: Qualcare PPO/HMO/WC	$29.99
Rate for Payer: UnitedHealthcare Commercial	$39.99
Rate for Payer: UnitedHealthcare Community & State	$4.82
Rate for Payer: Wellpoint Medicaid Managed Care	$5.30

CORT ALLOGRAFT 2 PK FC-0100-2

Facility

$19,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270691879
Hospital Revenue Code	278
Min. Negotiated Rate	$475.98
Max. Negotiated Rate	$9,875.00
Rate for Payer: Aetna Commercial	$7,505.00
Rate for Payer: Aetna Medicare Advantage	$5,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,036.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,036.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,036.25
Rate for Payer: Cigna Commercial	$9,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,779.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,345.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,962.50
Rate for Payer: UnitedHealthcare Community & State	$475.98
Rate for Payer: Wellpoint Medicaid Managed Care	$523.38

CORT ALLOGRAFT 2 PK FC-0100-2

Facility

$19,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270691879
Hospital Revenue Code	278
Min. Negotiated Rate	$2,962.50
Max. Negotiated Rate	$4,779.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,779.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,345.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,962.50

CORT ALLOGRAFT EA FC-0100-1

Facility

$9,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270693877
Hospital Revenue Code	278
Min. Negotiated Rate	$237.99
Max. Negotiated Rate	$4,937.50
Rate for Payer: Aetna Commercial	$3,752.50
Rate for Payer: Aetna Medicare Advantage	$2,962.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,518.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,518.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,518.12
Rate for Payer: Cigna Commercial	$4,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,389.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,172.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,481.25
Rate for Payer: UnitedHealthcare Community & State	$237.99
Rate for Payer: Wellpoint Medicaid Managed Care	$261.69

CORT ALLOGRAFT EA FC-0100-1

Facility

$9,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270693877
Hospital Revenue Code	278
Min. Negotiated Rate	$1,481.25
Max. Negotiated Rate	$2,389.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,389.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,172.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,481.25

CORTEX SCREW 2.4X18MM

Facility

$568.40

Service Code	HCPCS C1713
Hospital Charge Code	270704716
Hospital Revenue Code	278
Min. Negotiated Rate	$85.26
Max. Negotiated Rate	$137.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.05
Rate for Payer: Qualcare PPO/HMO/WC	$85.26

Know your out-of-pocket cost for care.

All Charges