Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ELBOW TO FINGER SHORT ARM

Facility

$618.00

Service Code	HCPCS 29075
Hospital Charge Code	94186025
Hospital Revenue Code	361
Min. Negotiated Rate	$92.70
Max. Negotiated Rate	$92.70
Rate for Payer: Qualcare PPO/HMO/WC	$92.70

ELBOW TO FINGER SHORT ARM

Facility

$618.00

Service Code	HCPCS 29075
Hospital Charge Code	94186025
Hospital Revenue Code	361
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$903.80
Rate for Payer: Aetna Medicare Advantage	$1,076.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,199.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,199.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$332.28
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	$1,199.43
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: Cigna Medicare Advantage	$332.28
Rate for Payer: Clover Medicare Advantage	$315.67
Rate for Payer: EmblemHealth Commercial	$996.84
Rate for Payer: Humana Medicare Advantage	$342.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$332.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.40
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.70
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$14.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$332.28
Rate for Payer: Wellcare Medicare Advantage	$332.28
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,472.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1,443.93

ELBOW - TWO VIEWS-BIL

Facility

$5,100.00

Service Code	HCPCS 7307050
Hospital Charge Code	94061219
Hospital Revenue Code	320
Min. Negotiated Rate	$122.91
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

ELBOW - TWO VIEWS-BIL

Facility

$5,100.00

Service Code	HCPCS 7307050
Hospital Charge Code	94061219
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ELBOW - TWO VIEWS-LT

Facility

$5,100.00

Service Code	HCPCS 73070LT
Hospital Charge Code	94061297
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ELBOW - TWO VIEWS-LT

Facility

$5,100.00

Service Code	HCPCS 73070LT
Hospital Charge Code	94061297
Hospital Revenue Code	320
Min. Negotiated Rate	$122.91
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

ELBOW - TWO VIEWS-RT

Facility

$5,100.00

Service Code	HCPCS 73070RT
Hospital Charge Code	94061299
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ELBOW - TWO VIEWS-RT

Facility

$5,100.00

Service Code	HCPCS 73070RT
Hospital Charge Code	94061299
Hospital Revenue Code	320
Min. Negotiated Rate	$122.91
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

ELBOW VENT W/SUNCTION PORT RT

Facility

$2.26

Hospital Charge Code	270643699
Hospital Revenue Code	270
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$0.34
Rate for Payer: Qualcare PPO/HMO/WC	$0.34

ELBOW VENT W/SUNCTION PORT RT

Facility

$2.26

Hospital Charge Code	270643699
Hospital Revenue Code	270
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$1.13
Rate for Payer: Aetna Commercial	$0.86
Rate for Payer: Aetna Medicare Advantage	$0.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.58
Rate for Payer: Cigna Commercial	$1.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.68
Rate for Payer: Oxford Commercial	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.34
Rate for Payer: UnitedHealthcare Commercial	$0.45
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

ELDEPRYL/5MG/TAB

Facility

$15.00

Hospital Charge Code	60632930
Hospital Revenue Code	250
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$5.70
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.50
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$3.00
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

ELDEPRYL/5MG/TAB

Facility

$15.00

Hospital Charge Code	60632930
Hospital Revenue Code	250
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

ELECRODE PAIRED 4 CHANNEL SET

Facility

$910.00

Hospital Charge Code	270690260
Hospital Revenue Code	272
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$136.50
Rate for Payer: Qualcare PPO/HMO/WC	$136.50

ELECRODE PAIRED 4 CHANNEL SET

Facility

$910.00

Hospital Charge Code	270690260
Hospital Revenue Code	272
Min. Negotiated Rate	$21.93
Max. Negotiated Rate	$455.00
Rate for Payer: Aetna Commercial	$345.80
Rate for Payer: Aetna Medicare Advantage	$273.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.05
Rate for Payer: Cigna Commercial	$455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$273.00
Rate for Payer: Oxford Commercial	$182.00
Rate for Payer: Qualcare PPO/HMO/WC	$136.50
Rate for Payer: UnitedHealthcare Commercial	$182.00
Rate for Payer: UnitedHealthcare Community & State	$21.93
Rate for Payer: Wellpoint Medicaid Managed Care	$24.11

ELECTIVE HIP JOINT REPLACEMENT

Facility

$19,956.23

Service Code	APR-DRG 3242
Min. Negotiated Rate	$19,564.93
Max. Negotiated Rate	$19,956.23
Rate for Payer: UnitedHealthcare Community & State	$19,564.93
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,956.23
Rate for Payer: Wellpoint Medicaid Managed Care	$19,564.93

ELECTIVE HIP JOINT REPLACEMENT

Facility

$18,315.67

Service Code	APR-DRG 3241
Min. Negotiated Rate	$17,956.54
Max. Negotiated Rate	$18,315.67
Rate for Payer: UnitedHealthcare Community & State	$17,956.54
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,315.67
Rate for Payer: Wellpoint Medicaid Managed Care	$17,956.54

ELECTIVE HIP JOINT REPLACEMENT

Facility

$27,385.39

Service Code	APR-DRG 3243
Min. Negotiated Rate	$26,848.42
Max. Negotiated Rate	$27,385.39
Rate for Payer: UnitedHealthcare Community & State	$26,848.42
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27,385.39
Rate for Payer: Wellpoint Medicaid Managed Care	$26,848.42

ELECTIVE HIP JOINT REPLACEMENT

Facility

$43,598.38

Service Code	APR-DRG 3244
Min. Negotiated Rate	$42,743.51
Max. Negotiated Rate	$43,598.38
Rate for Payer: UnitedHealthcare Community & State	$42,743.51
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$43,598.38
Rate for Payer: Wellpoint Medicaid Managed Care	$42,743.51

ELECTIVE KNEE JOINT REPLACEMENT

Facility

$37,595.29

Service Code	APR-DRG 3264
Min. Negotiated Rate	$36,858.13
Max. Negotiated Rate	$37,595.29
Rate for Payer: UnitedHealthcare Community & State	$36,858.13
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$37,595.29
Rate for Payer: Wellpoint Medicaid Managed Care	$36,858.13

ELECTIVE KNEE JOINT REPLACEMENT

Facility

$18,228.85

Service Code	APR-DRG 3261
Min. Negotiated Rate	$17,871.42
Max. Negotiated Rate	$18,228.85
Rate for Payer: UnitedHealthcare Community & State	$17,871.42
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,228.85
Rate for Payer: Wellpoint Medicaid Managed Care	$17,871.42

ELECTIVE KNEE JOINT REPLACEMENT

Facility

$27,573.07

Service Code	APR-DRG 3263
Min. Negotiated Rate	$27,032.42
Max. Negotiated Rate	$27,573.07
Rate for Payer: UnitedHealthcare Community & State	$27,032.42
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27,573.07
Rate for Payer: Wellpoint Medicaid Managed Care	$27,032.42

ELECTIVE KNEE JOINT REPLACEMENT

Facility

$19,251.50

Service Code	APR-DRG 3262
Min. Negotiated Rate	$18,874.02
Max. Negotiated Rate	$19,251.50
Rate for Payer: UnitedHealthcare Community & State	$18,874.02
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,251.50
Rate for Payer: Wellpoint Medicaid Managed Care	$18,874.02

ELECTODE 22FR 25 DEG CUT LOOP

Facility

$560.00

Hospital Charge Code	270678698
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$212.80
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.00
Rate for Payer: Oxford Commercial	$112.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Commercial	$112.00
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: Wellpoint Medicaid Managed Care	$14.84

ELECTODE 22FR 25 DEG CUT LOOP

Facility

$560.00

Hospital Charge Code	270678698
Hospital Revenue Code	272
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$84.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

ELECTODE 22FR ANGLED CUTTING

Facility

$560.00

Hospital Charge Code	270678697
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$212.80
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.00
Rate for Payer: Oxford Commercial	$112.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Commercial	$112.00
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: Wellpoint Medicaid Managed Care	$14.84

Know your out-of-pocket cost for care.

All Charges