Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ER CLOSED TX POST ANTH DISWOAN

Facility

$2,006.25

Service Code	HCPCS 27265
Hospital Charge Code	5700485
Hospital Revenue Code	450
Min. Negotiated Rate	$300.94
Max. Negotiated Rate	$300.94
Rate for Payer: Qualcare PPO/HMO/WC	$300.94

ER-CLOSED TX RADIUS FX-BI

Facility

$1,791.00

Hospital Charge Code	5790420
Hospital Revenue Code	450
Min. Negotiated Rate	$47.46
Max. Negotiated Rate	$895.50
Rate for Payer: Aetna Commercial	$680.58
Rate for Payer: Aetna Medicare Advantage	$537.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$456.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$456.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$456.70
Rate for Payer: Cigna Commercial	$895.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$537.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$268.65
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$47.46

ER-CLOSED TX RADIUS FX-BI

Facility

$1,791.00

Hospital Charge Code	5790420
Hospital Revenue Code	450
Min. Negotiated Rate	$268.65
Max. Negotiated Rate	$268.65
Rate for Payer: Qualcare PPO/HMO/WC	$268.65

ER CLOSED VERTEBRAL PROCESS FX

Facility

$563.75

Service Code	HCPCS 22305
Hospital Charge Code	5700553
Hospital Revenue Code	450
Min. Negotiated Rate	$84.56
Max. Negotiated Rate	$84.56
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CLOSED VERTEBRAL PROCESS FX

Facility

$563.75

Service Code	HCPCS 22305
Hospital Charge Code	5700553
Hospital Revenue Code	450
Min. Negotiated Rate	$14.94
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$214.22
Rate for Payer: Aetna Medicare Advantage	$169.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.76
Rate for Payer: Cigna Commercial	$281.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.56
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$14.94

ER-CLOS TX COND HUM FX-BI

Facility

$466.00

Hospital Charge Code	5790390
Hospital Revenue Code	450
Min. Negotiated Rate	$12.35
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$177.08
Rate for Payer: Aetna Medicare Advantage	$139.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.83
Rate for Payer: Cigna Commercial	$233.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.90
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$12.35

ER-CLOS TX COND HUM FX-BI

Facility

$466.00

Hospital Charge Code	5790390
Hospital Revenue Code	450
Min. Negotiated Rate	$69.90
Max. Negotiated Rate	$69.90
Rate for Payer: Qualcare PPO/HMO/WC	$69.90

ER-CLOS TX LAT MALL FX-BI

Facility

$466.00

Hospital Charge Code	5790595
Hospital Revenue Code	450
Min. Negotiated Rate	$69.90
Max. Negotiated Rate	$69.90
Rate for Payer: Qualcare PPO/HMO/WC	$69.90

ER-CLOS TX LAT MALL FX-BI

Facility

$466.00

Hospital Charge Code	5790595
Hospital Revenue Code	450
Min. Negotiated Rate	$12.35
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$177.08
Rate for Payer: Aetna Medicare Advantage	$139.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.83
Rate for Payer: Cigna Commercial	$233.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.90
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$12.35

ER-CLO TX FEM SHAFT FX-BI

Facility

$6,028.00

Hospital Charge Code	5790560
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$3,014.00
Rate for Payer: Aetna Commercial	$2,290.64
Rate for Payer: Aetna Medicare Advantage	$1,808.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,537.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,537.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,537.14
Rate for Payer: Cigna Commercial	$3,014.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$904.20
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$159.74

ER-CLO TX FEM SHAFT FX-BI

Facility

$6,028.00

Hospital Charge Code	5790560
Hospital Revenue Code	450
Min. Negotiated Rate	$904.20
Max. Negotiated Rate	$904.20
Rate for Payer: Qualcare PPO/HMO/WC	$904.20

ER CLSD DIST FING FX W/MAN EAC

Facility

$563.75

Service Code	HCPCS 26750
Hospital Charge Code	5700583
Hospital Revenue Code	450
Min. Negotiated Rate	$14.94
Max. Negotiated Rate	$1,057.82
Rate for Payer: Aetna Commercial	$797.10
Rate for Payer: Aetna Medicare Advantage	$949.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,057.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,057.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$293.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,057.82
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: Cigna Medicare Advantage	$293.05
Rate for Payer: Clover Medicare Advantage	$278.40
Rate for Payer: EmblemHealth Commercial	$879.15
Rate for Payer: Humana Medicare Advantage	$301.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$293.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.56
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$293.05
Rate for Payer: Wellcare Medicare Advantage	$293.05
Rate for Payer: Wellpoint Medicaid Managed Care	$14.94

ER CLSD DIST FING FX W/MAN EAC

Facility

$563.75

Service Code	HCPCS 26750
Hospital Charge Code	5700583
Hospital Revenue Code	450
Min. Negotiated Rate	$84.56
Max. Negotiated Rate	$84.56
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CLSD DIST RADIOULNA DIS W/M

Facility

$1,363.55

Service Code	HCPCS 25675
Hospital Charge Code	5700821
Hospital Revenue Code	450
Min. Negotiated Rate	$36.13
Max. Negotiated Rate	$1,057.82
Rate for Payer: Aetna Commercial	$797.10
Rate for Payer: Aetna Medicare Advantage	$949.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,057.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,057.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$293.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,057.82
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: Cigna Medicare Advantage	$293.05
Rate for Payer: Clover Medicare Advantage	$278.40
Rate for Payer: EmblemHealth Commercial	$879.15
Rate for Payer: Humana Medicare Advantage	$301.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$293.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$409.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$204.53
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$293.05
Rate for Payer: Wellcare Medicare Advantage	$293.05
Rate for Payer: Wellpoint Medicaid Managed Care	$36.13

ER CLSD DIST RADIOULNA DIS W/M

Facility

$1,363.55

Service Code	HCPCS 25675
Hospital Charge Code	5700821
Hospital Revenue Code	450
Min. Negotiated Rate	$204.53
Max. Negotiated Rate	$204.53
Rate for Payer: Qualcare PPO/HMO/WC	$204.53

ER CLSD FEMOR NCK FX W/O MAN

Facility

$906.60

Service Code	HCPCS 27230
Hospital Charge Code	5700755
Hospital Revenue Code	450
Min. Negotiated Rate	$24.02
Max. Negotiated Rate	$1,057.82
Rate for Payer: Aetna Commercial	$797.10
Rate for Payer: Aetna Medicare Advantage	$949.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,057.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,057.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$293.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$387.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,057.82
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: Cigna Medicare Advantage	$293.05
Rate for Payer: Clover Medicare Advantage	$278.40
Rate for Payer: EmblemHealth Commercial	$879.15
Rate for Payer: Humana Medicare Advantage	$301.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$293.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.99
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$293.05
Rate for Payer: Wellcare Medicare Advantage	$293.05
Rate for Payer: Wellpoint Medicaid Managed Care	$24.02

ER CLSD FEMOR NCK FX W/O MAN

Facility

$906.60

Service Code	HCPCS 27230
Hospital Charge Code	5700755
Hospital Revenue Code	450
Min. Negotiated Rate	$135.99
Max. Negotiated Rate	$135.99
Rate for Payer: Qualcare PPO/HMO/WC	$135.99

ER CLSD GREAT TROCHNTER W/O MA

Facility

$2,622.50

Service Code	HCPCS 27246
Hospital Charge Code	5700757
Hospital Revenue Code	450
Min. Negotiated Rate	$393.38
Max. Negotiated Rate	$393.38
Rate for Payer: Qualcare PPO/HMO/WC	$393.38

ER CLSD GREAT TROCHNTER W/O MA

Facility

$2,622.50

Service Code	HCPCS 27246
Hospital Charge Code	5700757
Hospital Revenue Code	450
Min. Negotiated Rate	$69.50
Max. Negotiated Rate	$1,057.82
Rate for Payer: Aetna Commercial	$797.10
Rate for Payer: Aetna Medicare Advantage	$949.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,057.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,057.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$293.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$321.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,057.82
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: Cigna Medicare Advantage	$293.05
Rate for Payer: Clover Medicare Advantage	$278.40
Rate for Payer: EmblemHealth Commercial	$879.15
Rate for Payer: Humana Medicare Advantage	$301.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$293.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$393.38
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$293.05
Rate for Payer: Wellcare Medicare Advantage	$293.05
Rate for Payer: Wellpoint Medicaid Managed Care	$69.50

ER CLSD HUME SFT FX W/ MANIP

Facility

$7,914.45

Service Code	HCPCS 24505
Hospital Charge Code	5700740
Hospital Revenue Code	450
Min. Negotiated Rate	$1,187.17
Max. Negotiated Rate	$1,187.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.17

ER CLSD HUME SFT FX W/ MANIP

Facility

$7,914.45

Service Code	HCPCS 24505
Hospital Charge Code	5700740
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$6,895.75
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$411.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,895.75
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,374.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.17
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$209.73

ER CLSD HUME SFT FX W/O ANES

Facility

$563.75

Service Code	HCPCS 24500
Hospital Charge Code	5700559
Hospital Revenue Code	450
Min. Negotiated Rate	$84.56
Max. Negotiated Rate	$84.56
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CLSD HUME SFT FX W/O ANES

Facility

$563.75

Service Code	HCPCS 24500
Hospital Charge Code	5700559
Hospital Revenue Code	450
Min. Negotiated Rate	$14.94
Max. Negotiated Rate	$1,057.82
Rate for Payer: Aetna Commercial	$797.10
Rate for Payer: Aetna Medicare Advantage	$949.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,057.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,057.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$293.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,057.82
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: Cigna Medicare Advantage	$293.05
Rate for Payer: Clover Medicare Advantage	$278.40
Rate for Payer: EmblemHealth Commercial	$879.15
Rate for Payer: Humana Medicare Advantage	$301.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$293.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.56
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$293.05
Rate for Payer: Wellcare Medicare Advantage	$293.05
Rate for Payer: Wellpoint Medicaid Managed Care	$14.94

ER CLSD PELVIC RING FX W/O MAN

Facility

$906.60

Service Code	HCPCS 27193
Hospital Charge Code	5700754
Hospital Revenue Code	450
Min. Negotiated Rate	$24.02
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$344.51
Rate for Payer: Aetna Medicare Advantage	$271.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.18
Rate for Payer: Cigna Commercial	$453.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.99
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$24.02

ER CLSD PELVIC RING FX W/O MAN

Facility

$906.60

Service Code	HCPCS 27193
Hospital Charge Code	5700754
Hospital Revenue Code	450
Min. Negotiated Rate	$135.99
Max. Negotiated Rate	$135.99
Rate for Payer: Qualcare PPO/HMO/WC	$135.99

Know your out-of-pocket cost for care.

All Charges