Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ER-TX INTERPHA DISLOC-BI

Facility

$4,148.00

Hospital Charge Code	5790680
Hospital Revenue Code	450
Min. Negotiated Rate	$109.92
Max. Negotiated Rate	$2,074.00
Rate for Payer: Aetna Commercial	$1,576.24
Rate for Payer: Aetna Medicare Advantage	$1,244.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,057.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,057.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,057.74
Rate for Payer: Cigna Commercial	$2,074.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,244.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$622.20
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$109.92

ER-TX KNUCKLE DISLOCAT-BI

Facility

$457.00

Hospital Charge Code	5790510
Hospital Revenue Code	450
Min. Negotiated Rate	$68.55
Max. Negotiated Rate	$68.55
Rate for Payer: Qualcare PPO/HMO/WC	$68.55

ER-TX KNUCKLE DISLOCAT-BI

Facility

$457.00

Hospital Charge Code	5790510
Hospital Revenue Code	450
Min. Negotiated Rate	$12.11
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$173.66
Rate for Payer: Aetna Medicare Advantage	$137.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.53
Rate for Payer: Cigna Commercial	$228.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$68.55
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$12.11

ER-TX LOW FX DSTL TBIA-BI

Facility

$9,423.70

Service Code	HCPCS 27825
Hospital Charge Code	5790615
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	$420.63
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	$2,827.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,413.56
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	$249.73

ER-TX LOW FX DSTL TBIA-BI

Facility

$9,423.70

Service Code	HCPCS 27825
Hospital Charge Code	5790615
Hospital Revenue Code	450
Min. Negotiated Rate	$1,413.56
Max. Negotiated Rate	$1,413.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,413.56

ER-TX METACARPAL FX-BI

Facility

$453.00

Service Code	HCPCS 26600
Hospital Charge Code	5790640
Hospital Revenue Code	450
Min. Negotiated Rate	$12.00
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	$130.68
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	$135.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.95
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	$12.00

ER-TX METACARPAL FX-BI

Facility

$453.00

Service Code	HCPCS 26600
Hospital Charge Code	5790640
Hospital Revenue Code	450
Min. Negotiated Rate	$67.95
Max. Negotiated Rate	$67.95
Rate for Payer: Qualcare PPO/HMO/WC	$67.95

ER-TX METACR FX EA BNE-BI

Facility

$348.00

Hospital Charge Code	5790485
Hospital Revenue Code	450
Min. Negotiated Rate	$52.20
Max. Negotiated Rate	$52.20
Rate for Payer: Qualcare PPO/HMO/WC	$52.20

ER-TX METACR FX EA BNE-BI

Facility

$348.00

Hospital Charge Code	5790485
Hospital Revenue Code	450
Min. Negotiated Rate	$9.22
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$132.24
Rate for Payer: Aetna Medicare Advantage	$104.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.74
Rate for Payer: Cigna Commercial	$174.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.20
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$9.22

ER-TX OPN DIST PHAL FX-BI

Facility

$7,682.00

Hospital Charge Code	5790535
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$3,841.00
Rate for Payer: Aetna Commercial	$2,919.16
Rate for Payer: Aetna Medicare Advantage	$2,304.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,958.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,958.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,958.91
Rate for Payer: Cigna Commercial	$3,841.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,304.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,152.30
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$203.57

ER-TX OPN DIST PHAL FX-BI

Facility

$7,682.00

Hospital Charge Code	5790535
Hospital Revenue Code	450
Min. Negotiated Rate	$1,152.30
Max. Negotiated Rate	$1,152.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,152.30

ER-TX RADIAL HEAD FRAC-BI

Facility

$492.00

Hospital Charge Code	5790415
Hospital Revenue Code	450
Min. Negotiated Rate	$73.80
Max. Negotiated Rate	$73.80
Rate for Payer: Qualcare PPO/HMO/WC	$73.80

ER-TX RADIAL HEAD FRAC-BI

Facility

$492.00

Hospital Charge Code	5790415
Hospital Revenue Code	450
Min. Negotiated Rate	$13.04
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$186.96
Rate for Payer: Aetna Medicare Advantage	$147.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.46
Rate for Payer: Cigna Commercial	$246.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.80
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$13.04

ER TX RADIAL HEAD FX W/O ANES

Facility

$563.75

Service Code	HCPCS 24650
Hospital Charge Code	5700563
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	$118.10
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 TX RADIAL HEAD FX W/O ANES

Facility

$563.75

Service Code	HCPCS 24650
Hospital Charge Code	5700563
Hospital Revenue Code	450
Min. Negotiated Rate	$84.56
Max. Negotiated Rate	$84.56
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER-TX RADIAL/ULNAR FX-BI

Facility

$453.00

Hospital Charge Code	5790440
Hospital Revenue Code	450
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$172.14
Rate for Payer: Aetna Medicare Advantage	$135.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.52
Rate for Payer: Cigna Commercial	$226.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.95
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$12.00

ER-TX RADIAL/ULNAR FX-BI

Facility

$453.00

Hospital Charge Code	5790440
Hospital Revenue Code	450
Min. Negotiated Rate	$67.95
Max. Negotiated Rate	$67.95
Rate for Payer: Qualcare PPO/HMO/WC	$67.95

ER TX STERNOCLAV DISL W/O MANI

Facility

$2,622.50

Service Code	HCPCS 23520
Hospital Charge Code	5700732
Hospital Revenue Code	450
Min. Negotiated Rate	$69.50
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	$105.42
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	$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	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$69.50

ER TX STERNOCLAV DISL W/O MANI

Facility

$2,622.50

Service Code	HCPCS 23520
Hospital Charge Code	5700732
Hospital Revenue Code	450
Min. Negotiated Rate	$393.38
Max. Negotiated Rate	$393.38
Rate for Payer: Qualcare PPO/HMO/WC	$393.38

ER-TX THUMB DISLOCATIN-BI

Facility

$492.00

Hospital Charge Code	5790490
Hospital Revenue Code	450
Min. Negotiated Rate	$13.04
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$186.96
Rate for Payer: Aetna Medicare Advantage	$147.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.46
Rate for Payer: Cigna Commercial	$246.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.80
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$13.04

ER-TX THUMB DISLOCATIN-BI

Facility

$492.00

Hospital Charge Code	5790490
Hospital Revenue Code	450
Min. Negotiated Rate	$73.80
Max. Negotiated Rate	$73.80
Rate for Payer: Qualcare PPO/HMO/WC	$73.80

ER TX TOE FX W/MANI

Facility

$1,037.10

Service Code	HCPCS 28515
Hospital Charge Code	5700611
Hospital Revenue Code	450
Min. Negotiated Rate	$155.56
Max. Negotiated Rate	$155.56
Rate for Payer: Qualcare PPO/HMO/WC	$155.56

ER TX TOE FX W/MANI

Facility

$1,037.10

Service Code	HCPCS 28515
Hospital Charge Code	5700611
Hospital Revenue Code	450
Min. Negotiated Rate	$27.48
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	$111.51
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	$311.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$155.56
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	$27.48

ER-TX TRIM ANKLE FX-BI

Facility

$463.00

Hospital Charge Code	5790610
Hospital Revenue Code	450
Min. Negotiated Rate	$69.45
Max. Negotiated Rate	$69.45
Rate for Payer: Qualcare PPO/HMO/WC	$69.45

ER-TX TRIM ANKLE FX-BI

Facility

$463.00

Hospital Charge Code	5790610
Hospital Revenue Code	450
Min. Negotiated Rate	$12.27
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$175.94
Rate for Payer: Aetna Medicare Advantage	$138.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.06
Rate for Payer: Cigna Commercial	$231.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.45
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$12.27

Know your out-of-pocket cost for care.

All Charges