Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FINGER CAST APPLICATION

Facility

$475.00

Service Code	HCPCS 29086
Hospital Charge Code	5780125
Hospital Revenue Code	450
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$71.25
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

FINGER CONTROL MITT CLOSED W/

Facility

$86.85

Hospital Charge Code	270650279
Hospital Revenue Code	271
Min. Negotiated Rate	$13.03
Max. Negotiated Rate	$13.03
Rate for Payer: Qualcare PPO/HMO/WC	$13.03

FINGER CONTROL MITT CLOSED W/

Facility

$86.85

Hospital Charge Code	270650279
Hospital Revenue Code	271
Min. Negotiated Rate	$2.09
Max. Negotiated Rate	$43.42
Rate for Payer: Aetna Commercial	$33.00
Rate for Payer: Aetna Medicare Advantage	$26.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.15
Rate for Payer: Cigna Commercial	$43.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.05
Rate for Payer: Oxford Commercial	$17.37
Rate for Payer: Qualcare PPO/HMO/WC	$13.03
Rate for Payer: UnitedHealthcare Commercial	$17.37
Rate for Payer: UnitedHealthcare Community & State	$2.09
Rate for Payer: Wellpoint Medicaid Managed Care	$2.30

FINGERCOT UAO799-1

Facility

$12.50

Hospital Charge Code	270601244
Hospital Revenue Code	272
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$6.25
Rate for Payer: Aetna Commercial	$4.75
Rate for Payer: Aetna Medicare Advantage	$3.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.19
Rate for Payer: Cigna Commercial	$6.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.75
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.88
Rate for Payer: UnitedHealthcare Commercial	$2.50
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.33

FINGERCOT UAO799-1

Facility

$12.50

Hospital Charge Code	270601244
Hospital Revenue Code	272
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$1.88
Rate for Payer: Qualcare PPO/HMO/WC	$1.88

FINGER-LT 2ND DIGIT

Facility

$251.00

Service Code	HCPCS 73140F1
Hospital Charge Code	94061329
Hospital Revenue Code	320
Min. Negotiated Rate	$6.05
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$95.38
Rate for Payer: Aetna Medicare Advantage	$75.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.00
Rate for Payer: Cigna Commercial	$125.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.30
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.65
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$6.05
Rate for Payer: Wellpoint Medicaid Managed Care	$6.65

FINGER-LT 2ND DIGIT

Facility

$251.00

Service Code	HCPCS 73140F1
Hospital Charge Code	94061329
Hospital Revenue Code	320
Min. Negotiated Rate	$37.65
Max. Negotiated Rate	$37.65
Rate for Payer: Qualcare PPO/HMO/WC	$37.65

FINGER-LT 3RD DIGIT

Facility

$311.00

Service Code	HCPCS 73140F2
Hospital Charge Code	94061331
Hospital Revenue Code	320
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$118.18
Rate for Payer: Aetna Medicare Advantage	$93.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.31
Rate for Payer: Cigna Commercial	$155.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.30
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.65
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$7.50
Rate for Payer: Wellpoint Medicaid Managed Care	$8.24

FINGER-LT 3RD DIGIT

Facility

$311.00

Service Code	HCPCS 73140F2
Hospital Charge Code	94061331
Hospital Revenue Code	320
Min. Negotiated Rate	$46.65
Max. Negotiated Rate	$46.65
Rate for Payer: Qualcare PPO/HMO/WC	$46.65

FINGER-LT 5TH DIGIT

Facility

$5,100.00

Service Code	HCPCS 73140F4
Hospital Charge Code	94061335
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

FINGER-LT 5TH DIGIT

Facility

$5,100.00

Service Code	HCPCS 73140F4
Hospital Charge Code	94061335
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

FINGER-LT HAND, 4TH DI

Facility

$5,100.00

Service Code	HCPCS 73140F3
Hospital Charge Code	94061333
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

FINGER-LT HAND, 4TH DI

Facility

$5,100.00

Service Code	HCPCS 73140F3
Hospital Charge Code	94061333
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

FINGER-LT HAND, THUMB

Facility

$5,100.00

Service Code	HCPCS 73140FA
Hospital Charge Code	94061347
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

FINGER-LT HAND, THUMB

Facility

$5,100.00

Service Code	HCPCS 73140FA
Hospital Charge Code	94061347
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

FINGER PULSE OXIMETER ECONOMY

Facility

$271.90

Hospital Charge Code	270665870
Hospital Revenue Code	270
Min. Negotiated Rate	$40.78
Max. Negotiated Rate	$40.78
Rate for Payer: Qualcare PPO/HMO/WC	$40.78

FINGER PULSE OXIMETER ECONOMY

Facility

$271.90

Hospital Charge Code	270665870
Hospital Revenue Code	270
Min. Negotiated Rate	$6.55
Max. Negotiated Rate	$135.95
Rate for Payer: Aetna Commercial	$103.32
Rate for Payer: Aetna Medicare Advantage	$81.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.33
Rate for Payer: Cigna Commercial	$135.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.57
Rate for Payer: Oxford Commercial	$54.38
Rate for Payer: Qualcare PPO/HMO/WC	$40.78
Rate for Payer: UnitedHealthcare Commercial	$54.38
Rate for Payer: UnitedHealthcare Community & State	$6.55
Rate for Payer: Wellpoint Medicaid Managed Care	$7.21

FINGER-RT 2ND DIGIT

Facility

$5,100.00

Service Code	HCPCS 73140F6
Hospital Charge Code	94061339
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

FINGER-RT 2ND DIGIT

Facility

$5,100.00

Service Code	HCPCS 73140F6
Hospital Charge Code	94061339
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

FINGER-RT 3RD DIGIT

Facility

$5,100.00

Service Code	HCPCS 73140F7
Hospital Charge Code	94061341
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

FINGER-RT 3RD DIGIT

Facility

$5,100.00

Service Code	HCPCS 73140F7
Hospital Charge Code	94061341
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

FINGER-RT 5TH DIGIT

Facility

$5,100.00

Service Code	HCPCS 73140F9
Hospital Charge Code	94061345
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

FINGER-RT 5TH DIGIT

Facility

$5,100.00

Service Code	HCPCS 73140F9
Hospital Charge Code	94061345
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

FINGER-RT HAND, 4TH DI

Facility

$250.00

Service Code	HCPCS 73140F8
Hospital Charge Code	94061343
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

FINGER-RT HAND, 4TH DI

Facility

$250.00

Service Code	HCPCS 73140F8
Hospital Charge Code	94061343
Hospital Revenue Code	320
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

Know your out-of-pocket cost for care.

All Charges