Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FOOT AP LAT LT

Facility

$6,601.19

Service Code	HCPCS 73620LT
Hospital Charge Code	2002459
Hospital Revenue Code	320
Min. Negotiated Rate	$159.09
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.36
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$159.09
Rate for Payer: Wellpoint Medicaid Managed Care	$174.93

FOOT ARCH LRF 155MM

Facility

$11,108.10

Service Code	HCPCS A4649
Hospital Charge Code	270699602
Hospital Revenue Code	272
Min. Negotiated Rate	$1,666.21
Max. Negotiated Rate	$1,666.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,666.21

FOOT ARCH LRF 155MM

Facility

$11,108.10

Service Code	HCPCS A4649
Hospital Charge Code	270699602
Hospital Revenue Code	272
Min. Negotiated Rate	$267.71
Max. Negotiated Rate	$5,554.05
Rate for Payer: Aetna Commercial	$4,221.08
Rate for Payer: Aetna Medicare Advantage	$3,332.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,832.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,832.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,832.57
Rate for Payer: Cigna Commercial	$5,554.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,332.43
Rate for Payer: Oxford Commercial	$2,221.62
Rate for Payer: Qualcare PPO/HMO/WC	$1,666.21
Rate for Payer: UnitedHealthcare Commercial	$2,221.62
Rate for Payer: UnitedHealthcare Community & State	$267.71
Rate for Payer: Wellpoint Medicaid Managed Care	$294.36

FOOT COMPL 3 VIEWS-BIL

Facility

$6,601.19

Service Code	HCPCS 7363050
Hospital Charge Code	94061253
Hospital Revenue Code	320
Min. Negotiated Rate	$159.09
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.36
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$159.09
Rate for Payer: Wellpoint Medicaid Managed Care	$174.93

FOOT COMPL 3 VIEWS-BIL

Facility

$6,601.19

Service Code	HCPCS 7363050
Hospital Charge Code	94061253
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

FOOT COMPL 3 VIEWS-LT

Facility

$6,601.19

Service Code	HCPCS 73630LT
Hospital Charge Code	94061401
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

FOOT COMPL 3 VIEWS-LT

Facility

$6,601.19

Service Code	HCPCS 73630LT
Hospital Charge Code	94061401
Hospital Revenue Code	320
Min. Negotiated Rate	$159.09
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.36
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$159.09
Rate for Payer: Wellpoint Medicaid Managed Care	$174.93

FOOT COMPL 3 VIEWS-RT

Facility

$6,601.19

Service Code	HCPCS 73630RT
Hospital Charge Code	94061403
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

FOOT COMPL 3 VIEWS-RT

Facility

$6,601.19

Service Code	HCPCS 73630RT
Hospital Charge Code	94061403
Hospital Revenue Code	320
Min. Negotiated Rate	$159.09
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.36
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$159.09
Rate for Payer: Wellpoint Medicaid Managed Care	$174.93

FOOT DROP STOP SPANAID

Facility

$136.10

Hospital Charge Code	270650097
Hospital Revenue Code	270
Min. Negotiated Rate	$20.41
Max. Negotiated Rate	$20.41
Rate for Payer: Qualcare PPO/HMO/WC	$20.41

FOOT DROP STOP SPANAID

Facility

$136.10

Hospital Charge Code	270650097
Hospital Revenue Code	270
Min. Negotiated Rate	$3.28
Max. Negotiated Rate	$68.05
Rate for Payer: Aetna Commercial	$51.72
Rate for Payer: Aetna Medicare Advantage	$40.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.71
Rate for Payer: Cigna Commercial	$68.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.83
Rate for Payer: Oxford Commercial	$27.22
Rate for Payer: Qualcare PPO/HMO/WC	$20.41
Rate for Payer: UnitedHealthcare Commercial	$27.22
Rate for Payer: UnitedHealthcare Community & State	$3.28
Rate for Payer: Wellpoint Medicaid Managed Care	$3.61

FOOTPRINTER ID NEWBORN DISP

Facility

$68.75

Hospital Charge Code	270649209
Hospital Revenue Code	272
Min. Negotiated Rate	$1.66
Max. Negotiated Rate	$34.38
Rate for Payer: Aetna Commercial	$26.12
Rate for Payer: Aetna Medicare Advantage	$20.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.53
Rate for Payer: Cigna Commercial	$34.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.62
Rate for Payer: Oxford Commercial	$13.75
Rate for Payer: Qualcare PPO/HMO/WC	$10.31
Rate for Payer: UnitedHealthcare Commercial	$13.75
Rate for Payer: UnitedHealthcare Community & State	$1.66
Rate for Payer: Wellpoint Medicaid Managed Care	$1.82

FOOTPRINTER ID NEWBORN DISP

Facility

$68.75

Hospital Charge Code	270649209
Hospital Revenue Code	272
Min. Negotiated Rate	$10.31
Max. Negotiated Rate	$10.31
Rate for Payer: Qualcare PPO/HMO/WC	$10.31

FOOTPRINTER KLEENPRINT

Facility

$109.60

Hospital Charge Code	270654607
Hospital Revenue Code	270
Min. Negotiated Rate	$2.64
Max. Negotiated Rate	$54.80
Rate for Payer: Aetna Commercial	$41.65
Rate for Payer: Aetna Medicare Advantage	$32.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.95
Rate for Payer: Cigna Commercial	$54.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.88
Rate for Payer: Oxford Commercial	$21.92
Rate for Payer: Qualcare PPO/HMO/WC	$16.44
Rate for Payer: UnitedHealthcare Commercial	$21.92
Rate for Payer: UnitedHealthcare Community & State	$2.64
Rate for Payer: Wellpoint Medicaid Managed Care	$2.90

FOOTPRINTER KLEENPRINT

Facility

$109.60

Hospital Charge Code	270654607
Hospital Revenue Code	270
Min. Negotiated Rate	$16.44
Max. Negotiated Rate	$16.44
Rate for Payer: Qualcare PPO/HMO/WC	$16.44

FOOTPRINT ULR 4.5 PK SUT SL.

Facility

$1,716.00

Service Code	HCPCS C1713
Hospital Charge Code	270688722
Hospital Revenue Code	278
Min. Negotiated Rate	$257.40
Max. Negotiated Rate	$415.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$343.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$377.52
Rate for Payer: Qualcare PPO/HMO/WC	$257.40

FOOTPRINT ULR 4.5 PK SUT SL.

Facility

$1,716.00

Service Code	HCPCS C1713
Hospital Charge Code	270688722
Hospital Revenue Code	278
Min. Negotiated Rate	$41.36
Max. Negotiated Rate	$858.00
Rate for Payer: Aetna Commercial	$652.08
Rate for Payer: Aetna Medicare Advantage	$514.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$437.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$437.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$343.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$437.58
Rate for Payer: Cigna Commercial	$858.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$377.52
Rate for Payer: Qualcare PPO/HMO/WC	$257.40
Rate for Payer: UnitedHealthcare Community & State	$41.36
Rate for Payer: Wellpoint Medicaid Managed Care	$45.47

FOOT PROCEDURES WITH CC

Facility

$62,549.73

Service Code	MSDRG 504
Min. Negotiated Rate	$19,045.59
Max. Negotiated Rate	$62,549.73
Rate for Payer: Aetna Commercial	$43,236.12
Rate for Payer: Aetna Medicare Advantage	$62,549.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40,241.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40,241.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,047.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40,241.53
Rate for Payer: Cigna Commercial	$34,980.21
Rate for Payer: Cigna Medicare Advantage	$20,047.99
Rate for Payer: Clover Medicare Advantage	$19,045.59
Rate for Payer: EmblemHealth Commercial	$60,143.97
Rate for Payer: Humana Medicare Advantage	$20,649.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,047.99
Rate for Payer: Oxford Commercial	$25,140.74
Rate for Payer: UnitedHealthcare Commercial	$44,085.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,047.99
Rate for Payer: Wellcare Medicare Advantage	$20,047.99

FOOT PROCEDURES WITH MCC

Facility

$92,347.04

Service Code	MSDRG 503
Min. Negotiated Rate	$28,118.49
Max. Negotiated Rate	$92,347.04
Rate for Payer: Aetna Commercial	$63,710.26
Rate for Payer: Aetna Medicare Advantage	$92,347.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62,339.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62,339.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29,598.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62,339.48
Rate for Payer: Cigna Commercial	$52,232.65
Rate for Payer: Cigna Medicare Advantage	$29,598.41
Rate for Payer: Clover Medicare Advantage	$28,118.49
Rate for Payer: EmblemHealth Commercial	$88,795.23
Rate for Payer: Humana Medicare Advantage	$30,486.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29,598.41
Rate for Payer: Oxford Commercial	$37,540.29
Rate for Payer: UnitedHealthcare Commercial	$65,828.09
Rate for Payer: UnitedHealthcare Medicare Advantage	$29,598.41
Rate for Payer: Wellcare Medicare Advantage	$29,598.41

FOOT PROCEDURES WITHOUT CC/MCC

Facility

$60,080.37

Service Code	MSDRG 505
Min. Negotiated Rate	$18,293.70
Max. Negotiated Rate	$60,080.37
Rate for Payer: Aetna Commercial	$41,539.40
Rate for Payer: Aetna Medicare Advantage	$60,080.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39,776.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39,776.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19,256.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39,776.31
Rate for Payer: Cigna Commercial	$33,550.46
Rate for Payer: Cigna Medicare Advantage	$19,256.53
Rate for Payer: Clover Medicare Advantage	$18,293.70
Rate for Payer: EmblemHealth Commercial	$57,769.59
Rate for Payer: Humana Medicare Advantage	$19,834.23
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19,256.53
Rate for Payer: Oxford Commercial	$24,113.16
Rate for Payer: UnitedHealthcare Commercial	$42,283.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$19,256.53
Rate for Payer: Wellcare Medicare Advantage	$19,256.53

FOOT RIGHT 3 VIEWS ROUTINE

Facility

$6,601.19

Service Code	HCPCS 73630RT
Hospital Charge Code	2000165
Hospital Revenue Code	320
Min. Negotiated Rate	$159.09
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.36
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$159.09
Rate for Payer: Wellpoint Medicaid Managed Care	$174.93

FOOT RIGHT 3 VIEWS ROUTINE

Facility

$6,601.19

Service Code	HCPCS 73630RT
Hospital Charge Code	2000165
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

FOOT RING LONG 155MM

Facility

$9,270.00

Hospital Charge Code	270674286
Hospital Revenue Code	272
Min. Negotiated Rate	$1,390.50
Max. Negotiated Rate	$1,390.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,390.50

FOOT RING LONG 155MM

Facility

$9,270.00

Hospital Charge Code	270674286
Hospital Revenue Code	272
Min. Negotiated Rate	$223.41
Max. Negotiated Rate	$4,635.00
Rate for Payer: Aetna Commercial	$3,522.60
Rate for Payer: Aetna Medicare Advantage	$2,781.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,363.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,363.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,363.85
Rate for Payer: Cigna Commercial	$4,635.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,781.00
Rate for Payer: Oxford Commercial	$1,854.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,390.50
Rate for Payer: UnitedHealthcare Commercial	$1,854.00
Rate for Payer: UnitedHealthcare Community & State	$223.41
Rate for Payer: Wellpoint Medicaid Managed Care	$245.66

FOOT RING LONG LRF 155MM

Facility

$12,916.75

Service Code	HCPCS C1713
Hospital Charge Code	270699600
Hospital Revenue Code	278
Min. Negotiated Rate	$311.29
Max. Negotiated Rate	$6,458.38
Rate for Payer: Aetna Commercial	$4,908.36
Rate for Payer: Aetna Medicare Advantage	$3,875.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,293.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,293.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,583.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,293.77
Rate for Payer: Cigna Commercial	$6,458.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,125.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,841.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,937.51
Rate for Payer: UnitedHealthcare Community & State	$311.29
Rate for Payer: Wellpoint Medicaid Managed Care	$342.29

Know your out-of-pocket cost for care.

All Charges