Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FOOT RING LONG LRF 155MM

Facility

$12,916.75

Service Code	HCPCS C1713
Hospital Charge Code	270699600
Hospital Revenue Code	278
Min. Negotiated Rate	$1,937.51
Max. Negotiated Rate	$3,125.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,583.35
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

FOOT RING SHORT LRF 155MM

Facility

$11,108.10

Service Code	HCPCS C1713
Hospital Charge Code	270699601
Hospital Revenue Code	278
Min. Negotiated Rate	$1,666.21
Max. Negotiated Rate	$2,688.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,221.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,688.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,443.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,666.21

FOOT RING SHORT LRF 155MM

Facility

$11,108.10

Service Code	HCPCS C1713
Hospital Charge Code	270699601
Hospital Revenue Code	278
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) NJ Health	$2,221.62
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	$2,688.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,443.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,666.21
Rate for Payer: UnitedHealthcare Community & State	$267.71
Rate for Payer: Wellpoint Medicaid Managed Care	$294.36

FOOT - TWO VIEWS-BIL

Facility

$6,601.19

Service Code	HCPCS 7362050
Hospital Charge Code	94061251
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 - TWO VIEWS-BIL

Facility

$6,601.19

Service Code	HCPCS 7362050
Hospital Charge Code	94061251
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

FOOT - TWO VIEWS-LT

Facility

$6,601.19

Service Code	HCPCS 73620LT
Hospital Charge Code	94061397
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

FOOT - TWO VIEWS-LT

Facility

$6,601.19

Service Code	HCPCS 73620LT
Hospital Charge Code	94061397
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 - TWO VIEWS-RT

Facility

$6,601.19

Service Code	HCPCS 73620RT
Hospital Charge Code	94061399
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

FOOT - TWO VIEWS-RT

Facility

$6,601.19

Service Code	HCPCS 73620RT
Hospital Charge Code	94061399
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

FORADIL 12MG CAP

Facility

$3.00

Hospital Charge Code	60635495
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

FORADIL 12MG CAP

Facility

$3.00

Hospital Charge Code	60635495
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

FORAMEN NEEDLE-LONG

Facility

$2,300.00

Hospital Charge Code	270702024
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$556.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$506.00
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

FORAMEN NEEDLE-LONG

Facility

$2,300.00

Hospital Charge Code	270702024
Hospital Revenue Code	278
Min. Negotiated Rate	$55.43
Max. Negotiated Rate	$1,150.00
Rate for Payer: Aetna Commercial	$874.00
Rate for Payer: Aetna Medicare Advantage	$690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$586.50
Rate for Payer: Cigna Commercial	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$506.00
Rate for Payer: Qualcare PPO/HMO/WC	$345.00
Rate for Payer: UnitedHealthcare Community & State	$55.43
Rate for Payer: Wellpoint Medicaid Managed Care	$60.95

FORCEP

Facility

$2,475.00

Hospital Charge Code	270657328
Hospital Revenue Code	272
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$742.50
Rate for Payer: Oxford Commercial	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$495.00
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

FORCEP

Facility

$2,475.00

Hospital Charge Code	270657328
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

FORCEP APPLYING NON-DETACH CRA

Facility

$1,483.70

Hospital Charge Code	270684904
Hospital Revenue Code	272
Min. Negotiated Rate	$35.76
Max. Negotiated Rate	$741.85
Rate for Payer: Aetna Commercial	$563.81
Rate for Payer: Aetna Medicare Advantage	$445.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$378.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$378.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$378.34
Rate for Payer: Cigna Commercial	$741.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$445.11
Rate for Payer: Oxford Commercial	$296.74
Rate for Payer: Qualcare PPO/HMO/WC	$222.56
Rate for Payer: UnitedHealthcare Commercial	$296.74
Rate for Payer: UnitedHealthcare Community & State	$35.76
Rate for Payer: Wellpoint Medicaid Managed Care	$39.32

FORCEP APPLYING NON-DETACH CRA

Facility

$1,483.70

Hospital Charge Code	270684904
Hospital Revenue Code	272
Min. Negotiated Rate	$222.56
Max. Negotiated Rate	$222.56
Rate for Payer: Qualcare PPO/HMO/WC	$222.56

FORCEP BIOPSY 3F PIRAN 505-160

Facility

$3,068.00

Hospital Charge Code	270608956
Hospital Revenue Code	272
Min. Negotiated Rate	$73.94
Max. Negotiated Rate	$1,534.00
Rate for Payer: Aetna Commercial	$1,165.84
Rate for Payer: Aetna Medicare Advantage	$920.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$782.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$782.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$782.34
Rate for Payer: Cigna Commercial	$1,534.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$920.40
Rate for Payer: Oxford Commercial	$613.60
Rate for Payer: Qualcare PPO/HMO/WC	$460.20
Rate for Payer: UnitedHealthcare Commercial	$613.60
Rate for Payer: UnitedHealthcare Community & State	$73.94
Rate for Payer: Wellpoint Medicaid Managed Care	$81.30

FORCEP BIOPSY 3F PIRAN 505-160

Facility

$3,068.00

Hospital Charge Code	270608956
Hospital Revenue Code	272
Min. Negotiated Rate	$460.20
Max. Negotiated Rate	$460.20
Rate for Payer: Qualcare PPO/HMO/WC	$460.20

FORCEP BIOPSY 70 DEG

Facility

$3,504.80

Hospital Charge Code	270689938
Hospital Revenue Code	272
Min. Negotiated Rate	$525.72
Max. Negotiated Rate	$525.72
Rate for Payer: Qualcare PPO/HMO/WC	$525.72

FORCEP BIOPSY 70 DEG

Facility

$3,504.80

Hospital Charge Code	270689938
Hospital Revenue Code	272
Min. Negotiated Rate	$84.47
Max. Negotiated Rate	$1,752.40
Rate for Payer: Aetna Commercial	$1,331.82
Rate for Payer: Aetna Medicare Advantage	$1,051.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$893.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$893.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$893.72
Rate for Payer: Cigna Commercial	$1,752.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,051.44
Rate for Payer: Oxford Commercial	$700.96
Rate for Payer: Qualcare PPO/HMO/WC	$525.72
Rate for Payer: UnitedHealthcare Commercial	$700.96
Rate for Payer: UnitedHealthcare Community & State	$84.47
Rate for Payer: Wellpoint Medicaid Managed Care	$92.88

FORCEP BIOPSY DIR BITE CT 548

Facility

$360.85

Hospital Charge Code	270608628
Hospital Revenue Code	272
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$180.43
Rate for Payer: Aetna Commercial	$137.12
Rate for Payer: Aetna Medicare Advantage	$108.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.02
Rate for Payer: Cigna Commercial	$180.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.25
Rate for Payer: Oxford Commercial	$72.17
Rate for Payer: Qualcare PPO/HMO/WC	$54.13
Rate for Payer: UnitedHealthcare Commercial	$72.17
Rate for Payer: UnitedHealthcare Community & State	$8.70
Rate for Payer: Wellpoint Medicaid Managed Care	$9.56

FORCEP BIOPSY DIR BITE CT 548

Facility

$360.85

Hospital Charge Code	270608628
Hospital Revenue Code	272
Min. Negotiated Rate	$54.13
Max. Negotiated Rate	$54.13
Rate for Payer: Qualcare PPO/HMO/WC	$54.13

FORCEP BIOPSY HOT LOWER

Facility

$137.50

Hospital Charge Code	270700218
Hospital Revenue Code	272
Min. Negotiated Rate	$20.62
Max. Negotiated Rate	$20.62
Rate for Payer: Qualcare PPO/HMO/WC	$20.62

FORCEP BIOPSY HOT LOWER

Facility

$137.50

Hospital Charge Code	270700218
Hospital Revenue Code	272
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$68.75
Rate for Payer: Aetna Commercial	$52.25
Rate for Payer: Aetna Medicare Advantage	$41.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.06
Rate for Payer: Cigna Commercial	$68.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.25
Rate for Payer: Oxford Commercial	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$20.62
Rate for Payer: UnitedHealthcare Commercial	$27.50
Rate for Payer: UnitedHealthcare Community & State	$3.31
Rate for Payer: Wellpoint Medicaid Managed Care	$3.64

Know your out-of-pocket cost for care.

All Charges