Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC

Facility

$48,185.94

Service Code	MSDRG 562
Min. Negotiated Rate	$14,672.00
Max. Negotiated Rate	$48,185.94
Rate for Payer: Aetna Commercial	$33,366.59
Rate for Payer: Aetna Medicare Advantage	$48,185.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,356.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,356.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,444.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,356.72
Rate for Payer: Cigna Commercial	$26,663.71
Rate for Payer: Cigna Medicare Advantage	$15,444.21
Rate for Payer: Clover Medicare Advantage	$14,672.00
Rate for Payer: EmblemHealth Commercial	$46,332.63
Rate for Payer: Humana Medicare Advantage	$15,907.54
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,444.21
Rate for Payer: Oxford Commercial	$19,163.56
Rate for Payer: UnitedHealthcare Commercial	$33,603.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,444.21
Rate for Payer: Wellcare Medicare Advantage	$15,444.21

FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC

Facility

$31,078.13

Service Code	MSDRG 563
Min. Negotiated Rate	$9,462.89
Max. Negotiated Rate	$31,078.13
Rate for Payer: Aetna Commercial	$21,611.55
Rate for Payer: Aetna Medicare Advantage	$31,078.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20,934.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20,934.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,960.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20,934.90
Rate for Payer: Cigna Commercial	$16,758.39
Rate for Payer: Cigna Medicare Advantage	$9,960.94
Rate for Payer: Clover Medicare Advantage	$9,462.89
Rate for Payer: EmblemHealth Commercial	$29,882.82
Rate for Payer: Humana Medicare Advantage	$10,259.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,960.94
Rate for Payer: Oxford Commercial	$12,044.48
Rate for Payer: UnitedHealthcare Commercial	$21,120.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,960.94
Rate for Payer: Wellcare Medicare Advantage	$9,960.94

FRAGIL X, PCR REFLEX SOUTHERN

Facility

$200.00

Service Code	HCPCS 81243
Hospital Charge Code	3038121
Hospital Revenue Code	310
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

FRAGIL X, PCR REFLEX SOUTHERN

Facility

$200.00

Service Code	HCPCS 81243
Hospital Charge Code	3038121
Hospital Revenue Code	310
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$205.90
Rate for Payer: Aetna Commercial	$155.15
Rate for Payer: Aetna Medicare Advantage	$184.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$205.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$205.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$57.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$205.90
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: Cigna Medicare Advantage	$57.04
Rate for Payer: Clover Medicare Advantage	$54.19
Rate for Payer: EmblemHealth Commercial	$171.12
Rate for Payer: Humana Medicare Advantage	$58.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$57.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$45.63
Rate for Payer: UnitedHealthcare Medicare Advantage	$57.04
Rate for Payer: Wellcare Medicare Advantage	$57.04
Rate for Payer: Wellpoint Medicaid Managed Care	$5.30

FRAGMENT 2.5 X 12

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270687650
Hospital Revenue Code	278
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

FRAGMENT 2.5 X 12

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270687650
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

FRAGMENT2.5 X 14

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270687651
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

FRAGMENT2.5 X 14

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270687651
Hospital Revenue Code	278
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

FRAGMENT 2.5 X 18

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270687652
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

FRAGMENT 2.5 X 18

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270687652
Hospital Revenue Code	278
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

FRAGMENT 2.5 X20

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270687653
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

FRAGMENT 2.5 X20

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270687653
Hospital Revenue Code	278
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

FRAGMENT SCREW DRILL

Facility

$525.00

Hospital Charge Code	270687655
Hospital Revenue Code	272
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.50
Rate for Payer: Oxford Commercial	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Commercial	$105.00
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

FRAGMENT SCREW DRILL

Facility

$525.00

Hospital Charge Code	270687655
Hospital Revenue Code	272
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$78.75
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

FRAGMIN 2500IU INJ

Facility

$80.00

Hospital Charge Code	60635130
Hospital Revenue Code	250
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$40.00
Rate for Payer: Aetna Commercial	$30.40
Rate for Payer: Aetna Medicare Advantage	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.40
Rate for Payer: Cigna Commercial	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.00
Rate for Payer: Oxford Commercial	$16.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00
Rate for Payer: UnitedHealthcare Commercial	$16.00
Rate for Payer: UnitedHealthcare Community & State	$1.93
Rate for Payer: Wellpoint Medicaid Managed Care	$2.12

FRAGMIN 2500IU INJ

Facility

$80.00

Hospital Charge Code	60635130
Hospital Revenue Code	250
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00

FRAGMIN 5000IU/0.2ML SYRINGE

Facility

$309.81

Service Code	HCPCS J1645
Hospital Charge Code	606390261
Hospital Revenue Code	636
Min. Negotiated Rate	$7.47
Max. Negotiated Rate	$154.91
Rate for Payer: Aetna Commercial	$117.73
Rate for Payer: Aetna Medicare Advantage	$92.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.00
Rate for Payer: Cigna Commercial	$154.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.97
Rate for Payer: Qualcare PPO/HMO/WC	$46.47
Rate for Payer: UnitedHealthcare Community & State	$7.47
Rate for Payer: Wellpoint Medicaid Managed Care	$8.21

FRAGMIN 5000IU/0.2ML SYRINGE

Facility

$309.81

Service Code	HCPCS J1645
Hospital Charge Code	606390261
Hospital Revenue Code	636
Min. Negotiated Rate	$46.47
Max. Negotiated Rate	$74.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.97
Rate for Payer: Qualcare PPO/HMO/WC	$46.47

FRAGMIN 5000IU INJ

Facility

$138.00

Hospital Charge Code	60635131
Hospital Revenue Code	250
Min. Negotiated Rate	$3.33
Max. Negotiated Rate	$69.00
Rate for Payer: Aetna Commercial	$52.44
Rate for Payer: Aetna Medicare Advantage	$41.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.19
Rate for Payer: Cigna Commercial	$69.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.40
Rate for Payer: Oxford Commercial	$27.60
Rate for Payer: Qualcare PPO/HMO/WC	$20.70
Rate for Payer: UnitedHealthcare Commercial	$27.60
Rate for Payer: UnitedHealthcare Community & State	$3.33
Rate for Payer: Wellpoint Medicaid Managed Care	$3.66

FRAGMIN 5000IU INJ

Facility

$138.00

Hospital Charge Code	60635131
Hospital Revenue Code	250
Min. Negotiated Rate	$20.70
Max. Negotiated Rate	$20.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.70

FRAME FIXATOR

Facility

$3,560.85

Hospital Charge Code	270673791
Hospital Revenue Code	272
Min. Negotiated Rate	$85.82
Max. Negotiated Rate	$1,780.42
Rate for Payer: Aetna Commercial	$1,353.12
Rate for Payer: Aetna Medicare Advantage	$1,068.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$908.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$908.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$908.02
Rate for Payer: Cigna Commercial	$1,780.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,068.26
Rate for Payer: Oxford Commercial	$712.17
Rate for Payer: Qualcare PPO/HMO/WC	$534.13
Rate for Payer: UnitedHealthcare Commercial	$712.17
Rate for Payer: UnitedHealthcare Community & State	$85.82
Rate for Payer: Wellpoint Medicaid Managed Care	$94.36

FRAME FIXATOR

Facility

$3,560.85

Hospital Charge Code	270673791
Hospital Revenue Code	272
Min. Negotiated Rate	$534.13
Max. Negotiated Rate	$534.13
Rate for Payer: Qualcare PPO/HMO/WC	$534.13

FRANSEEN 20GA 10 CM NEEDLE

Facility

$105.20

Hospital Charge Code	270659896
Hospital Revenue Code	270
Min. Negotiated Rate	$2.54
Max. Negotiated Rate	$52.60
Rate for Payer: Aetna Commercial	$39.98
Rate for Payer: Aetna Medicare Advantage	$31.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.83
Rate for Payer: Cigna Commercial	$52.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.56
Rate for Payer: Oxford Commercial	$21.04
Rate for Payer: Qualcare PPO/HMO/WC	$15.78
Rate for Payer: UnitedHealthcare Commercial	$21.04
Rate for Payer: UnitedHealthcare Community & State	$2.54
Rate for Payer: Wellpoint Medicaid Managed Care	$2.79

FRANSEEN 20GA 10 CM NEEDLE

Facility

$105.20

Hospital Charge Code	270659896
Hospital Revenue Code	270
Min. Negotiated Rate	$15.78
Max. Negotiated Rate	$15.78
Rate for Payer: Qualcare PPO/HMO/WC	$15.78

FREEDOM CONSTR HD 36MM T1 STD

Facility

$7,920.00

Service Code	HCPCS C1776
Hospital Charge Code	270692097
Hospital Revenue Code	278
Min. Negotiated Rate	$1,188.00
Max. Negotiated Rate	$1,916.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,584.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,916.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,742.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,188.00

Know your out-of-pocket cost for care.

All Charges