Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HIP AND FEMUR FRACTURE REPAIR

Facility

$26,573.45

Service Code	APR-DRG 3083
Min. Negotiated Rate	$26,052.40
Max. Negotiated Rate	$26,573.45
Rate for Payer: UnitedHealthcare Community & State	$26,052.40
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$26,573.45
Rate for Payer: Wellpoint Medicaid Managed Care	$26,052.40

HIP AND FEMUR FRACTURE REPAIR

Facility

$20,694.18

Service Code	APR-DRG 3082
Min. Negotiated Rate	$20,288.41
Max. Negotiated Rate	$20,694.18
Rate for Payer: UnitedHealthcare Community & State	$20,288.41
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,694.18
Rate for Payer: Wellpoint Medicaid Managed Care	$20,288.41

HIP AND FEMUR FRACTURE REPAIR

Facility

$17,547.08

Service Code	APR-DRG 3081
Min. Negotiated Rate	$17,203.02
Max. Negotiated Rate	$17,547.08
Rate for Payer: UnitedHealthcare Community & State	$17,203.02
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,547.08
Rate for Payer: Wellpoint Medicaid Managed Care	$17,203.02

HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC

Facility

$69,831.78

Service Code	MSDRG 481
Min. Negotiated Rate	$21,262.88
Max. Negotiated Rate	$69,831.78
Rate for Payer: Aetna Commercial	$48,239.70
Rate for Payer: Aetna Medicare Advantage	$69,831.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48,150.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48,150.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22,381.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48,150.27
Rate for Payer: Cigna Commercial	$39,196.47
Rate for Payer: Cigna Medicare Advantage	$22,381.98
Rate for Payer: Clover Medicare Advantage	$21,262.88
Rate for Payer: EmblemHealth Commercial	$67,145.94
Rate for Payer: Humana Medicare Advantage	$23,053.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22,381.98
Rate for Payer: Oxford Commercial	$28,171.03
Rate for Payer: UnitedHealthcare Commercial	$49,398.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$22,381.98
Rate for Payer: Wellcare Medicare Advantage	$22,381.98

HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC

Facility

$96,264.45

Service Code	MSDRG 480
Min. Negotiated Rate	$29,311.29
Max. Negotiated Rate	$96,264.45
Rate for Payer: Aetna Commercial	$66,401.97
Rate for Payer: Aetna Medicare Advantage	$96,264.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68,619.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68,619.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$30,853.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68,619.95
Rate for Payer: Cigna Commercial	$54,500.78
Rate for Payer: Cigna Medicare Advantage	$30,853.99
Rate for Payer: Clover Medicare Advantage	$29,311.29
Rate for Payer: EmblemHealth Commercial	$92,561.97
Rate for Payer: Humana Medicare Advantage	$31,779.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$30,853.99
Rate for Payer: Oxford Commercial	$39,170.43
Rate for Payer: UnitedHealthcare Commercial	$68,686.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$30,853.99
Rate for Payer: Wellcare Medicare Advantage	$30,853.99

HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC

Facility

$54,850.66

Service Code	MSDRG 482
Min. Negotiated Rate	$16,701.32
Max. Negotiated Rate	$54,850.66
Rate for Payer: Aetna Commercial	$37,946.01
Rate for Payer: Aetna Medicare Advantage	$54,850.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36,984.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36,984.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17,580.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36,984.99
Rate for Payer: Cigna Commercial	$30,522.53
Rate for Payer: Cigna Medicare Advantage	$17,580.34
Rate for Payer: Clover Medicare Advantage	$16,701.32
Rate for Payer: EmblemHealth Commercial	$52,741.02
Rate for Payer: Humana Medicare Advantage	$18,107.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17,580.34
Rate for Payer: Oxford Commercial	$21,936.95
Rate for Payer: UnitedHealthcare Commercial	$38,467.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$17,580.34
Rate for Payer: Wellcare Medicare Advantage	$17,580.34

HIP ARTHRO ACETEBULOPLASTY

Facility

$22,425.68

Service Code	HCPCS 29915
Hospital Charge Code	16000578
Hospital Revenue Code	360
Min. Negotiated Rate	$540.46
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,727.70
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,363.85
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$540.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$594.28

HIP ARTHRO ACETEBULOPLASTY

Facility

$22,425.68

Service Code	HCPCS 29915
Hospital Charge Code	16000578
Hospital Revenue Code	360
Min. Negotiated Rate	$3,363.85
Max. Negotiated Rate	$3,363.85
Rate for Payer: Qualcare PPO/HMO/WC	$3,363.85

HIP ARTHRO W/FEMOROPLASTY

Facility

$22,425.68

Service Code	HCPCS 29914
Hospital Charge Code	16000638
Hospital Revenue Code	360
Min. Negotiated Rate	$3,363.85
Max. Negotiated Rate	$3,363.85
Rate for Payer: Qualcare PPO/HMO/WC	$3,363.85

HIP ARTHRO W/FEMOROPLASTY

Facility

$22,425.68

Service Code	HCPCS 29914
Hospital Charge Code	16000638
Hospital Revenue Code	360
Min. Negotiated Rate	$540.46
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,727.70
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,363.85
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$540.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$594.28

HIP ARTHRO W/LABRAL REPAIR

Facility

$22,425.68

Service Code	HCPCS 29916
Hospital Charge Code	16000579
Hospital Revenue Code	360
Min. Negotiated Rate	$540.46
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,727.70
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,363.85
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$540.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$594.28

HIP ARTHRO W/LABRAL REPAIR

Facility

$22,425.68

Service Code	HCPCS 29916
Hospital Charge Code	16000579
Hospital Revenue Code	360
Min. Negotiated Rate	$3,363.85
Max. Negotiated Rate	$3,363.85
Rate for Payer: Qualcare PPO/HMO/WC	$3,363.85

HIP BIL W/WO PELVIS 3-4 VIEWS

Facility

$593.26

Service Code	HCPCS 73522
Hospital Charge Code	2011597
Hospital Revenue Code	320
Min. Negotiated Rate	$14.30
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.98
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$88.99
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$14.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$15.72

HIP BIL W/WO PELVIS 3-4 VIEWS

Facility

$5,100.00

Service Code	HCPCS 73522
Hospital Charge Code	94061481
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

HIP BIL W/WO PELVIS 3-4 VIEWS

Facility

$593.26

Service Code	HCPCS 73522
Hospital Charge Code	75190636
Hospital Revenue Code	320
Min. Negotiated Rate	$14.30
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.98
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$88.99
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$14.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$15.72

HIP BIL W/WO PELVIS 3-4 VIEWS

Facility

$593.26

Service Code	HCPCS 73522
Hospital Charge Code	75190636
Hospital Revenue Code	320
Min. Negotiated Rate	$88.99
Max. Negotiated Rate	$88.99
Rate for Payer: Qualcare PPO/HMO/WC	$88.99

HIP BIL W/WO PELVIS 3-4 VIEWS

Facility

$593.26

Service Code	HCPCS 73522
Hospital Charge Code	2011597
Hospital Revenue Code	320
Min. Negotiated Rate	$88.99
Max. Negotiated Rate	$88.99
Rate for Payer: Qualcare PPO/HMO/WC	$88.99

HIP BIL W/WO PELVIS 3-4 VIEWS

Facility

$5,100.00

Service Code	HCPCS 73522
Hospital Charge Code	94061481
Hospital Revenue Code	320
Min. Negotiated Rate	$52.39
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
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: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

HIP BIL W/WO PELVIS 3-4 VIEWS

Facility

$5,100.00

Service Code	HCPCS 73522
Hospital Charge Code	2011561
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

HIP BIL W/WO PELVIS 3-4 VIEWS

Facility

$593.26

Service Code	HCPCS 73522
Hospital Charge Code	94270261
Hospital Revenue Code	320
Min. Negotiated Rate	$14.30
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.98
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$88.99
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$14.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$15.72

HIP BIL W/WO PELVIS 3-4 VIEWS

Facility

$5,100.00

Service Code	HCPCS 73522
Hospital Charge Code	2011561
Hospital Revenue Code	320
Min. Negotiated Rate	$52.39
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
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: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

HIP BIL W/WO PELVIS 3-4 VIEWS

Facility

$593.26

Service Code	HCPCS 73522
Hospital Charge Code	94270261
Hospital Revenue Code	320
Min. Negotiated Rate	$88.99
Max. Negotiated Rate	$88.99
Rate for Payer: Qualcare PPO/HMO/WC	$88.99

HIP BI W/WO PELVIS =/> 5 VIEWS

Facility

$1,131.07

Service Code	HCPCS 73523
Hospital Charge Code	94061482
Hospital Revenue Code	320
Min. Negotiated Rate	$169.66
Max. Negotiated Rate	$169.66
Rate for Payer: Qualcare PPO/HMO/WC	$169.66

HIP BI W/WO PELVIS =/> 5 VIEWS

Facility

$1,131.07

Service Code	HCPCS 73523
Hospital Charge Code	75190637
Hospital Revenue Code	320
Min. Negotiated Rate	$27.26
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.32
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$169.66
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$27.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$29.97

HIP BI W/WO PELVIS =/> 5 VIEWS

Facility

$1,131.07

Service Code	HCPCS 73523
Hospital Charge Code	94270262
Hospital Revenue Code	320
Min. Negotiated Rate	$27.26
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.32
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$169.66
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$27.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$29.97

Know your out-of-pocket cost for care.

All Charges