Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IMPLANT TOE MEDIUM PC 10413

Facility

$4,588.00

Hospital Charge Code	270632583
Hospital Revenue Code	278
Min. Negotiated Rate	$110.57
Max. Negotiated Rate	$2,294.00
Rate for Payer: Aetna Commercial	$1,743.44
Rate for Payer: Aetna Medicare Advantage	$1,376.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,169.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,169.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$917.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,169.94
Rate for Payer: Cigna Commercial	$2,294.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,110.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,009.36
Rate for Payer: Qualcare PPO/HMO/WC	$688.20
Rate for Payer: UnitedHealthcare Community & State	$110.57
Rate for Payer: Wellpoint Medicaid Managed Care	$121.58

IMPLANT TOE MEDIUM PC 10413

Facility

$4,588.00

Hospital Charge Code	270632583
Hospital Revenue Code	278
Min. Negotiated Rate	$688.20
Max. Negotiated Rate	$1,110.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$917.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,110.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,009.36
Rate for Payer: Qualcare PPO/HMO/WC	$688.20

IMPLANT TOE MED M/L PC 14960

Facility

$4,588.00

Hospital Charge Code	270632584
Hospital Revenue Code	278
Min. Negotiated Rate	$688.20
Max. Negotiated Rate	$1,110.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$917.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,110.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,009.36
Rate for Payer: Qualcare PPO/HMO/WC	$688.20

IMPLANT TOE MED M/L PC 14960

Facility

$4,588.00

Hospital Charge Code	270632584
Hospital Revenue Code	278
Min. Negotiated Rate	$110.57
Max. Negotiated Rate	$2,294.00
Rate for Payer: Aetna Commercial	$1,743.44
Rate for Payer: Aetna Medicare Advantage	$1,376.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,169.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,169.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$917.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,169.94
Rate for Payer: Cigna Commercial	$2,294.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,110.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,009.36
Rate for Payer: Qualcare PPO/HMO/WC	$688.20
Rate for Payer: UnitedHealthcare Community & State	$110.57
Rate for Payer: Wellpoint Medicaid Managed Care	$121.58

IMPLANT TOE M/L NPC 14958

Facility

$3,844.00

Hospital Charge Code	270632588
Hospital Revenue Code	278
Min. Negotiated Rate	$576.60
Max. Negotiated Rate	$930.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$768.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$930.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$845.68
Rate for Payer: Qualcare PPO/HMO/WC	$576.60

IMPLANT TOE M/L NPC 14958

Facility

$3,844.00

Hospital Charge Code	270632588
Hospital Revenue Code	278
Min. Negotiated Rate	$92.64
Max. Negotiated Rate	$1,922.00
Rate for Payer: Aetna Commercial	$1,460.72
Rate for Payer: Aetna Medicare Advantage	$1,153.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$980.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$980.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$768.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$980.22
Rate for Payer: Cigna Commercial	$1,922.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$930.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$845.68
Rate for Payer: Qualcare PPO/HMO/WC	$576.60
Rate for Payer: UnitedHealthcare Community & State	$92.64
Rate for Payer: Wellpoint Medicaid Managed Care	$101.87

IMPLANT TOE SGARLATO KIT B

Facility

$1,050.00

Hospital Charge Code	27060877
Hospital Revenue Code	274
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

IMPLANT TOE SGARLATO KIT B

Facility

$1,050.00

Hospital Charge Code	27060877
Hospital Revenue Code	274
Min. Negotiated Rate	$25.30
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$399.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50
Rate for Payer: UnitedHealthcare Community & State	$25.30
Rate for Payer: Wellpoint Medicaid Managed Care	$27.82

IMPLANT TOE SMALL NPC 10060

Facility

$4,000.00

Hospital Charge Code	270632586
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

IMPLANT TOE SMALL NPC 10060

Facility

$4,000.00

Hospital Charge Code	270632586
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

IMPLANT TOE SMALL PC 10412

Facility

$4,588.00

Hospital Charge Code	270632582
Hospital Revenue Code	278
Min. Negotiated Rate	$110.57
Max. Negotiated Rate	$2,294.00
Rate for Payer: Aetna Commercial	$1,743.44
Rate for Payer: Aetna Medicare Advantage	$1,376.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,169.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,169.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$917.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,169.94
Rate for Payer: Cigna Commercial	$2,294.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,110.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,009.36
Rate for Payer: Qualcare PPO/HMO/WC	$688.20
Rate for Payer: UnitedHealthcare Community & State	$110.57
Rate for Payer: Wellpoint Medicaid Managed Care	$121.58

IMPLANT TOE SMALL PC 10412

Facility

$4,588.00

Hospital Charge Code	270632582
Hospital Revenue Code	278
Min. Negotiated Rate	$688.20
Max. Negotiated Rate	$1,110.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$917.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,110.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,009.36
Rate for Payer: Qualcare PPO/HMO/WC	$688.20

IMPLANT WM TOE DBL STEM 1526BR

Facility

$2,857.65

Hospital Charge Code	270612535
Hospital Revenue Code	278
Min. Negotiated Rate	$428.65
Max. Negotiated Rate	$691.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$571.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$691.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$628.68
Rate for Payer: Qualcare PPO/HMO/WC	$428.65

IMPLANT WM TOE DBL STEM 1526BR

Facility

$2,857.65

Hospital Charge Code	270612535
Hospital Revenue Code	278
Min. Negotiated Rate	$68.87
Max. Negotiated Rate	$1,428.83
Rate for Payer: Aetna Commercial	$1,085.91
Rate for Payer: Aetna Medicare Advantage	$857.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$728.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$728.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$571.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$728.70
Rate for Payer: Cigna Commercial	$1,428.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$691.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$628.68
Rate for Payer: Qualcare PPO/HMO/WC	$428.65
Rate for Payer: UnitedHealthcare Community & State	$68.87
Rate for Payer: Wellpoint Medicaid Managed Care	$75.73

IMPLANT WMT TOE FH 2-0 4260020

Facility

$5,011.25

Hospital Charge Code	270613945
Hospital Revenue Code	278
Min. Negotiated Rate	$120.77
Max. Negotiated Rate	$2,505.62
Rate for Payer: Aetna Commercial	$1,904.28
Rate for Payer: Aetna Medicare Advantage	$1,503.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,277.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,277.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,002.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,277.87
Rate for Payer: Cigna Commercial	$2,505.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,212.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,102.47
Rate for Payer: Qualcare PPO/HMO/WC	$751.69
Rate for Payer: UnitedHealthcare Community & State	$120.77
Rate for Payer: Wellpoint Medicaid Managed Care	$132.80

IMPLANT WMT TOE FH 2-0 4260020

Facility

$5,011.25

Hospital Charge Code	270613945
Hospital Revenue Code	278
Min. Negotiated Rate	$751.69
Max. Negotiated Rate	$1,212.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,002.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,212.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,102.47
Rate for Payer: Qualcare PPO/HMO/WC	$751.69

IMPLANT WMT TOE FH 4-0 4260004

Facility

$3,218.45

Hospital Charge Code	270611671
Hospital Revenue Code	278
Min. Negotiated Rate	$77.56
Max. Negotiated Rate	$1,609.22
Rate for Payer: Aetna Commercial	$1,223.01
Rate for Payer: Aetna Medicare Advantage	$965.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$820.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$820.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$820.70
Rate for Payer: Cigna Commercial	$1,609.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$708.06
Rate for Payer: Qualcare PPO/HMO/WC	$482.77
Rate for Payer: UnitedHealthcare Community & State	$77.56
Rate for Payer: Wellpoint Medicaid Managed Care	$85.29

IMPLANT WMT TOE FH 4-0 4260004

Facility

$3,218.45

Hospital Charge Code	270611671
Hospital Revenue Code	278
Min. Negotiated Rate	$482.77
Max. Negotiated Rate	$778.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$708.06
Rate for Payer: Qualcare PPO/HMO/WC	$482.77

IMPLAT PROSTOP 10 X 14

Facility

$6,075.00

Hospital Charge Code	270656519
Hospital Revenue Code	278
Min. Negotiated Rate	$146.41
Max. Negotiated Rate	$3,037.50
Rate for Payer: Aetna Commercial	$2,308.50
Rate for Payer: Aetna Medicare Advantage	$1,822.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,549.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,549.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,549.12
Rate for Payer: Cigna Commercial	$3,037.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,470.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,336.50
Rate for Payer: Qualcare PPO/HMO/WC	$911.25
Rate for Payer: UnitedHealthcare Community & State	$146.41
Rate for Payer: Wellpoint Medicaid Managed Care	$160.99

IMPLAT PROSTOP 10 X 14

Facility

$6,075.00

Hospital Charge Code	270656519
Hospital Revenue Code	278
Min. Negotiated Rate	$911.25
Max. Negotiated Rate	$1,470.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,470.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,336.50
Rate for Payer: Qualcare PPO/HMO/WC	$911.25

IMPL BREAST 325 MED PROF-NC$

Facility

$0.01

Service Code	HCPCS L8600
Hospital Charge Code	270697860
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

IMPL BREAST 325 MED PROF-NC$

Facility

$0.01

Service Code	HCPCS L8600
Hospital Charge Code	270697860
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

IMPL DEL SYS DISTAL BICEP BIOC

Facility

$5,500.00

Hospital Charge Code	270677574
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

IMPL DEL SYS DISTAL BICEP BIOC

Facility

$5,500.00

Hospital Charge Code	270677574
Hospital Revenue Code	278
Min. Negotiated Rate	$132.55
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$132.55
Rate for Payer: Wellpoint Medicaid Managed Care	$145.75

IMPL DEL SYS DIST BIOCOM BICEP

Facility

$5,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270681458
Hospital Revenue Code	278
Min. Negotiated Rate	$132.55
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$132.55
Rate for Payer: Wellpoint Medicaid Managed Care	$145.75

Know your out-of-pocket cost for care.

All Charges