Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ANISTREPLASE INJ 30 UNIT

Facility

$13,138.60

Hospital Charge Code	6008510
Hospital Revenue Code	636
Min. Negotiated Rate	$316.64
Max. Negotiated Rate	$6,569.30
Rate for Payer: Aetna Commercial	$4,992.67
Rate for Payer: Aetna Medicare Advantage	$3,941.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,350.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,350.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,350.34
Rate for Payer: Cigna Commercial	$6,569.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,179.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,970.79
Rate for Payer: UnitedHealthcare Community & State	$316.64
Rate for Payer: Wellpoint Medicaid Managed Care	$348.17

ANKLE AP&LAT POST-LT

Facility

$251.00

Service Code	HCPCS 73600LT
Hospital Charge Code	94061387
Hospital Revenue Code	320
Min. Negotiated Rate	$37.65
Max. Negotiated Rate	$37.65
Rate for Payer: Qualcare PPO/HMO/WC	$37.65

ANKLE AP&LAT POST-LT

Facility

$251.00

Service Code	HCPCS 73600LT
Hospital Charge Code	94061387
Hospital Revenue Code	320
Min. Negotiated Rate	$6.05
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$95.38
Rate for Payer: Aetna Medicare Advantage	$75.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.00
Rate for Payer: Cigna Commercial	$125.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.30
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.65
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$6.05
Rate for Payer: Wellpoint Medicaid Managed Care	$6.65

ANKLE AP&LAT POST-RT

Facility

$5,100.00

Service Code	HCPCS 73600RT
Hospital Charge Code	94061391
Hospital Revenue Code	320
Min. Negotiated Rate	$122.91
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
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: Wellpoint Medicaid Managed Care	$135.15

ANKLE AP&LAT POST-RT

Facility

$5,100.00

Service Code	HCPCS 73600RT
Hospital Charge Code	94061391
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ANKLE AP& LAT VIEWS-BI

Facility

$5,100.00

Service Code	HCPCS 7360050
Hospital Charge Code	94061247
Hospital Revenue Code	320
Min. Negotiated Rate	$122.91
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
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: Wellpoint Medicaid Managed Care	$135.15

ANKLE AP& LAT VIEWS-BI

Facility

$5,100.00

Service Code	HCPCS 7360050
Hospital Charge Code	94061247
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ANKLE AP& LAT VIEWS-LT

Facility

$5,100.00

Service Code	HCPCS 73600LT
Hospital Charge Code	94061385
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ANKLE AP& LAT VIEWS-LT

Facility

$5,100.00

Service Code	HCPCS 73600LT
Hospital Charge Code	94061385
Hospital Revenue Code	320
Min. Negotiated Rate	$122.91
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
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: Wellpoint Medicaid Managed Care	$135.15

ANKLE AP& LAT VIEWS-RT

Facility

$5,100.00

Service Code	HCPCS 73600RT
Hospital Charge Code	94061389
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ANKLE AP& LAT VIEWS-RT

Facility

$5,100.00

Service Code	HCPCS 73600RT
Hospital Charge Code	94061389
Hospital Revenue Code	320
Min. Negotiated Rate	$122.91
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
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: Wellpoint Medicaid Managed Care	$135.15

ANKLE ARTHROSCOPY W FUSION

Facility

$50,586.00

Service Code	HCPCS 29899
Hospital Charge Code	16000457
Hospital Revenue Code	360
Min. Negotiated Rate	$1,219.12
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	$1,355.00
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	$15,175.80
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,587.90
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,219.12
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	$1,340.53

ANKLE ARTHROSCOPY W FUSION

Facility

$50,586.00

Service Code	HCPCS 29899
Hospital Charge Code	16000457
Hospital Revenue Code	360
Min. Negotiated Rate	$7,587.90
Max. Negotiated Rate	$7,587.90
Rate for Payer: Qualcare PPO/HMO/WC	$7,587.90

ANKLE COMPL 3 VWS BIL

Facility

$6,601.19

Service Code	HCPCS 7361050
Hospital Charge Code	94061249
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

ANKLE COMPL 3 VWS BIL

Facility

$6,601.19

Service Code	HCPCS 7361050
Hospital Charge Code	94061249
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

ANKLE COMPL 3 VWS-LT

Facility

$6,601.19

Service Code	HCPCS 73610LT
Hospital Charge Code	94061393
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

ANKLE COMPL 3 VWS-LT

Facility

$6,601.19

Service Code	HCPCS 73610LT
Hospital Charge Code	94061393
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

ANKLE COMPL 3 VWS-RT

Facility

$6,601.19

Service Code	HCPCS 73610RT
Hospital Charge Code	94061395
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

ANKLE COMPL 3 VWS-RT

Facility

$6,601.19

Service Code	HCPCS 73610RT
Hospital Charge Code	94061395
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

ANKLE COMP TIBIA TM SZ 4

Facility

$22,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270695542
Hospital Revenue Code	278
Min. Negotiated Rate	$3,300.00
Max. Negotiated Rate	$5,324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,324.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,300.00

ANKLE COMP TIBIA TM SZ 4

Facility

$22,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270695542
Hospital Revenue Code	278
Min. Negotiated Rate	$530.20
Max. Negotiated Rate	$11,000.00
Rate for Payer: Aetna Commercial	$8,360.00
Rate for Payer: Aetna Medicare Advantage	$6,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,610.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,610.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,610.00
Rate for Payer: Cigna Commercial	$11,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,324.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,300.00
Rate for Payer: UnitedHealthcare Community & State	$530.20
Rate for Payer: Wellpoint Medicaid Managed Care	$583.00

ANKLE DISTRACTOR STRAP

Facility

$225.00

Service Code	HCPCS L1920
Hospital Charge Code	270661561
Hospital Revenue Code	274
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

ANKLE DISTRACTOR STRAP

Facility

$225.00

Service Code	HCPCS L1920
Hospital Charge Code	270661561
Hospital Revenue Code	274
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

ANKLE/FT ORTHOSIS LEFT SZ 7-9

Facility

$122.70

Service Code	HCPCS L1930
Hospital Charge Code	270669746
Hospital Revenue Code	274
Min. Negotiated Rate	$2.96
Max. Negotiated Rate	$61.35
Rate for Payer: Aetna Commercial	$46.63
Rate for Payer: Aetna Medicare Advantage	$36.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.29
Rate for Payer: Cigna Commercial	$61.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.99
Rate for Payer: Qualcare PPO/HMO/WC	$18.41
Rate for Payer: UnitedHealthcare Community & State	$2.96
Rate for Payer: Wellpoint Medicaid Managed Care	$3.25

ANKLE/FT ORTHOSIS LEFT SZ 7-9

Facility

$122.70

Service Code	HCPCS L1930
Hospital Charge Code	270669746
Hospital Revenue Code	274
Min. Negotiated Rate	$18.41
Max. Negotiated Rate	$29.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.99
Rate for Payer: Qualcare PPO/HMO/WC	$18.41

Know your out-of-pocket cost for care.

All Charges