Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KNEEALIGN 2 NAVIGATION UNIT

Facility

$3,125.00

Hospital Charge Code	270675510
Hospital Revenue Code	272
Min. Negotiated Rate	$75.31
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.50
Rate for Payer: Oxford Commercial	$625.00
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Commercial	$625.00
Rate for Payer: UnitedHealthcare Community & State	$75.31
Rate for Payer: Wellpoint Medicaid Managed Care	$82.81

KNEEALIGN 2 NAVIGATION UNIT

Facility

$3,125.00

Hospital Charge Code	270675510
Hospital Revenue Code	272
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$468.75
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

KNEEALIGN 2 NAVIGATION UNIT PL

Facility

$2,604.17

Hospital Charge Code	270685463
Hospital Revenue Code	272
Min. Negotiated Rate	$62.76
Max. Negotiated Rate	$1,302.09
Rate for Payer: Aetna Commercial	$989.58
Rate for Payer: Aetna Medicare Advantage	$781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$664.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$664.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$664.06
Rate for Payer: Cigna Commercial	$1,302.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$781.25
Rate for Payer: Oxford Commercial	$520.83
Rate for Payer: Qualcare PPO/HMO/WC	$390.63
Rate for Payer: UnitedHealthcare Commercial	$520.83
Rate for Payer: UnitedHealthcare Community & State	$62.76
Rate for Payer: Wellpoint Medicaid Managed Care	$69.01

KNEEALIGN 2 NAVIGATION UNIT PL

Facility

$2,604.17

Hospital Charge Code	270685463
Hospital Revenue Code	272
Min. Negotiated Rate	$390.63
Max. Negotiated Rate	$390.63
Rate for Payer: Qualcare PPO/HMO/WC	$390.63

KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT

Facility

$31,025.32

Service Code	APR-DRG 3133
Min. Negotiated Rate	$30,416.98
Max. Negotiated Rate	$31,025.32
Rate for Payer: UnitedHealthcare Community & State	$30,416.98
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$31,025.32
Rate for Payer: Wellpoint Medicaid Managed Care	$30,416.98

KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT

Facility

$49,653.74

Service Code	APR-DRG 3134
Min. Negotiated Rate	$48,680.14
Max. Negotiated Rate	$49,653.74
Rate for Payer: UnitedHealthcare Community & State	$48,680.14
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$49,653.74
Rate for Payer: Wellpoint Medicaid Managed Care	$48,680.14

KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT

Facility

$21,595.52

Service Code	APR-DRG 3132
Min. Negotiated Rate	$21,172.08
Max. Negotiated Rate	$21,595.52
Rate for Payer: UnitedHealthcare Community & State	$21,172.08
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,595.52
Rate for Payer: Wellpoint Medicaid Managed Care	$21,172.08

KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT

Facility

$16,747.84

Service Code	APR-DRG 3131
Min. Negotiated Rate	$16,419.45
Max. Negotiated Rate	$16,747.84
Rate for Payer: UnitedHealthcare Community & State	$16,419.45
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,747.84
Rate for Payer: Wellpoint Medicaid Managed Care	$16,419.45

KNEE ARTHROSCOP/SURGERY--RT

Facility

$35,454.57

Service Code	HCPCS 29876
Hospital Charge Code	16000179
Hospital Revenue Code	360
Min. Negotiated Rate	$854.46
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
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	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,636.37
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,318.19
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$854.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$939.55

KNEE ARTHROSCOP/SURGERY--RT

Facility

$35,454.57

Service Code	HCPCS 29876
Hospital Charge Code	16000179
Hospital Revenue Code	360
Min. Negotiated Rate	$5,318.19
Max. Negotiated Rate	$5,318.19
Rate for Payer: Qualcare PPO/HMO/WC	$5,318.19

KNEE ARTHROSCOP/SURG--RT

Facility

$35,454.57

Service Code	HCPCS 29879
Hospital Charge Code	16000192
Hospital Revenue Code	360
Min. Negotiated Rate	$854.46
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
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	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,636.37
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,318.19
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$854.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,822.27
Rate for Payer: Wellpoint Medicaid Managed Care	$8,649.28

KNEE ARTHROSCOP/SURG--RT

Facility

$35,454.57

Service Code	HCPCS 29879
Hospital Charge Code	16000192
Hospital Revenue Code	360
Min. Negotiated Rate	$5,318.19
Max. Negotiated Rate	$5,318.19
Rate for Payer: Qualcare PPO/HMO/WC	$5,318.19

KNEE ARTHROSCOPY KIT

Facility

$461.00

Hospital Charge Code	270338737
Hospital Revenue Code	272
Min. Negotiated Rate	$11.11
Max. Negotiated Rate	$230.50
Rate for Payer: Aetna Commercial	$175.18
Rate for Payer: Aetna Medicare Advantage	$138.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.56
Rate for Payer: Cigna Commercial	$230.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.30
Rate for Payer: Oxford Commercial	$92.20
Rate for Payer: Qualcare PPO/HMO/WC	$69.15
Rate for Payer: UnitedHealthcare Commercial	$92.20
Rate for Payer: UnitedHealthcare Community & State	$11.11
Rate for Payer: Wellpoint Medicaid Managed Care	$12.22

KNEE ARTHROSCOPY KIT

Facility

$461.00

Hospital Charge Code	270338737
Hospital Revenue Code	272
Min. Negotiated Rate	$69.15
Max. Negotiated Rate	$69.15
Rate for Payer: Qualcare PPO/HMO/WC	$69.15

KNEE ARTHROSCOPY W LAT RLS

Facility

$31,016.90

Service Code	HCPCS 29873
Hospital Charge Code	16000380
Hospital Revenue Code	360
Min. Negotiated Rate	$4,652.53
Max. Negotiated Rate	$4,652.53
Rate for Payer: Qualcare PPO/HMO/WC	$4,652.53

KNEE ARTHROSCOPY W LAT RLS

Facility

$31,016.90

Service Code	HCPCS 29873
Hospital Charge Code	16000380
Hospital Revenue Code	360
Min. Negotiated Rate	$747.51
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
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	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,305.07
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,652.53
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$747.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$821.95

KNEE BLOCK

Facility

$6,250.00

Hospital Charge Code	270667770
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

KNEE BLOCK

Facility

$6,250.00

Hospital Charge Code	270667770
Hospital Revenue Code	278
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

KNEE CREATION-SCP FOOT & ANKLE

Facility

$15,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270686278
Hospital Revenue Code	278
Min. Negotiated Rate	$374.75
Max. Negotiated Rate	$7,775.00
Rate for Payer: Aetna Commercial	$5,909.00
Rate for Payer: Aetna Medicare Advantage	$4,665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,965.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,965.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,965.25
Rate for Payer: Cigna Commercial	$7,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,763.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,421.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,332.50
Rate for Payer: UnitedHealthcare Community & State	$374.75
Rate for Payer: Wellpoint Medicaid Managed Care	$412.07

KNEE CREATION-SCP FOOT & ANKLE

Facility

$15,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270686278
Hospital Revenue Code	278
Min. Negotiated Rate	$2,332.50
Max. Negotiated Rate	$3,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,763.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,421.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,332.50

KNEE CREATION SCP FT & AN 15 3

Facility

$15,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270686281
Hospital Revenue Code	278
Min. Negotiated Rate	$374.75
Max. Negotiated Rate	$7,775.00
Rate for Payer: Aetna Commercial	$5,909.00
Rate for Payer: Aetna Medicare Advantage	$4,665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,965.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,965.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,965.25
Rate for Payer: Cigna Commercial	$7,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,763.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,421.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,332.50
Rate for Payer: UnitedHealthcare Community & State	$374.75
Rate for Payer: Wellpoint Medicaid Managed Care	$412.07

KNEE CREATION SCP FT & AN 15 3

Facility

$15,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270686281
Hospital Revenue Code	278
Min. Negotiated Rate	$2,332.50
Max. Negotiated Rate	$3,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,763.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,421.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,332.50

KNEE CREATIONS SCP FOOT ANKLE

Facility

$18,337.50

Service Code	HCPCS C1776
Hospital Charge Code	270680418
Hospital Revenue Code	278
Min. Negotiated Rate	$2,750.62
Max. Negotiated Rate	$4,437.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,667.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,437.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,034.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,750.62

KNEE CREATIONS SCP FOOT ANKLE

Facility

$18,337.50

Service Code	HCPCS C1776
Hospital Charge Code	270680418
Hospital Revenue Code	278
Min. Negotiated Rate	$441.93
Max. Negotiated Rate	$9,168.75
Rate for Payer: Aetna Commercial	$6,968.25
Rate for Payer: Aetna Medicare Advantage	$5,501.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,676.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,676.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,667.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,676.06
Rate for Payer: Cigna Commercial	$9,168.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,437.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,034.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,750.62
Rate for Payer: UnitedHealthcare Community & State	$441.93
Rate for Payer: Wellpoint Medicaid Managed Care	$485.94

KNEE EXCHANGE TRIAL SET COPAL

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690885
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$60.25
Rate for Payer: Wellpoint Medicaid Managed Care	$66.25

Know your out-of-pocket cost for care.

All Charges