Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC

Facility

$69,721.89

Service Code	MSDRG 486
Min. Negotiated Rate	$21,229.42
Max. Negotiated Rate	$69,721.89
Rate for Payer: Aetna Commercial	$48,164.21
Rate for Payer: Aetna Medicare Advantage	$69,721.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46,754.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46,754.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22,346.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46,754.61
Rate for Payer: Cigna Commercial	$39,132.85
Rate for Payer: Cigna Medicare Advantage	$22,346.76
Rate for Payer: Clover Medicare Advantage	$21,229.42
Rate for Payer: EmblemHealth Commercial	$67,040.28
Rate for Payer: Humana Medicare Advantage	$23,017.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22,346.76
Rate for Payer: Oxford Commercial	$28,125.29
Rate for Payer: UnitedHealthcare Commercial	$49,318.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$22,346.76
Rate for Payer: Wellcare Medicare Advantage	$22,346.76

KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC

Facility

$106,439.30

Service Code	MSDRG 485
Min. Negotiated Rate	$32,409.40
Max. Negotiated Rate	$106,439.30
Rate for Payer: Aetna Commercial	$73,393.26
Rate for Payer: Aetna Medicare Advantage	$106,439.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76,528.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76,528.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34,115.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76,528.69
Rate for Payer: Cigna Commercial	$60,391.95
Rate for Payer: Cigna Medicare Advantage	$34,115.16
Rate for Payer: Clover Medicare Advantage	$32,409.40
Rate for Payer: EmblemHealth Commercial	$102,345.48
Rate for Payer: Humana Medicare Advantage	$35,138.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34,115.16
Rate for Payer: Oxford Commercial	$43,404.50
Rate for Payer: UnitedHealthcare Commercial	$76,111.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$34,115.16
Rate for Payer: Wellcare Medicare Advantage	$34,115.16

KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC

Facility

$52,756.27

Service Code	MSDRG 487
Min. Negotiated Rate	$16,063.61
Max. Negotiated Rate	$52,756.27
Rate for Payer: Aetna Commercial	$36,506.89
Rate for Payer: Aetna Medicare Advantage	$52,756.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,821.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,821.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,909.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,821.94
Rate for Payer: Cigna Commercial	$29,309.87
Rate for Payer: Cigna Medicare Advantage	$16,909.06
Rate for Payer: Clover Medicare Advantage	$16,063.61
Rate for Payer: EmblemHealth Commercial	$50,727.18
Rate for Payer: Humana Medicare Advantage	$17,416.33
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,909.06
Rate for Payer: Oxford Commercial	$21,065.39
Rate for Payer: UnitedHealthcare Commercial	$36,938.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,909.06
Rate for Payer: Wellcare Medicare Advantage	$16,909.06

KNEE REVISON SPECIALTY BUNDLE

Facility

$62,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270685546
Hospital Revenue Code	278
Min. Negotiated Rate	$1,506.25
Max. Negotiated Rate	$31,250.00
Rate for Payer: Aetna Commercial	$23,750.00
Rate for Payer: Aetna Medicare Advantage	$18,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,937.50
Rate for Payer: Cigna Commercial	$31,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,125.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,375.00
Rate for Payer: UnitedHealthcare Community & State	$1,506.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1,656.25

KNEE REVISON SPECIALTY BUNDLE

Facility

$62,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270685546
Hospital Revenue Code	278
Min. Negotiated Rate	$9,375.00
Max. Negotiated Rate	$15,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,125.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,375.00

KNEES BILATERAL

Facility

$6,601.19

Service Code	HCPCS 7356050
Hospital Charge Code	2011352
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

KNEES BILATERAL

Facility

$6,601.19

Service Code	HCPCS 7356050
Hospital Charge Code	2011352
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

KNEE SPACER HIGH RELEASE MED

Facility

$19,950.00

Hospital Charge Code	270669747
Hospital Revenue Code	278
Min. Negotiated Rate	$2,992.50
Max. Negotiated Rate	$4,827.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,827.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,389.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,992.50

KNEE SPACER HIGH RELEASE MED

Facility

$19,950.00

Hospital Charge Code	270669747
Hospital Revenue Code	278
Min. Negotiated Rate	$480.80
Max. Negotiated Rate	$9,975.00
Rate for Payer: Aetna Commercial	$7,581.00
Rate for Payer: Aetna Medicare Advantage	$5,985.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,087.25
Rate for Payer: Cigna Commercial	$9,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,827.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,389.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,992.50
Rate for Payer: UnitedHealthcare Community & State	$480.80
Rate for Payer: Wellpoint Medicaid Managed Care	$528.67

KNEE SUPPORT LG

Facility

$48.90

Hospital Charge Code	270649585
Hospital Revenue Code	272
Min. Negotiated Rate	$7.33
Max. Negotiated Rate	$7.33
Rate for Payer: Qualcare PPO/HMO/WC	$7.33

KNEE SUPPORT LG

Facility

$48.90

Hospital Charge Code	270649585
Hospital Revenue Code	272
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$24.45
Rate for Payer: Aetna Commercial	$18.58
Rate for Payer: Aetna Medicare Advantage	$14.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.47
Rate for Payer: Cigna Commercial	$24.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.67
Rate for Payer: Oxford Commercial	$9.78
Rate for Payer: Qualcare PPO/HMO/WC	$7.33
Rate for Payer: UnitedHealthcare Commercial	$9.78
Rate for Payer: UnitedHealthcare Community & State	$1.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1.30

KNEE SUPPORT MED

Facility

$49.25

Hospital Charge Code	270649586
Hospital Revenue Code	272
Min. Negotiated Rate	$7.39
Max. Negotiated Rate	$7.39
Rate for Payer: Qualcare PPO/HMO/WC	$7.39

KNEE SUPPORT MED

Facility

$49.25

Hospital Charge Code	270649586
Hospital Revenue Code	272
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$24.62
Rate for Payer: Aetna Commercial	$18.71
Rate for Payer: Aetna Medicare Advantage	$14.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.56
Rate for Payer: Cigna Commercial	$24.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.78
Rate for Payer: Oxford Commercial	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$7.39
Rate for Payer: UnitedHealthcare Commercial	$9.85
Rate for Payer: UnitedHealthcare Community & State	$1.19
Rate for Payer: Wellpoint Medicaid Managed Care	$1.31

KNEE SUPPORT SMALL

Facility

$28.70

Hospital Charge Code	270649587
Hospital Revenue Code	272
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$14.35
Rate for Payer: Aetna Commercial	$10.91
Rate for Payer: Aetna Medicare Advantage	$8.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.32
Rate for Payer: Cigna Commercial	$14.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.61
Rate for Payer: Oxford Commercial	$5.74
Rate for Payer: Qualcare PPO/HMO/WC	$4.30
Rate for Payer: UnitedHealthcare Commercial	$5.74
Rate for Payer: UnitedHealthcare Community & State	$0.69
Rate for Payer: Wellpoint Medicaid Managed Care	$0.76

KNEE SUPPORT SMALL

Facility

$28.70

Hospital Charge Code	270649587
Hospital Revenue Code	272
Min. Negotiated Rate	$4.30
Max. Negotiated Rate	$4.30
Rate for Payer: Qualcare PPO/HMO/WC	$4.30

KNEE SUPPORT XL

Facility

$50.90

Hospital Charge Code	270649588
Hospital Revenue Code	272
Min. Negotiated Rate	$7.63
Max. Negotiated Rate	$7.63
Rate for Payer: Qualcare PPO/HMO/WC	$7.63

KNEE SUPPORT XL

Facility

$50.90

Hospital Charge Code	270649588
Hospital Revenue Code	272
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$25.45
Rate for Payer: Aetna Commercial	$19.34
Rate for Payer: Aetna Medicare Advantage	$15.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.98
Rate for Payer: Cigna Commercial	$25.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.27
Rate for Payer: Oxford Commercial	$10.18
Rate for Payer: Qualcare PPO/HMO/WC	$7.63
Rate for Payer: UnitedHealthcare Commercial	$10.18
Rate for Payer: UnitedHealthcare Community & State	$1.23
Rate for Payer: Wellpoint Medicaid Managed Care	$1.35

KNEE SYSTEM SOMBRERO PATELLA

Facility

$1,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270675246
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

KNEE SYSTEM SOMBRERO PATELLA

Facility

$1,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270675246
Hospital Revenue Code	278
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$36.15
Rate for Payer: Wellpoint Medicaid Managed Care	$39.75

KNEE USER KIT FOR GPS STATION

Facility

$1,750.00

Hospital Charge Code	270673239
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

KNEE USER KIT FOR GPS STATION

Facility

$1,750.00

Hospital Charge Code	270673239
Hospital Revenue Code	272
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$525.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$350.00
Rate for Payer: UnitedHealthcare Community & State	$42.17
Rate for Payer: Wellpoint Medicaid Managed Care	$46.38

KNEE ZIM POST GR 10 59964010

Facility

$4,672.50

Hospital Charge Code	270623447
Hospital Revenue Code	272
Min. Negotiated Rate	$700.88
Max. Negotiated Rate	$700.88
Rate for Payer: Qualcare PPO/HMO/WC	$700.88

KNEE ZIM POST GR 10 59964010

Facility

$4,672.50

Hospital Charge Code	270623447
Hospital Revenue Code	272
Min. Negotiated Rate	$112.61
Max. Negotiated Rate	$2,336.25
Rate for Payer: Aetna Commercial	$1,775.55
Rate for Payer: Aetna Medicare Advantage	$1,401.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,191.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,191.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,191.49
Rate for Payer: Cigna Commercial	$2,336.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,401.75
Rate for Payer: Oxford Commercial	$934.50
Rate for Payer: Qualcare PPO/HMO/WC	$700.88
Rate for Payer: UnitedHealthcare Commercial	$934.50
Rate for Payer: UnitedHealthcare Community & State	$112.61
Rate for Payer: Wellpoint Medicaid Managed Care	$123.82

KNEE ZIM TIB ART 1.8 57884008

Facility

$1,848.00

Hospital Charge Code	270626738
Hospital Revenue Code	272
Min. Negotiated Rate	$44.54
Max. Negotiated Rate	$924.00
Rate for Payer: Aetna Commercial	$702.24
Rate for Payer: Aetna Medicare Advantage	$554.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.24
Rate for Payer: Cigna Commercial	$924.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$554.40
Rate for Payer: Oxford Commercial	$369.60
Rate for Payer: Qualcare PPO/HMO/WC	$277.20
Rate for Payer: UnitedHealthcare Commercial	$369.60
Rate for Payer: UnitedHealthcare Community & State	$44.54
Rate for Payer: Wellpoint Medicaid Managed Care	$48.97

KNEE ZIM TIB ART 1.8 57884008

Facility

$1,848.00

Hospital Charge Code	270626738
Hospital Revenue Code	272
Min. Negotiated Rate	$277.20
Max. Negotiated Rate	$277.20
Rate for Payer: Qualcare PPO/HMO/WC	$277.20

Know your out-of-pocket cost for care.

All Charges