Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ARTHRODESIS GREAT TOE,IP JOINT

Facility

$19,998.60

Service Code	HCPCS 28755
Hospital Charge Code	16000726
Hospital Revenue Code	360
Min. Negotiated Rate	$2,999.79
Max. Negotiated Rate	$2,999.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79

ARTHRODESIS GREAT TOE,MTP JNT

Facility

$57,834.50

Service Code	HCPCS 28750
Hospital Charge Code	16000279
Hospital Revenue Code	360
Min. Negotiated Rate	$8,675.17
Max. Negotiated Rate	$8,675.17
Rate for Payer: Qualcare PPO/HMO/WC	$8,675.17

ARTHRODESIS GREAT TOE,MTP JNT

Facility

$57,834.50

Service Code	HCPCS 28750
Hospital Charge Code	16000279
Hospital Revenue Code	360
Min. Negotiated Rate	$1,393.81
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	$17,350.35
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,675.17
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,393.81
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	$1,532.61

ARTHRODESIS MT OR TME; SGL JOI

Facility

$50,347.74

Service Code	HCPCS 28740
Hospital Charge Code	16000454
Hospital Revenue Code	360
Min. Negotiated Rate	$1,213.38
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	$15,104.32
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,552.16
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,213.38
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	$1,334.22

ARTHRODESIS MT OR TME; SGL JOI

Facility

$50,347.74

Service Code	HCPCS 28740
Hospital Charge Code	16000454
Hospital Revenue Code	360
Min. Negotiated Rate	$7,552.16
Max. Negotiated Rate	$7,552.16
Rate for Payer: Qualcare PPO/HMO/WC	$7,552.16

ARTHRODESIS POST 1LEV LUMBAR

Facility

$47,548.90

Service Code	HCPCS 22612
Hospital Charge Code	16000374
Hospital Revenue Code	360
Min. Negotiated Rate	$1,145.93
Max. Negotiated Rate	$75,192.36
Rate for Payer: Aetna Commercial	$56,659.34
Rate for Payer: Aetna Medicare Advantage	$67,491.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75,192.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75,192.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,830.64
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	$75,192.36
Rate for Payer: Cigna Commercial	$41,754.94
Rate for Payer: Cigna Medicare Advantage	$20,830.64
Rate for Payer: Clover Medicare Advantage	$19,789.11
Rate for Payer: EmblemHealth Commercial	$62,491.92
Rate for Payer: Humana Medicare Advantage	$21,455.56
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,830.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,264.67
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,145.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,830.64
Rate for Payer: Wellcare Medicare Advantage	$20,830.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1,260.05

ARTHRODESIS POST 1LEV LUMBAR

Facility

$47,548.90

Service Code	HCPCS 22612
Hospital Charge Code	16000374
Hospital Revenue Code	360
Min. Negotiated Rate	$7,132.34
Max. Negotiated Rate	$7,132.34
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34

ARTHRODESIS POSTERIOR;EA ADD

Facility

$25,282.63

Service Code	HCPCS 22614
Hospital Charge Code	16000359
Hospital Revenue Code	360
Min. Negotiated Rate	$3,792.39
Max. Negotiated Rate	$3,792.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,792.39

ARTHRODESIS POSTERIOR;EA ADD

Facility

$25,282.63

Service Code	HCPCS 22614
Hospital Charge Code	16000359
Hospital Revenue Code	360
Min. Negotiated Rate	$609.31
Max. Negotiated Rate	$12,641.32
Rate for Payer: Aetna Commercial	$9,607.40
Rate for Payer: Aetna Medicare Advantage	$7,584.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,447.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,447.07
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	$6,447.07
Rate for Payer: Cigna Commercial	$12,641.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,584.79
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,792.39
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$609.31

ARTHRODESIS SACROILIAC JOINT

Facility

$124,290.30

Service Code	HCPCS 27279
Hospital Charge Code	16000875
Hospital Revenue Code	360
Min. Negotiated Rate	$18,643.54
Max. Negotiated Rate	$18,643.54
Rate for Payer: Qualcare PPO/HMO/WC	$18,643.54

ARTHRODESIS SACROILIAC JOINT

Facility

$124,290.30

Service Code	HCPCS 27279
Hospital Charge Code	16000875
Hospital Revenue Code	360
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$75,192.36
Rate for Payer: Aetna Commercial	$56,659.34
Rate for Payer: Aetna Medicare Advantage	$67,491.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75,192.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75,192.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,830.64
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	$75,192.36
Rate for Payer: Cigna Commercial	$41,754.94
Rate for Payer: Cigna Medicare Advantage	$20,830.64
Rate for Payer: Clover Medicare Advantage	$19,789.11
Rate for Payer: EmblemHealth Commercial	$62,491.92
Rate for Payer: Humana Medicare Advantage	$21,455.56
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,830.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37,287.09
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$18,643.54
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$2,995.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,830.64
Rate for Payer: Wellcare Medicare Advantage	$20,830.64
Rate for Payer: Wellpoint Medicaid Managed Care	$3,293.69

ARTHRODESIS SACROILIAC JOINT

Facility

$11,748.30

Service Code	HCPCS 27280
Hospital Charge Code	1600000856
Hospital Revenue Code	360
Min. Negotiated Rate	$283.13
Max. Negotiated Rate	$75,192.36
Rate for Payer: Aetna Commercial	$56,659.34
Rate for Payer: Aetna Medicare Advantage	$67,491.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75,192.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75,192.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,830.64
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	$75,192.36
Rate for Payer: Cigna Commercial	$41,754.94
Rate for Payer: Cigna Medicare Advantage	$20,830.64
Rate for Payer: Clover Medicare Advantage	$19,789.11
Rate for Payer: EmblemHealth Commercial	$62,491.92
Rate for Payer: Humana Medicare Advantage	$21,455.56
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,830.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,524.49
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,762.24
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$283.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,830.64
Rate for Payer: Wellcare Medicare Advantage	$20,830.64
Rate for Payer: Wellpoint Medicaid Managed Care	$311.33

ARTHRODESIS SACROILIAC JOINT

Facility

$11,748.30

Service Code	HCPCS 27280
Hospital Charge Code	1600000856
Hospital Revenue Code	360
Min. Negotiated Rate	$1,762.24
Max. Negotiated Rate	$1,762.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,762.24

ARTHROD MCP JOINT W/WO FIXATN

Facility

$26,471.80

Service Code	HCPCS 26850
Hospital Charge Code	16000859
Hospital Revenue Code	360
Min. Negotiated Rate	$637.97
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	$7,941.54
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,970.77
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$637.97
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	$701.50

ARTHROD MCP JOINT W/WO FIXATN

Facility

$26,471.80

Service Code	HCPCS 26850
Hospital Charge Code	16000859
Hospital Revenue Code	360
Min. Negotiated Rate	$3,970.77
Max. Negotiated Rate	$3,970.77
Rate for Payer: Qualcare PPO/HMO/WC	$3,970.77

ARTHROD MT OR TMT MULTI/TRANSV

Facility

$72,664.88

Service Code	HCPCS 28730
Hospital Charge Code	1600000289
Hospital Revenue Code	360
Min. Negotiated Rate	$10,899.73
Max. Negotiated Rate	$10,899.73
Rate for Payer: Qualcare PPO/HMO/WC	$10,899.73

ARTHROD MT OR TMT MULTI/TRANSV

Facility

$72,664.88

Service Code	HCPCS 28730
Hospital Charge Code	1600000289
Hospital Revenue Code	360
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$55,057.64
Rate for Payer: Aetna Commercial	$41,487.32
Rate for Payer: Aetna Medicare Advantage	$49,418.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55,057.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55,057.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,252.69
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	$55,057.64
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: Cigna Medicare Advantage	$15,252.69
Rate for Payer: Clover Medicare Advantage	$14,490.06
Rate for Payer: EmblemHealth Commercial	$45,758.07
Rate for Payer: Humana Medicare Advantage	$15,710.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,252.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,799.46
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$10,899.73
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,751.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,252.69
Rate for Payer: Wellcare Medicare Advantage	$15,252.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1,925.62

ARTHROD MT OR TMT MULTI/TRANSV

Facility

$72,664.88

Service Code	HCPCS 28730
Hospital Charge Code	1600000617
Hospital Revenue Code	360
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$55,057.64
Rate for Payer: Aetna Commercial	$41,487.32
Rate for Payer: Aetna Medicare Advantage	$49,418.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55,057.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55,057.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,252.69
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	$55,057.64
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: Cigna Medicare Advantage	$15,252.69
Rate for Payer: Clover Medicare Advantage	$14,490.06
Rate for Payer: EmblemHealth Commercial	$45,758.07
Rate for Payer: Humana Medicare Advantage	$15,710.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,252.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,799.46
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$10,899.73
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,751.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,252.69
Rate for Payer: Wellcare Medicare Advantage	$15,252.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1,925.62

ARTHROD MT OR TMT MULTI/TRANSV

Facility

$72,664.88

Service Code	HCPCS 28730
Hospital Charge Code	1600000617
Hospital Revenue Code	360
Min. Negotiated Rate	$10,899.73
Max. Negotiated Rate	$10,899.73
Rate for Payer: Qualcare PPO/HMO/WC	$10,899.73

Arthroereisis Sizer, 9 mm

Facility

$5,475.00

Hospital Charge Code	270684397
Hospital Revenue Code	272
Min. Negotiated Rate	$821.25
Max. Negotiated Rate	$821.25
Rate for Payer: Qualcare PPO/HMO/WC	$821.25

Arthroereisis Sizer, 9 mm

Facility

$5,475.00

Hospital Charge Code	270684397
Hospital Revenue Code	272
Min. Negotiated Rate	$131.95
Max. Negotiated Rate	$2,737.50
Rate for Payer: Aetna Commercial	$2,080.50
Rate for Payer: Aetna Medicare Advantage	$1,642.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,396.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,396.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,396.12
Rate for Payer: Cigna Commercial	$2,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,642.50
Rate for Payer: Oxford Commercial	$1,095.00
Rate for Payer: Qualcare PPO/HMO/WC	$821.25
Rate for Payer: UnitedHealthcare Commercial	$1,095.00
Rate for Payer: UnitedHealthcare Community & State	$131.95
Rate for Payer: Wellpoint Medicaid Managed Care	$145.09

ARTHROFLEXDECELDERM40X70X1.0MM

Facility

$13,805.00

Service Code	HCPCS Q4125
Hospital Charge Code	270698093
Hospital Revenue Code	278
Min. Negotiated Rate	$2,070.75
Max. Negotiated Rate	$3,340.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,761.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,340.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,037.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,070.75

ARTHROFLEXDECELDERM40X70X1.0MM

Facility

$13,805.00

Service Code	HCPCS Q4125
Hospital Charge Code	270698093
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$3,340.81
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,761.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$533.66
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,340.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,037.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,070.75
Rate for Payer: UnitedHealthcare Community & State	$332.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$365.83

ARTHROPLASTY ANKLE,

Facility

$37,086.60

Service Code	HCPCS 27700
Hospital Charge Code	16000566
Hospital Revenue Code	360
Min. Negotiated Rate	$5,562.99
Max. Negotiated Rate	$5,562.99
Rate for Payer: Qualcare PPO/HMO/WC	$5,562.99

ARTHROPLASTY ANKLE,

Facility

$37,086.60

Service Code	HCPCS 27700
Hospital Charge Code	16000566
Hospital Revenue Code	360
Min. Negotiated Rate	$893.79
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	$1,742.00
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	$11,125.98
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,562.99
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$893.79
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	$982.79

Know your out-of-pocket cost for care.

All Charges