Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MANIP SHLDR JOINT,UNDER ANESTH

Facility

$13,711.90

Service Code	HCPCS 23700
Hospital Charge Code	16000545
Hospital Revenue Code	360
Min. Negotiated Rate	$330.46
Max. Negotiated Rate	$6,895.75
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,895.75
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,113.57
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,056.78
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$330.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$363.37

MANIPULATE ANKLE UNDER GEN AN

Facility

$14,501.75

Service Code	HCPCS 27860
Hospital Charge Code	16000630
Hospital Revenue Code	360
Min. Negotiated Rate	$2,175.26
Max. Negotiated Rate	$2,175.26
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.26

MANIPULATE ANKLE UNDER GEN AN

Facility

$14,501.75

Service Code	HCPCS 27860
Hospital Charge Code	16000630
Hospital Revenue Code	360
Min. Negotiated Rate	$349.49
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	$862.00
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	$4,350.52
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.26
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$349.49
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	$384.30

MANIPULATE FINGER W/ANESTH

Facility

$6,331.60

Service Code	HCPCS 26340
Hospital Charge Code	16000475
Hospital Revenue Code	360
Min. Negotiated Rate	$949.74
Max. Negotiated Rate	$949.74
Rate for Payer: Qualcare PPO/HMO/WC	$949.74

MANIPULATE FINGER W/ANESTH

Facility

$6,331.60

Service Code	HCPCS 26340
Hospital Charge Code	16000475
Hospital Revenue Code	360
Min. Negotiated Rate	$152.59
Max. Negotiated Rate	$6,895.75
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
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	$6,895.75
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,899.48
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$949.74
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$152.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$167.79

MANIPULATE KNEE JNT UNDR ANES

Facility

$32,127.31

Service Code	HCPCS 27570
Hospital Charge Code	16000215
Hospital Revenue Code	360
Min. Negotiated Rate	$4,819.10
Max. Negotiated Rate	$4,819.10
Rate for Payer: Qualcare PPO/HMO/WC	$4,819.10

MANIPULATE KNEE JNT UNDR ANES

Facility

$32,127.31

Service Code	HCPCS 27570
Hospital Charge Code	16000215
Hospital Revenue Code	360
Min. Negotiated Rate	$774.27
Max. Negotiated Rate	$9,638.19
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,895.75
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,638.19
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,819.10
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$774.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,402.76
Rate for Payer: Wellpoint Medicaid Managed Care	$4,316.43

MANIPULATE WST W ANESTH LT

Facility

$19,424.35

Service Code	HCPCS 25259
Hospital Charge Code	16000394
Hospital Revenue Code	360
Min. Negotiated Rate	$2,913.65
Max. Negotiated Rate	$2,913.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,913.65

MANIPULATE WST W ANESTH LT

Facility

$19,424.35

Service Code	HCPCS 25259
Hospital Charge Code	16000394
Hospital Revenue Code	360
Min. Negotiated Rate	$468.13
Max. Negotiated Rate	$6,895.75
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
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	$6,895.75
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,827.31
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,913.65
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$468.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,404.80
Rate for Payer: Wellpoint Medicaid Managed Care	$4,318.43

MANIPULATOR HUMI *******

Facility

$131.00

Hospital Charge Code	1601061
Hospital Revenue Code	272
Min. Negotiated Rate	$19.65
Max. Negotiated Rate	$19.65
Rate for Payer: Qualcare PPO/HMO/WC	$19.65

MANIPULATOR HUMI *******

Facility

$131.00

Hospital Charge Code	1601061
Hospital Revenue Code	272
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$65.50
Rate for Payer: Aetna Commercial	$49.78
Rate for Payer: Aetna Medicare Advantage	$39.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.41
Rate for Payer: Cigna Commercial	$65.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.30
Rate for Payer: Oxford Commercial	$26.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.65
Rate for Payer: UnitedHealthcare Commercial	$26.20
Rate for Payer: UnitedHealthcare Community & State	$3.16
Rate for Payer: Wellpoint Medicaid Managed Care	$3.47

MANIPULATOR HUMI UTERINE 6003

Facility

$326.77

Hospital Charge Code	270600266
Hospital Revenue Code	272
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$163.38
Rate for Payer: Aetna Commercial	$124.17
Rate for Payer: Aetna Medicare Advantage	$98.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.33
Rate for Payer: Cigna Commercial	$163.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.03
Rate for Payer: Oxford Commercial	$65.35
Rate for Payer: Qualcare PPO/HMO/WC	$49.02
Rate for Payer: UnitedHealthcare Commercial	$65.35
Rate for Payer: UnitedHealthcare Community & State	$7.88
Rate for Payer: Wellpoint Medicaid Managed Care	$8.66

MANIPULATOR HUMI UTERINE 6003

Facility

$326.77

Hospital Charge Code	270600266
Hospital Revenue Code	272
Min. Negotiated Rate	$49.02
Max. Negotiated Rate	$49.02
Rate for Payer: Qualcare PPO/HMO/WC	$49.02

MANIPULATOR UTERINE 4.5MM

Facility

$129.83

Hospital Charge Code	270649443
Hospital Revenue Code	272
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$64.92
Rate for Payer: Aetna Commercial	$49.34
Rate for Payer: Aetna Medicare Advantage	$38.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.11
Rate for Payer: Cigna Commercial	$64.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.95
Rate for Payer: Oxford Commercial	$25.97
Rate for Payer: Qualcare PPO/HMO/WC	$19.47
Rate for Payer: UnitedHealthcare Commercial	$25.97
Rate for Payer: UnitedHealthcare Community & State	$3.13
Rate for Payer: Wellpoint Medicaid Managed Care	$3.44

MANIPULATOR UTERINE 4.5MM

Facility

$129.83

Hospital Charge Code	270649443
Hospital Revenue Code	272
Min. Negotiated Rate	$19.47
Max. Negotiated Rate	$19.47
Rate for Payer: Qualcare PPO/HMO/WC	$19.47

MANNICAL REPAIR DEVICE

Facility

$4,785.00

Hospital Charge Code	270661102
Hospital Revenue Code	270
Min. Negotiated Rate	$115.32
Max. Negotiated Rate	$2,392.50
Rate for Payer: Aetna Commercial	$1,818.30
Rate for Payer: Aetna Medicare Advantage	$1,435.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,220.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,220.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,220.17
Rate for Payer: Cigna Commercial	$2,392.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,435.50
Rate for Payer: Oxford Commercial	$957.00
Rate for Payer: Qualcare PPO/HMO/WC	$717.75
Rate for Payer: UnitedHealthcare Commercial	$957.00
Rate for Payer: UnitedHealthcare Community & State	$115.32
Rate for Payer: Wellpoint Medicaid Managed Care	$126.80

MANNICAL REPAIR DEVICE

Facility

$4,785.00

Hospital Charge Code	270661102
Hospital Revenue Code	270
Min. Negotiated Rate	$717.75
Max. Negotiated Rate	$717.75
Rate for Payer: Qualcare PPO/HMO/WC	$717.75

MANNITOL 10% 1000ML*****

Facility

$75.00

Hospital Charge Code	7000292
Hospital Revenue Code	258
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

MANNITOL 10% 1000ML*****

Facility

$75.00

Hospital Charge Code	7000292
Hospital Revenue Code	258
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

MANNITOL 12.5 GM/50 ML INJ

Facility

$13.53

Service Code	HCPCS J2151
Hospital Charge Code	6010144
Hospital Revenue Code	636
Min. Negotiated Rate	$2.03
Max. Negotiated Rate	$3.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.27
Rate for Payer: Qualcare PPO/HMO/WC	$2.03

MANNITOL 12.5 GM/50 ML INJ

Facility

$13.53

Service Code	HCPCS J2151
Hospital Charge Code	6010144
Hospital Revenue Code	636
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$6.76
Rate for Payer: Aetna Commercial	$5.14
Rate for Payer: Aetna Medicare Advantage	$4.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.45
Rate for Payer: Cigna Commercial	$6.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.27
Rate for Payer: Qualcare PPO/HMO/WC	$2.03
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

MANNITOL 20% 100G/500 ML IVCI

Facility

$344.35

Hospital Charge Code	60628640
Hospital Revenue Code	250
Min. Negotiated Rate	$51.65
Max. Negotiated Rate	$51.65
Rate for Payer: Qualcare PPO/HMO/WC	$51.65

MANNITOL 20% 100G/500 ML IVCI

Facility

$344.35

Hospital Charge Code	60628640
Hospital Revenue Code	250
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$172.18
Rate for Payer: Aetna Commercial	$130.85
Rate for Payer: Aetna Medicare Advantage	$103.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.81
Rate for Payer: Cigna Commercial	$172.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.31
Rate for Payer: Oxford Commercial	$68.87
Rate for Payer: Qualcare PPO/HMO/WC	$51.65
Rate for Payer: UnitedHealthcare Commercial	$68.87
Rate for Payer: UnitedHealthcare Community & State	$8.30
Rate for Payer: Wellpoint Medicaid Managed Care	$9.13

MANNITOL 20% 500ML ******

Facility

$52.00

Hospital Charge Code	7000300
Hospital Revenue Code	258
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$10.40
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$10.40
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

MANNITOL 20% 500ML ******

Facility

$52.00

Hospital Charge Code	7000300
Hospital Revenue Code	258
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

Know your out-of-pocket cost for care.

All Charges