Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PATELLOFEMORAL LEFT SZ 2

Facility

$12,580.00

Hospital Charge Code	270668853
Hospital Revenue Code	278
Min. Negotiated Rate	$303.18
Max. Negotiated Rate	$6,290.00
Rate for Payer: Aetna Commercial	$4,780.40
Rate for Payer: Aetna Medicare Advantage	$3,774.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,207.90
Rate for Payer: Cigna Commercial	$6,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00
Rate for Payer: UnitedHealthcare Community & State	$303.18
Rate for Payer: Wellpoint Medicaid Managed Care	$333.37

PATELLOFEMORAL LEFT SZ 2

Facility

$12,580.00

Hospital Charge Code	270668853
Hospital Revenue Code	278
Min. Negotiated Rate	$1,887.00
Max. Negotiated Rate	$3,044.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00

PATELLOFEMORAL LEFT SZ 3

Facility

$12,580.00

Hospital Charge Code	270668854
Hospital Revenue Code	278
Min. Negotiated Rate	$1,887.00
Max. Negotiated Rate	$3,044.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00

PATELLOFEMORAL LEFT SZ 3

Facility

$12,580.00

Hospital Charge Code	270668854
Hospital Revenue Code	278
Min. Negotiated Rate	$303.18
Max. Negotiated Rate	$6,290.00
Rate for Payer: Aetna Commercial	$4,780.40
Rate for Payer: Aetna Medicare Advantage	$3,774.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,207.90
Rate for Payer: Cigna Commercial	$6,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00
Rate for Payer: UnitedHealthcare Community & State	$303.18
Rate for Payer: Wellpoint Medicaid Managed Care	$333.37

PATELLOFEMORAL LEFT SZ 5

Facility

$12,580.00

Hospital Charge Code	270668856
Hospital Revenue Code	278
Min. Negotiated Rate	$303.18
Max. Negotiated Rate	$6,290.00
Rate for Payer: Aetna Commercial	$4,780.40
Rate for Payer: Aetna Medicare Advantage	$3,774.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,207.90
Rate for Payer: Cigna Commercial	$6,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00
Rate for Payer: UnitedHealthcare Community & State	$303.18
Rate for Payer: Wellpoint Medicaid Managed Care	$333.37

PATELLOFEMORAL LEFT SZ 5

Facility

$12,580.00

Hospital Charge Code	270668856
Hospital Revenue Code	278
Min. Negotiated Rate	$1,887.00
Max. Negotiated Rate	$3,044.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00

PATELLOFEMORAL LEFT SZ 6

Facility

$12,580.00

Hospital Charge Code	270668857
Hospital Revenue Code	278
Min. Negotiated Rate	$303.18
Max. Negotiated Rate	$6,290.00
Rate for Payer: Aetna Commercial	$4,780.40
Rate for Payer: Aetna Medicare Advantage	$3,774.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,207.90
Rate for Payer: Cigna Commercial	$6,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00
Rate for Payer: UnitedHealthcare Community & State	$303.18
Rate for Payer: Wellpoint Medicaid Managed Care	$333.37

PATELLOFEMORAL LEFT SZ 6

Facility

$12,580.00

Hospital Charge Code	270668857
Hospital Revenue Code	278
Min. Negotiated Rate	$1,887.00
Max. Negotiated Rate	$3,044.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00

PATELLOFEMORAL LEFT SZ 7

Facility

$12,580.00

Hospital Charge Code	270668858
Hospital Revenue Code	278
Min. Negotiated Rate	$1,887.00
Max. Negotiated Rate	$3,044.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00

PATELLOFEMORAL LEFT SZ 7

Facility

$12,580.00

Hospital Charge Code	270668858
Hospital Revenue Code	278
Min. Negotiated Rate	$303.18
Max. Negotiated Rate	$6,290.00
Rate for Payer: Aetna Commercial	$4,780.40
Rate for Payer: Aetna Medicare Advantage	$3,774.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,207.90
Rate for Payer: Cigna Commercial	$6,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00
Rate for Payer: UnitedHealthcare Community & State	$303.18
Rate for Payer: Wellpoint Medicaid Managed Care	$333.37

PATELLOFEMORAL LEFT SZ 8

Facility

$12,580.00

Hospital Charge Code	270668859
Hospital Revenue Code	278
Min. Negotiated Rate	$1,887.00
Max. Negotiated Rate	$3,044.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00

PATELLOFEMORAL LEFT SZ 8

Facility

$12,580.00

Hospital Charge Code	270668859
Hospital Revenue Code	278
Min. Negotiated Rate	$303.18
Max. Negotiated Rate	$6,290.00
Rate for Payer: Aetna Commercial	$4,780.40
Rate for Payer: Aetna Medicare Advantage	$3,774.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,207.90
Rate for Payer: Cigna Commercial	$6,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00
Rate for Payer: UnitedHealthcare Community & State	$303.18
Rate for Payer: Wellpoint Medicaid Managed Care	$333.37

PATELLOFEMORAL RIGHT SZ 2

Facility

$12,580.00

Hospital Charge Code	270668860
Hospital Revenue Code	278
Min. Negotiated Rate	$1,887.00
Max. Negotiated Rate	$3,044.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00

PATELLOFEMORAL RIGHT SZ 2

Facility

$12,580.00

Hospital Charge Code	270668860
Hospital Revenue Code	278
Min. Negotiated Rate	$303.18
Max. Negotiated Rate	$6,290.00
Rate for Payer: Aetna Commercial	$4,780.40
Rate for Payer: Aetna Medicare Advantage	$3,774.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,207.90
Rate for Payer: Cigna Commercial	$6,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00
Rate for Payer: UnitedHealthcare Community & State	$303.18
Rate for Payer: Wellpoint Medicaid Managed Care	$333.37

PATELLOFEMORAL RIGHT SZ 3

Facility

$12,580.00

Hospital Charge Code	270668861
Hospital Revenue Code	278
Min. Negotiated Rate	$1,887.00
Max. Negotiated Rate	$3,044.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00

PATELLOFEMORAL RIGHT SZ 3

Facility

$12,580.00

Hospital Charge Code	270668861
Hospital Revenue Code	278
Min. Negotiated Rate	$303.18
Max. Negotiated Rate	$6,290.00
Rate for Payer: Aetna Commercial	$4,780.40
Rate for Payer: Aetna Medicare Advantage	$3,774.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,207.90
Rate for Payer: Cigna Commercial	$6,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00
Rate for Payer: UnitedHealthcare Community & State	$303.18
Rate for Payer: Wellpoint Medicaid Managed Care	$333.37

PATELLOFERMORAL RIGHT SZ 4

Facility

$12,580.00

Hospital Charge Code	270668862
Hospital Revenue Code	278
Min. Negotiated Rate	$303.18
Max. Negotiated Rate	$6,290.00
Rate for Payer: Aetna Commercial	$4,780.40
Rate for Payer: Aetna Medicare Advantage	$3,774.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,207.90
Rate for Payer: Cigna Commercial	$6,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00
Rate for Payer: UnitedHealthcare Community & State	$303.18
Rate for Payer: Wellpoint Medicaid Managed Care	$333.37

PATELLOFERMORAL RIGHT SZ 4

Facility

$12,580.00

Hospital Charge Code	270668862
Hospital Revenue Code	278
Min. Negotiated Rate	$1,887.00
Max. Negotiated Rate	$3,044.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00

PATELLOFERMORAL RIGHT SZ 5

Facility

$12,580.00

Hospital Charge Code	270668863
Hospital Revenue Code	278
Min. Negotiated Rate	$303.18
Max. Negotiated Rate	$6,290.00
Rate for Payer: Aetna Commercial	$4,780.40
Rate for Payer: Aetna Medicare Advantage	$3,774.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,207.90
Rate for Payer: Cigna Commercial	$6,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00
Rate for Payer: UnitedHealthcare Community & State	$303.18
Rate for Payer: Wellpoint Medicaid Managed Care	$333.37

PATELLOFERMORAL RIGHT SZ 5

Facility

$12,580.00

Hospital Charge Code	270668863
Hospital Revenue Code	278
Min. Negotiated Rate	$1,887.00
Max. Negotiated Rate	$3,044.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00

PATELLOFERMORAL RIGHT SZ 6

Facility

$12,580.00

Hospital Charge Code	270668864
Hospital Revenue Code	278
Min. Negotiated Rate	$303.18
Max. Negotiated Rate	$6,290.00
Rate for Payer: Aetna Commercial	$4,780.40
Rate for Payer: Aetna Medicare Advantage	$3,774.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,207.90
Rate for Payer: Cigna Commercial	$6,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00
Rate for Payer: UnitedHealthcare Community & State	$303.18
Rate for Payer: Wellpoint Medicaid Managed Care	$333.37

PATELLOFERMORAL RIGHT SZ 6

Facility

$12,580.00

Hospital Charge Code	270668864
Hospital Revenue Code	278
Min. Negotiated Rate	$1,887.00
Max. Negotiated Rate	$3,044.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00

PATELLOFERMORAL RIGHT SZ 7

Facility

$12,580.00

Hospital Charge Code	270668865
Hospital Revenue Code	278
Min. Negotiated Rate	$1,887.00
Max. Negotiated Rate	$3,044.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00

PATELLOFERMORAL RIGHT SZ 7

Facility

$12,580.00

Hospital Charge Code	270668865
Hospital Revenue Code	278
Min. Negotiated Rate	$303.18
Max. Negotiated Rate	$6,290.00
Rate for Payer: Aetna Commercial	$4,780.40
Rate for Payer: Aetna Medicare Advantage	$3,774.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,207.90
Rate for Payer: Cigna Commercial	$6,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00
Rate for Payer: UnitedHealthcare Community & State	$303.18
Rate for Payer: Wellpoint Medicaid Managed Care	$333.37

PATELLOFERMORAL RIGHT SZ 8

Facility

$12,580.00

Hospital Charge Code	270668866
Hospital Revenue Code	278
Min. Negotiated Rate	$1,887.00
Max. Negotiated Rate	$3,044.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,516.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,767.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.00

Know your out-of-pocket cost for care.

All Charges