Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

POD NAIL ONYCHO RED 1-5

Facility

$372.00

Service Code	HCPCS 11720
Hospital Charge Code	84208055
Hospital Revenue Code	361
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

POD NAIL ONYCHO RED 1-5

Facility

$372.00

Service Code	HCPCS 11720
Hospital Charge Code	84208055
Hospital Revenue Code	361
Min. Negotiated Rate	$8.97
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
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	$252.97
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.60
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$8.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$9.86

POD NAIL P+A

Facility

$2,081.00

Service Code	HCPCS 11750
Hospital Charge Code	84208080
Hospital Revenue Code	361
Min. Negotiated Rate	$312.15
Max. Negotiated Rate	$312.15
Rate for Payer: Qualcare PPO/HMO/WC	$312.15

POD NAIL P+A

Facility

$2,081.00

Service Code	HCPCS 11750
Hospital Charge Code	84208080
Hospital Revenue Code	361
Min. Negotiated Rate	$50.15
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
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	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.30
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$312.15
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$50.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$55.15

POD NAIL UNIT BIOPSY

Facility

$2,081.00

Service Code	HCPCS 11755
Hospital Charge Code	84208085
Hospital Revenue Code	361
Min. Negotiated Rate	$50.15
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
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	$3,036.77
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.30
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$312.15
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$50.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$55.15

POD NAIL UNIT BIOPSY

Facility

$2,081.00

Service Code	HCPCS 11755
Hospital Charge Code	84208085
Hospital Revenue Code	361
Min. Negotiated Rate	$312.15
Max. Negotiated Rate	$312.15
Rate for Payer: Qualcare PPO/HMO/WC	$312.15

POD NONDYS NAILS

Facility

$216.00

Service Code	HCPCS 11719
Hospital Charge Code	84208050
Hospital Revenue Code	510
Min. Negotiated Rate	$32.40
Max. Negotiated Rate	$32.40
Rate for Payer: Qualcare PPO/HMO/WC	$32.40

POD NONDYS NAILS

Facility

$216.00

Service Code	HCPCS 11719
Hospital Charge Code	84208050
Hospital Revenue Code	510
Min. Negotiated Rate	$5.21
Max. Negotiated Rate	$252.97
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.97
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.80
Rate for Payer: Qualcare PPO/HMO/WC	$32.40
Rate for Payer: UnitedHealthcare Community & State	$5.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$5.72

PODOFOLIX 0.5% TOP

Facility

$666.52

Service Code	NDC 591320413
Hospital Charge Code	6023412
Hospital Revenue Code	250
Min. Negotiated Rate	$99.98
Max. Negotiated Rate	$99.98
Rate for Payer: Qualcare PPO/HMO/WC	$99.98

PODOFOLIX 0.5% TOP

Facility

$666.52

Service Code	NDC 591320413
Hospital Charge Code	6023412
Hospital Revenue Code	250
Min. Negotiated Rate	$16.06
Max. Negotiated Rate	$333.26
Rate for Payer: Aetna Commercial	$253.28
Rate for Payer: Aetna Medicare Advantage	$199.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.96
Rate for Payer: Cigna Commercial	$333.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.96
Rate for Payer: Oxford Commercial	$133.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.98
Rate for Payer: UnitedHealthcare Commercial	$133.30
Rate for Payer: UnitedHealthcare Community & State	$16.06
Rate for Payer: Wellpoint Medicaid Managed Care	$17.66

POD ONYCHO RED 6+

Facility

$372.00

Service Code	HCPCS 11721
Hospital Charge Code	84208060
Hospital Revenue Code	510
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

POD ONYCHO RED 6+

Facility

$372.00

Service Code	HCPCS 11721
Hospital Charge Code	84208060
Hospital Revenue Code	510
Min. Negotiated Rate	$8.97
Max. Negotiated Rate	$252.97
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.97
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.60
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Community & State	$8.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$197.37
Rate for Payer: Wellpoint Medicaid Managed Care	$9.86

PODOPHYLLUM 25% SOLUTION

Facility

$581.25

Hospital Charge Code	60628685
Hospital Revenue Code	250
Min. Negotiated Rate	$87.19
Max. Negotiated Rate	$87.19
Rate for Payer: Qualcare PPO/HMO/WC	$87.19

PODOPHYLLUM 25% SOLUTION

Facility

$581.25

Hospital Charge Code	60628685
Hospital Revenue Code	250
Min. Negotiated Rate	$14.01
Max. Negotiated Rate	$290.62
Rate for Payer: Aetna Commercial	$220.88
Rate for Payer: Aetna Medicare Advantage	$174.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.22
Rate for Payer: Cigna Commercial	$290.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.38
Rate for Payer: Oxford Commercial	$116.25
Rate for Payer: Qualcare PPO/HMO/WC	$87.19
Rate for Payer: UnitedHealthcare Commercial	$116.25
Rate for Payer: UnitedHealthcare Community & State	$14.01
Rate for Payer: Wellpoint Medicaid Managed Care	$15.40

POD ORTHOTIC CHECK OUT

Facility

$545.00

Service Code	HCPCS 97762
Hospital Charge Code	84208235
Hospital Revenue Code	420
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$207.10
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.97
Rate for Payer: Cigna Commercial	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.50
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$81.75
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$13.13
Rate for Payer: Wellpoint Medicaid Managed Care	$14.44

POD ORTHOTIC CHECK OUT

Facility

$545.00

Service Code	HCPCS 97762
Hospital Charge Code	84208235
Hospital Revenue Code	420
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$81.75
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

POD OV-ESTABLISHED-BRIEF

Facility

$319.65

Service Code	HCPCS 99211
Hospital Charge Code	84208265
Hospital Revenue Code	510
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$159.82
Rate for Payer: Aetna Commercial	$121.47
Rate for Payer: Aetna Medicare Advantage	$95.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.51
Rate for Payer: Cigna Commercial	$159.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.89
Rate for Payer: Qualcare PPO/HMO/WC	$47.95
Rate for Payer: UnitedHealthcare Community & State	$7.70
Rate for Payer: Wellpoint Medicaid Managed Care	$8.47

POD OV-ESTABLISHED-BRIEF

Facility

$319.65

Service Code	HCPCS 99211
Hospital Charge Code	84208265
Hospital Revenue Code	510
Min. Negotiated Rate	$47.95
Max. Negotiated Rate	$47.95
Rate for Payer: Qualcare PPO/HMO/WC	$47.95

POD OV-NEW-BRIEF

Facility

$319.65

Service Code	HCPCS 99201
Hospital Charge Code	84208240
Hospital Revenue Code	510
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$159.82
Rate for Payer: Aetna Commercial	$121.47
Rate for Payer: Aetna Medicare Advantage	$95.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.51
Rate for Payer: Cigna Commercial	$159.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.89
Rate for Payer: Qualcare PPO/HMO/WC	$47.95
Rate for Payer: UnitedHealthcare Community & State	$7.70
Rate for Payer: Wellpoint Medicaid Managed Care	$8.47

POD OV-NEW-BRIEF

Facility

$319.65

Service Code	HCPCS 99201
Hospital Charge Code	84208240
Hospital Revenue Code	510
Min. Negotiated Rate	$47.95
Max. Negotiated Rate	$47.95
Rate for Payer: Qualcare PPO/HMO/WC	$47.95

POD POSTERIOR SPLINT

Facility

$468.75

Service Code	HCPCS 29730
Hospital Charge Code	84208205
Hospital Revenue Code	510
Min. Negotiated Rate	$70.31
Max. Negotiated Rate	$70.31
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

POD POSTERIOR SPLINT

Facility

$468.75

Service Code	HCPCS 29730
Hospital Charge Code	84208205
Hospital Revenue Code	510
Min. Negotiated Rate	$11.30
Max. Negotiated Rate	$696.85
Rate for Payer: Aetna Commercial	$525.10
Rate for Payer: Aetna Medicare Advantage	$625.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$696.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$696.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$193.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$696.85
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: Cigna Medicare Advantage	$193.05
Rate for Payer: Clover Medicare Advantage	$183.40
Rate for Payer: EmblemHealth Commercial	$579.15
Rate for Payer: Humana Medicare Advantage	$198.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$193.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.62
Rate for Payer: Qualcare PPO/HMO/WC	$70.31
Rate for Payer: UnitedHealthcare Community & State	$11.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$193.05
Rate for Payer: Wellcare Medicare Advantage	$193.05
Rate for Payer: Wellpoint Medicaid Managed Care	$12.42

POD REM/BIVALVIN,FULL LEG

Facility

$468.75

Service Code	HCPCS 29705
Hospital Charge Code	84208200
Hospital Revenue Code	361
Min. Negotiated Rate	$70.31
Max. Negotiated Rate	$70.31
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

POD REM/BIVALVIN,FULL LEG

Facility

$468.75

Service Code	HCPCS 29705
Hospital Charge Code	84208200
Hospital Revenue Code	361
Min. Negotiated Rate	$11.30
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$903.80
Rate for Payer: Aetna Medicare Advantage	$1,076.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,199.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,199.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$332.28
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	$1,199.43
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: Cigna Medicare Advantage	$332.28
Rate for Payer: Clover Medicare Advantage	$315.67
Rate for Payer: EmblemHealth Commercial	$996.84
Rate for Payer: Humana Medicare Advantage	$342.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$332.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.62
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.31
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$11.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$332.28
Rate for Payer: Wellcare Medicare Advantage	$332.28
Rate for Payer: Wellpoint Medicaid Managed Care	$12.42

POD REMOVAL OF CAST

Facility

$468.75

Service Code	HCPCS 29700
Hospital Charge Code	84208195
Hospital Revenue Code	361
Min. Negotiated Rate	$70.31
Max. Negotiated Rate	$70.31
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

Know your out-of-pocket cost for care.

All Charges