Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PT APPLY CAST RIGID LEG

Facility

$1,360.45

Service Code	HCPCS 29445GP
Hospital Charge Code	422529445
Hospital Revenue Code	420
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

PT APPLY CAST SHORT ARM

Facility

$1,360.45

Service Code	HCPCS 29075GP
Hospital Charge Code	422529075
Hospital Revenue Code	420
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

PT APPLY CAST SHORT ARM

Facility

$1,360.45

Service Code	HCPCS 29075GP
Hospital Charge Code	422529075
Hospital Revenue Code	420
Min. Negotiated Rate	$32.79
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$516.97
Rate for Payer: Aetna Medicare Advantage	$408.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$346.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$346.91
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	$346.91
Rate for Payer: Cigna Commercial	$680.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$408.13
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$204.07
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$32.79
Rate for Payer: Wellpoint Medicaid Managed Care	$36.05

PT APPLY MULTLAY COMPRS ARM/HA

Facility

$869.79

Service Code	HCPCS 29584GP
Hospital Charge Code	422529584
Hospital Revenue Code	420
Min. Negotiated Rate	$130.47
Max. Negotiated Rate	$130.47
Rate for Payer: Qualcare PPO/HMO/WC	$130.47

PT APPLY MULTLAY COMPRS ARM/HA

Facility

$869.79

Service Code	HCPCS 29584GP
Hospital Charge Code	422529584
Hospital Revenue Code	420
Min. Negotiated Rate	$20.96
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$330.52
Rate for Payer: Aetna Medicare Advantage	$260.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.80
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	$221.80
Rate for Payer: Cigna Commercial	$434.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.94
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$130.47
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$20.96
Rate for Payer: Wellpoint Medicaid Managed Care	$23.05

PT APPLY MULTLAY COMPRS BL KNE

Facility

$869.79

Service Code	HCPCS 29581GP
Hospital Charge Code	422529581
Hospital Revenue Code	420
Min. Negotiated Rate	$20.96
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$330.52
Rate for Payer: Aetna Medicare Advantage	$260.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.80
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	$221.80
Rate for Payer: Cigna Commercial	$434.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.94
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$130.47
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$20.96
Rate for Payer: Wellpoint Medicaid Managed Care	$23.05

PT APPLY MULTLAY COMPRS BL KNE

Facility

$869.79

Service Code	HCPCS 29581GP
Hospital Charge Code	422529581
Hospital Revenue Code	420
Min. Negotiated Rate	$130.47
Max. Negotiated Rate	$130.47
Rate for Payer: Qualcare PPO/HMO/WC	$130.47

PT APPLY SPLINT LONG ARM

Facility

$777.42

Service Code	HCPCS 29105GP
Hospital Charge Code	422529105
Hospital Revenue Code	420
Min. Negotiated Rate	$18.74
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$295.42
Rate for Payer: Aetna Medicare Advantage	$233.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.24
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	$198.24
Rate for Payer: Cigna Commercial	$388.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$233.23
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$116.61
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$18.74
Rate for Payer: Wellpoint Medicaid Managed Care	$20.60

PT APPLY SPLINT LONG ARM

Facility

$777.42

Service Code	HCPCS 29105GP
Hospital Charge Code	422529105
Hospital Revenue Code	420
Min. Negotiated Rate	$116.61
Max. Negotiated Rate	$116.61
Rate for Payer: Qualcare PPO/HMO/WC	$116.61

PT APPLY STRAPPING ANKLE/FOOT

Facility

$458.00

Service Code	HCPCS 29540GP
Hospital Charge Code	422529540
Hospital Revenue Code	420
Min. Negotiated Rate	$68.70
Max. Negotiated Rate	$68.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.70

PT APPLY STRAPPING ANKLE/FOOT

Facility

$458.00

Service Code	HCPCS 29540GP
Hospital Charge Code	422529540
Hospital Revenue Code	420
Min. Negotiated Rate	$11.04
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$174.04
Rate for Payer: Aetna Medicare Advantage	$137.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.79
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	$116.79
Rate for Payer: Cigna Commercial	$229.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.40
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$11.04
Rate for Payer: Wellpoint Medicaid Managed Care	$12.14

PT APPLY STRAPPING ELBOW/WRIST

Facility

$342.69

Service Code	HCPCS 29260GP
Hospital Charge Code	422529260
Hospital Revenue Code	420
Min. Negotiated Rate	$8.26
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$130.22
Rate for Payer: Aetna Medicare Advantage	$102.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.39
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	$87.39
Rate for Payer: Cigna Commercial	$171.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.81
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.40
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$8.26
Rate for Payer: Wellpoint Medicaid Managed Care	$9.08

PT APPLY STRAPPING ELBOW/WRIST

Facility

$342.69

Service Code	HCPCS 29260GP
Hospital Charge Code	422529260
Hospital Revenue Code	420
Min. Negotiated Rate	$51.40
Max. Negotiated Rate	$51.40
Rate for Payer: Qualcare PPO/HMO/WC	$51.40

PT APPLY STRAPPING HAND/FINGER

Facility

$342.69

Service Code	HCPCS 29280GP
Hospital Charge Code	422529280
Hospital Revenue Code	420
Min. Negotiated Rate	$8.26
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$130.22
Rate for Payer: Aetna Medicare Advantage	$102.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.39
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	$87.39
Rate for Payer: Cigna Commercial	$171.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.81
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.40
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$8.26
Rate for Payer: Wellpoint Medicaid Managed Care	$9.08

PT APPLY STRAPPING HAND/FINGER

Facility

$342.69

Service Code	HCPCS 29280GP
Hospital Charge Code	422529280
Hospital Revenue Code	420
Min. Negotiated Rate	$51.40
Max. Negotiated Rate	$51.40
Rate for Payer: Qualcare PPO/HMO/WC	$51.40

PT APPLY STRAPPING HIP

Facility

$458.00

Service Code	HCPCS 29520GP
Hospital Charge Code	422529520
Hospital Revenue Code	420
Min. Negotiated Rate	$68.70
Max. Negotiated Rate	$68.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.70

PT APPLY STRAPPING HIP

Facility

$458.00

Service Code	HCPCS 29520GP
Hospital Charge Code	422529520
Hospital Revenue Code	420
Min. Negotiated Rate	$11.04
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$174.04
Rate for Payer: Aetna Medicare Advantage	$137.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.79
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	$116.79
Rate for Payer: Cigna Commercial	$229.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.40
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$11.04
Rate for Payer: Wellpoint Medicaid Managed Care	$12.14

PT APPLY STRAPPING KNEE

Facility

$244.50

Service Code	HCPCS 29530GP
Hospital Charge Code	422529530
Hospital Revenue Code	420
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$92.91
Rate for Payer: Aetna Medicare Advantage	$73.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.35
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	$62.35
Rate for Payer: Cigna Commercial	$122.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.35
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.67
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$5.89
Rate for Payer: Wellpoint Medicaid Managed Care	$6.48

PT APPLY STRAPPING KNEE

Facility

$244.50

Service Code	HCPCS 29530GP
Hospital Charge Code	422529530
Hospital Revenue Code	420
Min. Negotiated Rate	$36.67
Max. Negotiated Rate	$36.67
Rate for Payer: Qualcare PPO/HMO/WC	$36.67

PT APPLY STRAPPING SHOULDER

Facility

$458.00

Service Code	HCPCS 29240GP
Hospital Charge Code	422529240
Hospital Revenue Code	420
Min. Negotiated Rate	$11.04
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$174.04
Rate for Payer: Aetna Medicare Advantage	$137.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.79
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	$116.79
Rate for Payer: Cigna Commercial	$229.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.40
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$11.04
Rate for Payer: Wellpoint Medicaid Managed Care	$12.14

PT APPLY STRAPPING SHOULDER

Facility

$458.00

Service Code	HCPCS 29240GP
Hospital Charge Code	422529240
Hospital Revenue Code	420
Min. Negotiated Rate	$68.70
Max. Negotiated Rate	$68.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.70

PT APPLY STRAPPING THORAX

Facility

$458.00

Service Code	HCPCS 29200GP
Hospital Charge Code	422529200
Hospital Revenue Code	420
Min. Negotiated Rate	$68.70
Max. Negotiated Rate	$68.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.70

PT APPLY STRAPPING THORAX

Facility

$458.00

Service Code	HCPCS 29200GP
Hospital Charge Code	422529200
Hospital Revenue Code	420
Min. Negotiated Rate	$11.04
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$174.04
Rate for Payer: Aetna Medicare Advantage	$137.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.79
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	$116.79
Rate for Payer: Cigna Commercial	$229.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.40
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$11.04
Rate for Payer: Wellpoint Medicaid Managed Care	$12.14

PT APPLY STRAPPING TOES

Facility

$342.69

Service Code	HCPCS 29550GP
Hospital Charge Code	422529550
Hospital Revenue Code	420
Min. Negotiated Rate	$8.26
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$130.22
Rate for Payer: Aetna Medicare Advantage	$102.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.39
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	$87.39
Rate for Payer: Cigna Commercial	$171.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.81
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.40
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$8.26
Rate for Payer: Wellpoint Medicaid Managed Care	$9.08

PT APPLY STRAPPING TOES

Facility

$342.69

Service Code	HCPCS 29550GP
Hospital Charge Code	422529550
Hospital Revenue Code	420
Min. Negotiated Rate	$51.40
Max. Negotiated Rate	$51.40
Rate for Payer: Qualcare PPO/HMO/WC	$51.40

Know your out-of-pocket cost for care.

All Charges