Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PT VASOPNEUMATIC DEVICES

Facility

$91.25

Hospital Charge Code	9000415
Hospital Revenue Code	420
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$13.69

PT-VASOPNEUMATIC DEVICES

Facility

$114.00

Hospital Charge Code	9109025
Hospital Revenue Code	420
Min. Negotiated Rate	$17.10
Max. Negotiated Rate	$17.10
Rate for Payer: Qualcare PPO/HMO/WC	$17.10

PT-VASOPNEUMATIC DEVICES

Facility

$114.00

Hospital Charge Code	9109025
Hospital Revenue Code	420
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$43.32
Rate for Payer: Aetna Medicare Advantage	$34.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.07
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	$29.07
Rate for Payer: Cigna Commercial	$57.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.20
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.10
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$2.75
Rate for Payer: Wellpoint Medicaid Managed Care	$3.02

PT VASOPNEUMATIC TREAT

Facility

$214.00

Service Code	HCPCS 97016GP
Hospital Charge Code	422597016
Hospital Revenue Code	420
Min. Negotiated Rate	$5.16
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$81.32
Rate for Payer: Aetna Medicare Advantage	$64.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.57
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	$54.57
Rate for Payer: Cigna Commercial	$107.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.20
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.10
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$5.16
Rate for Payer: Wellpoint Medicaid Managed Care	$5.67

PT VASOPNEUMATIC TREAT

Facility

$214.00

Service Code	HCPCS 97016GP
Hospital Charge Code	422597016
Hospital Revenue Code	420
Min. Negotiated Rate	$32.10
Max. Negotiated Rate	$32.10
Rate for Payer: Qualcare PPO/HMO/WC	$32.10

PT WEDGE CAST CLUBFOOT

Facility

$1,485.20

Service Code	HCPCS 29750GP
Hospital Charge Code	422529750
Hospital Revenue Code	420
Min. Negotiated Rate	$35.79
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$564.38
Rate for Payer: Aetna Medicare Advantage	$445.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$378.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$378.73
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	$378.73
Rate for Payer: Cigna Commercial	$742.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$445.56
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$222.78
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$35.79
Rate for Payer: Wellpoint Medicaid Managed Care	$39.36

PT WEDGE CAST CLUBFOOT

Facility

$1,485.20

Service Code	HCPCS 29750GP
Hospital Charge Code	422529750
Hospital Revenue Code	420
Min. Negotiated Rate	$222.78
Max. Negotiated Rate	$222.78
Rate for Payer: Qualcare PPO/HMO/WC	$222.78

PT WEDGE CAST EXCPT CLUBFT CST

Facility

$1,485.20

Service Code	HCPCS 29740GP
Hospital Charge Code	422529740
Hospital Revenue Code	420
Min. Negotiated Rate	$222.78
Max. Negotiated Rate	$222.78
Rate for Payer: Qualcare PPO/HMO/WC	$222.78

PT WEDGE CAST EXCPT CLUBFT CST

Facility

$1,485.20

Service Code	HCPCS 29740GP
Hospital Charge Code	422529740
Hospital Revenue Code	420
Min. Negotiated Rate	$35.79
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$564.38
Rate for Payer: Aetna Medicare Advantage	$445.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$378.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$378.73
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	$378.73
Rate for Payer: Cigna Commercial	$742.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$445.56
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$222.78
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$35.79
Rate for Payer: Wellpoint Medicaid Managed Care	$39.36

PT WHEELCHAIR MANAGE EA 15 MIN

Facility

$164.50

Service Code	HCPCS 97542GP
Hospital Charge Code	422597542
Hospital Revenue Code	420
Min. Negotiated Rate	$3.96
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$62.51
Rate for Payer: Aetna Medicare Advantage	$49.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.95
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	$41.95
Rate for Payer: Cigna Commercial	$82.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.35
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.68
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.96
Rate for Payer: Wellpoint Medicaid Managed Care	$4.36

PT WHEELCHAIR MANAGE EA 15 MIN

Facility

$164.50

Service Code	HCPCS 97542GP
Hospital Charge Code	422597542
Hospital Revenue Code	420
Min. Negotiated Rate	$24.68
Max. Negotiated Rate	$24.68
Rate for Payer: Qualcare PPO/HMO/WC	$24.68

PT WHEELCHR MGT TRAING EA 15M

Facility

$73.00

Service Code	HCPCS 97542GP
Hospital Charge Code	9100135
Hospital Revenue Code	420
Min. Negotiated Rate	$10.95
Max. Negotiated Rate	$10.95
Rate for Payer: Qualcare PPO/HMO/WC	$10.95

PT WHEELCHR MGT TRAING EA 15M

Facility

$73.00

Service Code	HCPCS 97542GP
Hospital Charge Code	9100135
Hospital Revenue Code	420
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$27.74
Rate for Payer: Aetna Medicare Advantage	$21.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.61
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	$18.61
Rate for Payer: Cigna Commercial	$36.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.90
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.95
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$1.76
Rate for Payer: Wellpoint Medicaid Managed Care	$1.93

PT WHIRLPOOL

Facility

$185.00

Service Code	HCPCS 97022GP
Hospital Charge Code	422597022
Hospital Revenue Code	420
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$70.30
Rate for Payer: Aetna Medicare Advantage	$55.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.17
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	$47.17
Rate for Payer: Cigna Commercial	$92.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.50
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.75
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$4.46
Rate for Payer: Wellpoint Medicaid Managed Care	$4.90

PT WHIRLPOOL

Facility

$185.00

Service Code	HCPCS 97022GP
Hospital Charge Code	422597022
Hospital Revenue Code	420
Min. Negotiated Rate	$27.75
Max. Negotiated Rate	$27.75
Rate for Payer: Qualcare PPO/HMO/WC	$27.75

PT WINDOWING OF CAST

Facility

$869.79

Service Code	HCPCS 29730GP
Hospital Charge Code	422529730
Hospital Revenue Code	420
Min. Negotiated Rate	$130.47
Max. Negotiated Rate	$130.47
Rate for Payer: Qualcare PPO/HMO/WC	$130.47

PT WINDOWING OF CAST

Facility

$869.79

Service Code	HCPCS 29730GP
Hospital Charge Code	422529730
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-WORK HARD/COND ADD HR

Facility

$170.00

Hospital Charge Code	9109040
Hospital Revenue Code	420
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

PT-WORK HARD/COND ADD HR

Facility

$170.00

Hospital Charge Code	9109040
Hospital Revenue Code	420
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$64.60
Rate for Payer: Aetna Medicare Advantage	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
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	$43.35
Rate for Payer: Cigna Commercial	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$4.10
Rate for Payer: Wellpoint Medicaid Managed Care	$4.50

PT-WORK HARD/CONDITIO 2HR

Facility

$601.00

Hospital Charge Code	9109035
Hospital Revenue Code	420
Min. Negotiated Rate	$14.48
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$228.38
Rate for Payer: Aetna Medicare Advantage	$180.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.25
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	$153.25
Rate for Payer: Cigna Commercial	$300.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.30
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.15
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$14.48
Rate for Payer: Wellpoint Medicaid Managed Care	$15.93

PT-WORK HARD/CONDITIO 2HR

Facility

$601.00

Hospital Charge Code	9109035
Hospital Revenue Code	420
Min. Negotiated Rate	$90.15
Max. Negotiated Rate	$90.15
Rate for Payer: Qualcare PPO/HMO/WC	$90.15

PT WORK HARDENING 1ST 2 HRS

Facility

$601.00

Service Code	HCPCS 97545GP
Hospital Charge Code	422597545
Hospital Revenue Code	422
Min. Negotiated Rate	$14.48
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$228.38
Rate for Payer: Aetna Medicare Advantage	$180.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.25
Rate for Payer: Cigna Commercial	$300.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.30
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.15
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$14.48
Rate for Payer: Wellpoint Medicaid Managed Care	$15.93

PT WORK HARDENING 1ST 2 HRS

Facility

$601.00

Service Code	HCPCS 97545GP
Hospital Charge Code	422597545
Hospital Revenue Code	422
Min. Negotiated Rate	$90.15
Max. Negotiated Rate	$90.15
Rate for Payer: Qualcare PPO/HMO/WC	$90.15

PT WORK HARDENING EA ADD HR

Facility

$170.00

Service Code	HCPCS 97546GP
Hospital Charge Code	422597546
Hospital Revenue Code	422
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$64.60
Rate for Payer: Aetna Medicare Advantage	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.35
Rate for Payer: Cigna Commercial	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$4.10
Rate for Payer: Wellpoint Medicaid Managed Care	$4.50

PT WORK HARDENING EA ADD HR

Facility

$170.00

Service Code	HCPCS 97546GP
Hospital Charge Code	422597546
Hospital Revenue Code	422
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

Know your out-of-pocket cost for care.

All Charges