Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RECIP SAW BLADE D/S 68x0.80MM

Facility

$367.50

Hospital Charge Code	270674771
Hospital Revenue Code	272
Min. Negotiated Rate	$55.12
Max. Negotiated Rate	$55.12
Rate for Payer: Qualcare PPO/HMO/WC	$55.12

RECIP SAW BLADE D/S 68x0.80MM

Facility

$367.50

Hospital Charge Code	270674771
Hospital Revenue Code	272
Min. Negotiated Rate	$8.86
Max. Negotiated Rate	$183.75
Rate for Payer: Aetna Commercial	$139.65
Rate for Payer: Aetna Medicare Advantage	$110.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.71
Rate for Payer: Cigna Commercial	$183.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.25
Rate for Payer: Oxford Commercial	$73.50
Rate for Payer: Qualcare PPO/HMO/WC	$55.12
Rate for Payer: UnitedHealthcare Commercial	$73.50
Rate for Payer: UnitedHealthcare Community & State	$8.86
Rate for Payer: Wellpoint Medicaid Managed Care	$9.74

RECIP SAW BLADE D/S 68x1.00MM

Facility

$367.50

Hospital Charge Code	270674770
Hospital Revenue Code	272
Min. Negotiated Rate	$8.86
Max. Negotiated Rate	$183.75
Rate for Payer: Aetna Commercial	$139.65
Rate for Payer: Aetna Medicare Advantage	$110.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.71
Rate for Payer: Cigna Commercial	$183.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.25
Rate for Payer: Oxford Commercial	$73.50
Rate for Payer: Qualcare PPO/HMO/WC	$55.12
Rate for Payer: UnitedHealthcare Commercial	$73.50
Rate for Payer: UnitedHealthcare Community & State	$8.86
Rate for Payer: Wellpoint Medicaid Managed Care	$9.74

RECIP SAW BLADE D/S 68x1.00MM

Facility

$367.50

Hospital Charge Code	270674770
Hospital Revenue Code	272
Min. Negotiated Rate	$55.12
Max. Negotiated Rate	$55.12
Rate for Payer: Qualcare PPO/HMO/WC	$55.12

RECIP SAW BLADE D/S 68x1.10MM

Facility

$367.50

Hospital Charge Code	270674769
Hospital Revenue Code	272
Min. Negotiated Rate	$8.86
Max. Negotiated Rate	$183.75
Rate for Payer: Aetna Commercial	$139.65
Rate for Payer: Aetna Medicare Advantage	$110.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.71
Rate for Payer: Cigna Commercial	$183.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.25
Rate for Payer: Oxford Commercial	$73.50
Rate for Payer: Qualcare PPO/HMO/WC	$55.12
Rate for Payer: UnitedHealthcare Commercial	$73.50
Rate for Payer: UnitedHealthcare Community & State	$8.86
Rate for Payer: Wellpoint Medicaid Managed Care	$9.74

RECIP SAW BLADE D/S 68x1.10MM

Facility

$367.50

Hospital Charge Code	270674769
Hospital Revenue Code	272
Min. Negotiated Rate	$55.12
Max. Negotiated Rate	$55.12
Rate for Payer: Qualcare PPO/HMO/WC	$55.12

RECOMBIVAX(HEPATITIS)/3ML

Facility

$769.00

Hospital Charge Code	60634526
Hospital Revenue Code	250
Min. Negotiated Rate	$115.35
Max. Negotiated Rate	$115.35
Rate for Payer: Qualcare PPO/HMO/WC	$115.35

RECOMBIVAX(HEPATITIS)/3ML

Facility

$769.00

Hospital Charge Code	60634526
Hospital Revenue Code	250
Min. Negotiated Rate	$18.53
Max. Negotiated Rate	$384.50
Rate for Payer: Aetna Commercial	$292.22
Rate for Payer: Aetna Medicare Advantage	$230.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.09
Rate for Payer: Cigna Commercial	$384.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.70
Rate for Payer: Oxford Commercial	$153.80
Rate for Payer: Qualcare PPO/HMO/WC	$115.35
Rate for Payer: UnitedHealthcare Commercial	$153.80
Rate for Payer: UnitedHealthcare Community & State	$18.53
Rate for Payer: Wellpoint Medicaid Managed Care	$20.38

RECOMBX 2 MATA AUTOANTIBODY

Facility

$3,025.00

Service Code	HCPCS 83500
Hospital Charge Code	401083500
Hospital Revenue Code	301
Min. Negotiated Rate	$453.75
Max. Negotiated Rate	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$453.75

RECOMBX 2 MATA AUTOANTIBODY

Facility

$3,025.00

Service Code	HCPCS 83500
Hospital Charge Code	401083500
Hospital Revenue Code	301
Min. Negotiated Rate	$18.12
Max. Negotiated Rate	$1,512.50
Rate for Payer: Aetna Commercial	$61.61
Rate for Payer: Aetna Medicare Advantage	$73.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.76
Rate for Payer: Cigna Commercial	$1,512.50
Rate for Payer: Cigna Medicare Advantage	$22.65
Rate for Payer: Clover Medicare Advantage	$21.52
Rate for Payer: EmblemHealth Commercial	$67.95
Rate for Payer: Humana Medicare Advantage	$23.33
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$453.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$18.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.65
Rate for Payer: Wellcare Medicare Advantage	$22.65
Rate for Payer: Wellpoint Medicaid Managed Care	$80.16

RECOMBX AMPHIPHYSIN AUTO AB

Facility

$1,925.00

Service Code	HCPCS 83520
Hospital Charge Code	401083520
Hospital Revenue Code	301
Min. Negotiated Rate	$288.75
Max. Negotiated Rate	$288.75
Rate for Payer: Qualcare PPO/HMO/WC	$288.75

RECOMBX AMPHIPHYSIN AUTO AB

Facility

$1,925.00

Service Code	HCPCS 83520
Hospital Charge Code	401083520
Hospital Revenue Code	301
Min. Negotiated Rate	$13.82
Max. Negotiated Rate	$962.50
Rate for Payer: Aetna Commercial	$46.97
Rate for Payer: Aetna Medicare Advantage	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.34
Rate for Payer: Cigna Commercial	$962.50
Rate for Payer: Cigna Medicare Advantage	$17.27
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$577.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$288.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Medicare Advantage	$17.27
Rate for Payer: Wellpoint Medicaid Managed Care	$51.01

RECOMBX CV2 AUTOANTIBODY

Facility

$1,866.45

Service Code	HCPCS 84182
Hospital Charge Code	3038074
Hospital Revenue Code	301
Min. Negotiated Rate	$279.97
Max. Negotiated Rate	$279.97
Rate for Payer: Qualcare PPO/HMO/WC	$279.97

RECOMBX CV2 AUTOANTIBODY

Facility

$1,866.45

Service Code	HCPCS 84182
Hospital Charge Code	3038074
Hospital Revenue Code	301
Min. Negotiated Rate	$23.37
Max. Negotiated Rate	$933.23
Rate for Payer: Aetna Commercial	$79.45
Rate for Payer: Aetna Medicare Advantage	$94.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.44
Rate for Payer: Cigna Commercial	$933.23
Rate for Payer: Cigna Medicare Advantage	$29.21
Rate for Payer: Clover Medicare Advantage	$27.75
Rate for Payer: EmblemHealth Commercial	$87.63
Rate for Payer: Humana Medicare Advantage	$30.09
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$559.93
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$279.97
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$23.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.21
Rate for Payer: Wellcare Medicare Advantage	$29.21
Rate for Payer: Wellpoint Medicaid Managed Care	$49.46

RECOMBX MA TA AUTOANTIBODY TES

Facility

$925.00

Service Code	HCPCS 83520
Hospital Charge Code	401183520A
Hospital Revenue Code	301
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$138.75
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

RECOMBX MA TA AUTOANTIBODY TES

Facility

$925.00

Service Code	HCPCS 83520
Hospital Charge Code	401183520A
Hospital Revenue Code	301
Min. Negotiated Rate	$13.82
Max. Negotiated Rate	$462.50
Rate for Payer: Aetna Commercial	$46.97
Rate for Payer: Aetna Medicare Advantage	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.34
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: Cigna Medicare Advantage	$17.27
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Medicare Advantage	$17.27
Rate for Payer: Wellpoint Medicaid Managed Care	$24.51

RECON PLATE 8 HOLE

Facility

$2,750.00

Hospital Charge Code	270656548
Hospital Revenue Code	278
Min. Negotiated Rate	$66.28
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Community & State	$66.28
Rate for Payer: Wellpoint Medicaid Managed Care	$72.88

RECON PLATE 8 HOLE

Facility

$2,750.00

Hospital Charge Code	270656548
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

RECONSTR ANGLE TOE DEFORMITY S

Facility

$19,998.60

Service Code	HCPCS 28313
Hospital Charge Code	1600000633
Hospital Revenue Code	360
Min. Negotiated Rate	$2,999.79
Max. Negotiated Rate	$2,999.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79

RECONSTR ANGLE TOE DEFORMITY S

Facility

$19,998.60

Service Code	HCPCS 28313
Hospital Charge Code	1600000633
Hospital Revenue Code	360
Min. Negotiated Rate	$481.97
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	$1,016.00
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	$5,999.58
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$481.97
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	$529.96

RECONSTR DISLOC PATELLA W MSCL

Facility

$28,255.00

Service Code	HCPCS 27422
Hospital Charge Code	1600000465
Hospital Revenue Code	360
Min. Negotiated Rate	$4,238.25
Max. Negotiated Rate	$4,238.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,238.25

RECONSTR DISLOC PATELLA W MSCL

Facility

$28,255.00

Service Code	HCPCS 27422
Hospital Charge Code	1600000465
Hospital Revenue Code	360
Min. Negotiated Rate	$680.95
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,476.50
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,238.25
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$680.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$748.76

RECONSTRICTION KNEE

Facility

$22,425.68

Service Code	HCPCS 27427
Hospital Charge Code	16000563
Hospital Revenue Code	360
Min. Negotiated Rate	$3,363.85
Max. Negotiated Rate	$3,363.85
Rate for Payer: Qualcare PPO/HMO/WC	$3,363.85

RECONSTRICTION KNEE

Facility

$22,425.68

Service Code	HCPCS 27427
Hospital Charge Code	16000563
Hospital Revenue Code	360
Min. Negotiated Rate	$540.46
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,727.70
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,363.85
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$540.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$594.28

RECONSTR MCP JNT COLL LIGAM W

Facility

$12,831.32

Service Code	HCPCS 26542
Hospital Charge Code	16000854
Hospital Revenue Code	360
Min. Negotiated Rate	$1,924.70
Max. Negotiated Rate	$1,924.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,924.70

Know your out-of-pocket cost for care.

All Charges