Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

REHABILITATION

Facility

$12,210.47

Service Code	APR-DRG 8601
Min. Negotiated Rate	$11,971.05
Max. Negotiated Rate	$12,210.47
Rate for Payer: UnitedHealthcare Community & State	$11,971.05
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,210.47
Rate for Payer: Wellpoint Medicaid Managed Care	$11,971.05

REHABILITATION

Facility

$14,874.94

Service Code	APR-DRG 8602
Min. Negotiated Rate	$14,583.27
Max. Negotiated Rate	$14,874.94
Rate for Payer: UnitedHealthcare Community & State	$14,583.27
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,874.94
Rate for Payer: Wellpoint Medicaid Managed Care	$14,583.27

REHABILITATION WITH CC/MCC

Facility

$52,187.46

Service Code	MSDRG 945
Min. Negotiated Rate	$15,890.41
Max. Negotiated Rate	$52,187.46
Rate for Payer: Aetna Commercial	$36,116.04
Rate for Payer: Aetna Medicare Advantage	$52,187.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,124.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,124.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,726.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,124.11
Rate for Payer: Cigna Commercial	$28,980.50
Rate for Payer: Cigna Medicare Advantage	$16,726.75
Rate for Payer: Clover Medicare Advantage	$15,890.41
Rate for Payer: EmblemHealth Commercial	$50,180.25
Rate for Payer: Humana Medicare Advantage	$17,228.55
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,726.75
Rate for Payer: Oxford Commercial	$20,828.67
Rate for Payer: UnitedHealthcare Commercial	$36,523.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,726.75
Rate for Payer: Wellcare Medicare Advantage	$16,726.75

REHABILITATION WITHOUT CC/MCC

Facility

$39,200.52

Service Code	MSDRG 946
Min. Negotiated Rate	$11,936.06
Max. Negotiated Rate	$39,200.52
Rate for Payer: Aetna Commercial	$27,192.56
Rate for Payer: Aetna Medicare Advantage	$39,200.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,493.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,493.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,564.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,493.61
Rate for Payer: Cigna Commercial	$21,461.22
Rate for Payer: Cigna Medicare Advantage	$12,564.27
Rate for Payer: Clover Medicare Advantage	$11,936.06
Rate for Payer: EmblemHealth Commercial	$37,692.81
Rate for Payer: Humana Medicare Advantage	$12,941.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,564.27
Rate for Payer: Oxford Commercial	$15,424.46
Rate for Payer: UnitedHealthcare Commercial	$27,047.28
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,564.27
Rate for Payer: Wellcare Medicare Advantage	$12,564.27

REHAB SEMI-PRIVATE ROOM

Facility

$18,000.00

Hospital Charge Code	100820
Hospital Revenue Code	128
Min. Negotiated Rate	$2,321.00
Max. Negotiated Rate	$6,764.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,764.00
Rate for Payer: Oxford Commercial	$2,321.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,700.00
Rate for Payer: UnitedHealthcare Commercial	$4,071.00

REINFUSION

Facility

$1,670.40

Service Code	HCPCS 38241
Hospital Charge Code	3400306
Hospital Revenue Code	761
Min. Negotiated Rate	$250.56
Max. Negotiated Rate	$250.56
Rate for Payer: Qualcare PPO/HMO/WC	$250.56

REINFUSION

Facility

$1,670.40

Service Code	HCPCS 38241
Hospital Charge Code	3400306
Hospital Revenue Code	761
Min. Negotiated Rate	$40.26
Max. Negotiated Rate	$6,678.88
Rate for Payer: Aetna Commercial	$5,032.71
Rate for Payer: Aetna Medicare Advantage	$5,994.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,678.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,678.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,850.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$271.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,678.88
Rate for Payer: Cigna Commercial	$3,708.85
Rate for Payer: Cigna Medicare Advantage	$1,850.26
Rate for Payer: Clover Medicare Advantage	$1,757.75
Rate for Payer: EmblemHealth Commercial	$5,550.78
Rate for Payer: Humana Medicare Advantage	$1,905.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,850.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$501.12
Rate for Payer: Oxford Commercial	$334.08
Rate for Payer: Qualcare PPO/HMO/WC	$250.56
Rate for Payer: UnitedHealthcare Commercial	$334.08
Rate for Payer: UnitedHealthcare Community & State	$40.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,850.26
Rate for Payer: Wellcare Medicare Advantage	$1,850.26
Rate for Payer: Wellpoint Medicaid Managed Care	$44.27

REINFUSION BAG SET******

Facility

$30.00

Hospital Charge Code	8002511
Hospital Revenue Code	279
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

REINFUSION BAG SET******

Facility

$30.00

Hospital Charge Code	8002511
Hospital Revenue Code	279
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$15.00
Rate for Payer: Aetna Commercial	$11.40
Rate for Payer: Aetna Medicare Advantage	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.65
Rate for Payer: Cigna Commercial	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.00
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.50
Rate for Payer: UnitedHealthcare Commercial	$6.00
Rate for Payer: UnitedHealthcare Community & State	$0.72
Rate for Payer: Wellpoint Medicaid Managed Care	$0.80

REINFUSION PACK125

Facility

$145.00

Hospital Charge Code	270679094
Hospital Revenue Code	272
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$21.75
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

REINFUSION PACK125

Facility

$145.00

Hospital Charge Code	270679094
Hospital Revenue Code	272
Min. Negotiated Rate	$3.49
Max. Negotiated Rate	$72.50
Rate for Payer: Aetna Commercial	$55.10
Rate for Payer: Aetna Medicare Advantage	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.98
Rate for Payer: Cigna Commercial	$72.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.50
Rate for Payer: Oxford Commercial	$29.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.75
Rate for Payer: UnitedHealthcare Commercial	$29.00
Rate for Payer: UnitedHealthcare Community & State	$3.49
Rate for Payer: Wellpoint Medicaid Managed Care	$3.84

REINSERT RUPTRD BIC/TC TENDON

Facility

$44,916.00

Service Code	HCPCS 24342
Hospital Charge Code	16000547
Hospital Revenue Code	360
Min. Negotiated Rate	$6,737.40
Max. Negotiated Rate	$6,737.40
Rate for Payer: Qualcare PPO/HMO/WC	$6,737.40

REINSERT RUPTRD BIC/TC TENDON

Facility

$44,916.00

Service Code	HCPCS 24342
Hospital Charge Code	16000547
Hospital Revenue Code	360
Min. Negotiated Rate	$1,082.48
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	$13,474.80
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,737.40
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$1,082.48
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	$1,190.27

REINSERT SPINAL FIXATION DEVIC

Facility

$20,529.83

Service Code	HCPCS 22849
Hospital Charge Code	1600000304
Hospital Revenue Code	360
Min. Negotiated Rate	$494.77
Max. Negotiated Rate	$55,057.64
Rate for Payer: Aetna Commercial	$41,487.32
Rate for Payer: Aetna Medicare Advantage	$49,418.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55,057.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55,057.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,252.69
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	$55,057.64
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: Cigna Medicare Advantage	$15,252.69
Rate for Payer: Clover Medicare Advantage	$14,490.06
Rate for Payer: EmblemHealth Commercial	$45,758.07
Rate for Payer: Humana Medicare Advantage	$15,710.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,252.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,158.95
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,079.47
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$494.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,252.69
Rate for Payer: Wellcare Medicare Advantage	$15,252.69

REINSERT SPINAL FIXATION DEVIC

Facility

$20,529.83

Service Code	HCPCS 22849
Hospital Charge Code	1600000304
Hospital Revenue Code	360
Min. Negotiated Rate	$3,079.47
Max. Negotiated Rate	$3,079.47
Rate for Payer: Qualcare PPO/HMO/WC	$3,079.47

RE-INSTALL DATA AND VOICE

Facility

$4,012.50

Hospital Charge Code	270659143
Hospital Revenue Code	278
Min. Negotiated Rate	$601.88
Max. Negotiated Rate	$971.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$802.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$971.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$882.75
Rate for Payer: Qualcare PPO/HMO/WC	$601.88

RE-INSTALL DATA AND VOICE

Facility

$4,012.50

Hospital Charge Code	270659143
Hospital Revenue Code	278
Min. Negotiated Rate	$96.70
Max. Negotiated Rate	$2,006.25
Rate for Payer: Aetna Commercial	$1,524.75
Rate for Payer: Aetna Medicare Advantage	$1,203.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$802.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.19
Rate for Payer: Cigna Commercial	$2,006.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$971.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$882.75
Rate for Payer: Qualcare PPO/HMO/WC	$601.88
Rate for Payer: UnitedHealthcare Community & State	$96.70
Rate for Payer: Wellpoint Medicaid Managed Care	$106.33

RELAFEN/500MG

Facility

$5.00

Hospital Charge Code	60634809
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.50
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

RELAFEN/500MG

Facility

$5.00

Hospital Charge Code	60634809
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

RELEASE EXT TNDN HAND/FINGER

Facility

$14,854.00

Service Code	HCPCS 26445
Hospital Charge Code	16000362
Hospital Revenue Code	360
Min. Negotiated Rate	$2,228.10
Max. Negotiated Rate	$2,228.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,228.10

RELEASE EXT TNDN HAND/FINGER

Facility

$14,854.00

Service Code	HCPCS 26445
Hospital Charge Code	16000362
Hospital Revenue Code	360
Min. Negotiated Rate	$357.98
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	$1,355.00
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	$4,456.20
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,228.10
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$357.98
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	$393.63

RELEASE FLEXOR TENDON PALM

Facility

$12,289.60

Service Code	HCPCS 26442
Hospital Charge Code	16000556
Hospital Revenue Code	360
Min. Negotiated Rate	$296.18
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	$1,355.00
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	$3,686.88
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,843.44
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$296.18
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	$325.67

RELEASE FLEXOR TENDON PALM

Facility

$12,289.60

Service Code	HCPCS 26442
Hospital Charge Code	16000556
Hospital Revenue Code	360
Min. Negotiated Rate	$1,843.44
Max. Negotiated Rate	$1,843.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,843.44

RELEASE HAND/FINGER TENDON

Facility

$13,687.25

Service Code	HCPCS 26445
Hospital Charge Code	323026445
Hospital Revenue Code	450
Min. Negotiated Rate	$2,053.09
Max. Negotiated Rate	$2,053.09
Rate for Payer: Qualcare PPO/HMO/WC	$2,053.09

RELEASE HAND/FINGER TENDON

Facility

$13,687.25

Service Code	HCPCS 26445
Hospital Charge Code	323026445
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
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	$456.80
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	$4,106.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,053.09
Rate for Payer: UnitedHealthcare Community & State	$140.00
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	$362.71

Know your out-of-pocket cost for care.

All Charges