Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RELEASE IP JNT CONTRACTURE-EA

Facility

$14,854.00

Service Code	HCPCS 26525
Hospital Charge Code	16000506
Hospital Revenue Code	360
Min. Negotiated Rate	$357.98
Max. Negotiated Rate	$8,822.27
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
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	$6,895.75
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
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	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,822.27
Rate for Payer: Wellpoint Medicaid Managed Care	$8,649.28

RELEASE IP JNT CONTRACTURE-EA

Facility

$14,854.00

Service Code	HCPCS 26525
Hospital Charge Code	16000506
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 MULTIP TIB FIB ANKLE F

Facility

$12,289.60

Service Code	HCPCS 27681
Hospital Charge Code	16000714
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 MULTIP TIB FIB ANKLE F

Facility

$12,289.60

Service Code	HCPCS 27681
Hospital Charge Code	16000714
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	$1,016.00
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	$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 PALM CONTRACTURE

Facility

$14,972.60

Service Code	HCPCS 26045
Hospital Charge Code	16000840
Hospital Revenue Code	360
Min. Negotiated Rate	$2,245.89
Max. Negotiated Rate	$2,245.89
Rate for Payer: Qualcare PPO/HMO/WC	$2,245.89

RELEASE PALM CONTRACTURE

Facility

$14,972.60

Service Code	HCPCS 26045
Hospital Charge Code	16000840
Hospital Revenue Code	360
Min. Negotiated Rate	$360.84
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	$4,491.78
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,245.89
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$360.84
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	$396.77

RELEASE PALM/FINGER TENDON

Facility

$6,775.00

Service Code	HCPCS 26440
Hospital Charge Code	323026440
Hospital Revenue Code	450
Min. Negotiated Rate	$1,016.25
Max. Negotiated Rate	$1,016.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,016.25

RELEASE PALM/FINGER TENDON

Facility

$6,775.00

Service Code	HCPCS 26440
Hospital Charge Code	323026440
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$6,895.75
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$502.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,895.75
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,032.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,016.25
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$179.54

RELEASE PALM/FINGER TENDON

Facility

$7,359.90

Service Code	HCPCS 26440
Hospital Charge Code	16000281
Hospital Revenue Code	360
Min. Negotiated Rate	$177.37
Max. Negotiated Rate	$6,895.75
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
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	$6,895.75
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,207.97
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,103.98
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$177.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$195.04

RELEASE PALM/FINGER TENDON

Facility

$7,359.90

Service Code	HCPCS 26440
Hospital Charge Code	16000281
Hospital Revenue Code	360
Min. Negotiated Rate	$1,103.98
Max. Negotiated Rate	$1,103.98
Rate for Payer: Qualcare PPO/HMO/WC	$1,103.98

RELEASE SGL TIB FIB ANKLE FLXR

Facility

$30,595.00

Service Code	HCPCS 27680
Hospital Charge Code	16000414
Hospital Revenue Code	360
Min. Negotiated Rate	$737.34
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	$9,178.50
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$737.34
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	$810.77

RELEASE SGL TIB FIB ANKLE FLXR

Facility

$30,595.00

Service Code	HCPCS 27680
Hospital Charge Code	16000414
Hospital Revenue Code	360
Min. Negotiated Rate	$4,589.25
Max. Negotiated Rate	$4,589.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25

RELEFACT TRH/500MCG/1ML

Facility

$144.00

Hospital Charge Code	60634599
Hospital Revenue Code	250
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$21.60

RELEFACT TRH/500MCG/1ML

Facility

$144.00

Hospital Charge Code	60634599
Hospital Revenue Code	250
Min. Negotiated Rate	$3.47
Max. Negotiated Rate	$72.00
Rate for Payer: Aetna Commercial	$54.72
Rate for Payer: Aetna Medicare Advantage	$43.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.72
Rate for Payer: Cigna Commercial	$72.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.20
Rate for Payer: Oxford Commercial	$28.80
Rate for Payer: Qualcare PPO/HMO/WC	$21.60
Rate for Payer: UnitedHealthcare Commercial	$28.80
Rate for Payer: UnitedHealthcare Community & State	$3.47
Rate for Payer: Wellpoint Medicaid Managed Care	$3.82

RELEFACT TRH/500MCG/1ML

Facility

$711.00

Hospital Charge Code	60633814
Hospital Revenue Code	250
Min. Negotiated Rate	$17.14
Max. Negotiated Rate	$355.50
Rate for Payer: Aetna Commercial	$270.18
Rate for Payer: Aetna Medicare Advantage	$213.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.31
Rate for Payer: Cigna Commercial	$355.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.30
Rate for Payer: Oxford Commercial	$142.20
Rate for Payer: Qualcare PPO/HMO/WC	$106.65
Rate for Payer: UnitedHealthcare Commercial	$142.20
Rate for Payer: UnitedHealthcare Community & State	$17.14
Rate for Payer: Wellpoint Medicaid Managed Care	$18.84

RELEFACT TRH/500MCG/1ML

Facility

$711.00

Hospital Charge Code	60633814
Hospital Revenue Code	250
Min. Negotiated Rate	$106.65
Max. Negotiated Rate	$106.65
Rate for Payer: Qualcare PPO/HMO/WC	$106.65

RELEFAN 750MG TAB

Facility

$5.00

Hospital Charge Code	60635166
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

RELEFAN 750MG TAB

Facility

$5.00

Hospital Charge Code	60635166
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

RELIATACK FIXATION DEVICE 3X10

Facility

$4,317.55

Hospital Charge Code	270672733
Hospital Revenue Code	272
Min. Negotiated Rate	$104.05
Max. Negotiated Rate	$2,158.78
Rate for Payer: Aetna Commercial	$1,640.67
Rate for Payer: Aetna Medicare Advantage	$1,295.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,100.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,100.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,100.98
Rate for Payer: Cigna Commercial	$2,158.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,295.27
Rate for Payer: Oxford Commercial	$863.51
Rate for Payer: Qualcare PPO/HMO/WC	$647.63
Rate for Payer: UnitedHealthcare Commercial	$863.51
Rate for Payer: UnitedHealthcare Community & State	$104.05
Rate for Payer: Wellpoint Medicaid Managed Care	$114.42

RELIATACK FIXATION DEVICE 3X10

Facility

$4,317.55

Hospital Charge Code	270672733
Hospital Revenue Code	272
Min. Negotiated Rate	$647.63
Max. Negotiated Rate	$647.63
Rate for Payer: Qualcare PPO/HMO/WC	$647.63

RELINE MAS TAP 5.5MM CANN

Facility

$3,290.05

Hospital Charge Code	270696209
Hospital Revenue Code	272
Min. Negotiated Rate	$493.51
Max. Negotiated Rate	$493.51
Rate for Payer: Qualcare PPO/HMO/WC	$493.51

RELINE MAS TAP 5.5MM CANN

Facility

$3,290.05

Hospital Charge Code	270696209
Hospital Revenue Code	272
Min. Negotiated Rate	$79.29
Max. Negotiated Rate	$1,645.03
Rate for Payer: Aetna Commercial	$1,250.22
Rate for Payer: Aetna Medicare Advantage	$987.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$838.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$838.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$838.96
Rate for Payer: Cigna Commercial	$1,645.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$987.01
Rate for Payer: Oxford Commercial	$658.01
Rate for Payer: Qualcare PPO/HMO/WC	$493.51
Rate for Payer: UnitedHealthcare Commercial	$658.01
Rate for Payer: UnitedHealthcare Community & State	$79.29
Rate for Payer: Wellpoint Medicaid Managed Care	$87.19

RELINE O TI ROD 5.5 X 40 MM LO

Facility

$3,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270691446
Hospital Revenue Code	278
Min. Negotiated Rate	$594.00
Max. Negotiated Rate	$958.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$792.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$958.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$871.20
Rate for Payer: Qualcare PPO/HMO/WC	$594.00

RELINE O TI ROD 5.5 X 40 MM LO

Facility

$3,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270691446
Hospital Revenue Code	278
Min. Negotiated Rate	$95.44
Max. Negotiated Rate	$1,980.00
Rate for Payer: Aetna Commercial	$1,504.80
Rate for Payer: Aetna Medicare Advantage	$1,188.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,009.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,009.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$792.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,009.80
Rate for Payer: Cigna Commercial	$1,980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$958.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$871.20
Rate for Payer: Qualcare PPO/HMO/WC	$594.00
Rate for Payer: UnitedHealthcare Community & State	$95.44
Rate for Payer: Wellpoint Medicaid Managed Care	$104.94

RELINE O TI ROD 5.5X45 MM LORD

Facility

$3,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270692796
Hospital Revenue Code	278
Min. Negotiated Rate	$594.00
Max. Negotiated Rate	$958.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$792.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$958.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$871.20
Rate for Payer: Qualcare PPO/HMO/WC	$594.00

Know your out-of-pocket cost for care.

All Charges