Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

REPAIR LEAD PACE-DEFIB DUAL

Facility

$9,295.75

Service Code	HCPCS 33220
Hospital Charge Code	5100774
Hospital Revenue Code	361
Min. Negotiated Rate	$224.03
Max. Negotiated Rate	$16,025.66
Rate for Payer: Aetna Commercial	$12,075.74
Rate for Payer: Aetna Medicare Advantage	$14,384.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,025.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,025.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,439.61
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	$16,025.66
Rate for Payer: Cigna Commercial	$8,899.18
Rate for Payer: Cigna Medicare Advantage	$4,439.61
Rate for Payer: Clover Medicare Advantage	$4,217.63
Rate for Payer: EmblemHealth Commercial	$13,318.83
Rate for Payer: Humana Medicare Advantage	$4,572.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,439.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,788.72
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,394.36
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$224.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,439.61
Rate for Payer: Wellcare Medicare Advantage	$4,439.61
Rate for Payer: Wellpoint Medicaid Managed Care	$246.34

REPAIR LEAD PACE-DEFIB DUAL

Facility

$9,295.75

Service Code	HCPCS 33220
Hospital Charge Code	74110075
Hospital Revenue Code	361
Min. Negotiated Rate	$224.03
Max. Negotiated Rate	$16,025.66
Rate for Payer: Aetna Commercial	$12,075.74
Rate for Payer: Aetna Medicare Advantage	$14,384.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,025.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,025.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,439.61
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	$16,025.66
Rate for Payer: Cigna Commercial	$8,899.18
Rate for Payer: Cigna Medicare Advantage	$4,439.61
Rate for Payer: Clover Medicare Advantage	$4,217.63
Rate for Payer: EmblemHealth Commercial	$13,318.83
Rate for Payer: Humana Medicare Advantage	$4,572.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,439.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,788.72
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,394.36
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$224.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,439.61
Rate for Payer: Wellcare Medicare Advantage	$4,439.61
Rate for Payer: Wellpoint Medicaid Managed Care	$246.34

REPAIR LEAD PACE-DEFIB ONE

Facility

$26,605.00

Service Code	HCPCS 33218
Hospital Charge Code	5100773
Hospital Revenue Code	361
Min. Negotiated Rate	$641.18
Max. Negotiated Rate	$16,025.66
Rate for Payer: Aetna Commercial	$12,075.74
Rate for Payer: Aetna Medicare Advantage	$14,384.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,025.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,025.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,439.61
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	$16,025.66
Rate for Payer: Cigna Commercial	$8,899.18
Rate for Payer: Cigna Medicare Advantage	$4,439.61
Rate for Payer: Clover Medicare Advantage	$4,217.63
Rate for Payer: EmblemHealth Commercial	$13,318.83
Rate for Payer: Humana Medicare Advantage	$4,572.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,439.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,981.50
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,990.75
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$641.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,439.61
Rate for Payer: Wellcare Medicare Advantage	$4,439.61
Rate for Payer: Wellpoint Medicaid Managed Care	$705.03

REPAIR LEAD PACE-DEFIB ONE

Facility

$26,605.00

Service Code	HCPCS 33218
Hospital Charge Code	74110074
Hospital Revenue Code	361
Min. Negotiated Rate	$641.18
Max. Negotiated Rate	$16,025.66
Rate for Payer: Aetna Commercial	$12,075.74
Rate for Payer: Aetna Medicare Advantage	$14,384.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,025.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,025.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,439.61
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	$16,025.66
Rate for Payer: Cigna Commercial	$8,899.18
Rate for Payer: Cigna Medicare Advantage	$4,439.61
Rate for Payer: Clover Medicare Advantage	$4,217.63
Rate for Payer: EmblemHealth Commercial	$13,318.83
Rate for Payer: Humana Medicare Advantage	$4,572.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,439.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,981.50
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,990.75
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$641.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,439.61
Rate for Payer: Wellcare Medicare Advantage	$4,439.61
Rate for Payer: Wellpoint Medicaid Managed Care	$705.03

REPAIR LEAD PACE-DEFIB ONE

Facility

$26,605.00

Service Code	HCPCS 33218
Hospital Charge Code	74110074
Hospital Revenue Code	361
Min. Negotiated Rate	$3,990.75
Max. Negotiated Rate	$3,990.75
Rate for Payer: Qualcare PPO/HMO/WC	$3,990.75

REPAIR LEAD PACE-DEFIB ONE

Facility

$26,605.00

Service Code	HCPCS 33218
Hospital Charge Code	5100773
Hospital Revenue Code	361
Min. Negotiated Rate	$3,990.75
Max. Negotiated Rate	$3,990.75
Rate for Payer: Qualcare PPO/HMO/WC	$3,990.75

REPAIR LEAD PACE-DEFIB, ONE

Facility

$26,605.00

Service Code	HCPCS 33218
Hospital Charge Code	74110034
Hospital Revenue Code	361
Min. Negotiated Rate	$3,990.75
Max. Negotiated Rate	$3,990.75
Rate for Payer: Qualcare PPO/HMO/WC	$3,990.75

REPAIR LEAD PACE-DEFIB, ONE

Facility

$26,605.00

Service Code	HCPCS 33218
Hospital Charge Code	74110034
Hospital Revenue Code	361
Min. Negotiated Rate	$641.18
Max. Negotiated Rate	$16,025.66
Rate for Payer: Aetna Commercial	$12,075.74
Rate for Payer: Aetna Medicare Advantage	$14,384.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,025.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,025.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,439.61
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	$16,025.66
Rate for Payer: Cigna Commercial	$8,899.18
Rate for Payer: Cigna Medicare Advantage	$4,439.61
Rate for Payer: Clover Medicare Advantage	$4,217.63
Rate for Payer: EmblemHealth Commercial	$13,318.83
Rate for Payer: Humana Medicare Advantage	$4,572.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,439.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,981.50
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,990.75
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$641.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,439.61
Rate for Payer: Wellcare Medicare Advantage	$4,439.61
Rate for Payer: Wellpoint Medicaid Managed Care	$705.03

REPAIR LEAD PACE-DEFIB,ONE

Facility

$26,605.00

Service Code	HCPCS 33218
Hospital Charge Code	5100818
Hospital Revenue Code	481
Min. Negotiated Rate	$641.18
Max. Negotiated Rate	$16,025.66
Rate for Payer: Aetna Commercial	$12,075.74
Rate for Payer: Aetna Medicare Advantage	$14,384.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,025.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,025.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,439.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16,025.66
Rate for Payer: Cigna Commercial	$8,899.18
Rate for Payer: Cigna Medicare Advantage	$4,439.61
Rate for Payer: Clover Medicare Advantage	$4,217.63
Rate for Payer: EmblemHealth Commercial	$13,318.83
Rate for Payer: Humana Medicare Advantage	$4,572.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,439.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,981.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,990.75
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$641.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,439.61
Rate for Payer: Wellcare Medicare Advantage	$4,439.61
Rate for Payer: Wellpoint Medicaid Managed Care	$705.03

REPAIR LEAD PACE-DEFIB,ONE

Facility

$26,605.00

Service Code	HCPCS 33218
Hospital Charge Code	5100818
Hospital Revenue Code	481
Min. Negotiated Rate	$3,990.75
Max. Negotiated Rate	$3,990.75
Rate for Payer: Qualcare PPO/HMO/WC	$3,990.75

REPAIR LEAD PACE-DEFIB,ONE

Facility

$26,605.00

Service Code	HCPCS 33218
Hospital Charge Code	5100297
Hospital Revenue Code	361
Min. Negotiated Rate	$3,990.75
Max. Negotiated Rate	$3,990.75
Rate for Payer: Qualcare PPO/HMO/WC	$3,990.75

REPAIR LEAD PACE-DEFIB,ONE

Facility

$26,605.00

Service Code	HCPCS 33218
Hospital Charge Code	5100297
Hospital Revenue Code	361
Min. Negotiated Rate	$641.18
Max. Negotiated Rate	$16,025.66
Rate for Payer: Aetna Commercial	$12,075.74
Rate for Payer: Aetna Medicare Advantage	$14,384.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,025.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,025.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,439.61
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	$16,025.66
Rate for Payer: Cigna Commercial	$8,899.18
Rate for Payer: Cigna Medicare Advantage	$4,439.61
Rate for Payer: Clover Medicare Advantage	$4,217.63
Rate for Payer: EmblemHealth Commercial	$13,318.83
Rate for Payer: Humana Medicare Advantage	$4,572.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,439.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,981.50
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,990.75
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$641.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,439.61
Rate for Payer: Wellcare Medicare Advantage	$4,439.61
Rate for Payer: Wellpoint Medicaid Managed Care	$705.03

REPAIR LIVER WOUND

Facility

$13,705.32

Service Code	HCPCS 47360
Hospital Charge Code	1600000687
Hospital Revenue Code	360
Min. Negotiated Rate	$2,055.80
Max. Negotiated Rate	$2,055.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,055.80

REPAIR LIVER WOUND

Facility

$13,705.32

Service Code	HCPCS 47360
Hospital Charge Code	1600000687
Hospital Revenue Code	360
Min. Negotiated Rate	$330.30
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$5,208.02
Rate for Payer: Aetna Medicare Advantage	$4,111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,494.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,494.86
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	$3,494.86
Rate for Payer: Cigna Commercial	$6,852.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,111.60
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,055.80
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$330.30
Rate for Payer: Wellpoint Medicaid Managed Care	$363.19

REPAIR MULTI-COMP PENIS PROS

Facility

$29,933.90

Service Code	HCPCS 54408
Hospital Charge Code	1600000482
Hospital Revenue Code	360
Min. Negotiated Rate	$721.41
Max. Negotiated Rate	$22,993.64
Rate for Payer: Aetna Commercial	$17,326.29
Rate for Payer: Aetna Medicare Advantage	$20,638.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,993.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,993.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,369.96
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	$22,993.64
Rate for Payer: Cigna Commercial	$12,768.54
Rate for Payer: Cigna Medicare Advantage	$6,369.96
Rate for Payer: Clover Medicare Advantage	$6,051.46
Rate for Payer: EmblemHealth Commercial	$19,109.88
Rate for Payer: Humana Medicare Advantage	$6,561.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,369.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,980.17
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,490.09
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$721.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,369.96
Rate for Payer: Wellcare Medicare Advantage	$6,369.96
Rate for Payer: Wellpoint Medicaid Managed Care	$793.25

REPAIR MULTI-COMP PENIS PROS

Facility

$29,933.90

Service Code	HCPCS 54408
Hospital Charge Code	1600000482
Hospital Revenue Code	360
Min. Negotiated Rate	$4,490.09
Max. Negotiated Rate	$4,490.09
Rate for Payer: Qualcare PPO/HMO/WC	$4,490.09

REPAIR NAIL BED

Facility

$2,482.00

Service Code	HCPCS 11760
Hospital Charge Code	1600000712
Hospital Revenue Code	360
Min. Negotiated Rate	$59.82
Max. Negotiated Rate	$3,169.46
Rate for Payer: Aetna Commercial	$2,388.27
Rate for Payer: Aetna Medicare Advantage	$2,844.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,169.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,169.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$878.04
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	$3,169.46
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: Cigna Medicare Advantage	$878.04
Rate for Payer: Clover Medicare Advantage	$834.14
Rate for Payer: EmblemHealth Commercial	$2,634.12
Rate for Payer: Humana Medicare Advantage	$904.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$878.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$744.60
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$372.30
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$59.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$878.04
Rate for Payer: Wellcare Medicare Advantage	$878.04
Rate for Payer: Wellpoint Medicaid Managed Care	$65.77

REPAIR NAIL BED

Facility

$2,482.00

Service Code	HCPCS 11760
Hospital Charge Code	1600000712
Hospital Revenue Code	360
Min. Negotiated Rate	$372.30
Max. Negotiated Rate	$372.30
Rate for Payer: Qualcare PPO/HMO/WC	$372.30

REPAIR NASAL SEPTAL PERFORAT

Facility

$20,083.40

Service Code	HCPCS 30630
Hospital Charge Code	1600000739
Hospital Revenue Code	360
Min. Negotiated Rate	$3,012.51
Max. Negotiated Rate	$3,012.51
Rate for Payer: Qualcare PPO/HMO/WC	$3,012.51

REPAIR NASAL SEPTAL PERFORAT

Facility

$20,083.40

Service Code	HCPCS 30630
Hospital Charge Code	1600000739
Hospital Revenue Code	360
Min. Negotiated Rate	$484.01
Max. Negotiated Rate	$14,218.07
Rate for Payer: Aetna Commercial	$10,713.67
Rate for Payer: Aetna Medicare Advantage	$12,761.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,218.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,218.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,938.85
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	$14,218.07
Rate for Payer: Cigna Commercial	$7,895.42
Rate for Payer: Cigna Medicare Advantage	$3,938.85
Rate for Payer: Clover Medicare Advantage	$3,741.91
Rate for Payer: EmblemHealth Commercial	$11,816.55
Rate for Payer: Humana Medicare Advantage	$4,057.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,938.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,025.02
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,012.51
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$484.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,938.85
Rate for Payer: Wellcare Medicare Advantage	$3,938.85
Rate for Payer: Wellpoint Medicaid Managed Care	$532.21

REPAIR NASAL STENOSIS

Facility

$42,339.20

Service Code	HCPCS 30465
Hospital Charge Code	1600000738
Hospital Revenue Code	360
Min. Negotiated Rate	$6,350.88
Max. Negotiated Rate	$6,350.88
Rate for Payer: Qualcare PPO/HMO/WC	$6,350.88

REPAIR NASAL STENOSIS

Facility

$42,339.20

Service Code	HCPCS 30465
Hospital Charge Code	1600000738
Hospital Revenue Code	360
Min. Negotiated Rate	$1,020.37
Max. Negotiated Rate	$25,386.70
Rate for Payer: Aetna Commercial	$19,129.52
Rate for Payer: Aetna Medicare Advantage	$22,786.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,386.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,386.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,032.91
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	$25,386.70
Rate for Payer: Cigna Commercial	$14,097.46
Rate for Payer: Cigna Medicare Advantage	$7,032.91
Rate for Payer: Clover Medicare Advantage	$6,681.26
Rate for Payer: EmblemHealth Commercial	$21,098.73
Rate for Payer: Humana Medicare Advantage	$7,243.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,032.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,701.76
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,350.88
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$1,020.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,032.91
Rate for Payer: Wellcare Medicare Advantage	$7,032.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1,121.99

REPAIR NONUNION OF RAD OR ULNA

Facility

$45,935.07

Service Code	HCPCS 25400
Hospital Charge Code	16000836
Hospital Revenue Code	360
Min. Negotiated Rate	$1,107.04
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	$13,780.52
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,890.26
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$1,107.04
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	$1,217.28

REPAIR NONUNION OF RAD OR ULNA

Facility

$45,935.07

Service Code	HCPCS 25400
Hospital Charge Code	16000836
Hospital Revenue Code	360
Min. Negotiated Rate	$6,890.26
Max. Negotiated Rate	$6,890.26
Rate for Payer: Qualcare PPO/HMO/WC	$6,890.26

REPAIR OF BLADDER WOUND

Facility

$39,847.00

Service Code	HCPCS 51865
Hospital Charge Code	1600000324
Hospital Revenue Code	360
Min. Negotiated Rate	$960.31
Max. Negotiated Rate	$19,923.50
Rate for Payer: Aetna Commercial	$15,141.86
Rate for Payer: Aetna Medicare Advantage	$11,954.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,160.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,160.99
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	$10,160.99
Rate for Payer: Cigna Commercial	$19,923.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,954.10
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,977.05
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$960.31
Rate for Payer: Wellpoint Medicaid Managed Care	$1,055.95

Know your out-of-pocket cost for care.

All Charges