Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

REP&RECON FINGER VP IP JNT FA

Facility

$26,471.80

Service Code	HCPCS 26548
Hospital Charge Code	16000855
Hospital Revenue Code	360
Min. Negotiated Rate	$3,970.77
Max. Negotiated Rate	$3,970.77
Rate for Payer: Qualcare PPO/HMO/WC	$3,970.77

REP&RECON FINGER VP IP JNT FA

Facility

$26,471.80

Service Code	HCPCS 26548
Hospital Charge Code	16000855
Hospital Revenue Code	360
Min. Negotiated Rate	$637.97
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	$1,626.00
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	$7,941.54
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,970.77
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$637.97
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	$701.50

REP RECURRENT INC HERNIA REDC

Facility

$30,877.00

Service Code	HCPCS 49565
Hospital Charge Code	16000990
Hospital Revenue Code	360
Min. Negotiated Rate	$4,631.55
Max. Negotiated Rate	$4,631.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,631.55

REP RECURRENT INC HERNIA REDC

Facility

$30,877.00

Service Code	HCPCS 49565
Hospital Charge Code	16000990
Hospital Revenue Code	360
Min. Negotiated Rate	$744.14
Max. Negotiated Rate	$15,438.50
Rate for Payer: Aetna Commercial	$11,733.26
Rate for Payer: Aetna Medicare Advantage	$9,263.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,873.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,873.64
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	$7,873.64
Rate for Payer: Cigna Commercial	$15,438.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,263.10
Rate for Payer: Qualcare PPO/HMO/WC	$4,631.55
Rate for Payer: UnitedHealthcare Community & State	$744.14
Rate for Payer: Wellpoint Medicaid Managed Care	$818.24

REP RECURR FEMORAL HERNIA; INC

Facility

$15,383.24

Service Code	HCPCS 49557
Hospital Charge Code	1600000709
Hospital Revenue Code	360
Min. Negotiated Rate	$370.74
Max. Negotiated Rate	$15,354.26
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,354.26
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,614.97
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,307.49
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$370.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$407.66

REP RECURR FEMORAL HERNIA; INC

Facility

$15,383.24

Service Code	HCPCS 49557
Hospital Charge Code	1600000709
Hospital Revenue Code	360
Min. Negotiated Rate	$2,307.49
Max. Negotiated Rate	$2,307.49
Rate for Payer: Qualcare PPO/HMO/WC	$2,307.49

REPR ELBOW LAT LIGMNT W/TISS

Facility

$30,663.00

Service Code	HCPCS 24343
Hospital Charge Code	16000548
Hospital Revenue Code	360
Min. Negotiated Rate	$738.98
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	$1,626.00
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	$9,198.90
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,599.45
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$738.98
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	$812.57

REPR ELBOW LAT LIGMNT W/TISS

Facility

$30,663.00

Service Code	HCPCS 24343
Hospital Charge Code	16000548
Hospital Revenue Code	360
Min. Negotiated Rate	$4,599.45
Max. Negotiated Rate	$4,599.45
Rate for Payer: Qualcare PPO/HMO/WC	$4,599.45

REPR FOOT EXTENSOR TENDON EA

Facility

$19,998.60

Service Code	HCPCS 28208
Hospital Charge Code	16000451
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	$1,355.00
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	$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

REPR FOOT EXTENSOR TENDON EA

Facility

$19,998.60

Service Code	HCPCS 28208
Hospital Charge Code	16000451
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

REPR FOOT FLEXOR TENDON EA BL

Facility

$20,537.30

Service Code	HCPCS 28200
Hospital Charge Code	16000278
Hospital Revenue Code	360
Min. Negotiated Rate	$3,080.59
Max. Negotiated Rate	$3,080.59
Rate for Payer: Qualcare PPO/HMO/WC	$3,080.59

REPR FOOT FLEXOR TENDON EA BL

Facility

$20,537.30

Service Code	HCPCS 28200
Hospital Charge Code	16000278
Hospital Revenue Code	360
Min. Negotiated Rate	$494.95
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	$6,161.19
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,080.59
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$494.95
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	$544.24

REPR TORN COLLATRAL KNEE LIGAM

Facility

$44,325.10

Service Code	HCPCS 27405
Hospital Charge Code	16000562
Hospital Revenue Code	360
Min. Negotiated Rate	$6,648.77
Max. Negotiated Rate	$6,648.77
Rate for Payer: Qualcare PPO/HMO/WC	$6,648.77

REPR TORN COLLATRAL KNEE LIGAM

Facility

$44,325.10

Service Code	HCPCS 27405
Hospital Charge Code	16000562
Hospital Revenue Code	360
Min. Negotiated Rate	$1,068.23
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	$1,626.00
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	$13,297.53
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,648.77
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$1,068.23
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	$1,174.62

REP TENDN/MSCL - FARM.WRIST

Facility

$12,832.72

Service Code	HCPCS 25260
Hospital Charge Code	16000833
Hospital Revenue Code	360
Min. Negotiated Rate	$1,924.91
Max. Negotiated Rate	$1,924.91
Rate for Payer: Qualcare PPO/HMO/WC	$1,924.91

REP TENDN/MSCL - FARM.WRIST

Facility

$12,832.72

Service Code	HCPCS 25260
Hospital Charge Code	16000833
Hospital Revenue Code	360
Min. Negotiated Rate	$309.27
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	$1,626.00
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	$3,849.82
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,924.91
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$309.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$662.27
Rate for Payer: Wellpoint Medicaid Managed Care	$649.28

REPTILASE TEST

Facility

$390.00

Service Code	HCPCS 85635
Hospital Charge Code	38477063
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

REPTILASE TEST

Facility

$390.00

Service Code	HCPCS 85635
Hospital Charge Code	38477063
Hospital Revenue Code	305
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$26.79
Rate for Payer: Aetna Medicare Advantage	$31.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.56
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$9.85
Rate for Payer: Clover Medicare Advantage	$9.36
Rate for Payer: EmblemHealth Commercial	$29.55
Rate for Payer: Humana Medicare Advantage	$10.15
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.85
Rate for Payer: Wellcare Medicare Advantage	$9.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

REP T.M EXTENSOR FA/W,1' EA

Facility

$38,731.07

Service Code	HCPCS 25270
Hospital Charge Code	16000423
Hospital Revenue Code	360
Min. Negotiated Rate	$933.42
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	$1,626.00
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	$11,619.32
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,809.66
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$933.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,822.25
Rate for Payer: Wellpoint Medicaid Managed Care	$8,649.26

REP T.M EXTENSOR FA/W,1' EA

Facility

$38,731.07

Service Code	HCPCS 25270
Hospital Charge Code	16000423
Hospital Revenue Code	360
Min. Negotiated Rate	$5,809.66
Max. Negotiated Rate	$5,809.66
Rate for Payer: Qualcare PPO/HMO/WC	$5,809.66

REP TS FA/WR W FGRAFT

Facility

$30,651.00

Service Code	HCPCS 25275
Hospital Charge Code	16000834
Hospital Revenue Code	360
Min. Negotiated Rate	$738.69
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	$1,626.00
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	$9,195.30
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,597.65
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$738.69
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	$812.25

REP TS FA/WR W FGRAFT

Facility

$30,651.00

Service Code	HCPCS 25275
Hospital Charge Code	16000834
Hospital Revenue Code	360
Min. Negotiated Rate	$4,597.65
Max. Negotiated Rate	$4,597.65
Rate for Payer: Qualcare PPO/HMO/WC	$4,597.65

REP VENOUS BLOCK OPEN VENOUS

Facility

$7,917.57

Service Code	HCPCS 35460
Hospital Charge Code	5100609
Hospital Revenue Code	361
Min. Negotiated Rate	$1,187.64
Max. Negotiated Rate	$1,187.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.64

REP VENOUS BLOCK OPEN VENOUS

Facility

$7,917.57

Service Code	HCPCS 35460
Hospital Charge Code	5100609
Hospital Revenue Code	361
Min. Negotiated Rate	$190.81
Max. Negotiated Rate	$3,958.78
Rate for Payer: Aetna Commercial	$3,008.68
Rate for Payer: Aetna Medicare Advantage	$2,375.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,018.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,018.98
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	$2,018.98
Rate for Payer: Cigna Commercial	$3,958.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,375.27
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.64
Rate for Payer: UnitedHealthcare Community & State	$190.81
Rate for Payer: Wellpoint Medicaid Managed Care	$209.82

REREPAIR ING HERNIA,REDUCE-RT

Facility

$30,877.00

Service Code	HCPCS 49520
Hospital Charge Code	160000242
Hospital Revenue Code	360
Min. Negotiated Rate	$4,631.55
Max. Negotiated Rate	$4,631.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,631.55

Know your out-of-pocket cost for care.

All Charges