Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SHOE CAST CUSH XLG CL TOE

Facility

$44.85

Hospital Charge Code	270302730
Hospital Revenue Code	270
Min. Negotiated Rate	$6.73
Max. Negotiated Rate	$6.73
Rate for Payer: Qualcare PPO/HMO/WC	$6.73

SHOE CAST CUSH XLG CL TOE

Facility

$44.85

Hospital Charge Code	270302730
Hospital Revenue Code	270
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.43
Rate for Payer: Aetna Commercial	$17.04
Rate for Payer: Aetna Medicare Advantage	$13.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.44
Rate for Payer: Cigna Commercial	$22.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.46
Rate for Payer: Oxford Commercial	$8.97
Rate for Payer: Qualcare PPO/HMO/WC	$6.73
Rate for Payer: UnitedHealthcare Commercial	$8.97
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

SHOE CAST VINYL LG OP TOE

Facility

$23.90

Hospital Charge Code	270302745
Hospital Revenue Code	270
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$11.95
Rate for Payer: Aetna Commercial	$9.08
Rate for Payer: Aetna Medicare Advantage	$7.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.09
Rate for Payer: Cigna Commercial	$11.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.17
Rate for Payer: Oxford Commercial	$4.78
Rate for Payer: Qualcare PPO/HMO/WC	$3.58
Rate for Payer: UnitedHealthcare Commercial	$4.78
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.63

SHOE CAST VINYL LG OP TOE

Facility

$23.90

Hospital Charge Code	270302745
Hospital Revenue Code	270
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$3.58
Rate for Payer: Qualcare PPO/HMO/WC	$3.58

SHOE CAST VINYL MED OP TOE

Facility

$35.85

Hospital Charge Code	270302740
Hospital Revenue Code	270
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$17.93
Rate for Payer: Aetna Commercial	$13.62
Rate for Payer: Aetna Medicare Advantage	$10.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.14
Rate for Payer: Cigna Commercial	$17.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.76
Rate for Payer: Oxford Commercial	$7.17
Rate for Payer: Qualcare PPO/HMO/WC	$5.38
Rate for Payer: UnitedHealthcare Commercial	$7.17
Rate for Payer: UnitedHealthcare Community & State	$0.86
Rate for Payer: Wellpoint Medicaid Managed Care	$0.95

SHOE CAST VINYL MED OP TOE

Facility

$35.85

Hospital Charge Code	270302740
Hospital Revenue Code	270
Min. Negotiated Rate	$5.38
Max. Negotiated Rate	$5.38
Rate for Payer: Qualcare PPO/HMO/WC	$5.38

SHOE CAST VINYL MED O T****

Facility

$23.00

Hospital Charge Code	270301740
Hospital Revenue Code	270
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$8.74
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.90
Rate for Payer: Oxford Commercial	$4.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$4.60
Rate for Payer: UnitedHealthcare Community & State	$0.55
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

SHOE CAST VINYL MED O T****

Facility

$23.00

Hospital Charge Code	270301740
Hospital Revenue Code	270
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

SHOE CAST VINYL SM OP TOE

Facility

$35.85

Hospital Charge Code	270302735
Hospital Revenue Code	270
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$17.93
Rate for Payer: Aetna Commercial	$13.62
Rate for Payer: Aetna Medicare Advantage	$10.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.14
Rate for Payer: Cigna Commercial	$17.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.76
Rate for Payer: Oxford Commercial	$7.17
Rate for Payer: Qualcare PPO/HMO/WC	$5.38
Rate for Payer: UnitedHealthcare Commercial	$7.17
Rate for Payer: UnitedHealthcare Community & State	$0.86
Rate for Payer: Wellpoint Medicaid Managed Care	$0.95

SHOE CAST VINYL SM OP TOE

Facility

$35.85

Hospital Charge Code	270302735
Hospital Revenue Code	270
Min. Negotiated Rate	$5.38
Max. Negotiated Rate	$5.38
Rate for Payer: Qualcare PPO/HMO/WC	$5.38

SHOE CAST VINYL XLG OP TOE

Facility

$24.25

Hospital Charge Code	270302750
Hospital Revenue Code	270
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$12.12
Rate for Payer: Aetna Commercial	$9.21
Rate for Payer: Aetna Medicare Advantage	$7.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.18
Rate for Payer: Cigna Commercial	$12.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.28
Rate for Payer: Oxford Commercial	$4.85
Rate for Payer: Qualcare PPO/HMO/WC	$3.64
Rate for Payer: UnitedHealthcare Commercial	$4.85
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

SHOE CAST VINYL XLG OP TOE

Facility

$24.25

Hospital Charge Code	270302750
Hospital Revenue Code	270
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$3.64
Rate for Payer: Qualcare PPO/HMO/WC	$3.64

SHOE DARCO WEDGE HEEL RELIEF

Facility

$124.75

Hospital Charge Code	270642336
Hospital Revenue Code	272
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.38
Rate for Payer: Aetna Commercial	$47.41
Rate for Payer: Aetna Medicare Advantage	$37.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.81
Rate for Payer: Cigna Commercial	$62.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.42
Rate for Payer: Oxford Commercial	$24.95
Rate for Payer: Qualcare PPO/HMO/WC	$18.71
Rate for Payer: UnitedHealthcare Commercial	$24.95
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

SHOE DARCO WEDGE HEEL RELIEF

Facility

$124.75

Hospital Charge Code	270642336
Hospital Revenue Code	272
Min. Negotiated Rate	$18.71
Max. Negotiated Rate	$18.71
Rate for Payer: Qualcare PPO/HMO/WC	$18.71

SHOE HEEL WEDGE HEALING SZ L

Facility

$200.00

Hospital Charge Code	270678832
Hospital Revenue Code	270
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.00
Rate for Payer: Oxford Commercial	$40.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Commercial	$40.00
Rate for Payer: UnitedHealthcare Community & State	$4.82
Rate for Payer: Wellpoint Medicaid Managed Care	$5.30

SHOE HEEL WEDGE HEALING SZ L

Facility

$200.00

Hospital Charge Code	270678832
Hospital Revenue Code	270
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

SHOE HEEL WEDGE HEALING SZ M

Facility

$163.30

Hospital Charge Code	270678833
Hospital Revenue Code	270
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$24.50
Rate for Payer: Qualcare PPO/HMO/WC	$24.50

SHOE HEEL WEDGE HEALING SZ M

Facility

$163.30

Hospital Charge Code	270678833
Hospital Revenue Code	270
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$81.65
Rate for Payer: Aetna Commercial	$62.05
Rate for Payer: Aetna Medicare Advantage	$48.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.64
Rate for Payer: Cigna Commercial	$81.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.99
Rate for Payer: Oxford Commercial	$32.66
Rate for Payer: Qualcare PPO/HMO/WC	$24.50
Rate for Payer: UnitedHealthcare Commercial	$32.66
Rate for Payer: UnitedHealthcare Community & State	$3.94
Rate for Payer: Wellpoint Medicaid Managed Care	$4.33

SHOE ORTHOWEDGE HEALING SZ L

Facility

$126.60

Hospital Charge Code	270678831
Hospital Revenue Code	270
Min. Negotiated Rate	$3.05
Max. Negotiated Rate	$63.30
Rate for Payer: Aetna Commercial	$48.11
Rate for Payer: Aetna Medicare Advantage	$37.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.28
Rate for Payer: Cigna Commercial	$63.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.98
Rate for Payer: Oxford Commercial	$25.32
Rate for Payer: Qualcare PPO/HMO/WC	$18.99
Rate for Payer: UnitedHealthcare Commercial	$25.32
Rate for Payer: UnitedHealthcare Community & State	$3.05
Rate for Payer: Wellpoint Medicaid Managed Care	$3.35

SHOE ORTHOWEDGE HEALING SZ L

Facility

$126.60

Hospital Charge Code	270678831
Hospital Revenue Code	270
Min. Negotiated Rate	$18.99
Max. Negotiated Rate	$18.99
Rate for Payer: Qualcare PPO/HMO/WC	$18.99

SHOE ORTHOWEDGE LARGE

Facility

$184.95

Hospital Charge Code	270650012
Hospital Revenue Code	270
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$92.47
Rate for Payer: Aetna Commercial	$70.28
Rate for Payer: Aetna Medicare Advantage	$55.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.16
Rate for Payer: Cigna Commercial	$92.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.48
Rate for Payer: Oxford Commercial	$36.99
Rate for Payer: Qualcare PPO/HMO/WC	$27.74
Rate for Payer: UnitedHealthcare Commercial	$36.99
Rate for Payer: UnitedHealthcare Community & State	$4.46
Rate for Payer: Wellpoint Medicaid Managed Care	$4.90

SHOE ORTHOWEDGE LARGE

Facility

$184.95

Hospital Charge Code	270650012
Hospital Revenue Code	270
Min. Negotiated Rate	$27.74
Max. Negotiated Rate	$27.74
Rate for Payer: Qualcare PPO/HMO/WC	$27.74

SHOE ORTHO WEDGE MEDIUM

Facility

$174.75

Hospital Charge Code	270641374
Hospital Revenue Code	272
Min. Negotiated Rate	$4.21
Max. Negotiated Rate	$87.38
Rate for Payer: Aetna Commercial	$66.41
Rate for Payer: Aetna Medicare Advantage	$52.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.56
Rate for Payer: Cigna Commercial	$87.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.42
Rate for Payer: Oxford Commercial	$34.95
Rate for Payer: Qualcare PPO/HMO/WC	$26.21
Rate for Payer: UnitedHealthcare Commercial	$34.95
Rate for Payer: UnitedHealthcare Community & State	$4.21
Rate for Payer: Wellpoint Medicaid Managed Care	$4.63

SHOE ORTHO WEDGE MEDIUM

Facility

$174.75

Hospital Charge Code	270641374
Hospital Revenue Code	272
Min. Negotiated Rate	$26.21
Max. Negotiated Rate	$26.21
Rate for Payer: Qualcare PPO/HMO/WC	$26.21

SHOE ORTHOWEDGE XL

Facility

$176.50

Hospital Charge Code	270647499
Hospital Revenue Code	271
Min. Negotiated Rate	$4.25
Max. Negotiated Rate	$88.25
Rate for Payer: Aetna Commercial	$67.07
Rate for Payer: Aetna Medicare Advantage	$52.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.01
Rate for Payer: Cigna Commercial	$88.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.95
Rate for Payer: Oxford Commercial	$35.30
Rate for Payer: Qualcare PPO/HMO/WC	$26.48
Rate for Payer: UnitedHealthcare Commercial	$35.30
Rate for Payer: UnitedHealthcare Community & State	$4.25
Rate for Payer: Wellpoint Medicaid Managed Care	$4.68

Know your out-of-pocket cost for care.

All Charges