Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SHOE POST-OP MEN'S SM

Facility

$19.40

Hospital Charge Code	270302870
Hospital Revenue Code	270
Min. Negotiated Rate	$2.91
Max. Negotiated Rate	$2.91
Rate for Payer: Qualcare PPO/HMO/WC	$2.91

SHOE POST-OP MEN'S SM

Facility

$19.40

Hospital Charge Code	270302870
Hospital Revenue Code	270
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$9.70
Rate for Payer: Aetna Commercial	$7.37
Rate for Payer: Aetna Medicare Advantage	$5.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.95
Rate for Payer: Cigna Commercial	$9.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.82
Rate for Payer: Oxford Commercial	$3.88
Rate for Payer: Qualcare PPO/HMO/WC	$2.91
Rate for Payer: UnitedHealthcare Commercial	$3.88
Rate for Payer: UnitedHealthcare Community & State	$0.47
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

SHOE POST-OP MEN'S XL

Facility

$42.15

Hospital Charge Code	270633939
Hospital Revenue Code	270
Min. Negotiated Rate	$6.32
Max. Negotiated Rate	$6.32
Rate for Payer: Qualcare PPO/HMO/WC	$6.32

SHOE POST-OP MEN'S XL

Facility

$42.15

Hospital Charge Code	270633939
Hospital Revenue Code	270
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$21.07
Rate for Payer: Aetna Commercial	$16.02
Rate for Payer: Aetna Medicare Advantage	$12.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.75
Rate for Payer: Cigna Commercial	$21.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.64
Rate for Payer: Oxford Commercial	$8.43
Rate for Payer: Qualcare PPO/HMO/WC	$6.32
Rate for Payer: UnitedHealthcare Commercial	$8.43
Rate for Payer: UnitedHealthcare Community & State	$1.02
Rate for Payer: Wellpoint Medicaid Managed Care	$1.12

SHOE POST-OP SZ 10-10 1/2

Facility

$323.25

Hospital Charge Code	270600420
Hospital Revenue Code	270
Min. Negotiated Rate	$7.79
Max. Negotiated Rate	$161.62
Rate for Payer: Aetna Commercial	$122.83
Rate for Payer: Aetna Medicare Advantage	$96.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.43
Rate for Payer: Cigna Commercial	$161.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.97
Rate for Payer: Oxford Commercial	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$48.49
Rate for Payer: UnitedHealthcare Commercial	$64.65
Rate for Payer: UnitedHealthcare Community & State	$7.79
Rate for Payer: Wellpoint Medicaid Managed Care	$8.57

SHOE POST-OP SZ 10-10 1/2

Facility

$323.25

Hospital Charge Code	270600420
Hospital Revenue Code	270
Min. Negotiated Rate	$48.49
Max. Negotiated Rate	$48.49
Rate for Payer: Qualcare PPO/HMO/WC	$48.49

SHOE POST-OP SZ 11-12

Facility

$323.25

Hospital Charge Code	270600421
Hospital Revenue Code	270
Min. Negotiated Rate	$7.79
Max. Negotiated Rate	$161.62
Rate for Payer: Aetna Commercial	$122.83
Rate for Payer: Aetna Medicare Advantage	$96.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.43
Rate for Payer: Cigna Commercial	$161.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.97
Rate for Payer: Oxford Commercial	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$48.49
Rate for Payer: UnitedHealthcare Commercial	$64.65
Rate for Payer: UnitedHealthcare Community & State	$7.79
Rate for Payer: Wellpoint Medicaid Managed Care	$8.57

SHOE POST-OP SZ 11-12

Facility

$323.25

Hospital Charge Code	270600421
Hospital Revenue Code	270
Min. Negotiated Rate	$48.49
Max. Negotiated Rate	$48.49
Rate for Payer: Qualcare PPO/HMO/WC	$48.49

SHOE POST-OP SZ 8 1/2 - 9 1/2

Facility

$323.25

Hospital Charge Code	270600419
Hospital Revenue Code	270
Min. Negotiated Rate	$48.49
Max. Negotiated Rate	$48.49
Rate for Payer: Qualcare PPO/HMO/WC	$48.49

SHOE POST-OP SZ 8 1/2 - 9 1/2

Facility

$323.25

Hospital Charge Code	270600419
Hospital Revenue Code	270
Min. Negotiated Rate	$7.79
Max. Negotiated Rate	$161.62
Rate for Payer: Aetna Commercial	$122.83
Rate for Payer: Aetna Medicare Advantage	$96.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.43
Rate for Payer: Cigna Commercial	$161.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.97
Rate for Payer: Oxford Commercial	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$48.49
Rate for Payer: UnitedHealthcare Commercial	$64.65
Rate for Payer: UnitedHealthcare Community & State	$7.79
Rate for Payer: Wellpoint Medicaid Managed Care	$8.57

SHOE POST-OP WOMEN'S LG

Facility

$43.65

Hospital Charge Code	270302895
Hospital Revenue Code	270
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$21.82
Rate for Payer: Aetna Commercial	$16.59
Rate for Payer: Aetna Medicare Advantage	$13.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.13
Rate for Payer: Cigna Commercial	$21.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.10
Rate for Payer: Oxford Commercial	$8.73
Rate for Payer: Qualcare PPO/HMO/WC	$6.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: UnitedHealthcare Community & State	$1.05
Rate for Payer: Wellpoint Medicaid Managed Care	$1.16

SHOE POST-OP WOMEN'S LG

Facility

$43.65

Hospital Charge Code	270302895
Hospital Revenue Code	270
Min. Negotiated Rate	$6.55
Max. Negotiated Rate	$6.55
Rate for Payer: Qualcare PPO/HMO/WC	$6.55

SHOE POST-OP WOMEN'S MED

Facility

$19.40

Hospital Charge Code	270302890
Hospital Revenue Code	270
Min. Negotiated Rate	$2.91
Max. Negotiated Rate	$2.91
Rate for Payer: Qualcare PPO/HMO/WC	$2.91

SHOE POST-OP WOMEN'S MED

Facility

$19.40

Hospital Charge Code	270302890
Hospital Revenue Code	270
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$9.70
Rate for Payer: Aetna Commercial	$7.37
Rate for Payer: Aetna Medicare Advantage	$5.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.95
Rate for Payer: Cigna Commercial	$9.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.82
Rate for Payer: Oxford Commercial	$3.88
Rate for Payer: Qualcare PPO/HMO/WC	$2.91
Rate for Payer: UnitedHealthcare Commercial	$3.88
Rate for Payer: UnitedHealthcare Community & State	$0.47
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

SHOE POST-OP WOMEN'S SM

Facility

$18.85

Hospital Charge Code	270302885
Hospital Revenue Code	270
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$9.43
Rate for Payer: Aetna Commercial	$7.16
Rate for Payer: Aetna Medicare Advantage	$5.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.81
Rate for Payer: Cigna Commercial	$9.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.66
Rate for Payer: Oxford Commercial	$3.77
Rate for Payer: Qualcare PPO/HMO/WC	$2.83
Rate for Payer: UnitedHealthcare Commercial	$3.77
Rate for Payer: UnitedHealthcare Community & State	$0.45
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

SHOE POST-OP WOMEN'S SM

Facility

$18.85

Hospital Charge Code	270302885
Hospital Revenue Code	270
Min. Negotiated Rate	$2.83
Max. Negotiated Rate	$2.83
Rate for Payer: Qualcare PPO/HMO/WC	$2.83

SHOES ORTHOPEDIC CUSTOM

Facility

$3,064.85

Hospital Charge Code	270612972
Hospital Revenue Code	274
Min. Negotiated Rate	$459.73
Max. Negotiated Rate	$741.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$612.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$741.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$674.27
Rate for Payer: Qualcare PPO/HMO/WC	$459.73

SHOES ORTHOPEDIC CUSTOM

Facility

$3,064.85

Hospital Charge Code	270612972
Hospital Revenue Code	274
Min. Negotiated Rate	$73.86
Max. Negotiated Rate	$1,532.42
Rate for Payer: Aetna Commercial	$1,164.64
Rate for Payer: Aetna Medicare Advantage	$919.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$781.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$781.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$612.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$781.54
Rate for Payer: Cigna Commercial	$1,532.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$741.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$674.27
Rate for Payer: Qualcare PPO/HMO/WC	$459.73
Rate for Payer: UnitedHealthcare Community & State	$73.86
Rate for Payer: Wellpoint Medicaid Managed Care	$81.22

SHOOCIN SHEATH KIT 6F

Facility

$319.00

Hospital Charge Code	270705140
Hospital Revenue Code	279
Min. Negotiated Rate	$47.85
Max. Negotiated Rate	$47.85
Rate for Payer: Qualcare PPO/HMO/WC	$47.85

SHOOCIN SHEATH KIT 6F

Facility

$319.00

Hospital Charge Code	270705140
Hospital Revenue Code	279
Min. Negotiated Rate	$7.69
Max. Negotiated Rate	$159.50
Rate for Payer: Aetna Commercial	$121.22
Rate for Payer: Aetna Medicare Advantage	$95.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.34
Rate for Payer: Cigna Commercial	$159.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.70
Rate for Payer: Oxford Commercial	$63.80
Rate for Payer: Qualcare PPO/HMO/WC	$47.85
Rate for Payer: UnitedHealthcare Commercial	$63.80
Rate for Payer: UnitedHealthcare Community & State	$7.69
Rate for Payer: Wellpoint Medicaid Managed Care	$8.45

SHORELINE INTERBODY 16X14X7MM

Facility

$10,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693891
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$2,480.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,255.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

SHORELINE INTERBODY 16X14X7MM

Facility

$10,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693891
Hospital Revenue Code	278
Min. Negotiated Rate	$247.03
Max. Negotiated Rate	$5,125.00
Rate for Payer: Aetna Commercial	$3,895.00
Rate for Payer: Aetna Medicare Advantage	$3,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,613.75
Rate for Payer: Cigna Commercial	$5,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,255.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50
Rate for Payer: UnitedHealthcare Community & State	$247.03
Rate for Payer: Wellpoint Medicaid Managed Care	$271.62

SHORT ARM CAST

Facility

$1,066.99

Service Code	HCPCS 2907550
Hospital Charge Code	5792190
Hospital Revenue Code	450
Min. Negotiated Rate	$160.05
Max. Negotiated Rate	$160.05
Rate for Payer: Qualcare PPO/HMO/WC	$160.05

SHORT ARM CAST

Facility

$1,066.99

Service Code	HCPCS 2907550
Hospital Charge Code	5792190
Hospital Revenue Code	450
Min. Negotiated Rate	$28.28
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$405.46
Rate for Payer: Aetna Medicare Advantage	$320.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.08
Rate for Payer: Cigna Commercial	$533.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$160.05
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$28.28

SHORT ARM SPLINT DYNAMIC

Facility

$468.75

Service Code	HCPCS 29126
Hospital Charge Code	5780130
Hospital Revenue Code	450
Min. Negotiated Rate	$70.31
Max. Negotiated Rate	$70.31
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

Know your out-of-pocket cost for care.

All Charges