Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SPLENIC PROCEDURES WITH CC

Facility

$92,938.50

Service Code	MSDRG 800
Min. Negotiated Rate	$28,298.58
Max. Negotiated Rate	$92,938.50
Rate for Payer: Aetna Commercial	$64,116.66
Rate for Payer: Aetna Medicare Advantage	$92,938.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29,787.98
Rate for Payer: Cigna Commercial	$52,575.11
Rate for Payer: Cigna Medicare Advantage	$29,787.98
Rate for Payer: Clover Medicare Advantage	$28,298.58
Rate for Payer: EmblemHealth Commercial	$89,363.94
Rate for Payer: Humana Medicare Advantage	$30,681.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29,787.98
Rate for Payer: Oxford Commercial	$37,786.43
Rate for Payer: UnitedHealthcare Commercial	$66,259.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$29,787.98
Rate for Payer: Wellcare Medicare Advantage	$29,787.98

SPLENIC PROCEDURES WITH MCC

Facility

$148,515.59

Service Code	MSDRG 799
Min. Negotiated Rate	$45,221.09
Max. Negotiated Rate	$148,515.59
Rate for Payer: Aetna Commercial	$102,304.47
Rate for Payer: Aetna Medicare Advantage	$148,515.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$47,601.15
Rate for Payer: Cigna Commercial	$84,753.83
Rate for Payer: Cigna Medicare Advantage	$47,601.15
Rate for Payer: Clover Medicare Advantage	$45,221.09
Rate for Payer: EmblemHealth Commercial	$142,803.45
Rate for Payer: Humana Medicare Advantage	$49,029.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$47,601.15
Rate for Payer: Oxford Commercial	$60,913.71
Rate for Payer: UnitedHealthcare Commercial	$106,814.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$47,601.15
Rate for Payer: Wellcare Medicare Advantage	$47,601.15

SPLENIC PROCEDURES WITHOUT CC/MCC

Facility

$63,832.83

Service Code	MSDRG 801
Min. Negotiated Rate	$19,436.28
Max. Negotiated Rate	$63,832.83
Rate for Payer: Aetna Commercial	$44,117.74
Rate for Payer: Aetna Medicare Advantage	$63,832.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,459.24
Rate for Payer: Cigna Commercial	$35,723.15
Rate for Payer: Cigna Medicare Advantage	$20,459.24
Rate for Payer: Clover Medicare Advantage	$19,436.28
Rate for Payer: EmblemHealth Commercial	$61,377.72
Rate for Payer: Humana Medicare Advantage	$21,073.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,459.24
Rate for Payer: Oxford Commercial	$25,674.71
Rate for Payer: UnitedHealthcare Commercial	$45,021.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,459.24
Rate for Payer: Wellcare Medicare Advantage	$20,459.24

SPLINT ALUMIFOAM 1x18

Facility

$7.88

Hospital Charge Code	270649755
Hospital Revenue Code	272
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$1.18
Rate for Payer: Qualcare PPO/HMO/WC	$1.18

SPLINT ALUMIFOAM 1x18

Facility

$7.88

Hospital Charge Code	270649755
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.94
Rate for Payer: Aetna Commercial	$2.99
Rate for Payer: Aetna Medicare Advantage	$2.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.01
Rate for Payer: Cigna Commercial	$3.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.36
Rate for Payer: Oxford Commercial	$1.58
Rate for Payer: Qualcare PPO/HMO/WC	$1.18
Rate for Payer: UnitedHealthcare Commercial	$1.58
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

SPLINT ALUMIFOAM 4x16

Facility

$26.93

Hospital Charge Code	270649753
Hospital Revenue Code	272
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$4.04
Rate for Payer: Qualcare PPO/HMO/WC	$4.04

SPLINT ALUMIFOAM 4x16

Facility

$26.93

Hospital Charge Code	270649753
Hospital Revenue Code	272
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$13.46
Rate for Payer: Aetna Commercial	$10.23
Rate for Payer: Aetna Medicare Advantage	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.87
Rate for Payer: Cigna Commercial	$13.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.08
Rate for Payer: Oxford Commercial	$5.39
Rate for Payer: Qualcare PPO/HMO/WC	$4.04
Rate for Payer: UnitedHealthcare Commercial	$5.39
Rate for Payer: UnitedHealthcare Community & State	$0.65
Rate for Payer: Wellpoint Medicaid Managed Care	$0.71

SPLINT ALUMINUM *******

Facility

$25.00

Hospital Charge Code	8001976
Hospital Revenue Code	279
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

SPLINT ALUMINUM *******

Facility

$25.00

Hospital Charge Code	8001976
Hospital Revenue Code	279
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$9.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.50
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$5.00
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

SPLINT ALUMINUM FINGER

Facility

$9.65

Hospital Charge Code	270302020
Hospital Revenue Code	270
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$3.67
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.90
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$1.93
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

SPLINT ALUMINUM FINGER

Facility

$9.65

Hospital Charge Code	270302020
Hospital Revenue Code	270
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

SPLINT BASEBALL ******

Facility

$9.00

Hospital Charge Code	8001984
Hospital Revenue Code	279
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$3.42
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.70
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

SPLINT BASEBALL ******

Facility

$9.00

Hospital Charge Code	8001984
Hospital Revenue Code	279
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

SPLINT BASEBALL LARGE

Facility

$16.85

Hospital Charge Code	270600748
Hospital Revenue Code	270
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.43
Rate for Payer: Aetna Commercial	$6.40
Rate for Payer: Aetna Medicare Advantage	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.05
Rate for Payer: Oxford Commercial	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$3.37
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

SPLINT BASEBALL LARGE

Facility

$16.85

Hospital Charge Code	270600748
Hospital Revenue Code	270
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

SPLINT BASEBALL MEDIUM

Facility

$72.85

Hospital Charge Code	270649326
Hospital Revenue Code	272
Min. Negotiated Rate	$10.93
Max. Negotiated Rate	$10.93
Rate for Payer: Qualcare PPO/HMO/WC	$10.93

SPLINT BASEBALL MEDIUM

Facility

$72.85

Hospital Charge Code	270649326
Hospital Revenue Code	272
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$36.42
Rate for Payer: Aetna Commercial	$27.68
Rate for Payer: Aetna Medicare Advantage	$21.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.58
Rate for Payer: Cigna Commercial	$36.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.86
Rate for Payer: Oxford Commercial	$14.57
Rate for Payer: Qualcare PPO/HMO/WC	$10.93
Rate for Payer: UnitedHealthcare Commercial	$14.57
Rate for Payer: UnitedHealthcare Community & State	$1.76
Rate for Payer: Wellpoint Medicaid Managed Care	$1.93

SPLINT BASEBALL SMALL 11101

Facility

$6.07

Hospital Charge Code	270649328
Hospital Revenue Code	270
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$3.04
Rate for Payer: Aetna Commercial	$2.31
Rate for Payer: Aetna Medicare Advantage	$1.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.55
Rate for Payer: Cigna Commercial	$3.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.82
Rate for Payer: Oxford Commercial	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$0.91
Rate for Payer: UnitedHealthcare Commercial	$1.21
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

SPLINT BASEBALL SMALL 11101

Facility

$6.07

Hospital Charge Code	270649328
Hospital Revenue Code	270
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$0.91
Rate for Payer: Qualcare PPO/HMO/WC	$0.91

SPLINT BASEBALL TOAD LRG 11103

Facility

$6.07

Hospital Charge Code	270649329
Hospital Revenue Code	270
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$0.91
Rate for Payer: Qualcare PPO/HMO/WC	$0.91

SPLINT BASEBALL TOAD LRG 11103

Facility

$6.07

Hospital Charge Code	270649329
Hospital Revenue Code	270
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$3.04
Rate for Payer: Aetna Commercial	$2.31
Rate for Payer: Aetna Medicare Advantage	$1.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.55
Rate for Payer: Cigna Commercial	$3.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.82
Rate for Payer: Oxford Commercial	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$0.91
Rate for Payer: UnitedHealthcare Commercial	$1.21
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

SPLINT BROWN MED

Facility

$18.45

Hospital Charge Code	270600311
Hospital Revenue Code	272
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$2.77
Rate for Payer: Qualcare PPO/HMO/WC	$2.77

SPLINT BROWN MED

Facility

$18.45

Hospital Charge Code	270600311
Hospital Revenue Code	272
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$9.22
Rate for Payer: Aetna Commercial	$7.01
Rate for Payer: Aetna Medicare Advantage	$5.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.70
Rate for Payer: Cigna Commercial	$9.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.54
Rate for Payer: Oxford Commercial	$3.69
Rate for Payer: Qualcare PPO/HMO/WC	$2.77
Rate for Payer: UnitedHealthcare Commercial	$3.69
Rate for Payer: UnitedHealthcare Community & State	$0.44
Rate for Payer: Wellpoint Medicaid Managed Care	$0.49

SPLINT BROWN SM

Facility

$11.25

Hospital Charge Code	270600310
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$4.28
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.38
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$2.25
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

SPLINT BROWN SM

Facility

$11.25

Hospital Charge Code	270600310
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

Know your out-of-pocket cost for care.

All Charges