Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SPLINT BUCKS BOOT LG

Facility

$91.25

Hospital Charge Code	270600079
Hospital Revenue Code	270
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$13.69

SPLINT BUCKS BOOT LG

Facility

$91.25

Hospital Charge Code	270600079
Hospital Revenue Code	270
Min. Negotiated Rate	$2.20
Max. Negotiated Rate	$45.62
Rate for Payer: Aetna Commercial	$34.67
Rate for Payer: Aetna Medicare Advantage	$27.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.27
Rate for Payer: Cigna Commercial	$45.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.38
Rate for Payer: Oxford Commercial	$18.25
Rate for Payer: Qualcare PPO/HMO/WC	$13.69
Rate for Payer: UnitedHealthcare Commercial	$18.25
Rate for Payer: UnitedHealthcare Community & State	$2.20
Rate for Payer: Wellpoint Medicaid Managed Care	$2.42

SPLINT BUCKS BOOT MED

Facility

$91.25

Hospital Charge Code	270600077
Hospital Revenue Code	270
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$13.69

SPLINT BUCKS BOOT MED

Facility

$91.25

Hospital Charge Code	270600077
Hospital Revenue Code	270
Min. Negotiated Rate	$2.20
Max. Negotiated Rate	$45.62
Rate for Payer: Aetna Commercial	$34.67
Rate for Payer: Aetna Medicare Advantage	$27.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.27
Rate for Payer: Cigna Commercial	$45.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.38
Rate for Payer: Oxford Commercial	$18.25
Rate for Payer: Qualcare PPO/HMO/WC	$13.69
Rate for Payer: UnitedHealthcare Commercial	$18.25
Rate for Payer: UnitedHealthcare Community & State	$2.20
Rate for Payer: Wellpoint Medicaid Managed Care	$2.42

SPLINT BUCKS BOOT SM

Facility

$91.25

Hospital Charge Code	270600074
Hospital Revenue Code	270
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$13.69

SPLINT BUCKS BOOT SM

Facility

$91.25

Hospital Charge Code	270600074
Hospital Revenue Code	270
Min. Negotiated Rate	$2.20
Max. Negotiated Rate	$45.62
Rate for Payer: Aetna Commercial	$34.67
Rate for Payer: Aetna Medicare Advantage	$27.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.27
Rate for Payer: Cigna Commercial	$45.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.38
Rate for Payer: Oxford Commercial	$18.25
Rate for Payer: Qualcare PPO/HMO/WC	$13.69
Rate for Payer: UnitedHealthcare Commercial	$18.25
Rate for Payer: UnitedHealthcare Community & State	$2.20
Rate for Payer: Wellpoint Medicaid Managed Care	$2.42

SPLINT CLAVICAL 2-WAY LARGE

Facility

$25.03

Hospital Charge Code	270650143
Hospital Revenue Code	270
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.52
Rate for Payer: Aetna Commercial	$9.51
Rate for Payer: Aetna Medicare Advantage	$7.51
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	$12.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.51
Rate for Payer: Oxford Commercial	$5.01
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$5.01
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

SPLINT CLAVICAL 2-WAY LARGE

Facility

$25.03

Hospital Charge Code	270650143
Hospital Revenue Code	270
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

SPLINT CLAVICAL 2-WAY MEDIUM

Facility

$27.75

Hospital Charge Code	270650141
Hospital Revenue Code	270
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$13.88
Rate for Payer: Aetna Commercial	$10.54
Rate for Payer: Aetna Medicare Advantage	$8.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.08
Rate for Payer: Cigna Commercial	$13.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.32
Rate for Payer: Oxford Commercial	$5.55
Rate for Payer: Qualcare PPO/HMO/WC	$4.16
Rate for Payer: UnitedHealthcare Commercial	$5.55
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

SPLINT CLAVICAL 2-WAY MEDIUM

Facility

$27.75

Hospital Charge Code	270650141
Hospital Revenue Code	270
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$4.16
Rate for Payer: Qualcare PPO/HMO/WC	$4.16

SPLINT CLAVICAL 2-WAY SMALL

Facility

$28.15

Hospital Charge Code	270650142
Hospital Revenue Code	270
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$14.07
Rate for Payer: Aetna Commercial	$10.70
Rate for Payer: Aetna Medicare Advantage	$8.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.18
Rate for Payer: Cigna Commercial	$14.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.45
Rate for Payer: Oxford Commercial	$5.63
Rate for Payer: Qualcare PPO/HMO/WC	$4.22
Rate for Payer: UnitedHealthcare Commercial	$5.63
Rate for Payer: UnitedHealthcare Community & State	$0.68
Rate for Payer: Wellpoint Medicaid Managed Care	$0.75

SPLINT CLAVICAL 2-WAY SMALL

Facility

$28.15

Hospital Charge Code	270650142
Hospital Revenue Code	270
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$4.22
Rate for Payer: Qualcare PPO/HMO/WC	$4.22

SPLINT CLAVICLE LARGE

Facility

$32.70

Hospital Charge Code	270649331
Hospital Revenue Code	272
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$16.35
Rate for Payer: Aetna Commercial	$12.43
Rate for Payer: Aetna Medicare Advantage	$9.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.34
Rate for Payer: Cigna Commercial	$16.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.81
Rate for Payer: Oxford Commercial	$6.54
Rate for Payer: Qualcare PPO/HMO/WC	$4.91
Rate for Payer: UnitedHealthcare Commercial	$6.54
Rate for Payer: UnitedHealthcare Community & State	$0.79
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

SPLINT CLAVICLE LARGE

Facility

$32.70

Hospital Charge Code	270649331
Hospital Revenue Code	272
Min. Negotiated Rate	$4.91
Max. Negotiated Rate	$4.91
Rate for Payer: Qualcare PPO/HMO/WC	$4.91

SPLINT CLAVICLE MEDIUM

Facility

$32.95

Hospital Charge Code	270649332
Hospital Revenue Code	272
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$16.48
Rate for Payer: Aetna Commercial	$12.52
Rate for Payer: Aetna Medicare Advantage	$9.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.40
Rate for Payer: Cigna Commercial	$16.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.88
Rate for Payer: Oxford Commercial	$6.59
Rate for Payer: Qualcare PPO/HMO/WC	$4.94
Rate for Payer: UnitedHealthcare Commercial	$6.59
Rate for Payer: UnitedHealthcare Community & State	$0.79
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

SPLINT CLAVICLE MEDIUM

Facility

$32.95

Hospital Charge Code	270649332
Hospital Revenue Code	272
Min. Negotiated Rate	$4.94
Max. Negotiated Rate	$4.94
Rate for Payer: Qualcare PPO/HMO/WC	$4.94

SPLINT CLAVICLE SMALL

Facility

$32.70

Hospital Charge Code	270649333
Hospital Revenue Code	272
Min. Negotiated Rate	$4.91
Max. Negotiated Rate	$4.91
Rate for Payer: Qualcare PPO/HMO/WC	$4.91

SPLINT CLAVICLE SMALL

Facility

$32.70

Hospital Charge Code	270649333
Hospital Revenue Code	272
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$16.35
Rate for Payer: Aetna Commercial	$12.43
Rate for Payer: Aetna Medicare Advantage	$9.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.34
Rate for Payer: Cigna Commercial	$16.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.81
Rate for Payer: Oxford Commercial	$6.54
Rate for Payer: Qualcare PPO/HMO/WC	$4.91
Rate for Payer: UnitedHealthcare Commercial	$6.54
Rate for Payer: UnitedHealthcare Community & State	$0.79
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

SPLINT CLAVICLE X-LARGE

Facility

$27.70

Hospital Charge Code	270649334
Hospital Revenue Code	272
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$13.85
Rate for Payer: Aetna Commercial	$10.53
Rate for Payer: Aetna Medicare Advantage	$8.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.06
Rate for Payer: Cigna Commercial	$13.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.31
Rate for Payer: Oxford Commercial	$5.54
Rate for Payer: Qualcare PPO/HMO/WC	$4.16
Rate for Payer: UnitedHealthcare Commercial	$5.54
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.73

SPLINT CLAVICLE X-LARGE

Facility

$27.70

Hospital Charge Code	270649334
Hospital Revenue Code	272
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$4.16
Rate for Payer: Qualcare PPO/HMO/WC	$4.16

SPLINT CLAVICLE X-SMALL

Facility

$30.15

Hospital Charge Code	270649335
Hospital Revenue Code	272
Min. Negotiated Rate	$4.52
Max. Negotiated Rate	$4.52
Rate for Payer: Qualcare PPO/HMO/WC	$4.52

SPLINT CLAVICLE X-SMALL

Facility

$30.15

Hospital Charge Code	270649335
Hospital Revenue Code	272
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$15.07
Rate for Payer: Aetna Commercial	$11.46
Rate for Payer: Aetna Medicare Advantage	$9.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.69
Rate for Payer: Cigna Commercial	$15.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.04
Rate for Payer: Oxford Commercial	$6.03
Rate for Payer: Qualcare PPO/HMO/WC	$4.52
Rate for Payer: UnitedHealthcare Commercial	$6.03
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.80

SPLINT COCK UP

Facility

$299.90

Hospital Charge Code	270644330
Hospital Revenue Code	272
Min. Negotiated Rate	$44.98
Max. Negotiated Rate	$44.98
Rate for Payer: Qualcare PPO/HMO/WC	$44.98

SPLINT COCK UP

Facility

$299.90

Hospital Charge Code	270644330
Hospital Revenue Code	272
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$149.95
Rate for Payer: Aetna Commercial	$113.96
Rate for Payer: Aetna Medicare Advantage	$89.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.47
Rate for Payer: Cigna Commercial	$149.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.97
Rate for Payer: Oxford Commercial	$59.98
Rate for Payer: Qualcare PPO/HMO/WC	$44.98
Rate for Payer: UnitedHealthcare Commercial	$59.98
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

SPLINT COCK-UP WRIST MED RT

Facility

$32.60

Hospital Charge Code	270649000
Hospital Revenue Code	272
Min. Negotiated Rate	$4.89
Max. Negotiated Rate	$4.89
Rate for Payer: Qualcare PPO/HMO/WC	$4.89

Know your out-of-pocket cost for care.

All Charges