Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SPLINT IROM REGULAR LONG

Facility

$1,625.65

Hospital Charge Code	270610223
Hospital Revenue Code	270
Min. Negotiated Rate	$39.18
Max. Negotiated Rate	$812.83
Rate for Payer: Aetna Commercial	$617.75
Rate for Payer: Aetna Medicare Advantage	$487.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.54
Rate for Payer: Cigna Commercial	$812.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.69
Rate for Payer: Oxford Commercial	$325.13
Rate for Payer: Qualcare PPO/HMO/WC	$243.85
Rate for Payer: UnitedHealthcare Commercial	$325.13
Rate for Payer: UnitedHealthcare Community & State	$39.18
Rate for Payer: Wellpoint Medicaid Managed Care	$43.08

SPLINT IROM REGULAR SHORT

Facility

$1,625.65

Hospital Charge Code	270610222
Hospital Revenue Code	270
Min. Negotiated Rate	$39.18
Max. Negotiated Rate	$812.83
Rate for Payer: Aetna Commercial	$617.75
Rate for Payer: Aetna Medicare Advantage	$487.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.54
Rate for Payer: Cigna Commercial	$812.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.69
Rate for Payer: Oxford Commercial	$325.13
Rate for Payer: Qualcare PPO/HMO/WC	$243.85
Rate for Payer: UnitedHealthcare Commercial	$325.13
Rate for Payer: UnitedHealthcare Community & State	$39.18
Rate for Payer: Wellpoint Medicaid Managed Care	$43.08

SPLINT IROM REGULAR SHORT

Facility

$1,625.65

Hospital Charge Code	270610222
Hospital Revenue Code	270
Min. Negotiated Rate	$243.85
Max. Negotiated Rate	$243.85
Rate for Payer: Qualcare PPO/HMO/WC	$243.85

SPLINT LARGE RESTING HAND

Facility

$645.00

Hospital Charge Code	270647015
Hospital Revenue Code	271
Min. Negotiated Rate	$15.54
Max. Negotiated Rate	$322.50
Rate for Payer: Aetna Commercial	$245.10
Rate for Payer: Aetna Medicare Advantage	$193.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.47
Rate for Payer: Cigna Commercial	$322.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.50
Rate for Payer: Oxford Commercial	$129.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.75
Rate for Payer: UnitedHealthcare Commercial	$129.00
Rate for Payer: UnitedHealthcare Community & State	$15.54
Rate for Payer: Wellpoint Medicaid Managed Care	$17.09

SPLINT LARGE RESTING HAND

Facility

$645.00

Hospital Charge Code	270647015
Hospital Revenue Code	271
Min. Negotiated Rate	$96.75
Max. Negotiated Rate	$96.75
Rate for Payer: Qualcare PPO/HMO/WC	$96.75

SPLINT MED-LG 10.5 LT 1155535

Facility

$58.60

Hospital Charge Code	270642163
Hospital Revenue Code	272
Min. Negotiated Rate	$8.79
Max. Negotiated Rate	$8.79
Rate for Payer: Qualcare PPO/HMO/WC	$8.79

SPLINT MED-LG 10.5 LT 1155535

Facility

$58.60

Hospital Charge Code	270642163
Hospital Revenue Code	272
Min. Negotiated Rate	$1.41
Max. Negotiated Rate	$29.30
Rate for Payer: Aetna Commercial	$22.27
Rate for Payer: Aetna Medicare Advantage	$17.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.94
Rate for Payer: Cigna Commercial	$29.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.58
Rate for Payer: Oxford Commercial	$11.72
Rate for Payer: Qualcare PPO/HMO/WC	$8.79
Rate for Payer: UnitedHealthcare Commercial	$11.72
Rate for Payer: UnitedHealthcare Community & State	$1.41
Rate for Payer: Wellpoint Medicaid Managed Care	$1.55

SPLINT MED-LG 10.5 RT 1155635

Facility

$56.60

Hospital Charge Code	270642164
Hospital Revenue Code	272
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$28.30
Rate for Payer: Aetna Commercial	$21.51
Rate for Payer: Aetna Medicare Advantage	$16.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.43
Rate for Payer: Cigna Commercial	$28.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.98
Rate for Payer: Oxford Commercial	$11.32
Rate for Payer: Qualcare PPO/HMO/WC	$8.49
Rate for Payer: UnitedHealthcare Commercial	$11.32
Rate for Payer: UnitedHealthcare Community & State	$1.36
Rate for Payer: Wellpoint Medicaid Managed Care	$1.50

SPLINT MED-LG 10.5 RT 1155635

Facility

$56.60

Hospital Charge Code	270642164
Hospital Revenue Code	272
Min. Negotiated Rate	$8.49
Max. Negotiated Rate	$8.49
Rate for Payer: Qualcare PPO/HMO/WC	$8.49

SPLINT MED-LG 8 LEFT 1155335

Facility

$49.40

Hospital Charge Code	270642161
Hospital Revenue Code	272
Min. Negotiated Rate	$7.41
Max. Negotiated Rate	$7.41
Rate for Payer: Qualcare PPO/HMO/WC	$7.41

SPLINT MED-LG 8 LEFT 1155335

Facility

$49.40

Hospital Charge Code	270642161
Hospital Revenue Code	272
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$24.70
Rate for Payer: Aetna Commercial	$18.77
Rate for Payer: Aetna Medicare Advantage	$14.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.60
Rate for Payer: Cigna Commercial	$24.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.82
Rate for Payer: Oxford Commercial	$9.88
Rate for Payer: Qualcare PPO/HMO/WC	$7.41
Rate for Payer: UnitedHealthcare Commercial	$9.88
Rate for Payer: UnitedHealthcare Community & State	$1.19
Rate for Payer: Wellpoint Medicaid Managed Care	$1.31

SPLINT MED-LG 8 RIGHT 1155435

Facility

$48.45

Hospital Charge Code	270642162
Hospital Revenue Code	272
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$24.23
Rate for Payer: Aetna Commercial	$18.41
Rate for Payer: Aetna Medicare Advantage	$14.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.35
Rate for Payer: Cigna Commercial	$24.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.54
Rate for Payer: Oxford Commercial	$9.69
Rate for Payer: Qualcare PPO/HMO/WC	$7.27
Rate for Payer: UnitedHealthcare Commercial	$9.69
Rate for Payer: UnitedHealthcare Community & State	$1.17
Rate for Payer: Wellpoint Medicaid Managed Care	$1.28

SPLINT MED-LG 8 RIGHT 1155435

Facility

$48.45

Hospital Charge Code	270642162
Hospital Revenue Code	272
Min. Negotiated Rate	$7.27
Max. Negotiated Rate	$7.27
Rate for Payer: Qualcare PPO/HMO/WC	$7.27

SPLINT MEDT DOYLE NASL 1524050

Facility

$278.00

Hospital Charge Code	270627434
Hospital Revenue Code	272
Min. Negotiated Rate	$41.70
Max. Negotiated Rate	$41.70
Rate for Payer: Qualcare PPO/HMO/WC	$41.70

SPLINT MEDT DOYLE NASL 1524050

Facility

$278.00

Hospital Charge Code	270627434
Hospital Revenue Code	272
Min. Negotiated Rate	$6.70
Max. Negotiated Rate	$139.00
Rate for Payer: Aetna Commercial	$105.64
Rate for Payer: Aetna Medicare Advantage	$83.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.89
Rate for Payer: Cigna Commercial	$139.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.40
Rate for Payer: Oxford Commercial	$55.60
Rate for Payer: Qualcare PPO/HMO/WC	$41.70
Rate for Payer: UnitedHealthcare Commercial	$55.60
Rate for Payer: UnitedHealthcare Community & State	$6.70
Rate for Payer: Wellpoint Medicaid Managed Care	$7.37

SPLINT METACARPAL************

Facility

$8.00

Hospital Charge Code	8003576
Hospital Revenue Code	279
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$3.04
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.40
Rate for Payer: Oxford Commercial	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$1.60
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

SPLINT METACARPAL************

Facility

$8.00

Hospital Charge Code	8003576
Hospital Revenue Code	279
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

SPLINT METACARPAL L ADULT

Facility

$86.75

Hospital Charge Code	270610011
Hospital Revenue Code	270
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$13.01
Rate for Payer: Qualcare PPO/HMO/WC	$13.01

SPLINT METACARPAL L ADULT

Facility

$86.75

Hospital Charge Code	270610011
Hospital Revenue Code	270
Min. Negotiated Rate	$2.09
Max. Negotiated Rate	$43.38
Rate for Payer: Aetna Commercial	$32.97
Rate for Payer: Aetna Medicare Advantage	$26.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.12
Rate for Payer: Cigna Commercial	$43.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.02
Rate for Payer: Oxford Commercial	$17.35
Rate for Payer: Qualcare PPO/HMO/WC	$13.01
Rate for Payer: UnitedHealthcare Commercial	$17.35
Rate for Payer: UnitedHealthcare Community & State	$2.09
Rate for Payer: Wellpoint Medicaid Managed Care	$2.30

SPLINT METACARPAL LEFT MEDIUM

Facility

$22.05

Hospital Charge Code	270653987
Hospital Revenue Code	272
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$3.31
Rate for Payer: Qualcare PPO/HMO/WC	$3.31

SPLINT METACARPAL LEFT MEDIUM

Facility

$22.05

Hospital Charge Code	270653987
Hospital Revenue Code	272
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$11.03
Rate for Payer: Aetna Commercial	$8.38
Rate for Payer: Aetna Medicare Advantage	$6.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.62
Rate for Payer: Cigna Commercial	$11.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.62
Rate for Payer: Oxford Commercial	$4.41
Rate for Payer: Qualcare PPO/HMO/WC	$3.31
Rate for Payer: UnitedHealthcare Commercial	$4.41
Rate for Payer: UnitedHealthcare Community & State	$0.53
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

SPLINT METACARPAL PADDED SM LT

Facility

$27.30

Hospital Charge Code	270676701
Hospital Revenue Code	270
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$13.65
Rate for Payer: Aetna Commercial	$10.37
Rate for Payer: Aetna Medicare Advantage	$8.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.96
Rate for Payer: Cigna Commercial	$13.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.19
Rate for Payer: Oxford Commercial	$5.46
Rate for Payer: Qualcare PPO/HMO/WC	$4.09
Rate for Payer: UnitedHealthcare Commercial	$5.46
Rate for Payer: UnitedHealthcare Community & State	$0.66
Rate for Payer: Wellpoint Medicaid Managed Care	$0.72

SPLINT METACARPAL PADDED SM LT

Facility

$27.30

Hospital Charge Code	270676701
Hospital Revenue Code	270
Min. Negotiated Rate	$4.09
Max. Negotiated Rate	$4.09
Rate for Payer: Qualcare PPO/HMO/WC	$4.09

SPLINT METACARPAL RIGHT LARGE

Facility

$28.15

Hospital Charge Code	270653990
Hospital Revenue Code	272
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$4.22
Rate for Payer: Qualcare PPO/HMO/WC	$4.22

SPLINT METACARPAL RIGHT LARGE

Facility

$28.15

Hospital Charge Code	270653990
Hospital Revenue Code	272
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

Know your out-of-pocket cost for care.

All Charges