Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BELT PELVIC EXTRA****

Facility

$253.00

Hospital Charge Code	8001968
Hospital Revenue Code	279
Min. Negotiated Rate	$6.10
Max. Negotiated Rate	$126.50
Rate for Payer: Aetna Commercial	$96.14
Rate for Payer: Aetna Medicare Advantage	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.52
Rate for Payer: Cigna Commercial	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.90
Rate for Payer: Oxford Commercial	$50.60
Rate for Payer: Qualcare PPO/HMO/WC	$37.95
Rate for Payer: UnitedHealthcare Commercial	$50.60
Rate for Payer: UnitedHealthcare Community & State	$6.10
Rate for Payer: Wellpoint Medicaid Managed Care	$6.70

BELT PELVIC EXTRA****

Facility

$253.00

Hospital Charge Code	8001968
Hospital Revenue Code	279
Min. Negotiated Rate	$37.95
Max. Negotiated Rate	$37.95
Rate for Payer: Qualcare PPO/HMO/WC	$37.95

BELT PELVIC TRACTIN ZIMCODE

Facility

$86.80

Hospital Charge Code	270654048
Hospital Revenue Code	270
Min. Negotiated Rate	$2.09
Max. Negotiated Rate	$43.40
Rate for Payer: Aetna Commercial	$32.98
Rate for Payer: Aetna Medicare Advantage	$26.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.13
Rate for Payer: Cigna Commercial	$43.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.04
Rate for Payer: Oxford Commercial	$17.36
Rate for Payer: Qualcare PPO/HMO/WC	$13.02
Rate for Payer: UnitedHealthcare Commercial	$17.36
Rate for Payer: UnitedHealthcare Community & State	$2.09
Rate for Payer: Wellpoint Medicaid Managed Care	$2.30

BELT PELVIC TRACTIN ZIMCODE

Facility

$86.80

Hospital Charge Code	270654048
Hospital Revenue Code	270
Min. Negotiated Rate	$13.02
Max. Negotiated Rate	$13.02
Rate for Payer: Qualcare PPO/HMO/WC	$13.02

BELT PELVIC TRACTION 1570-01

Facility

$150.45

Hospital Charge Code	270302700
Hospital Revenue Code	270
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$75.22
Rate for Payer: Aetna Commercial	$57.17
Rate for Payer: Aetna Medicare Advantage	$45.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.36
Rate for Payer: Cigna Commercial	$75.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.13
Rate for Payer: Oxford Commercial	$30.09
Rate for Payer: Qualcare PPO/HMO/WC	$22.57
Rate for Payer: UnitedHealthcare Commercial	$30.09
Rate for Payer: UnitedHealthcare Community & State	$3.63
Rate for Payer: Wellpoint Medicaid Managed Care	$3.99

BELT PELVIC TRACTION 1570-01

Facility

$150.45

Hospital Charge Code	270302700
Hospital Revenue Code	270
Min. Negotiated Rate	$22.57
Max. Negotiated Rate	$22.57
Rate for Payer: Qualcare PPO/HMO/WC	$22.57

BELT PELVIC TRACTION 30/34

Facility

$101.50

Hospital Charge Code	270650450
Hospital Revenue Code	272
Min. Negotiated Rate	$15.22
Max. Negotiated Rate	$15.22
Rate for Payer: Qualcare PPO/HMO/WC	$15.22

BELT PELVIC TRACTION 30/34

Facility

$101.50

Hospital Charge Code	270650450
Hospital Revenue Code	272
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$50.75
Rate for Payer: Aetna Commercial	$38.57
Rate for Payer: Aetna Medicare Advantage	$30.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.88
Rate for Payer: Cigna Commercial	$50.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.45
Rate for Payer: Oxford Commercial	$20.30
Rate for Payer: Qualcare PPO/HMO/WC	$15.22
Rate for Payer: UnitedHealthcare Commercial	$20.30
Rate for Payer: UnitedHealthcare Community & State	$2.45
Rate for Payer: Wellpoint Medicaid Managed Care	$2.69

BELT PELVIC TRACTION 34/38

Facility

$102.95

Hospital Charge Code	270650451
Hospital Revenue Code	272
Min. Negotiated Rate	$2.48
Max. Negotiated Rate	$51.48
Rate for Payer: Aetna Commercial	$39.12
Rate for Payer: Aetna Medicare Advantage	$30.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.25
Rate for Payer: Cigna Commercial	$51.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.89
Rate for Payer: Oxford Commercial	$20.59
Rate for Payer: Qualcare PPO/HMO/WC	$15.44
Rate for Payer: UnitedHealthcare Commercial	$20.59
Rate for Payer: UnitedHealthcare Community & State	$2.48
Rate for Payer: Wellpoint Medicaid Managed Care	$2.73

BELT PELVIC TRACTION 34/38

Facility

$102.95

Hospital Charge Code	270650451
Hospital Revenue Code	272
Min. Negotiated Rate	$15.44
Max. Negotiated Rate	$15.44
Rate for Payer: Qualcare PPO/HMO/WC	$15.44

BELT PELVIC TRACTION 38-42

Facility

$102.95

Hospital Charge Code	270650452
Hospital Revenue Code	272
Min. Negotiated Rate	$2.48
Max. Negotiated Rate	$51.48
Rate for Payer: Aetna Commercial	$39.12
Rate for Payer: Aetna Medicare Advantage	$30.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.25
Rate for Payer: Cigna Commercial	$51.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.89
Rate for Payer: Oxford Commercial	$20.59
Rate for Payer: Qualcare PPO/HMO/WC	$15.44
Rate for Payer: UnitedHealthcare Commercial	$20.59
Rate for Payer: UnitedHealthcare Community & State	$2.48
Rate for Payer: Wellpoint Medicaid Managed Care	$2.73

BELT PELVIC TRACTION 38-42

Facility

$102.95

Hospital Charge Code	270650452
Hospital Revenue Code	272
Min. Negotiated Rate	$15.44
Max. Negotiated Rate	$15.44
Rate for Payer: Qualcare PPO/HMO/WC	$15.44

BELT PELVIC TRACTION 46/50

Facility

$118.05

Hospital Charge Code	270650453
Hospital Revenue Code	272
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$59.02
Rate for Payer: Aetna Commercial	$44.86
Rate for Payer: Aetna Medicare Advantage	$35.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.10
Rate for Payer: Cigna Commercial	$59.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.41
Rate for Payer: Oxford Commercial	$23.61
Rate for Payer: Qualcare PPO/HMO/WC	$17.71
Rate for Payer: UnitedHealthcare Commercial	$23.61
Rate for Payer: UnitedHealthcare Community & State	$2.85
Rate for Payer: Wellpoint Medicaid Managed Care	$3.13

BELT PELVIC TRACTION 46/50

Facility

$118.05

Hospital Charge Code	270650453
Hospital Revenue Code	272
Min. Negotiated Rate	$17.71
Max. Negotiated Rate	$17.71
Rate for Payer: Qualcare PPO/HMO/WC	$17.71

BELT PELVIC TRACTION 60/80

Facility

$89.90

Hospital Charge Code	270650454
Hospital Revenue Code	272
Min. Negotiated Rate	$13.48
Max. Negotiated Rate	$13.48
Rate for Payer: Qualcare PPO/HMO/WC	$13.48

BELT PELVIC TRACTION 60/80

Facility

$89.90

Hospital Charge Code	270650454
Hospital Revenue Code	272
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$44.95
Rate for Payer: Aetna Commercial	$34.16
Rate for Payer: Aetna Medicare Advantage	$26.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.92
Rate for Payer: Cigna Commercial	$44.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.97
Rate for Payer: Oxford Commercial	$17.98
Rate for Payer: Qualcare PPO/HMO/WC	$13.48
Rate for Payer: UnitedHealthcare Commercial	$17.98
Rate for Payer: UnitedHealthcare Community & State	$2.17
Rate for Payer: Wellpoint Medicaid Managed Care	$2.38

BELT PELVIC TRACTION ZIMCODE

Facility

$86.80

Hospital Charge Code	270654045
Hospital Revenue Code	272
Min. Negotiated Rate	$2.09
Max. Negotiated Rate	$43.40
Rate for Payer: Aetna Commercial	$32.98
Rate for Payer: Aetna Medicare Advantage	$26.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.13
Rate for Payer: Cigna Commercial	$43.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.04
Rate for Payer: Oxford Commercial	$17.36
Rate for Payer: Qualcare PPO/HMO/WC	$13.02
Rate for Payer: UnitedHealthcare Commercial	$17.36
Rate for Payer: UnitedHealthcare Community & State	$2.09
Rate for Payer: Wellpoint Medicaid Managed Care	$2.30

BELT PELVIC TRACTION ZIMCODE

Facility

$86.80

Hospital Charge Code	270654045
Hospital Revenue Code	272
Min. Negotiated Rate	$13.02
Max. Negotiated Rate	$13.02
Rate for Payer: Qualcare PPO/HMO/WC	$13.02

BELT PELVIC TRACTION ZIMCODE

Facility

$86.80

Hospital Charge Code	270654046
Hospital Revenue Code	272
Min. Negotiated Rate	$13.02
Max. Negotiated Rate	$13.02
Rate for Payer: Qualcare PPO/HMO/WC	$13.02

BELT PELVIC TRACTION ZIMCODE

Facility

$86.80

Hospital Charge Code	270654046
Hospital Revenue Code	272
Min. Negotiated Rate	$2.09
Max. Negotiated Rate	$43.40
Rate for Payer: Aetna Commercial	$32.98
Rate for Payer: Aetna Medicare Advantage	$26.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.13
Rate for Payer: Cigna Commercial	$43.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.04
Rate for Payer: Oxford Commercial	$17.36
Rate for Payer: Qualcare PPO/HMO/WC	$13.02
Rate for Payer: UnitedHealthcare Commercial	$17.36
Rate for Payer: UnitedHealthcare Community & State	$2.09
Rate for Payer: Wellpoint Medicaid Managed Care	$2.30

BELT RIB MEN'S UNIVERSAL

Facility

$32.00

Hospital Charge Code	270302695
Hospital Revenue Code	270
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$12.16
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.60
Rate for Payer: Oxford Commercial	$6.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$6.40
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

BELT RIB MEN'S UNIVERSAL

Facility

$32.00

Hospital Charge Code	270302695
Hospital Revenue Code	270
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

BELT RIB UNIVERSAL***

Facility

$71.00

Hospital Charge Code	8001505
Hospital Revenue Code	279
Min. Negotiated Rate	$1.71
Max. Negotiated Rate	$35.50
Rate for Payer: Aetna Commercial	$26.98
Rate for Payer: Aetna Medicare Advantage	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.11
Rate for Payer: Cigna Commercial	$35.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.30
Rate for Payer: Oxford Commercial	$14.20
Rate for Payer: Qualcare PPO/HMO/WC	$10.65
Rate for Payer: UnitedHealthcare Commercial	$14.20
Rate for Payer: UnitedHealthcare Community & State	$1.71
Rate for Payer: Wellpoint Medicaid Managed Care	$1.88

BELT RIB UNIVERSAL***

Facility

$71.00

Hospital Charge Code	8001505
Hospital Revenue Code	279
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

BELT RIB WOMEN'S UNIVERSAL

Facility

$32.00

Hospital Charge Code	270302675
Hospital Revenue Code	270
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$12.16
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.60
Rate for Payer: Oxford Commercial	$6.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$6.40
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

Know your out-of-pocket cost for care.

All Charges