Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TEMP PACEMAKER INSERTION

Facility

$18,455.00

Service Code	HCPCS 33210
Hospital Charge Code	7411015
Hospital Revenue Code	480
Min. Negotiated Rate	$2,768.25
Max. Negotiated Rate	$2,768.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,768.25

TEMP PACEMAKER INSERTION

Facility

$18,455.00

Service Code	HCPCS 33210
Hospital Charge Code	7411015
Hospital Revenue Code	480
Min. Negotiated Rate	$331.06
Max. Negotiated Rate	$35,488.33
Rate for Payer: Aetna Commercial	$26,741.35
Rate for Payer: Aetna Medicare Advantage	$31,853.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,488.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,488.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,831.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$331.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,488.33
Rate for Payer: Cigna Commercial	$19,706.96
Rate for Payer: Cigna Medicare Advantage	$9,831.38
Rate for Payer: Clover Medicare Advantage	$9,339.81
Rate for Payer: EmblemHealth Commercial	$29,494.14
Rate for Payer: Humana Medicare Advantage	$10,126.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,831.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,536.50
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,768.25
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$444.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,831.38
Rate for Payer: Wellcare Medicare Advantage	$9,831.38
Rate for Payer: Wellpoint Medicaid Managed Care	$489.06

TEMP PACEMAKER INSERTION

Facility

$18,455.00

Service Code	HCPCS 33210
Hospital Charge Code	366833210
Hospital Revenue Code	480
Min. Negotiated Rate	$331.06
Max. Negotiated Rate	$35,488.33
Rate for Payer: Aetna Commercial	$26,741.35
Rate for Payer: Aetna Medicare Advantage	$31,853.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,488.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,488.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,831.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$331.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,488.33
Rate for Payer: Cigna Commercial	$19,706.96
Rate for Payer: Cigna Medicare Advantage	$9,831.38
Rate for Payer: Clover Medicare Advantage	$9,339.81
Rate for Payer: EmblemHealth Commercial	$29,494.14
Rate for Payer: Humana Medicare Advantage	$10,126.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,831.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,536.50
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,768.25
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$444.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,831.38
Rate for Payer: Wellcare Medicare Advantage	$9,831.38
Rate for Payer: Wellpoint Medicaid Managed Care	$489.06

TEMP PACEMAKER INSERTION

Facility

$18,455.00

Service Code	HCPCS 33210
Hospital Charge Code	366833210
Hospital Revenue Code	480
Min. Negotiated Rate	$2,768.25
Max. Negotiated Rate	$2,768.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,768.25

TEMP PROBE COVER CARE

Facility

$2.34

Hospital Charge Code	270658673
Hospital Revenue Code	270
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.35
Rate for Payer: Qualcare PPO/HMO/WC	$0.35

TEMP PROBE COVER CARE

Facility

$2.34

Hospital Charge Code	270658673
Hospital Revenue Code	270
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.17
Rate for Payer: Aetna Commercial	$0.89
Rate for Payer: Aetna Medicare Advantage	$0.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.60
Rate for Payer: Cigna Commercial	$1.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.70
Rate for Payer: Oxford Commercial	$0.47
Rate for Payer: Qualcare PPO/HMO/WC	$0.35
Rate for Payer: UnitedHealthcare Commercial	$0.47
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

TEMP TREND INDICATOR CRYSTAL**

Facility

$8.00

Hospital Charge Code	2300861
Hospital Revenue Code	272
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

TEMP TREND INDICATOR CRYSTAL**

Facility

$8.00

Hospital Charge Code	2300861
Hospital Revenue Code	272
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

TEMPURATURE PROBE 72

Facility

$45.00

Hospital Charge Code	270688450
Hospital Revenue Code	272
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

TEMPURATURE PROBE 72

Facility

$45.00

Hospital Charge Code	270688450
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.50
Rate for Payer: Oxford Commercial	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Commercial	$9.00
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

TEMSIROLIMUS 25 MG/ML VIAL

Facility

$10,011.06

Hospital Charge Code	6063943251
Hospital Revenue Code	636
Min. Negotiated Rate	$1,501.66
Max. Negotiated Rate	$2,422.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,422.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,501.66

TEMSIROLIMUS 25 MG/ML VIAL

Facility

$10,011.06

Hospital Charge Code	6063943251
Hospital Revenue Code	636
Min. Negotiated Rate	$241.27
Max. Negotiated Rate	$5,005.53
Rate for Payer: Aetna Commercial	$3,804.20
Rate for Payer: Aetna Medicare Advantage	$3,003.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,552.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,552.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,552.82
Rate for Payer: Cigna Commercial	$5,005.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,422.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,501.66
Rate for Payer: UnitedHealthcare Community & State	$241.27
Rate for Payer: Wellpoint Medicaid Managed Care	$265.29

TENA HELICAL BLADE 90MM

Facility

$3,389.60

Hospital Charge Code	270681850
Hospital Revenue Code	272
Min. Negotiated Rate	$81.69
Max. Negotiated Rate	$1,694.80
Rate for Payer: Aetna Commercial	$1,288.05
Rate for Payer: Aetna Medicare Advantage	$1,016.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$864.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$864.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$864.35
Rate for Payer: Cigna Commercial	$1,694.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,016.88
Rate for Payer: Oxford Commercial	$677.92
Rate for Payer: Qualcare PPO/HMO/WC	$508.44
Rate for Payer: UnitedHealthcare Commercial	$677.92
Rate for Payer: UnitedHealthcare Community & State	$81.69
Rate for Payer: Wellpoint Medicaid Managed Care	$89.82

TENA HELICAL BLADE 90MM

Facility

$3,389.60

Hospital Charge Code	270681850
Hospital Revenue Code	272
Min. Negotiated Rate	$508.44
Max. Negotiated Rate	$508.44
Rate for Payer: Qualcare PPO/HMO/WC	$508.44

TENDERFOOT HEEL INCISION

Facility

$5.00

Hospital Charge Code	270649806
Hospital Revenue Code	272
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.50
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

TENDERFOOT HEEL INCISION

Facility

$5.00

Hospital Charge Code	270649806
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

TENDON ACHILES BONE ON BONE

Facility

$8,693.75

Hospital Charge Code	270637059
Hospital Revenue Code	278
Min. Negotiated Rate	$209.52
Max. Negotiated Rate	$4,346.88
Rate for Payer: Aetna Commercial	$3,303.62
Rate for Payer: Aetna Medicare Advantage	$2,608.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,216.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,216.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,738.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,216.91
Rate for Payer: Cigna Commercial	$4,346.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,103.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,912.62
Rate for Payer: Qualcare PPO/HMO/WC	$1,304.06
Rate for Payer: UnitedHealthcare Community & State	$209.52
Rate for Payer: Wellpoint Medicaid Managed Care	$230.38

TENDON ACHILES BONE ON BONE

Facility

$8,693.75

Hospital Charge Code	270637059
Hospital Revenue Code	278
Min. Negotiated Rate	$1,304.06
Max. Negotiated Rate	$2,103.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,738.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,103.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,912.62
Rate for Payer: Qualcare PPO/HMO/WC	$1,304.06

TENDON ACHILLES 10MM DOWEL

Facility

$13,026.25

Service Code	HCPCS C1762
Hospital Charge Code	270668501
Hospital Revenue Code	278
Min. Negotiated Rate	$1,953.94
Max. Negotiated Rate	$3,152.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,605.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,152.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,865.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,953.94

TENDON ACHILLES 10MM DOWEL

Facility

$13,026.25

Service Code	HCPCS C1762
Hospital Charge Code	270668501
Hospital Revenue Code	278
Min. Negotiated Rate	$313.93
Max. Negotiated Rate	$6,513.12
Rate for Payer: Aetna Commercial	$4,949.98
Rate for Payer: Aetna Medicare Advantage	$3,907.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,321.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,321.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,605.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,321.69
Rate for Payer: Cigna Commercial	$6,513.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,152.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,865.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,953.94
Rate for Payer: UnitedHealthcare Community & State	$313.93
Rate for Payer: Wellpoint Medicaid Managed Care	$345.20

TENDON ACHILLES ALGRAFT 130200

Facility

$4,994.75

Hospital Charge Code	270633903
Hospital Revenue Code	278
Min. Negotiated Rate	$749.21
Max. Negotiated Rate	$1,208.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,098.85
Rate for Payer: Qualcare PPO/HMO/WC	$749.21

TENDON ACHILLES ALGRAFT 130200

Facility

$4,994.75

Hospital Charge Code	270633903
Hospital Revenue Code	278
Min. Negotiated Rate	$120.37
Max. Negotiated Rate	$2,497.38
Rate for Payer: Aetna Commercial	$1,898.01
Rate for Payer: Aetna Medicare Advantage	$1,498.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,273.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,273.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,273.66
Rate for Payer: Cigna Commercial	$2,497.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,098.85
Rate for Payer: Qualcare PPO/HMO/WC	$749.21
Rate for Payer: UnitedHealthcare Community & State	$120.37
Rate for Payer: Wellpoint Medicaid Managed Care	$132.36

TENDON ACHILLES FF 930210

Facility

$2,863.25

Hospital Charge Code	270620344
Hospital Revenue Code	278
Min. Negotiated Rate	$69.00
Max. Negotiated Rate	$1,431.62
Rate for Payer: Aetna Commercial	$1,088.04
Rate for Payer: Aetna Medicare Advantage	$858.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$730.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$730.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$730.13
Rate for Payer: Cigna Commercial	$1,431.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$692.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$629.91
Rate for Payer: Qualcare PPO/HMO/WC	$429.49
Rate for Payer: UnitedHealthcare Community & State	$69.00
Rate for Payer: Wellpoint Medicaid Managed Care	$75.88

TENDON ACHILLES FF 930210

Facility

$2,863.25

Hospital Charge Code	270620344
Hospital Revenue Code	278
Min. Negotiated Rate	$429.49
Max. Negotiated Rate	$692.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$692.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$629.91
Rate for Payer: Qualcare PPO/HMO/WC	$429.49

TENDON ACHILLES W/BONE 021604

Facility

$3,729.65

Hospital Charge Code	270617936
Hospital Revenue Code	278
Min. Negotiated Rate	$89.88
Max. Negotiated Rate	$1,864.83
Rate for Payer: Aetna Commercial	$1,417.27
Rate for Payer: Aetna Medicare Advantage	$1,118.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$951.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$951.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$745.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$951.06
Rate for Payer: Cigna Commercial	$1,864.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$902.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$820.52
Rate for Payer: Qualcare PPO/HMO/WC	$559.45
Rate for Payer: UnitedHealthcare Community & State	$89.88
Rate for Payer: Wellpoint Medicaid Managed Care	$98.84

Know your out-of-pocket cost for care.

All Charges