Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TOE FLEX HINGE W/GR G426-0010

Facility

$2,681.65

Hospital Charge Code	270611667
Hospital Revenue Code	278
Min. Negotiated Rate	$64.63
Max. Negotiated Rate	$1,340.83
Rate for Payer: Aetna Commercial	$1,019.03
Rate for Payer: Aetna Medicare Advantage	$804.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$683.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$683.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$536.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$683.82
Rate for Payer: Cigna Commercial	$1,340.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$589.96
Rate for Payer: Qualcare PPO/HMO/WC	$402.25
Rate for Payer: UnitedHealthcare Community & State	$64.63
Rate for Payer: Wellpoint Medicaid Managed Care	$71.06

TOE FLEX HINGE W/GRMT #0

Facility

$6,280.00

Hospital Charge Code	270644931
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$1,519.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,381.60
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/GRMT #0

Facility

$6,280.00

Hospital Charge Code	270644931
Hospital Revenue Code	278
Min. Negotiated Rate	$151.35
Max. Negotiated Rate	$3,140.00
Rate for Payer: Aetna Commercial	$2,386.40
Rate for Payer: Aetna Medicare Advantage	$1,884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.40
Rate for Payer: Cigna Commercial	$3,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,381.60
Rate for Payer: Qualcare PPO/HMO/WC	$942.00
Rate for Payer: UnitedHealthcare Community & State	$151.35
Rate for Payer: Wellpoint Medicaid Managed Care	$166.42

TOE FLEX HINGE W/GRMT #1

Facility

$6,280.00

Service Code	HCPCS C1776
Hospital Charge Code	270668530
Hospital Revenue Code	278
Min. Negotiated Rate	$151.35
Max. Negotiated Rate	$3,140.00
Rate for Payer: Aetna Commercial	$2,386.40
Rate for Payer: Aetna Medicare Advantage	$1,884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.40
Rate for Payer: Cigna Commercial	$3,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,381.60
Rate for Payer: Qualcare PPO/HMO/WC	$942.00
Rate for Payer: UnitedHealthcare Community & State	$151.35
Rate for Payer: Wellpoint Medicaid Managed Care	$166.42

TOE FLEX HINGE W/GRMT #1

Facility

$6,280.00

Service Code	HCPCS C1776
Hospital Charge Code	270668530
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$1,519.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,381.60
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/GRMT #2

Facility

$6,280.00

Hospital Charge Code	270611669
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$1,519.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,381.60
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/GRMT #2

Facility

$6,280.00

Hospital Charge Code	270611669
Hospital Revenue Code	278
Min. Negotiated Rate	$151.35
Max. Negotiated Rate	$3,140.00
Rate for Payer: Aetna Commercial	$2,386.40
Rate for Payer: Aetna Medicare Advantage	$1,884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.40
Rate for Payer: Cigna Commercial	$3,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,381.60
Rate for Payer: Qualcare PPO/HMO/WC	$942.00
Rate for Payer: UnitedHealthcare Community & State	$151.35
Rate for Payer: Wellpoint Medicaid Managed Care	$166.42

TOE FLEX HINGE W/GRMT #3

Facility

$6,280.00

Service Code	HCPCS C1776
Hospital Charge Code	270611670
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$1,519.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,381.60
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/GRMT #3

Facility

$6,280.00

Service Code	HCPCS C1776
Hospital Charge Code	270611670
Hospital Revenue Code	278
Min. Negotiated Rate	$151.35
Max. Negotiated Rate	$3,140.00
Rate for Payer: Aetna Commercial	$2,386.40
Rate for Payer: Aetna Medicare Advantage	$1,884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.40
Rate for Payer: Cigna Commercial	$3,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,381.60
Rate for Payer: Qualcare PPO/HMO/WC	$942.00
Rate for Payer: UnitedHealthcare Community & State	$151.35
Rate for Payer: Wellpoint Medicaid Managed Care	$166.42

TOE FLEX HINGE W/GRMT #4

Facility

$6,280.00

Service Code	HCPCS C1776
Hospital Charge Code	270675527
Hospital Revenue Code	278
Min. Negotiated Rate	$151.35
Max. Negotiated Rate	$3,140.00
Rate for Payer: Aetna Commercial	$2,386.40
Rate for Payer: Aetna Medicare Advantage	$1,884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.40
Rate for Payer: Cigna Commercial	$3,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,381.60
Rate for Payer: Qualcare PPO/HMO/WC	$942.00
Rate for Payer: UnitedHealthcare Community & State	$151.35
Rate for Payer: Wellpoint Medicaid Managed Care	$166.42

TOE FLEX HINGE W/GRMT #4

Facility

$6,280.00

Service Code	HCPCS C1776
Hospital Charge Code	270675527
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$1,519.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,381.60
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/GRMT #5

Facility

$6,280.00

Hospital Charge Code	270611672
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$1,519.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,381.60
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/GRMT #5

Facility

$6,280.00

Hospital Charge Code	270611672
Hospital Revenue Code	278
Min. Negotiated Rate	$151.35
Max. Negotiated Rate	$3,140.00
Rate for Payer: Aetna Commercial	$2,386.40
Rate for Payer: Aetna Medicare Advantage	$1,884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.40
Rate for Payer: Cigna Commercial	$3,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,381.60
Rate for Payer: Qualcare PPO/HMO/WC	$942.00
Rate for Payer: UnitedHealthcare Community & State	$151.35
Rate for Payer: Wellpoint Medicaid Managed Care	$166.42

TOE FLEX HINGE W/O GRMT #3

Facility

$6,280.00

Hospital Charge Code	270645984
Hospital Revenue Code	278
Min. Negotiated Rate	$151.35
Max. Negotiated Rate	$3,140.00
Rate for Payer: Aetna Commercial	$2,386.40
Rate for Payer: Aetna Medicare Advantage	$1,884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.40
Rate for Payer: Cigna Commercial	$3,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,381.60
Rate for Payer: Qualcare PPO/HMO/WC	$942.00
Rate for Payer: UnitedHealthcare Community & State	$151.35
Rate for Payer: Wellpoint Medicaid Managed Care	$166.42

TOE FLEX HINGE W/O GRMT #3

Facility

$6,280.00

Hospital Charge Code	270645984
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$1,519.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,381.60
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/O GRMT #6

Facility

$6,280.00

Hospital Charge Code	270675545
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$1,519.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,381.60
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/O GRMT #6

Facility

$6,280.00

Hospital Charge Code	270675545
Hospital Revenue Code	278
Min. Negotiated Rate	$151.35
Max. Negotiated Rate	$3,140.00
Rate for Payer: Aetna Commercial	$2,386.40
Rate for Payer: Aetna Medicare Advantage	$1,884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.40
Rate for Payer: Cigna Commercial	$3,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,381.60
Rate for Payer: Qualcare PPO/HMO/WC	$942.00
Rate for Payer: UnitedHealthcare Community & State	$151.35
Rate for Payer: Wellpoint Medicaid Managed Care	$166.42

TOE FLXBL HNGE SWNSN#6 4260006

Facility

$1,736.00

Service Code	HCPCS C1776
Hospital Charge Code	270611673
Hospital Revenue Code	278
Min. Negotiated Rate	$41.84
Max. Negotiated Rate	$868.00
Rate for Payer: Aetna Commercial	$659.68
Rate for Payer: Aetna Medicare Advantage	$520.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$442.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$442.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$347.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$442.68
Rate for Payer: Cigna Commercial	$868.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$420.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$381.92
Rate for Payer: Qualcare PPO/HMO/WC	$260.40
Rate for Payer: UnitedHealthcare Community & State	$41.84
Rate for Payer: Wellpoint Medicaid Managed Care	$46.00

TOE FLXBL HNGE SWNSN#6 4260006

Facility

$1,736.00

Service Code	HCPCS C1776
Hospital Charge Code	270611673
Hospital Revenue Code	278
Min. Negotiated Rate	$260.40
Max. Negotiated Rate	$420.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$347.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$420.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$381.92
Rate for Payer: Qualcare PPO/HMO/WC	$260.40

TOE FLXBL HNGE SWNSN#7 4260007

Facility

$1,736.00

Hospital Charge Code	270611655
Hospital Revenue Code	278
Min. Negotiated Rate	$41.84
Max. Negotiated Rate	$868.00
Rate for Payer: Aetna Commercial	$659.68
Rate for Payer: Aetna Medicare Advantage	$520.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$442.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$442.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$347.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$442.68
Rate for Payer: Cigna Commercial	$868.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$420.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$381.92
Rate for Payer: Qualcare PPO/HMO/WC	$260.40
Rate for Payer: UnitedHealthcare Community & State	$41.84
Rate for Payer: Wellpoint Medicaid Managed Care	$46.00

TOE FLXBL HNGE SWNSN#7 4260007

Facility

$1,736.00

Hospital Charge Code	270611655
Hospital Revenue Code	278
Min. Negotiated Rate	$260.40
Max. Negotiated Rate	$420.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$347.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$420.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$381.92
Rate for Payer: Qualcare PPO/HMO/WC	$260.40

TOE FLX HNGE W/GRMT#1 G4260001

Facility

$1,736.00

Hospital Charge Code	270611668
Hospital Revenue Code	278
Min. Negotiated Rate	$41.84
Max. Negotiated Rate	$868.00
Rate for Payer: Aetna Commercial	$659.68
Rate for Payer: Aetna Medicare Advantage	$520.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$442.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$442.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$347.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$442.68
Rate for Payer: Cigna Commercial	$868.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$420.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$381.92
Rate for Payer: Qualcare PPO/HMO/WC	$260.40
Rate for Payer: UnitedHealthcare Community & State	$41.84
Rate for Payer: Wellpoint Medicaid Managed Care	$46.00

TOE FLX HNGE W/GRMT#1 G4260001

Facility

$1,736.00

Hospital Charge Code	270611668
Hospital Revenue Code	278
Min. Negotiated Rate	$260.40
Max. Negotiated Rate	$420.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$347.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$420.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$381.92
Rate for Payer: Qualcare PPO/HMO/WC	$260.40

TOE GREAT TTNM SWNSN#0 4833110

Facility

$3,794.45

Hospital Charge Code	270611657
Hospital Revenue Code	278
Min. Negotiated Rate	$91.45
Max. Negotiated Rate	$1,897.22
Rate for Payer: Aetna Commercial	$1,441.89
Rate for Payer: Aetna Medicare Advantage	$1,138.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$967.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$967.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$758.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$967.58
Rate for Payer: Cigna Commercial	$1,897.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$834.78
Rate for Payer: Qualcare PPO/HMO/WC	$569.17
Rate for Payer: UnitedHealthcare Community & State	$91.45
Rate for Payer: Wellpoint Medicaid Managed Care	$100.55

TOE GREAT TTNM SWNSN#0 4833110

Facility

$3,794.45

Hospital Charge Code	270611657
Hospital Revenue Code	278
Min. Negotiated Rate	$569.17
Max. Negotiated Rate	$918.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$758.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$834.78
Rate for Payer: Qualcare PPO/HMO/WC	$569.17

Know your out-of-pocket cost for care.

All Charges