Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TRACTION BUCKS *****

Facility

$93.00

Hospital Charge Code	8001877
Hospital Revenue Code	279
Min. Negotiated Rate	$13.95
Max. Negotiated Rate	$13.95
Rate for Payer: Qualcare PPO/HMO/WC	$13.95

TRACTION CERVICAL*******

Facility

$285.00

Hospital Charge Code	8002073
Hospital Revenue Code	279
Min. Negotiated Rate	$42.75
Max. Negotiated Rate	$42.75
Rate for Payer: Qualcare PPO/HMO/WC	$42.75

TRACTION CERVICAL*******

Facility

$285.00

Hospital Charge Code	8002073
Hospital Revenue Code	279
Min. Negotiated Rate	$6.87
Max. Negotiated Rate	$142.50
Rate for Payer: Aetna Commercial	$108.30
Rate for Payer: Aetna Medicare Advantage	$85.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.67
Rate for Payer: Cigna Commercial	$142.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.50
Rate for Payer: Oxford Commercial	$57.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.75
Rate for Payer: UnitedHealthcare Commercial	$57.00
Rate for Payer: UnitedHealthcare Community & State	$6.87
Rate for Payer: Wellpoint Medicaid Managed Care	$7.55

TRACTION - MECHANICAL

Facility

$148.00

Service Code	HCPCS 97012GP
Hospital Charge Code	9107005
Hospital Revenue Code	420
Min. Negotiated Rate	$22.20
Max. Negotiated Rate	$22.20
Rate for Payer: Qualcare PPO/HMO/WC	$22.20

TRACTION - MECHANICAL

Facility

$148.00

Service Code	HCPCS 97012GP
Hospital Charge Code	9107005
Hospital Revenue Code	420
Min. Negotiated Rate	$3.57
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$56.24
Rate for Payer: Aetna Medicare Advantage	$44.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.74
Rate for Payer: Cigna Commercial	$74.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.40
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.20
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.57
Rate for Payer: Wellpoint Medicaid Managed Care	$3.92

TRACTION MECHANICAL CQ

Facility

$148.00

Service Code	HCPCS 97012GP
Hospital Charge Code	409197012Q
Hospital Revenue Code	420
Min. Negotiated Rate	$3.57
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$56.24
Rate for Payer: Aetna Medicare Advantage	$44.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.74
Rate for Payer: Cigna Commercial	$74.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.40
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.20
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.57
Rate for Payer: Wellpoint Medicaid Managed Care	$3.92

TRACTION MECHANICAL CQ

Facility

$148.00

Service Code	HCPCS 97012GP
Hospital Charge Code	409197012Q
Hospital Revenue Code	420
Min. Negotiated Rate	$22.20
Max. Negotiated Rate	$22.20
Rate for Payer: Qualcare PPO/HMO/WC	$22.20

TRACTION PELVIC *******

Facility

$289.00

Hospital Charge Code	8001950
Hospital Revenue Code	279
Min. Negotiated Rate	$6.96
Max. Negotiated Rate	$144.50
Rate for Payer: Aetna Commercial	$109.82
Rate for Payer: Aetna Medicare Advantage	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.69
Rate for Payer: Cigna Commercial	$144.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.70
Rate for Payer: Oxford Commercial	$57.80
Rate for Payer: Qualcare PPO/HMO/WC	$43.35
Rate for Payer: UnitedHealthcare Commercial	$57.80
Rate for Payer: UnitedHealthcare Community & State	$6.96
Rate for Payer: Wellpoint Medicaid Managed Care	$7.66

TRACTION PELVIC *******

Facility

$289.00

Hospital Charge Code	8001950
Hospital Revenue Code	279
Min. Negotiated Rate	$43.35
Max. Negotiated Rate	$43.35
Rate for Payer: Qualcare PPO/HMO/WC	$43.35

TRACTION RUSSEL******

Facility

$60.00

Hospital Charge Code	8001943
Hospital Revenue Code	279
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.00
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$12.00
Rate for Payer: UnitedHealthcare Community & State	$1.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

TRACTION RUSSEL******

Facility

$60.00

Hospital Charge Code	8001943
Hospital Revenue Code	279
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

TRACTION SKELETAL********

Facility

$60.00

Hospital Charge Code	8004509
Hospital Revenue Code	272
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

TRACTION SKELETAL********

Facility

$60.00

Hospital Charge Code	8004509
Hospital Revenue Code	272
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.00
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$12.00
Rate for Payer: UnitedHealthcare Community & State	$1.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

TRAILBLAZER ANGLE .014X150

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683674S
Hospital Revenue Code	278
Min. Negotiated Rate	$127.25
Max. Negotiated Rate	$2,640.00
Rate for Payer: Aetna Commercial	$2,006.40
Rate for Payer: Aetna Medicare Advantage	$1,584.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,346.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,346.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,346.40
Rate for Payer: Cigna Commercial	$2,640.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,161.60
Rate for Payer: Qualcare PPO/HMO/WC	$792.00
Rate for Payer: UnitedHealthcare Community & State	$127.25
Rate for Payer: Wellpoint Medicaid Managed Care	$139.92

TRAILBLAZER ANGLE .014X150

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683674N
Hospital Revenue Code	278
Min. Negotiated Rate	$792.00
Max. Negotiated Rate	$1,277.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,161.60
Rate for Payer: Qualcare PPO/HMO/WC	$792.00

TRAILBLAZER ANGLE .014X150

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683674S
Hospital Revenue Code	278
Min. Negotiated Rate	$792.00
Max. Negotiated Rate	$1,277.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,161.60
Rate for Payer: Qualcare PPO/HMO/WC	$792.00

TRAILBLAZER ANGLE .014X150

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683674N
Hospital Revenue Code	278
Min. Negotiated Rate	$127.25
Max. Negotiated Rate	$2,640.00
Rate for Payer: Aetna Commercial	$2,006.40
Rate for Payer: Aetna Medicare Advantage	$1,584.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,346.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,346.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,346.40
Rate for Payer: Cigna Commercial	$2,640.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,161.60
Rate for Payer: Qualcare PPO/HMO/WC	$792.00
Rate for Payer: UnitedHealthcare Community & State	$127.25
Rate for Payer: Wellpoint Medicaid Managed Care	$139.92

Trailblazer Angle .018 x 150

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683675N
Hospital Revenue Code	278
Min. Negotiated Rate	$792.00
Max. Negotiated Rate	$1,277.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,161.60
Rate for Payer: Qualcare PPO/HMO/WC	$792.00

Trailblazer Angle .018 x 150

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683675S
Hospital Revenue Code	278
Min. Negotiated Rate	$127.25
Max. Negotiated Rate	$2,640.00
Rate for Payer: Aetna Commercial	$2,006.40
Rate for Payer: Aetna Medicare Advantage	$1,584.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,346.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,346.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,346.40
Rate for Payer: Cigna Commercial	$2,640.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,161.60
Rate for Payer: Qualcare PPO/HMO/WC	$792.00
Rate for Payer: UnitedHealthcare Community & State	$127.25
Rate for Payer: Wellpoint Medicaid Managed Care	$139.92

Trailblazer Angle .018 x 150

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683675N
Hospital Revenue Code	278
Min. Negotiated Rate	$127.25
Max. Negotiated Rate	$2,640.00
Rate for Payer: Aetna Commercial	$2,006.40
Rate for Payer: Aetna Medicare Advantage	$1,584.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,346.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,346.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,346.40
Rate for Payer: Cigna Commercial	$2,640.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,161.60
Rate for Payer: Qualcare PPO/HMO/WC	$792.00
Rate for Payer: UnitedHealthcare Community & State	$127.25
Rate for Payer: Wellpoint Medicaid Managed Care	$139.92

Trailblazer Angle .018 x 150

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683675S
Hospital Revenue Code	278
Min. Negotiated Rate	$792.00
Max. Negotiated Rate	$1,277.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,161.60
Rate for Payer: Qualcare PPO/HMO/WC	$792.00

Trailblazer Angle .035 x 150

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683677S
Hospital Revenue Code	278
Min. Negotiated Rate	$127.25
Max. Negotiated Rate	$2,640.00
Rate for Payer: Aetna Commercial	$2,006.40
Rate for Payer: Aetna Medicare Advantage	$1,584.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,346.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,346.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,346.40
Rate for Payer: Cigna Commercial	$2,640.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,161.60
Rate for Payer: Qualcare PPO/HMO/WC	$792.00
Rate for Payer: UnitedHealthcare Community & State	$127.25
Rate for Payer: Wellpoint Medicaid Managed Care	$139.92

Trailblazer Angle .035 x 150

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683677S
Hospital Revenue Code	278
Min. Negotiated Rate	$792.00
Max. Negotiated Rate	$1,277.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,161.60
Rate for Payer: Qualcare PPO/HMO/WC	$792.00

Trailblazer Angle .035 x 150

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683677N
Hospital Revenue Code	278
Min. Negotiated Rate	$127.25
Max. Negotiated Rate	$2,640.00
Rate for Payer: Aetna Commercial	$2,006.40
Rate for Payer: Aetna Medicare Advantage	$1,584.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,346.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,346.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,346.40
Rate for Payer: Cigna Commercial	$2,640.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,161.60
Rate for Payer: Qualcare PPO/HMO/WC	$792.00
Rate for Payer: UnitedHealthcare Community & State	$127.25
Rate for Payer: Wellpoint Medicaid Managed Care	$139.92

Trailblazer Angle .035 x 150

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683677N
Hospital Revenue Code	278
Min. Negotiated Rate	$792.00
Max. Negotiated Rate	$1,277.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,161.60
Rate for Payer: Qualcare PPO/HMO/WC	$792.00

Know your out-of-pocket cost for care.

All Charges