Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TR BAND LONG W INFLATR XXRF06L

Facility

$210.00

Hospital Charge Code	270643741S
Hospital Revenue Code	272
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

TR BAND LONG W INFLATR XXRF06L

Facility

$1,150.00

Hospital Charge Code	270643741
Hospital Revenue Code	272
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$172.50
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

TR BAND LONG W INFLATR XXRF06L

Facility

$210.00

Hospital Charge Code	270643741S
Hospital Revenue Code	272
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$105.00
Rate for Payer: Aetna Commercial	$79.80
Rate for Payer: Aetna Medicare Advantage	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.55
Rate for Payer: Cigna Commercial	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.00
Rate for Payer: Oxford Commercial	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Commercial	$42.00
Rate for Payer: UnitedHealthcare Community & State	$5.06
Rate for Payer: Wellpoint Medicaid Managed Care	$5.57

TR BAND LONG W INFLATR XXRF06L

Facility

$175.00

Hospital Charge Code	270643741N
Hospital Revenue Code	272
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.50
Rate for Payer: Oxford Commercial	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$35.00
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.64

TR BAND LONG W INFLATR XXRF06L

Facility

$1,150.00

Hospital Charge Code	270643741
Hospital Revenue Code	272
Min. Negotiated Rate	$27.71
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$437.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$345.00
Rate for Payer: Oxford Commercial	$230.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Commercial	$230.00
Rate for Payer: UnitedHealthcare Community & State	$27.71
Rate for Payer: Wellpoint Medicaid Managed Care	$30.48

TR BAND STD W/INFLATOR XXRF06

Facility

$1,150.00

Hospital Charge Code	270643105
Hospital Revenue Code	272
Min. Negotiated Rate	$27.71
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$437.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$345.00
Rate for Payer: Oxford Commercial	$230.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Commercial	$230.00
Rate for Payer: UnitedHealthcare Community & State	$27.71
Rate for Payer: Wellpoint Medicaid Managed Care	$30.48

TR BAND STD W/INFLATOR XXRF06

Facility

$1,150.00

Hospital Charge Code	270643105
Hospital Revenue Code	272
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$172.50
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

TR BAND STD W/INFLATOR XXRF06

Facility

$210.00

Hospital Charge Code	270643105S
Hospital Revenue Code	272
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$105.00
Rate for Payer: Aetna Commercial	$79.80
Rate for Payer: Aetna Medicare Advantage	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.55
Rate for Payer: Cigna Commercial	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.00
Rate for Payer: Oxford Commercial	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Commercial	$42.00
Rate for Payer: UnitedHealthcare Community & State	$5.06
Rate for Payer: Wellpoint Medicaid Managed Care	$5.57

TR BAND STD W/INFLATOR XXRF06

Facility

$175.00

Hospital Charge Code	270643105N
Hospital Revenue Code	272
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.50
Rate for Payer: Oxford Commercial	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$35.00
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.64

TR BAND STD W/INFLATOR XXRF06

Facility

$175.00

Hospital Charge Code	270643105N
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

TR BAND STD W/INFLATOR XXRF06

Facility

$210.00

Hospital Charge Code	270643105S
Hospital Revenue Code	272
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

TR BAND STD W INFTR XX RF06

Facility

$210.00

Hospital Charge Code	270643105C
Hospital Revenue Code	272
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

TR BAND STD W INFTR XX RF06

Facility

$210.00

Hospital Charge Code	270643105C
Hospital Revenue Code	272
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$105.00
Rate for Payer: Aetna Commercial	$79.80
Rate for Payer: Aetna Medicare Advantage	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.55
Rate for Payer: Cigna Commercial	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.00
Rate for Payer: Oxford Commercial	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Commercial	$42.00
Rate for Payer: UnitedHealthcare Community & State	$5.06
Rate for Payer: Wellpoint Medicaid Managed Care	$5.57

TRCOR2 UROBIOP NDL18x20

Facility

$235.00

Hospital Charge Code	270643164
Hospital Revenue Code	272
Min. Negotiated Rate	$35.25
Max. Negotiated Rate	$35.25
Rate for Payer: Qualcare PPO/HMO/WC	$35.25

TRCOR2 UROBIOP NDL18x20

Facility

$235.00

Hospital Charge Code	270643164
Hospital Revenue Code	272
Min. Negotiated Rate	$5.66
Max. Negotiated Rate	$117.50
Rate for Payer: Aetna Commercial	$89.30
Rate for Payer: Aetna Medicare Advantage	$70.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.92
Rate for Payer: Cigna Commercial	$117.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.50
Rate for Payer: Oxford Commercial	$47.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.25
Rate for Payer: UnitedHealthcare Commercial	$47.00
Rate for Payer: UnitedHealthcare Community & State	$5.66
Rate for Payer: Wellpoint Medicaid Managed Care	$6.23

TRCU VENIPUNCTURE

Facility

$26.25

Service Code	HCPCS 36415
Hospital Charge Code	1000101
Hospital Revenue Code	300
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$25.40
Rate for Payer: Aetna Medicare Advantage	$30.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.71
Rate for Payer: Cigna Commercial	$13.12
Rate for Payer: Cigna Medicare Advantage	$9.34
Rate for Payer: Clover Medicare Advantage	$8.87
Rate for Payer: EmblemHealth Commercial	$28.02
Rate for Payer: Humana Medicare Advantage	$9.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.88
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.94
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.34
Rate for Payer: Wellcare Medicare Advantage	$9.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.70

TRCU VENIPUNCTURE

Facility

$26.25

Service Code	HCPCS 36415
Hospital Charge Code	1000101
Hospital Revenue Code	300
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$3.94
Rate for Payer: Qualcare PPO/HMO/WC	$3.94

TREANDA 100MG/20ML

Facility

$23,893.27

Service Code	HCPCS J9033
Hospital Charge Code	60630209
Hospital Revenue Code	636
Min. Negotiated Rate	$3,583.99
Max. Negotiated Rate	$5,782.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,782.17
Rate for Payer: Qualcare PPO/HMO/WC	$3,583.99

TREANDA 100MG/20ML

Facility

$23,893.27

Service Code	HCPCS J9033
Hospital Charge Code	60630209
Hospital Revenue Code	636
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$5,782.17
Rate for Payer: Aetna Commercial	$5.88
Rate for Payer: Aetna Medicare Advantage	$7.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.80
Rate for Payer: Cigna Medicare Advantage	$2.16
Rate for Payer: Clover Medicare Advantage	$2.05
Rate for Payer: EmblemHealth Commercial	$6.48
Rate for Payer: Humana Medicare Advantage	$2.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,782.17
Rate for Payer: Qualcare PPO/HMO/WC	$3,583.99
Rate for Payer: UnitedHealthcare Community & State	$575.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.16
Rate for Payer: Wellcare Medicare Advantage	$2.16
Rate for Payer: Wellpoint Medicaid Managed Care	$633.17

TREANDA 25MG/1ML

Facility

$5,973.32

Service Code	HCPCS J9033
Hospital Charge Code	60630210
Hospital Revenue Code	636
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$1,445.54
Rate for Payer: Aetna Commercial	$5.88
Rate for Payer: Aetna Medicare Advantage	$7.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.80
Rate for Payer: Cigna Medicare Advantage	$2.16
Rate for Payer: Clover Medicare Advantage	$2.05
Rate for Payer: EmblemHealth Commercial	$6.48
Rate for Payer: Humana Medicare Advantage	$2.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,445.54
Rate for Payer: Qualcare PPO/HMO/WC	$896.00
Rate for Payer: UnitedHealthcare Community & State	$143.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.16
Rate for Payer: Wellcare Medicare Advantage	$2.16
Rate for Payer: Wellpoint Medicaid Managed Care	$158.29

TREANDA 25MG/1ML

Facility

$5,973.32

Service Code	HCPCS J9033
Hospital Charge Code	60630210
Hospital Revenue Code	636
Min. Negotiated Rate	$896.00
Max. Negotiated Rate	$1,445.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,445.54
Rate for Payer: Qualcare PPO/HMO/WC	$896.00

Treat Ankle Dislocation

Facility

$28,255.00

Service Code	HCPCS 27848
Hospital Charge Code	16000715
Hospital Revenue Code	360
Min. Negotiated Rate	$4,238.25
Max. Negotiated Rate	$4,238.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,238.25

Treat Ankle Dislocation

Facility

$28,255.00

Service Code	HCPCS 27848
Hospital Charge Code	16000715
Hospital Revenue Code	360
Min. Negotiated Rate	$680.95
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,476.50
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,238.25
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$680.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$748.76

TREAT ANKLE FRACTURE

Facility

$63,197.33

Service Code	HCPCS 28445
Hospital Charge Code	16000573
Hospital Revenue Code	360
Min. Negotiated Rate	$9,479.60
Max. Negotiated Rate	$9,479.60
Rate for Payer: Qualcare PPO/HMO/WC	$9,479.60

TREAT ANKLE FRACTURE

Facility

$63,197.33

Service Code	HCPCS 28445
Hospital Charge Code	16000573
Hospital Revenue Code	360
Min. Negotiated Rate	$1,355.00
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18,959.20
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,479.60
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,523.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1,674.73

Know your out-of-pocket cost for care.

All Charges