Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TREATMENT TIBIAL FX

Facility

$645.00

Service Code	HCPCS 27760
Hospital Charge Code	9808210
Hospital Revenue Code	361
Min. Negotiated Rate	$15.54
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$797.10
Rate for Payer: Aetna Medicare Advantage	$949.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,057.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,057.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$293.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,057.82
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: Cigna Medicare Advantage	$293.05
Rate for Payer: Clover Medicare Advantage	$278.40
Rate for Payer: EmblemHealth Commercial	$879.15
Rate for Payer: Humana Medicare Advantage	$301.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$293.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.50
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.75
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$15.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$293.05
Rate for Payer: Wellcare Medicare Advantage	$293.05
Rate for Payer: Wellpoint Medicaid Managed Care	$17.09

TREATMENT ZONE 12CM ENDO 135CM

Facility

$12,975.00

Hospital Charge Code	2709003198
Hospital Revenue Code	272
Min. Negotiated Rate	$1,946.25
Max. Negotiated Rate	$1,946.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25

TREATMENT ZONE 12CM ENDO 135CM

Facility

$12,975.00

Hospital Charge Code	2709003198
Hospital Revenue Code	272
Min. Negotiated Rate	$312.70
Max. Negotiated Rate	$6,487.50
Rate for Payer: Aetna Commercial	$4,930.50
Rate for Payer: Aetna Medicare Advantage	$3,892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,308.62
Rate for Payer: Cigna Commercial	$6,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,892.50
Rate for Payer: Oxford Commercial	$2,595.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25
Rate for Payer: UnitedHealthcare Commercial	$2,595.00
Rate for Payer: UnitedHealthcare Community & State	$312.70
Rate for Payer: Wellpoint Medicaid Managed Care	$343.84

TREATMENT ZONE 12CM ENDOVASULA

Facility

$12,975.00

Hospital Charge Code	2709003192
Hospital Revenue Code	272
Min. Negotiated Rate	$312.70
Max. Negotiated Rate	$6,487.50
Rate for Payer: Aetna Commercial	$4,930.50
Rate for Payer: Aetna Medicare Advantage	$3,892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,308.62
Rate for Payer: Cigna Commercial	$6,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,892.50
Rate for Payer: Oxford Commercial	$2,595.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25
Rate for Payer: UnitedHealthcare Commercial	$2,595.00
Rate for Payer: UnitedHealthcare Community & State	$312.70
Rate for Payer: Wellpoint Medicaid Managed Care	$343.84

TREATMENT ZONE 12CM ENDOVASULA

Facility

$12,975.00

Hospital Charge Code	2709003192
Hospital Revenue Code	272
Min. Negotiated Rate	$1,946.25
Max. Negotiated Rate	$1,946.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25

TREATMENT ZONE 18CM ENDOVASCUL

Facility

$12,975.00

Hospital Charge Code	2709003193
Hospital Revenue Code	272
Min. Negotiated Rate	$312.70
Max. Negotiated Rate	$6,487.50
Rate for Payer: Aetna Commercial	$4,930.50
Rate for Payer: Aetna Medicare Advantage	$3,892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,308.62
Rate for Payer: Cigna Commercial	$6,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,892.50
Rate for Payer: Oxford Commercial	$2,595.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25
Rate for Payer: UnitedHealthcare Commercial	$2,595.00
Rate for Payer: UnitedHealthcare Community & State	$312.70
Rate for Payer: Wellpoint Medicaid Managed Care	$343.84

TREATMENT ZONE 18CM ENDOVASCUL

Facility

$12,975.00

Hospital Charge Code	2709003193
Hospital Revenue Code	272
Min. Negotiated Rate	$1,946.25
Max. Negotiated Rate	$1,946.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25

TREATMENT ZONE 24CM ENDOVASCUL

Facility

$12,975.00

Hospital Charge Code	2709003194
Hospital Revenue Code	272
Min. Negotiated Rate	$1,946.25
Max. Negotiated Rate	$1,946.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25

TREATMENT ZONE 24CM ENDOVASCUL

Facility

$12,975.00

Hospital Charge Code	2709003194
Hospital Revenue Code	272
Min. Negotiated Rate	$312.70
Max. Negotiated Rate	$6,487.50
Rate for Payer: Aetna Commercial	$4,930.50
Rate for Payer: Aetna Medicare Advantage	$3,892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,308.62
Rate for Payer: Cigna Commercial	$6,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,892.50
Rate for Payer: Oxford Commercial	$2,595.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25
Rate for Payer: UnitedHealthcare Commercial	$2,595.00
Rate for Payer: UnitedHealthcare Community & State	$312.70
Rate for Payer: Wellpoint Medicaid Managed Care	$343.84

TREATMENT ZONE 30CM ENDO 106CM

Facility

$12,975.00

Hospital Charge Code	2709003195
Hospital Revenue Code	275
Min. Negotiated Rate	$312.70
Max. Negotiated Rate	$6,487.50
Rate for Payer: Aetna Commercial	$4,930.50
Rate for Payer: Aetna Medicare Advantage	$3,892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,308.62
Rate for Payer: Cigna Commercial	$6,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,139.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,854.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25
Rate for Payer: UnitedHealthcare Community & State	$312.70
Rate for Payer: Wellpoint Medicaid Managed Care	$343.84

TREATMENT ZONE 30CM ENDO 106CM

Facility

$12,975.00

Hospital Charge Code	2709003195
Hospital Revenue Code	275
Min. Negotiated Rate	$1,946.25
Max. Negotiated Rate	$3,139.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,139.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,854.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25

TREATMENT ZONE 40CM ENDO 106CM

Facility

$12,975.00

Hospital Charge Code	2709003196
Hospital Revenue Code	272
Min. Negotiated Rate	$312.70
Max. Negotiated Rate	$6,487.50
Rate for Payer: Aetna Commercial	$4,930.50
Rate for Payer: Aetna Medicare Advantage	$3,892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,308.62
Rate for Payer: Cigna Commercial	$6,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,892.50
Rate for Payer: Oxford Commercial	$2,595.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25
Rate for Payer: UnitedHealthcare Commercial	$2,595.00
Rate for Payer: UnitedHealthcare Community & State	$312.70
Rate for Payer: Wellpoint Medicaid Managed Care	$343.84

TREATMENT ZONE 40CM ENDO 106CM

Facility

$12,975.00

Hospital Charge Code	2709003196
Hospital Revenue Code	272
Min. Negotiated Rate	$1,946.25
Max. Negotiated Rate	$1,946.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25

TREATMENT ZONE 40CM ENDO 135CM

Facility

$12,975.00

Hospital Charge Code	2709003199
Hospital Revenue Code	272
Min. Negotiated Rate	$1,946.25
Max. Negotiated Rate	$1,946.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25

TREATMENT ZONE 40CM ENDO 135CM

Facility

$12,975.00

Hospital Charge Code	2709003199
Hospital Revenue Code	272
Min. Negotiated Rate	$312.70
Max. Negotiated Rate	$6,487.50
Rate for Payer: Aetna Commercial	$4,930.50
Rate for Payer: Aetna Medicare Advantage	$3,892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,308.62
Rate for Payer: Cigna Commercial	$6,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,892.50
Rate for Payer: Oxford Commercial	$2,595.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25
Rate for Payer: UnitedHealthcare Commercial	$2,595.00
Rate for Payer: UnitedHealthcare Community & State	$312.70
Rate for Payer: Wellpoint Medicaid Managed Care	$343.84

TREATMENT ZONE 50CM ENDO 135CM

Facility

$12,975.00

Hospital Charge Code	2709003200
Hospital Revenue Code	272
Min. Negotiated Rate	$1,946.25
Max. Negotiated Rate	$1,946.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25

TREATMENT ZONE 50CM ENDO 135CM

Facility

$12,975.00

Hospital Charge Code	2709003200
Hospital Revenue Code	272
Min. Negotiated Rate	$312.70
Max. Negotiated Rate	$6,487.50
Rate for Payer: Aetna Commercial	$4,930.50
Rate for Payer: Aetna Medicare Advantage	$3,892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,308.62
Rate for Payer: Cigna Commercial	$6,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,892.50
Rate for Payer: Oxford Commercial	$2,595.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25
Rate for Payer: UnitedHealthcare Commercial	$2,595.00
Rate for Payer: UnitedHealthcare Community & State	$312.70
Rate for Payer: Wellpoint Medicaid Managed Care	$343.84

TREATMENT ZONE 50 ENDO 106CM

Facility

$12,975.00

Hospital Charge Code	2709003197
Hospital Revenue Code	272
Min. Negotiated Rate	$1,946.25
Max. Negotiated Rate	$1,946.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25

TREATMENT ZONE 50 ENDO 106CM

Facility

$12,975.00

Hospital Charge Code	2709003197
Hospital Revenue Code	272
Min. Negotiated Rate	$312.70
Max. Negotiated Rate	$6,487.50
Rate for Payer: Aetna Commercial	$4,930.50
Rate for Payer: Aetna Medicare Advantage	$3,892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,308.62
Rate for Payer: Cigna Commercial	$6,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,892.50
Rate for Payer: Oxford Commercial	$2,595.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25
Rate for Payer: UnitedHealthcare Commercial	$2,595.00
Rate for Payer: UnitedHealthcare Community & State	$312.70
Rate for Payer: Wellpoint Medicaid Managed Care	$343.84

TREATMENT ZONE 6CM ENDOVASCULA

Facility

$12,975.00

Hospital Charge Code	2709003191
Hospital Revenue Code	272
Min. Negotiated Rate	$1,946.25
Max. Negotiated Rate	$1,946.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25

TREATMENT ZONE 6CM ENDOVASCULA

Facility

$12,975.00

Hospital Charge Code	2709003191
Hospital Revenue Code	272
Min. Negotiated Rate	$312.70
Max. Negotiated Rate	$6,487.50
Rate for Payer: Aetna Commercial	$4,930.50
Rate for Payer: Aetna Medicare Advantage	$3,892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,308.62
Rate for Payer: Cigna Commercial	$6,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,892.50
Rate for Payer: Oxford Commercial	$2,595.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25
Rate for Payer: UnitedHealthcare Commercial	$2,595.00
Rate for Payer: UnitedHealthcare Community & State	$312.70
Rate for Payer: Wellpoint Medicaid Managed Care	$343.84

TREAT METACARPAL FRACTURE

Facility

$48,992.10

Service Code	HCPCS 26615
Hospital Charge Code	16000256
Hospital Revenue Code	360
Min. Negotiated Rate	$1,180.71
Max. Negotiated Rate	$14,834.00
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,697.63
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,348.81
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,180.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1,298.29

TREAT METACARPAL FRACTURE

Facility

$48,992.10

Service Code	HCPCS 26615
Hospital Charge Code	16000256
Hospital Revenue Code	360
Min. Negotiated Rate	$7,348.81
Max. Negotiated Rate	$7,348.81
Rate for Payer: Qualcare PPO/HMO/WC	$7,348.81

TREAT METATARSAL FRACTURES

Facility

$48,992.10

Service Code	HCPCS 28485
Hospital Charge Code	16000222
Hospital Revenue Code	360
Min. Negotiated Rate	$7,348.81
Max. Negotiated Rate	$7,348.81
Rate for Payer: Qualcare PPO/HMO/WC	$7,348.81

TREAT METATARSAL FRACTURES

Facility

$48,992.10

Service Code	HCPCS 28485
Hospital Charge Code	16000222
Hospital Revenue Code	360
Min. Negotiated Rate	$1,180.71
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	$1,626.00
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	$14,697.63
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,348.81
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,180.71
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	$1,298.29

Know your out-of-pocket cost for care.

All Charges