Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

UNLISTED PX LUNG/PLEURA

Facility

$3,630.70

Service Code	HCPCS 32999
Hospital Charge Code	2692117
Hospital Revenue Code	361
Min. Negotiated Rate	$544.61
Max. Negotiated Rate	$544.61
Rate for Payer: Qualcare PPO/HMO/WC	$544.61

UNLISTED PX LUNG/PLEURA

Facility

$3,630.70

Service Code	HCPCS 32999
Hospital Charge Code	2692117
Hospital Revenue Code	361
Min. Negotiated Rate	$87.50
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,027.08
Rate for Payer: Aetna Medicare Advantage	$2,414.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$745.25
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	$2,690.13
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: Cigna Medicare Advantage	$745.25
Rate for Payer: Clover Medicare Advantage	$707.99
Rate for Payer: EmblemHealth Commercial	$2,235.75
Rate for Payer: Humana Medicare Advantage	$767.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$745.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.21
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$544.61
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$87.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$745.25
Rate for Payer: Wellcare Medicare Advantage	$745.25
Rate for Payer: Wellpoint Medicaid Managed Care	$96.21

UNLISTED PX LUNG/PLEURA

Facility

$3,630.70

Service Code	HCPCS 32999
Hospital Charge Code	321032999
Hospital Revenue Code	361
Min. Negotiated Rate	$87.50
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,027.08
Rate for Payer: Aetna Medicare Advantage	$2,414.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$745.25
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	$2,690.13
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: Cigna Medicare Advantage	$745.25
Rate for Payer: Clover Medicare Advantage	$707.99
Rate for Payer: EmblemHealth Commercial	$2,235.75
Rate for Payer: Humana Medicare Advantage	$767.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$745.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.21
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$544.61
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$87.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$745.25
Rate for Payer: Wellcare Medicare Advantage	$745.25
Rate for Payer: Wellpoint Medicaid Managed Care	$96.21

UNLISTED PX LUNG/PLEURA

Facility

$3,630.70

Service Code	HCPCS 32999
Hospital Charge Code	321032999
Hospital Revenue Code	361
Min. Negotiated Rate	$544.61
Max. Negotiated Rate	$544.61
Rate for Payer: Qualcare PPO/HMO/WC	$544.61

UNLISTED PX LUNG/PLEURA

Facility

$2,883.20

Service Code	HCPCS 32999
Hospital Charge Code	7411389
Hospital Revenue Code	361
Min. Negotiated Rate	$432.48
Max. Negotiated Rate	$432.48
Rate for Payer: Qualcare PPO/HMO/WC	$432.48

UNLISTED PX LUNG/PLEURA

Facility

$2,883.20

Service Code	HCPCS 32999
Hospital Charge Code	7411389
Hospital Revenue Code	361
Min. Negotiated Rate	$69.49
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,027.08
Rate for Payer: Aetna Medicare Advantage	$2,414.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$745.25
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	$2,690.13
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: Cigna Medicare Advantage	$745.25
Rate for Payer: Clover Medicare Advantage	$707.99
Rate for Payer: EmblemHealth Commercial	$2,235.75
Rate for Payer: Humana Medicare Advantage	$767.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$745.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$864.96
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$432.48
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$69.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$745.25
Rate for Payer: Wellcare Medicare Advantage	$745.25
Rate for Payer: Wellpoint Medicaid Managed Care	$76.40

UNLISTED PX, SMALL INTESTINE

Facility

$11,542.70

Service Code	HCPCS 44799
Hospital Charge Code	1600000469
Hospital Revenue Code	360
Min. Negotiated Rate	$278.18
Max. Negotiated Rate	$5,311.00
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
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	$3,889.52
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,462.81
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,731.40
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$278.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$305.88

UNLISTED PX, SMALL INTESTINE

Facility

$11,542.70

Service Code	HCPCS 44799
Hospital Charge Code	1600000469
Hospital Revenue Code	360
Min. Negotiated Rate	$1,731.40
Max. Negotiated Rate	$1,731.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,731.40

UNLISTED SURG PATHOLOGY PROCD

Facility

$66.00

Service Code	HCPCS 88399
Hospital Charge Code	38477060
Hospital Revenue Code	312
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

UNLISTED SURG PATHOLOGY PROCD

Facility

$66.00

Service Code	HCPCS 88399
Hospital Charge Code	38477060
Hospital Revenue Code	312
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$223.48
Rate for Payer: Aetna Commercial	$168.40
Rate for Payer: Aetna Medicare Advantage	$200.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$61.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.48
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$61.91
Rate for Payer: Clover Medicare Advantage	$58.81
Rate for Payer: EmblemHealth Commercial	$185.73
Rate for Payer: Humana Medicare Advantage	$63.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$61.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$1.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$61.91
Rate for Payer: Wellcare Medicare Advantage	$61.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.75

UNLSTD LAPAROSCOPY HERNIA PROC

Facility

$17,954.72

Service Code	HCPCS 49659
Hospital Charge Code	16000166
Hospital Revenue Code	360
Min. Negotiated Rate	$432.71
Max. Negotiated Rate	$25,925.77
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$25,925.77
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,386.42
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,693.21
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$432.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$475.80

UNLSTD LAPAROSCOPY HERNIA PROC

Facility

$17,954.72

Service Code	HCPCS 49659
Hospital Charge Code	16000166
Hospital Revenue Code	360
Min. Negotiated Rate	$2,693.21
Max. Negotiated Rate	$2,693.21
Rate for Payer: Qualcare PPO/HMO/WC	$2,693.21

UNLSTD MUSCULOSKELTL SYSTEM OP

Facility

$11,149.60

Service Code	HCPCS 20999
Hospital Charge Code	16000322
Hospital Revenue Code	360
Min. Negotiated Rate	$1,672.44
Max. Negotiated Rate	$1,672.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,672.44

UNLSTD MUSCULOSKELTL SYSTEM OP

Facility

$11,149.60

Service Code	HCPCS 20999
Hospital Charge Code	16000322
Hospital Revenue Code	360
Min. Negotiated Rate	$268.71
Max. Negotiated Rate	$3,344.88
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	$1,626.00
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	$3,344.88
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,672.44
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$268.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$293.05
Rate for Payer: Wellcare Medicare Advantage	$293.05
Rate for Payer: Wellpoint Medicaid Managed Care	$295.46

UNLSTD PROC DENTOALVEOLAR STRT

Facility

$8,124.18

Service Code	HCPCS 41899
Hospital Charge Code	16000741
Hospital Revenue Code	360
Min. Negotiated Rate	$1,218.63
Max. Negotiated Rate	$1,218.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.63

UNLSTD PROC DENTOALVEOLAR STRT

Facility

$8,124.18

Service Code	HCPCS 41899
Hospital Charge Code	16000741
Hospital Revenue Code	360
Min. Negotiated Rate	$195.79
Max. Negotiated Rate	$2,437.25
Rate for Payer: Aetna Commercial	$765.35
Rate for Payer: Aetna Medicare Advantage	$911.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,015.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,015.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$281.38
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	$1,015.70
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: Cigna Medicare Advantage	$281.38
Rate for Payer: Clover Medicare Advantage	$267.31
Rate for Payer: EmblemHealth Commercial	$844.14
Rate for Payer: Humana Medicare Advantage	$289.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$281.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,437.25
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.63
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$195.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$281.38
Rate for Payer: Wellcare Medicare Advantage	$281.38
Rate for Payer: Wellpoint Medicaid Managed Care	$215.29

UNLSTD PROCD PHARYNX ADENOIDS

Facility

$1,129.88

Service Code	HCPCS 42999
Hospital Charge Code	16000585
Hospital Revenue Code	360
Min. Negotiated Rate	$169.48
Max. Negotiated Rate	$169.48
Rate for Payer: Qualcare PPO/HMO/WC	$169.48

UNLSTD PROCD PHARYNX ADENOIDS

Facility

$1,129.88

Service Code	HCPCS 42999
Hospital Charge Code	16000585
Hospital Revenue Code	360
Min. Negotiated Rate	$27.23
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$765.35
Rate for Payer: Aetna Medicare Advantage	$911.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,015.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,015.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$281.38
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	$1,015.70
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: Cigna Medicare Advantage	$281.38
Rate for Payer: Clover Medicare Advantage	$267.31
Rate for Payer: EmblemHealth Commercial	$844.14
Rate for Payer: Humana Medicare Advantage	$289.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$281.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$338.96
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$169.48
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$27.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$281.38
Rate for Payer: Wellcare Medicare Advantage	$281.38
Rate for Payer: Wellpoint Medicaid Managed Care	$29.94

UNLSTD PROCEDRE PELVIS/HIP JNT

Facility

$19,503.55

Service Code	HCPCS 27299
Hospital Charge Code	16000876
Hospital Revenue Code	360
Min. Negotiated Rate	$2,925.53
Max. Negotiated Rate	$2,925.53
Rate for Payer: Qualcare PPO/HMO/WC	$2,925.53

UNLSTD PROCEDRE PELVIS/HIP JNT

Facility

$19,503.55

Service Code	HCPCS 27299
Hospital Charge Code	16000876
Hospital Revenue Code	360
Min. Negotiated Rate	$278.40
Max. Negotiated Rate	$5,851.06
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	$1,626.00
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	$5,851.06
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,925.53
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$470.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$293.05
Rate for Payer: Wellcare Medicare Advantage	$293.05
Rate for Payer: Wellpoint Medicaid Managed Care	$516.84

UNLSTD PROCEDURE FOREARM /WST

Facility

$859.60

Service Code	HCPCS 25999
Hospital Charge Code	16000698
Hospital Revenue Code	360
Min. Negotiated Rate	$20.72
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	$1,626.00
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	$257.88
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$128.94
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$20.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$293.05
Rate for Payer: Wellcare Medicare Advantage	$293.05
Rate for Payer: Wellpoint Medicaid Managed Care	$22.78

UNLSTD PROCEDURE FOREARM /WST

Facility

$859.60

Service Code	HCPCS 25999
Hospital Charge Code	16000698
Hospital Revenue Code	360
Min. Negotiated Rate	$128.94
Max. Negotiated Rate	$128.94
Rate for Payer: Qualcare PPO/HMO/WC	$128.94

UNLSTD PROCEDURE HANDS /FINGER

Facility

$1,007.96

Service Code	HCPCS 26989
Hospital Charge Code	16000363
Hospital Revenue Code	360
Min. Negotiated Rate	$151.19
Max. Negotiated Rate	$151.19
Rate for Payer: Qualcare PPO/HMO/WC	$151.19

UNLSTD PROCEDURE HANDS /FINGER

Facility

$1,007.96

Service Code	HCPCS 26989
Hospital Charge Code	16000363
Hospital Revenue Code	360
Min. Negotiated Rate	$24.29
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	$1,626.00
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	$302.39
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$151.19
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$24.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$293.05
Rate for Payer: Wellcare Medicare Advantage	$293.05
Rate for Payer: Wellpoint Medicaid Managed Care	$26.71

UNLSTD PROCEDURE LEG OR ANKLE

Facility

$859.60

Service Code	HCPCS 27899
Hospital Charge Code	16000415
Hospital Revenue Code	360
Min. Negotiated Rate	$128.94
Max. Negotiated Rate	$128.94
Rate for Payer: Qualcare PPO/HMO/WC	$128.94

Know your out-of-pocket cost for care.

All Charges