Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

WC TRIM NAILS

Facility

$170.00

Service Code	HCPCS 11719
Hospital Charge Code	9800040
Hospital Revenue Code	510
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$252.97
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.97
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Community & State	$4.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$4.50

WC TRIM NAILS

Facility

$170.00

Service Code	HCPCS 11719
Hospital Charge Code	9800040
Hospital Revenue Code	510
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

WC UNNA BOOT

Facility

$348.75

Service Code	HCPCS 29580
Hospital Charge Code	9800170
Hospital Revenue Code	510
Min. Negotiated Rate	$52.31
Max. Negotiated Rate	$52.31
Rate for Payer: Qualcare PPO/HMO/WC	$52.31

WC UNNA BOOT

Facility

$348.75

Service Code	HCPCS 29580
Hospital Charge Code	9800170
Hospital Revenue Code	510
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$696.85
Rate for Payer: Aetna Commercial	$525.10
Rate for Payer: Aetna Medicare Advantage	$625.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$696.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$696.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$193.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$696.85
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: Cigna Medicare Advantage	$193.05
Rate for Payer: Clover Medicare Advantage	$183.40
Rate for Payer: EmblemHealth Commercial	$579.15
Rate for Payer: Humana Medicare Advantage	$198.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$193.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.62
Rate for Payer: Qualcare PPO/HMO/WC	$52.31
Rate for Payer: UnitedHealthcare Community & State	$8.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$193.05
Rate for Payer: Wellcare Medicare Advantage	$193.05
Rate for Payer: Wellpoint Medicaid Managed Care	$9.24

WC UNNA BOOT LEFT

Facility

$348.75

Service Code	HCPCS 29580LT
Hospital Charge Code	9800172
Hospital Revenue Code	510
Min. Negotiated Rate	$52.31
Max. Negotiated Rate	$52.31
Rate for Payer: Qualcare PPO/HMO/WC	$52.31

WC UNNA BOOT LEFT

Facility

$348.75

Service Code	HCPCS 29580LT
Hospital Charge Code	9800172
Hospital Revenue Code	510
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$174.38
Rate for Payer: Aetna Commercial	$132.53
Rate for Payer: Aetna Medicare Advantage	$104.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.93
Rate for Payer: Cigna Commercial	$174.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.62
Rate for Payer: Qualcare PPO/HMO/WC	$52.31
Rate for Payer: UnitedHealthcare Community & State	$8.40
Rate for Payer: Wellpoint Medicaid Managed Care	$9.24

WC UNNA BOOT RIGHT

Facility

$348.75

Service Code	HCPCS 29580RT
Hospital Charge Code	9800171
Hospital Revenue Code	510
Min. Negotiated Rate	$52.31
Max. Negotiated Rate	$52.31
Rate for Payer: Qualcare PPO/HMO/WC	$52.31

WC UNNA BOOT RIGHT

Facility

$348.75

Service Code	HCPCS 29580RT
Hospital Charge Code	9800171
Hospital Revenue Code	510
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$174.38
Rate for Payer: Aetna Commercial	$132.53
Rate for Payer: Aetna Medicare Advantage	$104.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.93
Rate for Payer: Cigna Commercial	$174.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.62
Rate for Payer: Qualcare PPO/HMO/WC	$52.31
Rate for Payer: UnitedHealthcare Community & State	$8.40
Rate for Payer: Wellpoint Medicaid Managed Care	$9.24

WC UNNA FLEX 4X10

Facility

$458.00

Service Code	HCPCS A6456
Hospital Charge Code	9808195
Hospital Revenue Code	272
Min. Negotiated Rate	$68.70
Max. Negotiated Rate	$68.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.70

WC UNNA FLEX 4X10

Facility

$458.00

Service Code	HCPCS A6456
Hospital Charge Code	9808195
Hospital Revenue Code	272
Min. Negotiated Rate	$11.04
Max. Negotiated Rate	$229.00
Rate for Payer: Aetna Commercial	$174.04
Rate for Payer: Aetna Medicare Advantage	$137.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.79
Rate for Payer: Cigna Commercial	$229.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.40
Rate for Payer: Oxford Commercial	$91.60
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Commercial	$91.60
Rate for Payer: UnitedHealthcare Community & State	$11.04
Rate for Payer: Wellpoint Medicaid Managed Care	$12.14

WC US,PREGNT UTERUS,LIMITED

Facility

$6,700.00

Service Code	HCPCS 76815
Hospital Charge Code	83652271
Hospital Revenue Code	402
Min. Negotiated Rate	$67.76
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$161.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$177.55

WC US,PREGNT UTERUS,LIMITED

Facility

$6,700.00

Service Code	HCPCS 76815
Hospital Charge Code	83652271
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

WC WEDGE EXCISION NAIL

Facility

$545.00

Service Code	HCPCS 11765
Hospital Charge Code	9800072
Hospital Revenue Code	361
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$81.75
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

WC WEDGE EXCISION NAIL

Facility

$545.00

Service Code	HCPCS 11765
Hospital Charge Code	9800072
Hospital Revenue Code	361
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
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	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.50
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$81.75
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$13.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$14.44

WD REPAIR EXCL FEET/HNDS<2.5CM

Facility

$1,293.00

Service Code	HCPCS 12031
Hospital Charge Code	83652071
Hospital Revenue Code	761
Min. Negotiated Rate	$31.16
Max. Negotiated Rate	$1,743.30
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.90
Rate for Payer: Oxford Commercial	$258.60
Rate for Payer: Qualcare PPO/HMO/WC	$193.95
Rate for Payer: UnitedHealthcare Commercial	$258.60
Rate for Payer: UnitedHealthcare Community & State	$31.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$34.26

WD REPAIR EXCL FEET/HNDS<2.5CM

Facility

$1,293.00

Service Code	HCPCS 12031
Hospital Charge Code	87502505
Hospital Revenue Code	761
Min. Negotiated Rate	$193.95
Max. Negotiated Rate	$193.95
Rate for Payer: Qualcare PPO/HMO/WC	$193.95

WD REPAIR EXCL FEET/HNDS<2.5CM

Facility

$1,293.00

Service Code	HCPCS 12031
Hospital Charge Code	87502505
Hospital Revenue Code	761
Min. Negotiated Rate	$31.16
Max. Negotiated Rate	$1,743.30
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.90
Rate for Payer: Oxford Commercial	$258.60
Rate for Payer: Qualcare PPO/HMO/WC	$193.95
Rate for Payer: UnitedHealthcare Commercial	$258.60
Rate for Payer: UnitedHealthcare Community & State	$31.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$34.26

WD REPAIR EXCL FEET/HNDS<2.5CM

Facility

$1,293.00

Service Code	HCPCS 12031
Hospital Charge Code	83652071
Hospital Revenue Code	761
Min. Negotiated Rate	$193.95
Max. Negotiated Rate	$193.95
Rate for Payer: Qualcare PPO/HMO/WC	$193.95

WEANING PARAMETERS

Facility

$6,100.00

Service Code	HCPCS 94150
Hospital Charge Code	9500050
Hospital Revenue Code	460
Min. Negotiated Rate	$915.00
Max. Negotiated Rate	$915.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00

WEANING PARAMETERS

Facility

$6,100.00

Service Code	HCPCS 94150
Hospital Charge Code	9500050
Hospital Revenue Code	460
Min. Negotiated Rate	$125.84
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$415.81
Rate for Payer: Aetna Medicare Advantage	$495.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$551.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$551.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$152.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$551.81
Rate for Payer: Cigna Commercial	$306.43
Rate for Payer: Cigna Medicare Advantage	$152.87
Rate for Payer: Clover Medicare Advantage	$145.23
Rate for Payer: EmblemHealth Commercial	$458.61
Rate for Payer: Humana Medicare Advantage	$157.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$152.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,830.00
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$147.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$152.87
Rate for Payer: Wellcare Medicare Advantage	$152.87
Rate for Payer: Wellpoint Medicaid Managed Care	$161.65

WEDGE 2 0X 20 X 8

Facility

$10,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270687065
Hospital Revenue Code	278
Min. Negotiated Rate	$264.50
Max. Negotiated Rate	$5,487.50
Rate for Payer: Aetna Commercial	$4,170.50
Rate for Payer: Aetna Medicare Advantage	$3,292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,798.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,798.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,798.62
Rate for Payer: Cigna Commercial	$5,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,655.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,414.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,646.25
Rate for Payer: UnitedHealthcare Community & State	$264.50
Rate for Payer: Wellpoint Medicaid Managed Care	$290.84

WEDGE 2 0X 20 X 8

Facility

$10,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270687065
Hospital Revenue Code	278
Min. Negotiated Rate	$1,646.25
Max. Negotiated Rate	$2,655.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,655.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,414.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,646.25

WEDGE 3.1X13

Facility

$2,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270705977
Hospital Revenue Code	278
Min. Negotiated Rate	$311.25
Max. Negotiated Rate	$502.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$415.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$502.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$456.50
Rate for Payer: Qualcare PPO/HMO/WC	$311.25

WEDGE 3.1X13

Facility

$2,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270705977
Hospital Revenue Code	278
Min. Negotiated Rate	$50.01
Max. Negotiated Rate	$1,037.50
Rate for Payer: Aetna Commercial	$788.50
Rate for Payer: Aetna Medicare Advantage	$622.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$529.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$529.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$415.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$529.12
Rate for Payer: Cigna Commercial	$1,037.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$502.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$456.50
Rate for Payer: Qualcare PPO/HMO/WC	$311.25
Rate for Payer: UnitedHealthcare Community & State	$50.01
Rate for Payer: Wellpoint Medicaid Managed Care	$54.99

WEDGE ALLOGRAFT LAPIDUS 5MM 5D

Facility

$14,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270699356
Hospital Revenue Code	278
Min. Negotiated Rate	$2,212.50
Max. Negotiated Rate	$3,569.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,569.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,245.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,212.50

Know your out-of-pocket cost for care.

All Charges