Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BONE GRAFT SUB PRO OSTEN 2RG15

Facility

$5,232.85

Hospital Charge Code	270632401
Hospital Revenue Code	272
Min. Negotiated Rate	$784.93
Max. Negotiated Rate	$784.93
Rate for Payer: Qualcare PPO/HMO/WC	$784.93

BONE GRFT,MAJ/LG

Facility

$30,595.00

Service Code	HCPCS 20902
Hospital Charge Code	16000795
Hospital Revenue Code	360
Min. Negotiated Rate	$4,589.25
Max. Negotiated Rate	$4,589.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25

BONE GRFT,MAJ/LG

Facility

$30,595.00

Service Code	HCPCS 20902
Hospital Charge Code	16000795
Hospital Revenue Code	360
Min. Negotiated Rate	$737.34
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	$9,178.50
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$737.34
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	$810.77

BONE GRFT,MINOR/SM

Facility

$30,595.00

Service Code	HCPCS 20900
Hospital Charge Code	16000336
Hospital Revenue Code	360
Min. Negotiated Rate	$4,589.25
Max. Negotiated Rate	$4,589.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25

BONE GRFT,MINOR/SM

Facility

$30,595.00

Service Code	HCPCS 20900
Hospital Charge Code	16000336
Hospital Revenue Code	360
Min. Negotiated Rate	$737.34
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	$9,178.50
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$737.34
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	$810.77

BONE GUIDE GLENOID LT

Facility

$5,700.00

Service Code	HCPCS A4649
Hospital Charge Code	270699507
Hospital Revenue Code	272
Min. Negotiated Rate	$855.00
Max. Negotiated Rate	$855.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00

BONE GUIDE GLENOID LT

Facility

$5,700.00

Service Code	HCPCS A4649
Hospital Charge Code	270699507
Hospital Revenue Code	272
Min. Negotiated Rate	$137.37
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$2,166.00
Rate for Payer: Aetna Medicare Advantage	$1,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.50
Rate for Payer: Cigna Commercial	$2,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,710.00
Rate for Payer: Oxford Commercial	$1,140.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00
Rate for Payer: UnitedHealthcare Commercial	$1,140.00
Rate for Payer: UnitedHealthcare Community & State	$137.37
Rate for Payer: Wellpoint Medicaid Managed Care	$151.05

BONE GUIDE MINI LT REV SHLDR

Facility

$5,700.00

Service Code	HCPCS A4649
Hospital Charge Code	270693854
Hospital Revenue Code	272
Min. Negotiated Rate	$137.37
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$2,166.00
Rate for Payer: Aetna Medicare Advantage	$1,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.50
Rate for Payer: Cigna Commercial	$2,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,710.00
Rate for Payer: Oxford Commercial	$1,140.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00
Rate for Payer: UnitedHealthcare Commercial	$1,140.00
Rate for Payer: UnitedHealthcare Community & State	$137.37
Rate for Payer: Wellpoint Medicaid Managed Care	$151.05

BONE GUIDE MINI LT REV SHLDR

Facility

$5,700.00

Service Code	HCPCS A4649
Hospital Charge Code	270693854
Hospital Revenue Code	272
Min. Negotiated Rate	$855.00
Max. Negotiated Rate	$855.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00

BONE HOLDING FORCEP

Facility

$500.60

Hospital Charge Code	270655154
Hospital Revenue Code	272
Min. Negotiated Rate	$75.09
Max. Negotiated Rate	$75.09
Rate for Payer: Qualcare PPO/HMO/WC	$75.09

BONE HOLDING FORCEP

Facility

$500.60

Hospital Charge Code	270655154
Hospital Revenue Code	272
Min. Negotiated Rate	$12.06
Max. Negotiated Rate	$250.30
Rate for Payer: Aetna Commercial	$190.23
Rate for Payer: Aetna Medicare Advantage	$150.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.65
Rate for Payer: Cigna Commercial	$250.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.18
Rate for Payer: Oxford Commercial	$100.12
Rate for Payer: Qualcare PPO/HMO/WC	$75.09
Rate for Payer: UnitedHealthcare Commercial	$100.12
Rate for Payer: UnitedHealthcare Community & State	$12.06
Rate for Payer: Wellpoint Medicaid Managed Care	$13.27

BONE IMAGING LMTD AREA

Facility

$741.24

Service Code	HCPCS 78300
Hospital Charge Code	406078300
Hospital Revenue Code	341
Min. Negotiated Rate	$111.19
Max. Negotiated Rate	$111.19
Rate for Payer: Qualcare PPO/HMO/WC	$111.19

BONE IMAGING LMTD AREA

Facility

$741.24

Service Code	HCPCS 78300
Hospital Charge Code	406078300
Hospital Revenue Code	341
Min. Negotiated Rate	$17.86
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$1,291.84
Rate for Payer: Aetna Medicare Advantage	$1,538.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$474.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,714.39
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: Cigna Medicare Advantage	$332.46
Rate for Payer: Clover Medicare Advantage	$451.19
Rate for Payer: EmblemHealth Commercial	$1,424.82
Rate for Payer: Humana Medicare Advantage	$489.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$474.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.37
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$111.19
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$17.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$474.94
Rate for Payer: Wellcare Medicare Advantage	$474.94
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$185.13
Rate for Payer: Wellpoint Medicaid Managed Care	$19.64

BONE IMAGING MULT AREAS

Facility

$1,840.40

Service Code	HCPCS 78305
Hospital Charge Code	406078305
Hospital Revenue Code	341
Min. Negotiated Rate	$276.06
Max. Negotiated Rate	$276.06
Rate for Payer: Qualcare PPO/HMO/WC	$276.06

BONE IMAGING MULT AREAS

Facility

$1,840.40

Service Code	HCPCS 78305
Hospital Charge Code	406078305
Hospital Revenue Code	341
Min. Negotiated Rate	$44.35
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$1,291.84
Rate for Payer: Aetna Medicare Advantage	$1,538.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$474.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,714.39
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: Cigna Medicare Advantage	$332.46
Rate for Payer: Clover Medicare Advantage	$451.19
Rate for Payer: EmblemHealth Commercial	$1,424.82
Rate for Payer: Humana Medicare Advantage	$489.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$474.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.12
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$276.06
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$44.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$474.94
Rate for Payer: Wellcare Medicare Advantage	$474.94
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,205.13
Rate for Payer: Wellpoint Medicaid Managed Care	$48.77

BONE LENGTH STUDY

Facility

$5,100.00

Service Code	HCPCS 77073
Hospital Charge Code	94061195
Hospital Revenue Code	320
Min. Negotiated Rate	$25.09
Max. Negotiated Rate	$1,975.00
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	$25.09
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	$86.94
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	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$216.59
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

BONE LENGTH STUDY

Facility

$5,100.00

Service Code	HCPCS 77073
Hospital Charge Code	94061195
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

BONE MARROW ******

Facility

$313.00

Hospital Charge Code	8002222
Hospital Revenue Code	279
Min. Negotiated Rate	$46.95
Max. Negotiated Rate	$46.95
Rate for Payer: Qualcare PPO/HMO/WC	$46.95

BONE MARROW ******

Facility

$313.00

Hospital Charge Code	8002222
Hospital Revenue Code	279
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$156.50
Rate for Payer: Aetna Commercial	$118.94
Rate for Payer: Aetna Medicare Advantage	$93.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.81
Rate for Payer: Cigna Commercial	$156.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.90
Rate for Payer: Oxford Commercial	$62.60
Rate for Payer: Qualcare PPO/HMO/WC	$46.95
Rate for Payer: UnitedHealthcare Commercial	$62.60
Rate for Payer: UnitedHealthcare Community & State	$7.54
Rate for Payer: Wellpoint Medicaid Managed Care	$8.29

BONE MARROW ASPIRATE CONCENTRA

Facility

$4,900.00

Hospital Charge Code	270665576
Hospital Revenue Code	270
Min. Negotiated Rate	$735.00
Max. Negotiated Rate	$735.00
Rate for Payer: Qualcare PPO/HMO/WC	$735.00

BONE MARROW ASPIRATE CONCENTRA

Facility

$4,900.00

Hospital Charge Code	270665576
Hospital Revenue Code	270
Min. Negotiated Rate	$118.09
Max. Negotiated Rate	$2,450.00
Rate for Payer: Aetna Commercial	$1,862.00
Rate for Payer: Aetna Medicare Advantage	$1,470.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,249.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,249.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,249.50
Rate for Payer: Cigna Commercial	$2,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,470.00
Rate for Payer: Oxford Commercial	$980.00
Rate for Payer: Qualcare PPO/HMO/WC	$735.00
Rate for Payer: UnitedHealthcare Commercial	$980.00
Rate for Payer: UnitedHealthcare Community & State	$118.09
Rate for Payer: Wellpoint Medicaid Managed Care	$129.85

BONE MARROW ASPIRATE KIT

Facility

$11,475.00

Hospital Charge Code	270671802
Hospital Revenue Code	272
Min. Negotiated Rate	$276.55
Max. Negotiated Rate	$5,737.50
Rate for Payer: Aetna Commercial	$4,360.50
Rate for Payer: Aetna Medicare Advantage	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,926.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,926.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,926.12
Rate for Payer: Cigna Commercial	$5,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.50
Rate for Payer: Oxford Commercial	$2,295.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,721.25
Rate for Payer: UnitedHealthcare Commercial	$2,295.00
Rate for Payer: UnitedHealthcare Community & State	$276.55
Rate for Payer: Wellpoint Medicaid Managed Care	$304.09

BONE MARROW ASPIRATE KIT

Facility

$11,475.00

Hospital Charge Code	270671802
Hospital Revenue Code	272
Min. Negotiated Rate	$1,721.25
Max. Negotiated Rate	$1,721.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,721.25

BONE MARROW ASPIRATION

Facility

$1,457.45

Service Code	HCPCS 38220
Hospital Charge Code	93500143
Hospital Revenue Code	761
Min. Negotiated Rate	$35.12
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$348.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$437.24
Rate for Payer: Oxford Commercial	$291.49
Rate for Payer: Qualcare PPO/HMO/WC	$218.62
Rate for Payer: UnitedHealthcare Commercial	$291.49
Rate for Payer: UnitedHealthcare Community & State	$35.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$38.62

BONE MARROW ASPIRATION

Facility

$1,457.45

Service Code	HCPCS 38220
Hospital Charge Code	93500143
Hospital Revenue Code	761
Min. Negotiated Rate	$218.62
Max. Negotiated Rate	$218.62
Rate for Payer: Qualcare PPO/HMO/WC	$218.62

Know your out-of-pocket cost for care.

All Charges