Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BRACE AIR STIRRUP ******

Facility

$158.00

Hospital Charge Code	8003063
Hospital Revenue Code	279
Min. Negotiated Rate	$23.70
Max. Negotiated Rate	$23.70
Rate for Payer: Qualcare PPO/HMO/WC	$23.70

BRACE ANKLE *********

Facility

$110.00

Hospital Charge Code	8003311
Hospital Revenue Code	279
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

BRACE ANKLE *********

Facility

$110.00

Hospital Charge Code	8003311
Hospital Revenue Code	279
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.00
Rate for Payer: Oxford Commercial	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$22.00
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

BRACE ANKLE LEFT PEDIATRIC

Facility

$97.50

Hospital Charge Code	270667755
Hospital Revenue Code	270
Min. Negotiated Rate	$14.62
Max. Negotiated Rate	$14.62
Rate for Payer: Qualcare PPO/HMO/WC	$14.62

BRACE ANKLE LEFT PEDIATRIC

Facility

$97.50

Hospital Charge Code	270667755
Hospital Revenue Code	270
Min. Negotiated Rate	$2.35
Max. Negotiated Rate	$48.75
Rate for Payer: Aetna Commercial	$37.05
Rate for Payer: Aetna Medicare Advantage	$29.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.86
Rate for Payer: Cigna Commercial	$48.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.25
Rate for Payer: Oxford Commercial	$19.50
Rate for Payer: Qualcare PPO/HMO/WC	$14.62
Rate for Payer: UnitedHealthcare Commercial	$19.50
Rate for Payer: UnitedHealthcare Community & State	$2.35
Rate for Payer: Wellpoint Medicaid Managed Care	$2.58

BRACE ANKLE LEFT SMALL

Facility

$119.50

Hospital Charge Code	270653991
Hospital Revenue Code	272
Min. Negotiated Rate	$17.93
Max. Negotiated Rate	$17.93
Rate for Payer: Qualcare PPO/HMO/WC	$17.93

BRACE ANKLE LEFT SMALL

Facility

$119.50

Hospital Charge Code	270653991
Hospital Revenue Code	272
Min. Negotiated Rate	$2.88
Max. Negotiated Rate	$59.75
Rate for Payer: Aetna Commercial	$45.41
Rate for Payer: Aetna Medicare Advantage	$35.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.47
Rate for Payer: Cigna Commercial	$59.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.85
Rate for Payer: Oxford Commercial	$23.90
Rate for Payer: Qualcare PPO/HMO/WC	$17.93
Rate for Payer: UnitedHealthcare Commercial	$23.90
Rate for Payer: UnitedHealthcare Community & State	$2.88
Rate for Payer: Wellpoint Medicaid Managed Care	$3.17

BRACE ANKLE LEFT STD

Facility

$274.45

Hospital Charge Code	270600737
Hospital Revenue Code	270
Min. Negotiated Rate	$41.17
Max. Negotiated Rate	$41.17
Rate for Payer: Qualcare PPO/HMO/WC	$41.17

BRACE ANKLE LEFT STD

Facility

$274.45

Hospital Charge Code	270600737
Hospital Revenue Code	270
Min. Negotiated Rate	$6.61
Max. Negotiated Rate	$137.22
Rate for Payer: Aetna Commercial	$104.29
Rate for Payer: Aetna Medicare Advantage	$82.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.98
Rate for Payer: Cigna Commercial	$137.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.33
Rate for Payer: Oxford Commercial	$54.89
Rate for Payer: Qualcare PPO/HMO/WC	$41.17
Rate for Payer: UnitedHealthcare Commercial	$54.89
Rate for Payer: UnitedHealthcare Community & State	$6.61
Rate for Payer: Wellpoint Medicaid Managed Care	$7.27

BRACE ANKLE LG LEFT AIR STIRRP

Facility

$109.95

Hospital Charge Code	270651659
Hospital Revenue Code	270
Min. Negotiated Rate	$16.49
Max. Negotiated Rate	$16.49
Rate for Payer: Qualcare PPO/HMO/WC	$16.49

BRACE ANKLE LG LEFT AIR STIRRP

Facility

$109.95

Hospital Charge Code	270651659
Hospital Revenue Code	270
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$54.98
Rate for Payer: Aetna Commercial	$41.78
Rate for Payer: Aetna Medicare Advantage	$32.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.04
Rate for Payer: Cigna Commercial	$54.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.98
Rate for Payer: Oxford Commercial	$21.99
Rate for Payer: Qualcare PPO/HMO/WC	$16.49
Rate for Payer: UnitedHealthcare Commercial	$21.99
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.91

BRACE ANKLE LG RIGHT AIR STRIP

Facility

$109.95

Hospital Charge Code	270651660
Hospital Revenue Code	270
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$54.98
Rate for Payer: Aetna Commercial	$41.78
Rate for Payer: Aetna Medicare Advantage	$32.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.04
Rate for Payer: Cigna Commercial	$54.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.98
Rate for Payer: Oxford Commercial	$21.99
Rate for Payer: Qualcare PPO/HMO/WC	$16.49
Rate for Payer: UnitedHealthcare Commercial	$21.99
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.91

BRACE ANKLE LG RIGHT AIR STRIP

Facility

$109.95

Hospital Charge Code	270651660
Hospital Revenue Code	270
Min. Negotiated Rate	$16.49
Max. Negotiated Rate	$16.49
Rate for Payer: Qualcare PPO/HMO/WC	$16.49

BRACE ANKLE MED LEFT AIR STRIP

Facility

$107.20

Hospital Charge Code	270651661
Hospital Revenue Code	270
Min. Negotiated Rate	$16.08
Max. Negotiated Rate	$16.08
Rate for Payer: Qualcare PPO/HMO/WC	$16.08

BRACE ANKLE MED LEFT AIR STRIP

Facility

$107.20

Hospital Charge Code	270651661
Hospital Revenue Code	270
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$53.60
Rate for Payer: Aetna Commercial	$40.74
Rate for Payer: Aetna Medicare Advantage	$32.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.34
Rate for Payer: Cigna Commercial	$53.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.16
Rate for Payer: Oxford Commercial	$21.44
Rate for Payer: Qualcare PPO/HMO/WC	$16.08
Rate for Payer: UnitedHealthcare Commercial	$21.44
Rate for Payer: UnitedHealthcare Community & State	$2.58
Rate for Payer: Wellpoint Medicaid Managed Care	$2.84

BRACE ANKLE MED RIGHT AIR

Facility

$107.20

Hospital Charge Code	270653965
Hospital Revenue Code	272
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$53.60
Rate for Payer: Aetna Commercial	$40.74
Rate for Payer: Aetna Medicare Advantage	$32.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.34
Rate for Payer: Cigna Commercial	$53.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.16
Rate for Payer: Oxford Commercial	$21.44
Rate for Payer: Qualcare PPO/HMO/WC	$16.08
Rate for Payer: UnitedHealthcare Commercial	$21.44
Rate for Payer: UnitedHealthcare Community & State	$2.58
Rate for Payer: Wellpoint Medicaid Managed Care	$2.84

BRACE ANKLE MED RIGHT AIR

Facility

$107.20

Hospital Charge Code	270653965
Hospital Revenue Code	272
Min. Negotiated Rate	$16.08
Max. Negotiated Rate	$16.08
Rate for Payer: Qualcare PPO/HMO/WC	$16.08

BRACE ANKLE RIGHT STD

Facility

$274.45

Hospital Charge Code	270600747
Hospital Revenue Code	270
Min. Negotiated Rate	$41.17
Max. Negotiated Rate	$41.17
Rate for Payer: Qualcare PPO/HMO/WC	$41.17

BRACE ANKLE RIGHT STD

Facility

$274.45

Hospital Charge Code	270600747
Hospital Revenue Code	270
Min. Negotiated Rate	$6.61
Max. Negotiated Rate	$137.22
Rate for Payer: Aetna Commercial	$104.29
Rate for Payer: Aetna Medicare Advantage	$82.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.98
Rate for Payer: Cigna Commercial	$137.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.33
Rate for Payer: Oxford Commercial	$54.89
Rate for Payer: Qualcare PPO/HMO/WC	$41.17
Rate for Payer: UnitedHealthcare Commercial	$54.89
Rate for Payer: UnitedHealthcare Community & State	$6.61
Rate for Payer: Wellpoint Medicaid Managed Care	$7.27

BRACE ANKLE RIGHT W/ WRAP SM 1

Facility

$101.70

Hospital Charge Code	270664515
Hospital Revenue Code	270
Min. Negotiated Rate	$15.26
Max. Negotiated Rate	$15.26
Rate for Payer: Qualcare PPO/HMO/WC	$15.26

BRACE ANKLE RIGHT W/ WRAP SM 1

Facility

$101.70

Hospital Charge Code	270664515
Hospital Revenue Code	270
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$50.85
Rate for Payer: Aetna Commercial	$38.65
Rate for Payer: Aetna Medicare Advantage	$30.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.93
Rate for Payer: Cigna Commercial	$50.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.51
Rate for Payer: Oxford Commercial	$20.34
Rate for Payer: Qualcare PPO/HMO/WC	$15.26
Rate for Payer: UnitedHealthcare Commercial	$20.34
Rate for Payer: UnitedHealthcare Community & State	$2.45
Rate for Payer: Wellpoint Medicaid Managed Care	$2.70

BRACE ANKLE RIGHT W/ WRAP SM 8

Facility

$101.70

Hospital Charge Code	270664500
Hospital Revenue Code	270
Min. Negotiated Rate	$15.26
Max. Negotiated Rate	$15.26
Rate for Payer: Qualcare PPO/HMO/WC	$15.26

BRACE ANKLE RIGHT W/ WRAP SM 8

Facility

$101.70

Hospital Charge Code	270664500
Hospital Revenue Code	270
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$50.85
Rate for Payer: Aetna Commercial	$38.65
Rate for Payer: Aetna Medicare Advantage	$30.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.93
Rate for Payer: Cigna Commercial	$50.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.51
Rate for Payer: Oxford Commercial	$20.34
Rate for Payer: Qualcare PPO/HMO/WC	$15.26
Rate for Payer: UnitedHealthcare Commercial	$20.34
Rate for Payer: UnitedHealthcare Community & State	$2.45
Rate for Payer: Wellpoint Medicaid Managed Care	$2.70

BRACE ANKLE SM RIGHT AIR STRIP

Facility

$112.15

Hospital Charge Code	270651662
Hospital Revenue Code	270
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$56.08
Rate for Payer: Aetna Commercial	$42.62
Rate for Payer: Aetna Medicare Advantage	$33.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.60
Rate for Payer: Cigna Commercial	$56.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: Oxford Commercial	$22.43
Rate for Payer: Qualcare PPO/HMO/WC	$16.82
Rate for Payer: UnitedHealthcare Commercial	$22.43
Rate for Payer: UnitedHealthcare Community & State	$2.70
Rate for Payer: Wellpoint Medicaid Managed Care	$2.97

BRACE ANKLE SM RIGHT AIR STRIP

Facility

$112.15

Hospital Charge Code	270651662
Hospital Revenue Code	270
Min. Negotiated Rate	$16.82
Max. Negotiated Rate	$16.82
Rate for Payer: Qualcare PPO/HMO/WC	$16.82

Know your out-of-pocket cost for care.

All Charges