Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BRACE ANKLE UNIVERSAL 02E

Facility

$93.89

Hospital Charge Code	270634716
Hospital Revenue Code	270
Min. Negotiated Rate	$2.26
Max. Negotiated Rate	$46.95
Rate for Payer: Aetna Commercial	$35.68
Rate for Payer: Aetna Medicare Advantage	$28.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.94
Rate for Payer: Cigna Commercial	$46.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.17
Rate for Payer: Oxford Commercial	$18.78
Rate for Payer: Qualcare PPO/HMO/WC	$14.08
Rate for Payer: UnitedHealthcare Commercial	$18.78
Rate for Payer: UnitedHealthcare Community & State	$2.26
Rate for Payer: Wellpoint Medicaid Managed Care	$2.49

BRACE ANKLE UNIVERSAL 02E

Facility

$93.89

Hospital Charge Code	270634716
Hospital Revenue Code	270
Min. Negotiated Rate	$14.08
Max. Negotiated Rate	$14.08
Rate for Payer: Qualcare PPO/HMO/WC	$14.08

BRACE BME BILATERAL AFO

Facility

$2,437.65

Hospital Charge Code	270612667
Hospital Revenue Code	270
Min. Negotiated Rate	$365.65
Max. Negotiated Rate	$365.65
Rate for Payer: Qualcare PPO/HMO/WC	$365.65

BRACE BME BILATERAL AFO

Facility

$2,437.65

Hospital Charge Code	270612667
Hospital Revenue Code	270
Min. Negotiated Rate	$58.75
Max. Negotiated Rate	$1,218.83
Rate for Payer: Aetna Commercial	$926.31
Rate for Payer: Aetna Medicare Advantage	$731.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$621.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$621.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$621.60
Rate for Payer: Cigna Commercial	$1,218.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$731.29
Rate for Payer: Oxford Commercial	$487.53
Rate for Payer: Qualcare PPO/HMO/WC	$365.65
Rate for Payer: UnitedHealthcare Commercial	$487.53
Rate for Payer: UnitedHealthcare Community & State	$58.75
Rate for Payer: Wellpoint Medicaid Managed Care	$64.60

BRACE BME TLSO CUSTOM

Facility

$5,184.00

Hospital Charge Code	270612725
Hospital Revenue Code	274
Min. Negotiated Rate	$777.60
Max. Negotiated Rate	$1,254.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,036.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,254.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,140.48
Rate for Payer: Qualcare PPO/HMO/WC	$777.60

BRACE BME TLSO CUSTOM

Facility

$607.25

Hospital Charge Code	270612780
Hospital Revenue Code	270
Min. Negotiated Rate	$14.63
Max. Negotiated Rate	$303.62
Rate for Payer: Aetna Commercial	$230.75
Rate for Payer: Aetna Medicare Advantage	$182.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.85
Rate for Payer: Cigna Commercial	$303.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.18
Rate for Payer: Oxford Commercial	$121.45
Rate for Payer: Qualcare PPO/HMO/WC	$91.09
Rate for Payer: UnitedHealthcare Commercial	$121.45
Rate for Payer: UnitedHealthcare Community & State	$14.63
Rate for Payer: Wellpoint Medicaid Managed Care	$16.09

BRACE BME TLSO CUSTOM

Facility

$5,184.00

Hospital Charge Code	270612725
Hospital Revenue Code	274
Min. Negotiated Rate	$124.93
Max. Negotiated Rate	$2,592.00
Rate for Payer: Aetna Commercial	$1,969.92
Rate for Payer: Aetna Medicare Advantage	$1,555.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,321.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,321.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,036.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,321.92
Rate for Payer: Cigna Commercial	$2,592.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,254.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,140.48
Rate for Payer: Qualcare PPO/HMO/WC	$777.60
Rate for Payer: UnitedHealthcare Community & State	$124.93
Rate for Payer: Wellpoint Medicaid Managed Care	$137.38

BRACE BME TLSO CUSTOM

Facility

$607.25

Hospital Charge Code	270612780
Hospital Revenue Code	270
Min. Negotiated Rate	$91.09
Max. Negotiated Rate	$91.09
Rate for Payer: Qualcare PPO/HMO/WC	$91.09

BRACE HINGED KNEE

Facility

$1,250.00

Service Code	HCPCS L1833
Hospital Charge Code	270648595
Hospital Revenue Code	274
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

BRACE HINGED KNEE

Facility

$1,250.00

Service Code	HCPCS L1833
Hospital Charge Code	270648595
Hospital Revenue Code	274
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

BRACE HIP ABDUCTN W/PELVIC BND

Facility

$7,132.25

Hospital Charge Code	270643598
Hospital Revenue Code	272
Min. Negotiated Rate	$1,069.84
Max. Negotiated Rate	$1,069.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,069.84

BRACE HIP ABDUCTN W/PELVIC BND

Facility

$7,132.25

Hospital Charge Code	270643598
Hospital Revenue Code	272
Min. Negotiated Rate	$171.89
Max. Negotiated Rate	$3,566.12
Rate for Payer: Aetna Commercial	$2,710.26
Rate for Payer: Aetna Medicare Advantage	$2,139.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,818.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,818.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,818.72
Rate for Payer: Cigna Commercial	$3,566.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,139.68
Rate for Payer: Oxford Commercial	$1,426.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,069.84
Rate for Payer: UnitedHealthcare Commercial	$1,426.45
Rate for Payer: UnitedHealthcare Community & State	$171.89
Rate for Payer: Wellpoint Medicaid Managed Care	$189.00

BRACE HIP SPICA

Facility

$1,564.55

Hospital Charge Code	270647425
Hospital Revenue Code	270
Min. Negotiated Rate	$234.68
Max. Negotiated Rate	$234.68
Rate for Payer: Qualcare PPO/HMO/WC	$234.68

BRACE HIP SPICA

Facility

$1,564.55

Hospital Charge Code	270647425
Hospital Revenue Code	270
Min. Negotiated Rate	$37.71
Max. Negotiated Rate	$782.27
Rate for Payer: Aetna Commercial	$594.53
Rate for Payer: Aetna Medicare Advantage	$469.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$398.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$398.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$398.96
Rate for Payer: Cigna Commercial	$782.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$469.37
Rate for Payer: Oxford Commercial	$312.91
Rate for Payer: Qualcare PPO/HMO/WC	$234.68
Rate for Payer: UnitedHealthcare Commercial	$312.91
Rate for Payer: UnitedHealthcare Community & State	$37.71
Rate for Payer: Wellpoint Medicaid Managed Care	$41.46

BRACE HIP SPICA PELVIC BAND

Facility

$8,609.25

Hospital Charge Code	270647016
Hospital Revenue Code	278
Min. Negotiated Rate	$1,291.39
Max. Negotiated Rate	$2,083.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,721.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,083.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,894.04
Rate for Payer: Qualcare PPO/HMO/WC	$1,291.39

BRACE HIP SPICA PELVIC BAND

Facility

$8,609.25

Hospital Charge Code	270647016
Hospital Revenue Code	278
Min. Negotiated Rate	$207.48
Max. Negotiated Rate	$4,304.62
Rate for Payer: Aetna Commercial	$3,271.51
Rate for Payer: Aetna Medicare Advantage	$2,582.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,195.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,195.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,721.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,195.36
Rate for Payer: Cigna Commercial	$4,304.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,083.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,894.04
Rate for Payer: Qualcare PPO/HMO/WC	$1,291.39
Rate for Payer: UnitedHealthcare Community & State	$207.48
Rate for Payer: Wellpoint Medicaid Managed Care	$228.15

BRACE HUMERAL

Facility

$224.75

Hospital Charge Code	270645092
Hospital Revenue Code	272
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.38
Rate for Payer: Aetna Commercial	$85.41
Rate for Payer: Aetna Medicare Advantage	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.31
Rate for Payer: Cigna Commercial	$112.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.42
Rate for Payer: Oxford Commercial	$44.95
Rate for Payer: Qualcare PPO/HMO/WC	$33.71
Rate for Payer: UnitedHealthcare Commercial	$44.95
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

BRACE HUMERAL

Facility

$224.75

Hospital Charge Code	270645092
Hospital Revenue Code	272
Min. Negotiated Rate	$33.71
Max. Negotiated Rate	$33.71
Rate for Payer: Qualcare PPO/HMO/WC	$33.71

BRACE HUMERUS FRACTURE XXL LFT

Facility

$380.75

Hospital Charge Code	270647900
Hospital Revenue Code	272
Min. Negotiated Rate	$9.18
Max. Negotiated Rate	$190.38
Rate for Payer: Aetna Commercial	$144.69
Rate for Payer: Aetna Medicare Advantage	$114.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.09
Rate for Payer: Cigna Commercial	$190.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.22
Rate for Payer: Oxford Commercial	$76.15
Rate for Payer: Qualcare PPO/HMO/WC	$57.11
Rate for Payer: UnitedHealthcare Commercial	$76.15
Rate for Payer: UnitedHealthcare Community & State	$9.18
Rate for Payer: Wellpoint Medicaid Managed Care	$10.09

BRACE HUMERUS FRACTURE XXL LFT

Facility

$380.75

Hospital Charge Code	270647900
Hospital Revenue Code	272
Min. Negotiated Rate	$57.11
Max. Negotiated Rate	$57.11
Rate for Payer: Qualcare PPO/HMO/WC	$57.11

BRACE IMPANT INTERNAL KIT

Facility

$4,875.00

Hospital Charge Code	270662540
Hospital Revenue Code	272
Min. Negotiated Rate	$117.49
Max. Negotiated Rate	$2,437.50
Rate for Payer: Aetna Commercial	$1,852.50
Rate for Payer: Aetna Medicare Advantage	$1,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,243.12
Rate for Payer: Cigna Commercial	$2,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,462.50
Rate for Payer: Oxford Commercial	$975.00
Rate for Payer: Qualcare PPO/HMO/WC	$731.25
Rate for Payer: UnitedHealthcare Commercial	$975.00
Rate for Payer: UnitedHealthcare Community & State	$117.49
Rate for Payer: Wellpoint Medicaid Managed Care	$129.19

BRACE IMPANT INTERNAL KIT

Facility

$4,875.00

Hospital Charge Code	270662540
Hospital Revenue Code	272
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$731.25
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

BRACE INTERNAL FOREFOOT

Facility

$6,975.00

Hospital Charge Code	270684478
Hospital Revenue Code	271
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,046.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

BRACE INTERNAL FOREFOOT

Facility

$6,975.00

Hospital Charge Code	270684478
Hospital Revenue Code	271
Min. Negotiated Rate	$168.10
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,650.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,092.50
Rate for Payer: Oxford Commercial	$1,395.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25
Rate for Payer: UnitedHealthcare Commercial	$1,395.00
Rate for Payer: UnitedHealthcare Community & State	$168.10
Rate for Payer: Wellpoint Medicaid Managed Care	$184.84

BRACE ISO-ULNAR FRACTURE *****

Facility

$276.00

Hospital Charge Code	8002966
Hospital Revenue Code	279
Min. Negotiated Rate	$6.65
Max. Negotiated Rate	$138.00
Rate for Payer: Aetna Commercial	$104.88
Rate for Payer: Aetna Medicare Advantage	$82.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.38
Rate for Payer: Cigna Commercial	$138.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.80
Rate for Payer: Oxford Commercial	$55.20
Rate for Payer: Qualcare PPO/HMO/WC	$41.40
Rate for Payer: UnitedHealthcare Commercial	$55.20
Rate for Payer: UnitedHealthcare Community & State	$6.65
Rate for Payer: Wellpoint Medicaid Managed Care	$7.31

Know your out-of-pocket cost for care.

All Charges