Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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

BRACE JEWETT

Facility

$2,476.85

Hospital Charge Code	270606585
Hospital Revenue Code	270
Min. Negotiated Rate	$371.53
Max. Negotiated Rate	$371.53
Rate for Payer: Qualcare PPO/HMO/WC	$371.53

BRACE JEWETT

Facility

$2,476.85

Hospital Charge Code	270606585
Hospital Revenue Code	270
Min. Negotiated Rate	$59.69
Max. Negotiated Rate	$1,238.42
Rate for Payer: Aetna Commercial	$941.20
Rate for Payer: Aetna Medicare Advantage	$743.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.60
Rate for Payer: Cigna Commercial	$1,238.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$743.05
Rate for Payer: Oxford Commercial	$495.37
Rate for Payer: Qualcare PPO/HMO/WC	$371.53
Rate for Payer: UnitedHealthcare Commercial	$495.37
Rate for Payer: UnitedHealthcare Community & State	$59.69
Rate for Payer: Wellpoint Medicaid Managed Care	$65.64

BRACE KNEE COOL X-ACT

Facility

$625.00

Hospital Charge Code	270678079
Hospital Revenue Code	270
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$125.00
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

BRACE KNEE COOL X-ACT

Facility

$625.00

Hospital Charge Code	270678079
Hospital Revenue Code	270
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

BRACE KNEE CUSTOM FOR LEG

Facility

$23,139.80

Hospital Charge Code	270651757
Hospital Revenue Code	274
Min. Negotiated Rate	$3,470.97
Max. Negotiated Rate	$5,599.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,627.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,599.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,090.76
Rate for Payer: Qualcare PPO/HMO/WC	$3,470.97

BRACE KNEE CUSTOM FOR LEG

Facility

$23,139.80

Hospital Charge Code	270651757
Hospital Revenue Code	274
Min. Negotiated Rate	$557.67
Max. Negotiated Rate	$11,569.90
Rate for Payer: Aetna Commercial	$8,793.12
Rate for Payer: Aetna Medicare Advantage	$6,941.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,900.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,900.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,627.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,900.65
Rate for Payer: Cigna Commercial	$11,569.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,599.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,090.76
Rate for Payer: Qualcare PPO/HMO/WC	$3,470.97
Rate for Payer: UnitedHealthcare Community & State	$557.67
Rate for Payer: Wellpoint Medicaid Managed Care	$613.20

BRACE KNEE CUSTOM FOR LEG

Facility

$23,139.80

Hospital Charge Code	270521757
Hospital Revenue Code	274
Min. Negotiated Rate	$3,470.97
Max. Negotiated Rate	$5,599.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,627.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,599.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,090.76
Rate for Payer: Qualcare PPO/HMO/WC	$3,470.97

BRACE KNEE CUSTOM FOR LEG

Facility

$23,139.80

Hospital Charge Code	270521757
Hospital Revenue Code	274
Min. Negotiated Rate	$557.67
Max. Negotiated Rate	$11,569.90
Rate for Payer: Aetna Commercial	$8,793.12
Rate for Payer: Aetna Medicare Advantage	$6,941.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,900.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,900.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,627.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,900.65
Rate for Payer: Cigna Commercial	$11,569.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,599.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,090.76
Rate for Payer: Qualcare PPO/HMO/WC	$3,470.97
Rate for Payer: UnitedHealthcare Community & State	$557.67
Rate for Payer: Wellpoint Medicaid Managed Care	$613.20

BRACE KNEE LG

Facility

$49.55

Hospital Charge Code	270649575
Hospital Revenue Code	272
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$24.77
Rate for Payer: Aetna Commercial	$18.83
Rate for Payer: Aetna Medicare Advantage	$14.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.64
Rate for Payer: Cigna Commercial	$24.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.87
Rate for Payer: Oxford Commercial	$9.91
Rate for Payer: Qualcare PPO/HMO/WC	$7.43
Rate for Payer: UnitedHealthcare Commercial	$9.91
Rate for Payer: UnitedHealthcare Community & State	$1.19
Rate for Payer: Wellpoint Medicaid Managed Care	$1.31

BRACE KNEE LG

Facility

$49.55

Hospital Charge Code	270649575
Hospital Revenue Code	272
Min. Negotiated Rate	$7.43
Max. Negotiated Rate	$7.43
Rate for Payer: Qualcare PPO/HMO/WC	$7.43

BRACE KNEE MEDIUM

Facility

$49.55

Hospital Charge Code	270649576
Hospital Revenue Code	272
Min. Negotiated Rate	$7.43
Max. Negotiated Rate	$7.43
Rate for Payer: Qualcare PPO/HMO/WC	$7.43

BRACE KNEE MEDIUM

Facility

$49.55

Hospital Charge Code	270649576
Hospital Revenue Code	272
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$24.77
Rate for Payer: Aetna Commercial	$18.83
Rate for Payer: Aetna Medicare Advantage	$14.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.64
Rate for Payer: Cigna Commercial	$24.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.87
Rate for Payer: Oxford Commercial	$9.91
Rate for Payer: Qualcare PPO/HMO/WC	$7.43
Rate for Payer: UnitedHealthcare Commercial	$9.91
Rate for Payer: UnitedHealthcare Community & State	$1.19
Rate for Payer: Wellpoint Medicaid Managed Care	$1.31

BRACE KNEE POST OP LARGE FULL

Facility

$610.15

Hospital Charge Code	270636638
Hospital Revenue Code	270
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$305.07
Rate for Payer: Aetna Commercial	$231.86
Rate for Payer: Aetna Medicare Advantage	$183.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.59
Rate for Payer: Cigna Commercial	$305.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.04
Rate for Payer: Oxford Commercial	$122.03
Rate for Payer: Qualcare PPO/HMO/WC	$91.52
Rate for Payer: UnitedHealthcare Commercial	$122.03
Rate for Payer: UnitedHealthcare Community & State	$14.70
Rate for Payer: Wellpoint Medicaid Managed Care	$16.17

BRACE KNEE POST OP LARGE FULL

Facility

$610.15

Hospital Charge Code	270636638
Hospital Revenue Code	270
Min. Negotiated Rate	$91.52
Max. Negotiated Rate	$91.52
Rate for Payer: Qualcare PPO/HMO/WC	$91.52

BRACE KNEE POST-OP LG 19

Facility

$74.90

Hospital Charge Code	270649581N
Hospital Revenue Code	272
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.45
Rate for Payer: Aetna Commercial	$28.46
Rate for Payer: Aetna Medicare Advantage	$22.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.10
Rate for Payer: Cigna Commercial	$37.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.47
Rate for Payer: Oxford Commercial	$14.98
Rate for Payer: Qualcare PPO/HMO/WC	$11.23
Rate for Payer: UnitedHealthcare Commercial	$14.98
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.98

BRACE KNEE POST-OP LG 19

Facility

$74.70

Hospital Charge Code	270649581
Hospital Revenue Code	272
Min. Negotiated Rate	$11.21
Max. Negotiated Rate	$11.21
Rate for Payer: Qualcare PPO/HMO/WC	$11.21

BRACE KNEE POST-OP LG 19

Facility

$74.70

Hospital Charge Code	270649581
Hospital Revenue Code	272
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$37.35
Rate for Payer: Aetna Commercial	$28.39
Rate for Payer: Aetna Medicare Advantage	$22.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.05
Rate for Payer: Cigna Commercial	$37.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.41
Rate for Payer: Oxford Commercial	$14.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.21
Rate for Payer: UnitedHealthcare Commercial	$14.94
Rate for Payer: UnitedHealthcare Community & State	$1.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1.98

BRACE KNEE POST-OP LG 19

Facility

$74.90

Hospital Charge Code	270649581N
Hospital Revenue Code	272
Min. Negotiated Rate	$11.23
Max. Negotiated Rate	$11.23
Rate for Payer: Qualcare PPO/HMO/WC	$11.23

BRACE KNEE POST-OP LG 19

Facility

$74.70

Hospital Charge Code	270649581S
Hospital Revenue Code	272
Min. Negotiated Rate	$11.21
Max. Negotiated Rate	$11.21
Rate for Payer: Qualcare PPO/HMO/WC	$11.21

BRACE KNEE POST-OP LG 19

Facility

$74.70

Hospital Charge Code	270649581S
Hospital Revenue Code	272
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$37.35
Rate for Payer: Aetna Commercial	$28.39
Rate for Payer: Aetna Medicare Advantage	$22.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.05
Rate for Payer: Cigna Commercial	$37.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.41
Rate for Payer: Oxford Commercial	$14.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.21
Rate for Payer: UnitedHealthcare Commercial	$14.94
Rate for Payer: UnitedHealthcare Community & State	$1.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1.98

BRACE KNEE POST-OP MED 19

Facility

$74.00

Hospital Charge Code	270649582
Hospital Revenue Code	272
Min. Negotiated Rate	$11.10
Max. Negotiated Rate	$11.10
Rate for Payer: Qualcare PPO/HMO/WC	$11.10

BRACE KNEE POST-OP MED 19

Facility

$74.00

Hospital Charge Code	270649582
Hospital Revenue Code	272
Min. Negotiated Rate	$1.78
Max. Negotiated Rate	$37.00
Rate for Payer: Aetna Commercial	$28.12
Rate for Payer: Aetna Medicare Advantage	$22.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.87
Rate for Payer: Cigna Commercial	$37.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.20
Rate for Payer: Oxford Commercial	$14.80
Rate for Payer: Qualcare PPO/HMO/WC	$11.10
Rate for Payer: UnitedHealthcare Commercial	$14.80
Rate for Payer: UnitedHealthcare Community & State	$1.78
Rate for Payer: Wellpoint Medicaid Managed Care	$1.96

BRACE KNEE POST-OP SM 19

Facility

$74.70

Hospital Charge Code	270649583
Hospital Revenue Code	272
Min. Negotiated Rate	$11.21
Max. Negotiated Rate	$11.21
Rate for Payer: Qualcare PPO/HMO/WC	$11.21

BRACE KNEE POST-OP SM 19

Facility

$74.70

Hospital Charge Code	270649583
Hospital Revenue Code	272
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$37.35
Rate for Payer: Aetna Commercial	$28.39
Rate for Payer: Aetna Medicare Advantage	$22.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.05
Rate for Payer: Cigna Commercial	$37.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.41
Rate for Payer: Oxford Commercial	$14.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.21
Rate for Payer: UnitedHealthcare Commercial	$14.94
Rate for Payer: UnitedHealthcare Community & State	$1.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1.98

Know your out-of-pocket cost for care.

All Charges