Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BRACE KNEE POST OP SMALL FULL

Facility

$610.15

Hospital Charge Code	270636639
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 SMALL FULL

Facility

$610.15

Hospital Charge Code	270636639
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 XL 19

Facility

$74.70

Hospital Charge Code	270649584
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 XL 19

Facility

$74.70

Hospital Charge Code	270649584
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 SMALL

Facility

$50.20

Hospital Charge Code	270649577
Hospital Revenue Code	272
Min. Negotiated Rate	$7.53
Max. Negotiated Rate	$7.53
Rate for Payer: Qualcare PPO/HMO/WC	$7.53

BRACE KNEE SMALL

Facility

$50.20

Hospital Charge Code	270649577
Hospital Revenue Code	272
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$25.10
Rate for Payer: Aetna Commercial	$19.08
Rate for Payer: Aetna Medicare Advantage	$15.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.80
Rate for Payer: Cigna Commercial	$25.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.06
Rate for Payer: Oxford Commercial	$10.04
Rate for Payer: Qualcare PPO/HMO/WC	$7.53
Rate for Payer: UnitedHealthcare Commercial	$10.04
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.33

BRACE KNEE XL

Facility

$49.55

Hospital Charge Code	270649578
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 XL

Facility

$49.55

Hospital Charge Code	270649578
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 XXL 12

Facility

$51.80

Hospital Charge Code	270649579
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$25.90
Rate for Payer: Aetna Commercial	$19.68
Rate for Payer: Aetna Medicare Advantage	$15.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.21
Rate for Payer: Cigna Commercial	$25.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.54
Rate for Payer: Oxford Commercial	$10.36
Rate for Payer: Qualcare PPO/HMO/WC	$7.77
Rate for Payer: UnitedHealthcare Commercial	$10.36
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.37

BRACE KNEE XXL 12

Facility

$51.80

Hospital Charge Code	270649579
Hospital Revenue Code	272
Min. Negotiated Rate	$7.77
Max. Negotiated Rate	$7.77
Rate for Payer: Qualcare PPO/HMO/WC	$7.77

BRACE KNEE XXL 19

Facility

$74.90

Hospital Charge Code	270649580
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 XXL 19

Facility

$74.90

Hospital Charge Code	270649580
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 KNIGHT TAYLOR CUSTOM

Facility

$2,441.00

Service Code	HCPCS L0520
Hospital Charge Code	270612936
Hospital Revenue Code	274
Min. Negotiated Rate	$58.83
Max. Negotiated Rate	$1,220.50
Rate for Payer: Aetna Commercial	$927.58
Rate for Payer: Aetna Medicare Advantage	$732.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$622.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$622.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$488.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$622.46
Rate for Payer: Cigna Commercial	$1,220.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$590.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$537.02
Rate for Payer: Qualcare PPO/HMO/WC	$366.15
Rate for Payer: UnitedHealthcare Community & State	$58.83
Rate for Payer: Wellpoint Medicaid Managed Care	$64.69

BRACE KNIGHT TAYLOR CUSTOM

Facility

$2,441.00

Service Code	HCPCS L0520
Hospital Charge Code	270612936
Hospital Revenue Code	274
Min. Negotiated Rate	$366.15
Max. Negotiated Rate	$590.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$488.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$590.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$537.02
Rate for Payer: Qualcare PPO/HMO/WC	$366.15

BRACE L/S W/FITTING FEE

Facility

$718.45

Hospital Charge Code	270606584
Hospital Revenue Code	270
Min. Negotiated Rate	$17.31
Max. Negotiated Rate	$359.23
Rate for Payer: Aetna Commercial	$273.01
Rate for Payer: Aetna Medicare Advantage	$215.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.20
Rate for Payer: Cigna Commercial	$359.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.53
Rate for Payer: Oxford Commercial	$143.69
Rate for Payer: Qualcare PPO/HMO/WC	$107.77
Rate for Payer: UnitedHealthcare Commercial	$143.69
Rate for Payer: UnitedHealthcare Community & State	$17.31
Rate for Payer: Wellpoint Medicaid Managed Care	$19.04

BRACE L/S W/FITTING FEE

Facility

$1,577.65

Hospital Charge Code	270607056
Hospital Revenue Code	270
Min. Negotiated Rate	$236.65
Max. Negotiated Rate	$236.65
Rate for Payer: Qualcare PPO/HMO/WC	$236.65

BRACE L/S W/FITTING FEE

Facility

$718.45

Hospital Charge Code	270606584
Hospital Revenue Code	270
Min. Negotiated Rate	$107.77
Max. Negotiated Rate	$107.77
Rate for Payer: Qualcare PPO/HMO/WC	$107.77

BRACE L/S W/FITTING FEE

Facility

$1,577.65

Hospital Charge Code	270607056
Hospital Revenue Code	270
Min. Negotiated Rate	$38.02
Max. Negotiated Rate	$788.83
Rate for Payer: Aetna Commercial	$599.51
Rate for Payer: Aetna Medicare Advantage	$473.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$402.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$402.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$402.30
Rate for Payer: Cigna Commercial	$788.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$473.30
Rate for Payer: Oxford Commercial	$315.53
Rate for Payer: Qualcare PPO/HMO/WC	$236.65
Rate for Payer: UnitedHealthcare Commercial	$315.53
Rate for Payer: UnitedHealthcare Community & State	$38.02
Rate for Payer: Wellpoint Medicaid Managed Care	$41.81

BRACE LUMBAR SUPPORT CUSTOM

Facility

$730.00

Service Code	HCPCS L0515
Hospital Charge Code	270612867
Hospital Revenue Code	274
Min. Negotiated Rate	$17.59
Max. Negotiated Rate	$365.00
Rate for Payer: Aetna Commercial	$277.40
Rate for Payer: Aetna Medicare Advantage	$219.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.15
Rate for Payer: Cigna Commercial	$365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$160.60
Rate for Payer: Qualcare PPO/HMO/WC	$109.50
Rate for Payer: UnitedHealthcare Community & State	$17.59
Rate for Payer: Wellpoint Medicaid Managed Care	$19.34

BRACE LUMBAR SUPPORT CUSTOM

Facility

$730.00

Service Code	HCPCS L0515
Hospital Charge Code	270612867
Hospital Revenue Code	274
Min. Negotiated Rate	$109.50
Max. Negotiated Rate	$176.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$160.60
Rate for Payer: Qualcare PPO/HMO/WC	$109.50

BRACE NECK-HIP L0700

Facility

$6,368.85

Hospital Charge Code	270622823
Hospital Revenue Code	270
Min. Negotiated Rate	$955.33
Max. Negotiated Rate	$955.33
Rate for Payer: Qualcare PPO/HMO/WC	$955.33

BRACE NECK-HIP L0700

Facility

$6,368.85

Hospital Charge Code	270622823
Hospital Revenue Code	270
Min. Negotiated Rate	$153.49
Max. Negotiated Rate	$3,184.43
Rate for Payer: Aetna Commercial	$2,420.16
Rate for Payer: Aetna Medicare Advantage	$1,910.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,624.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,624.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,624.06
Rate for Payer: Cigna Commercial	$3,184.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,910.65
Rate for Payer: Oxford Commercial	$1,273.77
Rate for Payer: Qualcare PPO/HMO/WC	$955.33
Rate for Payer: UnitedHealthcare Commercial	$1,273.77
Rate for Payer: UnitedHealthcare Community & State	$153.49
Rate for Payer: Wellpoint Medicaid Managed Care	$168.77

BRACE ORTHO 16

Facility

$695.25

Hospital Charge Code	270674929
Hospital Revenue Code	271
Min. Negotiated Rate	$104.29
Max. Negotiated Rate	$104.29
Rate for Payer: Qualcare PPO/HMO/WC	$104.29

BRACE ORTHO 16

Facility

$695.25

Hospital Charge Code	270674929
Hospital Revenue Code	271
Min. Negotiated Rate	$16.76
Max. Negotiated Rate	$347.62
Rate for Payer: Aetna Commercial	$264.19
Rate for Payer: Aetna Medicare Advantage	$208.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.29
Rate for Payer: Cigna Commercial	$347.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.57
Rate for Payer: Oxford Commercial	$139.05
Rate for Payer: Qualcare PPO/HMO/WC	$104.29
Rate for Payer: UnitedHealthcare Commercial	$139.05
Rate for Payer: UnitedHealthcare Community & State	$16.76
Rate for Payer: Wellpoint Medicaid Managed Care	$18.42

BRACE PTB FX

Facility

$3,933.65

Hospital Charge Code	270606239
Hospital Revenue Code	270
Min. Negotiated Rate	$94.80
Max. Negotiated Rate	$1,966.83
Rate for Payer: Aetna Commercial	$1,494.79
Rate for Payer: Aetna Medicare Advantage	$1,180.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,003.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,003.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,003.08
Rate for Payer: Cigna Commercial	$1,966.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,180.10
Rate for Payer: Oxford Commercial	$786.73
Rate for Payer: Qualcare PPO/HMO/WC	$590.05
Rate for Payer: UnitedHealthcare Commercial	$786.73
Rate for Payer: UnitedHealthcare Community & State	$94.80
Rate for Payer: Wellpoint Medicaid Managed Care	$104.24

Know your out-of-pocket cost for care.

All Charges