Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BRACE PTB FX

Facility

$3,933.65

Hospital Charge Code	270606239
Hospital Revenue Code	270
Min. Negotiated Rate	$590.05
Max. Negotiated Rate	$590.05
Rate for Payer: Qualcare PPO/HMO/WC	$590.05

BRACE SHOULDER ARC 2.0

Facility

$895.00

Hospital Charge Code	270678204
Hospital Revenue Code	270
Min. Negotiated Rate	$134.25
Max. Negotiated Rate	$134.25
Rate for Payer: Qualcare PPO/HMO/WC	$134.25

BRACE SHOULDER ARC 2.0

Facility

$895.00

Hospital Charge Code	270678204
Hospital Revenue Code	270
Min. Negotiated Rate	$21.57
Max. Negotiated Rate	$447.50
Rate for Payer: Aetna Commercial	$340.10
Rate for Payer: Aetna Medicare Advantage	$268.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$228.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$228.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$228.22
Rate for Payer: Cigna Commercial	$447.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.50
Rate for Payer: Oxford Commercial	$179.00
Rate for Payer: Qualcare PPO/HMO/WC	$134.25
Rate for Payer: UnitedHealthcare Commercial	$179.00
Rate for Payer: UnitedHealthcare Community & State	$21.57
Rate for Payer: Wellpoint Medicaid Managed Care	$23.72

BRACE SHOULDER SLINGSHOT

Facility

$8.61

Hospital Charge Code	270655443
Hospital Revenue Code	270
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$1.29
Rate for Payer: Qualcare PPO/HMO/WC	$1.29

BRACE SHOULDER SLINGSHOT

Facility

$8.61

Hospital Charge Code	270655443
Hospital Revenue Code	270
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$4.30
Rate for Payer: Aetna Commercial	$3.27
Rate for Payer: Aetna Medicare Advantage	$2.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.20
Rate for Payer: Cigna Commercial	$4.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.58
Rate for Payer: Oxford Commercial	$1.72
Rate for Payer: Qualcare PPO/HMO/WC	$1.29
Rate for Payer: UnitedHealthcare Commercial	$1.72
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

BRACHIAL DRAPE

Facility

$65.00

Hospital Charge Code	2709003648
Hospital Revenue Code	272
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$32.50
Rate for Payer: Aetna Commercial	$24.70
Rate for Payer: Aetna Medicare Advantage	$19.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.57
Rate for Payer: Cigna Commercial	$32.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$13.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.75
Rate for Payer: UnitedHealthcare Commercial	$13.00
Rate for Payer: UnitedHealthcare Community & State	$1.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1.72

BRACHIAL DRAPE

Facility

$13.00

Hospital Charge Code	270658351
Hospital Revenue Code	271
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

BRACHIAL DRAPE

Facility

$13.00

Hospital Charge Code	270658351
Hospital Revenue Code	271
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

BRACHIAL DRAPE

Facility

$65.00

Hospital Charge Code	2709003648
Hospital Revenue Code	272
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

BRACHIAL DRAPE XRAY

Facility

$90.00

Hospital Charge Code	2709006572
Hospital Revenue Code	272
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.00
Rate for Payer: Oxford Commercial	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$18.00
Rate for Payer: UnitedHealthcare Community & State	$2.17
Rate for Payer: Wellpoint Medicaid Managed Care	$2.38

BRACHIAL DRAPE XRAY

Facility

$90.00

Hospital Charge Code	2709006572
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

BRACHYTX ISODOSE CALC COMP-GL

Facility

$1,887.22

Service Code	HCPCS 77328
Hospital Charge Code	85000565
Hospital Revenue Code	333
Min. Negotiated Rate	$283.08
Max. Negotiated Rate	$283.08
Rate for Payer: Qualcare PPO/HMO/WC	$283.08

BRACHYTX ISODOSE CALC COMP-GL

Facility

$1,887.22

Service Code	HCPCS 77328
Hospital Charge Code	85000565
Hospital Revenue Code	333
Min. Negotiated Rate	$45.48
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$717.14
Rate for Payer: Aetna Medicare Advantage	$566.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$481.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$481.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$481.24
Rate for Payer: Cigna Commercial	$943.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$566.17
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$283.08
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$45.48
Rate for Payer: Wellpoint Medicaid Managed Care	$50.01

BRACHYTX ISODOSE CALC COMP-PC

Facility

$556.65

Service Code	HCPCS 7732826
Hospital Charge Code	85000575
Hospital Revenue Code	333
Min. Negotiated Rate	$83.50
Max. Negotiated Rate	$83.50
Rate for Payer: Qualcare PPO/HMO/WC	$83.50

BRACHYTX ISODOSE CALC COMP-PC

Facility

$556.65

Service Code	HCPCS 7732826
Hospital Charge Code	85000575
Hospital Revenue Code	333
Min. Negotiated Rate	$13.42
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$211.53
Rate for Payer: Aetna Medicare Advantage	$167.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$141.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$141.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$141.95
Rate for Payer: Cigna Commercial	$278.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.00
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$83.50
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$13.42
Rate for Payer: Wellpoint Medicaid Managed Care	$14.75

BRACHYTX ISODOSE CALC COMP-TC

Facility

$1,000.20

Service Code	HCPCS 77328TC
Hospital Charge Code	85000570
Hospital Revenue Code	333
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$380.08
Rate for Payer: Aetna Medicare Advantage	$300.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.05
Rate for Payer: Cigna Commercial	$500.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.06
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.03
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.51

BRACHYTX ISODOSE CALC COMP-TC

Facility

$1,000.20

Service Code	HCPCS 77328TC
Hospital Charge Code	85000570
Hospital Revenue Code	333
Min. Negotiated Rate	$150.03
Max. Negotiated Rate	$150.03
Rate for Payer: Qualcare PPO/HMO/WC	$150.03

BRACHYTX ISODOSE CALC INTERM-P

Facility

$370.45

Service Code	HCPCS 7732726
Hospital Charge Code	85000560
Hospital Revenue Code	333
Min. Negotiated Rate	$55.57
Max. Negotiated Rate	$55.57
Rate for Payer: Qualcare PPO/HMO/WC	$55.57

BRACHYTX ISODOSE CALC INTERM-P

Facility

$370.45

Service Code	HCPCS 7732726
Hospital Charge Code	85000560
Hospital Revenue Code	333
Min. Negotiated Rate	$8.93
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$140.77
Rate for Payer: Aetna Medicare Advantage	$111.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.46
Rate for Payer: Cigna Commercial	$185.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.14
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.57
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$8.93
Rate for Payer: Wellpoint Medicaid Managed Care	$9.82

BRACHYTX ISODOSE CALC INTERM-T

Facility

$794.55

Service Code	HCPCS 77327TC
Hospital Charge Code	85000555
Hospital Revenue Code	333
Min. Negotiated Rate	$119.18
Max. Negotiated Rate	$119.18
Rate for Payer: Qualcare PPO/HMO/WC	$119.18

BRACHYTX ISODOSE CALC INTERM-T

Facility

$794.55

Service Code	HCPCS 77327TC
Hospital Charge Code	85000555
Hospital Revenue Code	333
Min. Negotiated Rate	$19.15
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$301.93
Rate for Payer: Aetna Medicare Advantage	$238.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$202.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$202.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$202.61
Rate for Payer: Cigna Commercial	$397.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.37
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$119.18
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$19.15
Rate for Payer: Wellpoint Medicaid Managed Care	$21.06

BRACHYTX ISODOSE CALC SIMP-PC

Facility

$247.05

Service Code	HCPCS 7732626
Hospital Charge Code	85000545
Hospital Revenue Code	333
Min. Negotiated Rate	$5.95
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$93.88
Rate for Payer: Aetna Medicare Advantage	$74.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.00
Rate for Payer: Cigna Commercial	$123.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.11
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.06
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$5.95
Rate for Payer: Wellpoint Medicaid Managed Care	$6.55

BRACHYTX ISODOSE CALC SIMP-PC

Facility

$247.05

Service Code	HCPCS 7732626
Hospital Charge Code	85000545
Hospital Revenue Code	333
Min. Negotiated Rate	$37.06
Max. Negotiated Rate	$37.06
Rate for Payer: Qualcare PPO/HMO/WC	$37.06

BRACHYTX ISODOSE CALC SIMP-TC

Facility

$582.60

Service Code	HCPCS 77326TC
Hospital Charge Code	85000540
Hospital Revenue Code	333
Min. Negotiated Rate	$14.04
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$221.39
Rate for Payer: Aetna Medicare Advantage	$174.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.56
Rate for Payer: Cigna Commercial	$291.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.78
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.39
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$14.04
Rate for Payer: Wellpoint Medicaid Managed Care	$15.44

BRACHYTX ISODOSE CALC SIMP-TC

Facility

$582.60

Service Code	HCPCS 77326TC
Hospital Charge Code	85000540
Hospital Revenue Code	333
Min. Negotiated Rate	$87.39
Max. Negotiated Rate	$87.39
Rate for Payer: Qualcare PPO/HMO/WC	$87.39

Know your out-of-pocket cost for care.

All Charges