Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CASE 2.7/3.5MM VA-LCP ELBW SYS

Facility

$6,201.65

Hospital Charge Code	270677662
Hospital Revenue Code	272
Min. Negotiated Rate	$149.46
Max. Negotiated Rate	$3,100.82
Rate for Payer: Aetna Commercial	$2,356.63
Rate for Payer: Aetna Medicare Advantage	$1,860.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,581.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,581.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,581.42
Rate for Payer: Cigna Commercial	$3,100.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,860.49
Rate for Payer: Oxford Commercial	$1,240.33
Rate for Payer: Qualcare PPO/HMO/WC	$930.25
Rate for Payer: UnitedHealthcare Commercial	$1,240.33
Rate for Payer: UnitedHealthcare Community & State	$149.46
Rate for Payer: Wellpoint Medicaid Managed Care	$164.34

CASE 2.7/3.5MM VA-LCP ELBW SYS

Facility

$6,201.65

Hospital Charge Code	270677662
Hospital Revenue Code	272
Min. Negotiated Rate	$930.25
Max. Negotiated Rate	$930.25
Rate for Payer: Qualcare PPO/HMO/WC	$930.25

CASE SURGICAL W/O BRACKETS 11

Facility

$3,495.00

Hospital Charge Code	270665199
Hospital Revenue Code	270
Min. Negotiated Rate	$84.23
Max. Negotiated Rate	$1,747.50
Rate for Payer: Aetna Commercial	$1,328.10
Rate for Payer: Aetna Medicare Advantage	$1,048.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$891.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$891.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$891.23
Rate for Payer: Cigna Commercial	$1,747.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,048.50
Rate for Payer: Oxford Commercial	$699.00
Rate for Payer: Qualcare PPO/HMO/WC	$524.25
Rate for Payer: UnitedHealthcare Commercial	$699.00
Rate for Payer: UnitedHealthcare Community & State	$84.23
Rate for Payer: Wellpoint Medicaid Managed Care	$92.62

CASE SURGICAL W/O BRACKETS 11

Facility

$3,495.00

Hospital Charge Code	270665199
Hospital Revenue Code	270
Min. Negotiated Rate	$524.25
Max. Negotiated Rate	$524.25
Rate for Payer: Qualcare PPO/HMO/WC	$524.25

CASE TRIMANO

Facility

$1,850.00

Hospital Charge Code	270676551
Hospital Revenue Code	272
Min. Negotiated Rate	$44.59
Max. Negotiated Rate	$925.00
Rate for Payer: Aetna Commercial	$703.00
Rate for Payer: Aetna Medicare Advantage	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.75
Rate for Payer: Cigna Commercial	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$555.00
Rate for Payer: Oxford Commercial	$370.00
Rate for Payer: Qualcare PPO/HMO/WC	$277.50
Rate for Payer: UnitedHealthcare Commercial	$370.00
Rate for Payer: UnitedHealthcare Community & State	$44.59
Rate for Payer: Wellpoint Medicaid Managed Care	$49.02

CASE TRIMANO

Facility

$1,850.00

Hospital Charge Code	270676551
Hospital Revenue Code	272
Min. Negotiated Rate	$277.50
Max. Negotiated Rate	$277.50
Rate for Payer: Qualcare PPO/HMO/WC	$277.50

CASE V6.6 GENERIC ATO MODEL

Facility

$550.00

Hospital Charge Code	270648533
Hospital Revenue Code	272
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

CASE V6.6 GENERIC ATO MODEL

Facility

$550.00

Hospital Charge Code	270648533
Hospital Revenue Code	272
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.00
Rate for Payer: Oxford Commercial	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$110.00
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

CASHEW NUT (F202) IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	39900356
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CASHEW NUT (F202) IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	39900356
Hospital Revenue Code	305
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.84
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CASPOFUNGIN 50 MG INJ

Facility

$2,232.05

Hospital Charge Code	60629259
Hospital Revenue Code	636
Min. Negotiated Rate	$53.79
Max. Negotiated Rate	$1,116.03
Rate for Payer: Aetna Commercial	$848.18
Rate for Payer: Aetna Medicare Advantage	$669.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$569.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$569.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$569.17
Rate for Payer: Cigna Commercial	$1,116.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$540.16
Rate for Payer: Qualcare PPO/HMO/WC	$334.81
Rate for Payer: UnitedHealthcare Community & State	$53.79
Rate for Payer: Wellpoint Medicaid Managed Care	$59.15

CASPOFUNGIN 50 MG INJ

Facility

$2,232.05

Hospital Charge Code	60629259
Hospital Revenue Code	636
Min. Negotiated Rate	$334.81
Max. Negotiated Rate	$540.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$540.16
Rate for Payer: Qualcare PPO/HMO/WC	$334.81

CASPR2 ANTIBODY

Facility

$2,525.00

Service Code	HCPCS 86255
Hospital Charge Code	3038552
Hospital Revenue Code	302
Min. Negotiated Rate	$378.75
Max. Negotiated Rate	$378.75
Rate for Payer: Qualcare PPO/HMO/WC	$378.75

CASPR2 ANTIBODY

Facility

$2,525.00

Service Code	HCPCS 86255
Hospital Charge Code	3038552
Hospital Revenue Code	302
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$1,262.50
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.50
Rate for Payer: Cigna Commercial	$1,262.50
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$757.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$378.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$66.91

CASSETTE MICRODEBRIDER 2 DISP

Facility

$1,651.00

Hospital Charge Code	270658055
Hospital Revenue Code	272
Min. Negotiated Rate	$39.79
Max. Negotiated Rate	$825.50
Rate for Payer: Aetna Commercial	$627.38
Rate for Payer: Aetna Medicare Advantage	$495.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$421.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$421.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$421.00
Rate for Payer: Cigna Commercial	$825.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$495.30
Rate for Payer: Oxford Commercial	$330.20
Rate for Payer: Qualcare PPO/HMO/WC	$247.65
Rate for Payer: UnitedHealthcare Commercial	$330.20
Rate for Payer: UnitedHealthcare Community & State	$39.79
Rate for Payer: Wellpoint Medicaid Managed Care	$43.75

CASSETTE MICRODEBRIDER 2 DISP

Facility

$1,651.00

Hospital Charge Code	270658055
Hospital Revenue Code	272
Min. Negotiated Rate	$247.65
Max. Negotiated Rate	$247.65
Rate for Payer: Qualcare PPO/HMO/WC	$247.65

CASSETTE PRUGE

Facility

$4,875.00

Hospital Charge Code	270681572
Hospital Revenue Code	278
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$1,179.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,072.50
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

CASSETTE PRUGE

Facility

$4,875.00

Hospital Charge Code	270681572
Hospital Revenue Code	278
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) NJ Health	$975.00
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	$1,179.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,072.50
Rate for Payer: Qualcare PPO/HMO/WC	$731.25
Rate for Payer: UnitedHealthcare Community & State	$117.49
Rate for Payer: Wellpoint Medicaid Managed Care	$129.19

CAST AIR RT STS ANKLE BRACE

Facility

$328.85

Hospital Charge Code	270602912
Hospital Revenue Code	270
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$164.43
Rate for Payer: Aetna Commercial	$124.96
Rate for Payer: Aetna Medicare Advantage	$98.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.86
Rate for Payer: Cigna Commercial	$164.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.66
Rate for Payer: Oxford Commercial	$65.77
Rate for Payer: Qualcare PPO/HMO/WC	$49.33
Rate for Payer: UnitedHealthcare Commercial	$65.77
Rate for Payer: UnitedHealthcare Community & State	$7.93
Rate for Payer: Wellpoint Medicaid Managed Care	$8.71

CAST AIR RT STS ANKLE BRACE

Facility

$328.85

Hospital Charge Code	270602912
Hospital Revenue Code	270
Min. Negotiated Rate	$49.33
Max. Negotiated Rate	$49.33
Rate for Payer: Qualcare PPO/HMO/WC	$49.33

CAST ARM APPLICATION OF

Facility

$374.45

Hospital Charge Code	4000022
Hospital Revenue Code	270
Min. Negotiated Rate	$56.17
Max. Negotiated Rate	$56.17
Rate for Payer: Qualcare PPO/HMO/WC	$56.17

CAST ARM APPLICATION OF

Facility

$374.45

Hospital Charge Code	4000022
Hospital Revenue Code	270
Min. Negotiated Rate	$9.02
Max. Negotiated Rate	$187.22
Rate for Payer: Aetna Commercial	$142.29
Rate for Payer: Aetna Medicare Advantage	$112.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.48
Rate for Payer: Cigna Commercial	$187.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.33
Rate for Payer: Oxford Commercial	$74.89
Rate for Payer: Qualcare PPO/HMO/WC	$56.17
Rate for Payer: UnitedHealthcare Commercial	$74.89
Rate for Payer: UnitedHealthcare Community & State	$9.02
Rate for Payer: Wellpoint Medicaid Managed Care	$9.92

CAST BOOT **********

Facility

$219.00

Hospital Charge Code	8001927
Hospital Revenue Code	279
Min. Negotiated Rate	$32.85
Max. Negotiated Rate	$32.85
Rate for Payer: Qualcare PPO/HMO/WC	$32.85

CAST BOOT **********

Facility

$219.00

Hospital Charge Code	8001927
Hospital Revenue Code	279
Min. Negotiated Rate	$5.28
Max. Negotiated Rate	$109.50
Rate for Payer: Aetna Commercial	$83.22
Rate for Payer: Aetna Medicare Advantage	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.84
Rate for Payer: Cigna Commercial	$109.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.70
Rate for Payer: Oxford Commercial	$43.80
Rate for Payer: Qualcare PPO/HMO/WC	$32.85
Rate for Payer: UnitedHealthcare Commercial	$43.80
Rate for Payer: UnitedHealthcare Community & State	$5.28
Rate for Payer: Wellpoint Medicaid Managed Care	$5.80

CAST FINGER APPLICATION OF****

Facility

$122.00

Hospital Charge Code	4000014
Hospital Revenue Code	279
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$61.00
Rate for Payer: Aetna Commercial	$46.36
Rate for Payer: Aetna Medicare Advantage	$36.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.11
Rate for Payer: Cigna Commercial	$61.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.60
Rate for Payer: Oxford Commercial	$24.40
Rate for Payer: Qualcare PPO/HMO/WC	$18.30
Rate for Payer: UnitedHealthcare Commercial	$24.40
Rate for Payer: UnitedHealthcare Community & State	$2.94
Rate for Payer: Wellpoint Medicaid Managed Care	$3.23

Know your out-of-pocket cost for care.

All Charges