Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

02 SENSOR

Facility

$400.00

Hospital Charge Code	270656111
Hospital Revenue Code	271
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

02 SENSOR

Facility

$400.00

Hospital Charge Code	270656111
Hospital Revenue Code	271
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.00
Rate for Payer: Oxford Commercial	$80.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Commercial	$80.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.60

.035 KWIRE

Facility

$75.00

Hospital Charge Code	270684633
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

.035 KWIRE

Facility

$75.00

Hospital Charge Code	270684633
Hospital Revenue Code	272
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

03.5 X 26MM POLYAXIAL SCREW

Facility

$2,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270697209
Hospital Revenue Code	278
Min. Negotiated Rate	$57.84
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$912.00
Rate for Payer: Aetna Medicare Advantage	$720.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$612.00
Rate for Payer: Cigna Commercial	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$580.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$528.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00
Rate for Payer: UnitedHealthcare Community & State	$57.84
Rate for Payer: Wellpoint Medicaid Managed Care	$63.60

03.5 X 26MM POLYAXIAL SCREW

Facility

$2,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270697209
Hospital Revenue Code	278
Min. Negotiated Rate	$360.00
Max. Negotiated Rate	$580.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$480.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$580.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$528.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00

.045 GUIDEWIRE

Facility

$50.00

Hospital Charge Code	270656146
Hospital Revenue Code	272
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$25.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$10.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

.045 GUIDEWIRE

Facility

$50.00

Hospital Charge Code	270656146
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

.045 K-WIRE

Facility

$50.00

Hospital Charge Code	270656148
Hospital Revenue Code	272
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$25.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$10.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

.045 K-WIRE

Facility

$50.00

Hospital Charge Code	270656148
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

0.8X100 K-WIRE

Facility

$121.75

Hospital Charge Code	270668753
Hospital Revenue Code	272
Min. Negotiated Rate	$2.93
Max. Negotiated Rate	$60.88
Rate for Payer: Aetna Commercial	$46.27
Rate for Payer: Aetna Medicare Advantage	$36.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.05
Rate for Payer: Cigna Commercial	$60.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.52
Rate for Payer: Oxford Commercial	$24.35
Rate for Payer: Qualcare PPO/HMO/WC	$18.26
Rate for Payer: UnitedHealthcare Commercial	$24.35
Rate for Payer: UnitedHealthcare Community & State	$2.93
Rate for Payer: Wellpoint Medicaid Managed Care	$3.23

0.8X100 K-WIRE

Facility

$121.75

Hospital Charge Code	270668753
Hospital Revenue Code	272
Min. Negotiated Rate	$18.26
Max. Negotiated Rate	$18.26
Rate for Payer: Qualcare PPO/HMO/WC	$18.26

0.9MM ANTI SKIVE PIN PROSTEP

Facility

$427.45

Service Code	HCPCS C1713
Hospital Charge Code	270702758
Hospital Revenue Code	278
Min. Negotiated Rate	$64.12
Max. Negotiated Rate	$103.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$94.04
Rate for Payer: Qualcare PPO/HMO/WC	$64.12

0.9MM ANTI SKIVE PIN PROSTEP

Facility

$427.45

Service Code	HCPCS C1713
Hospital Charge Code	270702758
Hospital Revenue Code	278
Min. Negotiated Rate	$10.30
Max. Negotiated Rate	$213.72
Rate for Payer: Aetna Commercial	$162.43
Rate for Payer: Aetna Medicare Advantage	$128.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.00
Rate for Payer: Cigna Commercial	$213.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$94.04
Rate for Payer: Qualcare PPO/HMO/WC	$64.12
Rate for Payer: UnitedHealthcare Community & State	$10.30
Rate for Payer: Wellpoint Medicaid Managed Care	$11.33

.09% NACL 1000cc BOTTLE

Facility

$5.10

Hospital Charge Code	270650059
Hospital Revenue Code	258
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.55
Rate for Payer: Aetna Commercial	$1.94
Rate for Payer: Aetna Medicare Advantage	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.30
Rate for Payer: Cigna Commercial	$2.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.53
Rate for Payer: Oxford Commercial	$1.02
Rate for Payer: Qualcare PPO/HMO/WC	$0.77
Rate for Payer: UnitedHealthcare Commercial	$1.02
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

.09% NACL 1000cc BOTTLE

Facility

$5.10

Hospital Charge Code	270650059
Hospital Revenue Code	258
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$0.77
Rate for Payer: Qualcare PPO/HMO/WC	$0.77

.09 NS 3000ML (CBI)

Facility

$33.10

Hospital Charge Code	270651076
Hospital Revenue Code	270
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$4.96
Rate for Payer: Qualcare PPO/HMO/WC	$4.96

.09 NS 3000ML (CBI)

Facility

$33.10

Hospital Charge Code	270651076
Hospital Revenue Code	270
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$16.55
Rate for Payer: Aetna Commercial	$12.58
Rate for Payer: Aetna Medicare Advantage	$9.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.44
Rate for Payer: Cigna Commercial	$16.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.93
Rate for Payer: Oxford Commercial	$6.62
Rate for Payer: Qualcare PPO/HMO/WC	$4.96
Rate for Payer: UnitedHealthcare Commercial	$6.62
Rate for Payer: UnitedHealthcare Community & State	$0.80
Rate for Payer: Wellpoint Medicaid Managed Care	$0.88

0 DEG ECCENTRIC INSERT 36MM.

Facility

$4,529.05

Service Code	HCPCS C1713
Hospital Charge Code	270705130
Hospital Revenue Code	278
Min. Negotiated Rate	$679.36
Max. Negotiated Rate	$1,096.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$905.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,096.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$996.39
Rate for Payer: Qualcare PPO/HMO/WC	$679.36

0 DEG ECCENTRIC INSERT 36MM.

Facility

$4,529.05

Service Code	HCPCS C1713
Hospital Charge Code	270705130
Hospital Revenue Code	278
Min. Negotiated Rate	$109.15
Max. Negotiated Rate	$2,264.53
Rate for Payer: Aetna Commercial	$1,721.04
Rate for Payer: Aetna Medicare Advantage	$1,358.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,154.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,154.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$905.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,154.91
Rate for Payer: Cigna Commercial	$2,264.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,096.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$996.39
Rate for Payer: Qualcare PPO/HMO/WC	$679.36
Rate for Payer: UnitedHealthcare Community & State	$109.15
Rate for Payer: Wellpoint Medicaid Managed Care	$120.02

0DM LINER 28MM

Facility

$6,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270677461
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

0DM LINER 28MM

Facility

$6,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270677461
Hospital Revenue Code	278
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

100MM X 7.5MM HEADED SCREW

Facility

$2,270.00

Hospital Charge Code	270656776
Hospital Revenue Code	278
Min. Negotiated Rate	$340.50
Max. Negotiated Rate	$549.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$454.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$549.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$499.40
Rate for Payer: Qualcare PPO/HMO/WC	$340.50

100MM X 7.5MM HEADED SCREW

Facility

$2,270.00

Hospital Charge Code	270656776
Hospital Revenue Code	278
Min. Negotiated Rate	$54.71
Max. Negotiated Rate	$1,135.00
Rate for Payer: Aetna Commercial	$862.60
Rate for Payer: Aetna Medicare Advantage	$681.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$578.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$578.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$454.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$578.85
Rate for Payer: Cigna Commercial	$1,135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$549.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$499.40
Rate for Payer: Qualcare PPO/HMO/WC	$340.50
Rate for Payer: UnitedHealthcare Community & State	$54.71
Rate for Payer: Wellpoint Medicaid Managed Care	$60.16

10.2MM CANN DRILL BIT LENGTH 2

Facility

$3,300.00

Hospital Charge Code	270686947
Hospital Revenue Code	272
Min. Negotiated Rate	$495.00
Max. Negotiated Rate	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$495.00

Know your out-of-pocket cost for care.

All Charges