Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

150MM CARBON ROD

Facility

$775.00

Hospital Charge Code	270339505
Hospital Revenue Code	278
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25
Rate for Payer: UnitedHealthcare Community & State	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$20.54

15/3 FIRST FRACTURE KIT

Facility

$21,600.00

Hospital Charge Code	270657324
Hospital Revenue Code	278
Min. Negotiated Rate	$3,240.00
Max. Negotiated Rate	$5,227.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,227.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,752.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,240.00

15/3 FIRST FRACTURE KIT

Facility

$21,600.00

Hospital Charge Code	270657324
Hospital Revenue Code	278
Min. Negotiated Rate	$520.56
Max. Negotiated Rate	$10,800.00
Rate for Payer: Aetna Commercial	$8,208.00
Rate for Payer: Aetna Medicare Advantage	$6,480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,508.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,508.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,508.00
Rate for Payer: Cigna Commercial	$10,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,227.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,752.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,240.00
Rate for Payer: UnitedHealthcare Community & State	$520.56
Rate for Payer: Wellpoint Medicaid Managed Care	$572.40

1.5.CC AUGMENT

Facility

$9,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270686218
Hospital Revenue Code	278
Min. Negotiated Rate	$239.79
Max. Negotiated Rate	$4,975.00
Rate for Payer: Aetna Commercial	$3,781.00
Rate for Payer: Aetna Medicare Advantage	$2,985.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,537.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,537.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,537.25
Rate for Payer: Cigna Commercial	$4,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,407.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,189.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,492.50
Rate for Payer: UnitedHealthcare Community & State	$239.79
Rate for Payer: Wellpoint Medicaid Managed Care	$263.68

1.5.CC AUGMENT

Facility

$9,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270686218
Hospital Revenue Code	278
Min. Negotiated Rate	$1,492.50
Max. Negotiated Rate	$2,407.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,407.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,189.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,492.50

15 CM X 20 CM OVAL

Facility

$7,325.00

Service Code	HCPCS C1781
Hospital Charge Code	270684331
Hospital Revenue Code	278
Min. Negotiated Rate	$1,098.75
Max. Negotiated Rate	$1,772.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,772.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,611.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,098.75

15 CM X 20 CM OVAL

Facility

$7,325.00

Service Code	HCPCS C1781
Hospital Charge Code	270684331
Hospital Revenue Code	278
Min. Negotiated Rate	$176.53
Max. Negotiated Rate	$3,662.50
Rate for Payer: Aetna Commercial	$2,783.50
Rate for Payer: Aetna Medicare Advantage	$2,197.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,867.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,867.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,867.88
Rate for Payer: Cigna Commercial	$3,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,772.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,611.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,098.75
Rate for Payer: UnitedHealthcare Community & State	$176.53
Rate for Payer: Wellpoint Medicaid Managed Care	$194.11

15 CM X 20 CM OVAL

Facility

$7,325.00

Service Code	HCPCS C1781
Hospital Charge Code	270684334
Hospital Revenue Code	278
Min. Negotiated Rate	$1,098.75
Max. Negotiated Rate	$1,772.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,772.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,611.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,098.75

15 CM X 20 CM OVAL

Facility

$7,325.00

Service Code	HCPCS C1781
Hospital Charge Code	270684334
Hospital Revenue Code	278
Min. Negotiated Rate	$176.53
Max. Negotiated Rate	$3,662.50
Rate for Payer: Aetna Commercial	$2,783.50
Rate for Payer: Aetna Medicare Advantage	$2,197.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,867.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,867.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,867.88
Rate for Payer: Cigna Commercial	$3,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,772.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,611.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,098.75
Rate for Payer: UnitedHealthcare Community & State	$176.53
Rate for Payer: Wellpoint Medicaid Managed Care	$194.11

1.5 DRILL BIT

Facility

$366.00

Hospital Charge Code	270686111
Hospital Revenue Code	272
Min. Negotiated Rate	$8.82
Max. Negotiated Rate	$183.00
Rate for Payer: Aetna Commercial	$139.08
Rate for Payer: Aetna Medicare Advantage	$109.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.33
Rate for Payer: Cigna Commercial	$183.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.80
Rate for Payer: Oxford Commercial	$73.20
Rate for Payer: Qualcare PPO/HMO/WC	$54.90
Rate for Payer: UnitedHealthcare Commercial	$73.20
Rate for Payer: UnitedHealthcare Community & State	$8.82
Rate for Payer: Wellpoint Medicaid Managed Care	$9.70

1.5 DRILL BIT

Facility

$366.00

Hospital Charge Code	270677816
Hospital Revenue Code	272
Min. Negotiated Rate	$54.90
Max. Negotiated Rate	$54.90
Rate for Payer: Qualcare PPO/HMO/WC	$54.90

1.5 DRILL BIT

Facility

$366.00

Hospital Charge Code	270686111
Hospital Revenue Code	272
Min. Negotiated Rate	$54.90
Max. Negotiated Rate	$54.90
Rate for Payer: Qualcare PPO/HMO/WC	$54.90

1.5 DRILL BIT

Facility

$366.00

Hospital Charge Code	270677816
Hospital Revenue Code	272
Min. Negotiated Rate	$8.82
Max. Negotiated Rate	$183.00
Rate for Payer: Aetna Commercial	$139.08
Rate for Payer: Aetna Medicare Advantage	$109.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.33
Rate for Payer: Cigna Commercial	$183.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.80
Rate for Payer: Oxford Commercial	$73.20
Rate for Payer: Qualcare PPO/HMO/WC	$54.90
Rate for Payer: UnitedHealthcare Commercial	$73.20
Rate for Payer: UnitedHealthcare Community & State	$8.82
Rate for Payer: Wellpoint Medicaid Managed Care	$9.70

15 LITRE 1 MIN FLOW METER

Facility

$208.00

Hospital Charge Code	270663148
Hospital Revenue Code	270
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$31.20
Rate for Payer: Qualcare PPO/HMO/WC	$31.20

15 LITRE 1 MIN FLOW METER

Facility

$208.00

Hospital Charge Code	270663148
Hospital Revenue Code	270
Min. Negotiated Rate	$5.01
Max. Negotiated Rate	$104.00
Rate for Payer: Aetna Commercial	$79.04
Rate for Payer: Aetna Medicare Advantage	$62.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.04
Rate for Payer: Cigna Commercial	$104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.40
Rate for Payer: Oxford Commercial	$41.60
Rate for Payer: Qualcare PPO/HMO/WC	$31.20
Rate for Payer: UnitedHealthcare Commercial	$41.60
Rate for Payer: UnitedHealthcare Community & State	$5.01
Rate for Payer: Wellpoint Medicaid Managed Care	$5.51

1.5 LOCKING SCREW 10MM

Facility

$2,431.55

Service Code	HCPCS C1713
Hospital Charge Code	270681691
Hospital Revenue Code	278
Min. Negotiated Rate	$58.60
Max. Negotiated Rate	$1,215.78
Rate for Payer: Aetna Commercial	$923.99
Rate for Payer: Aetna Medicare Advantage	$729.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$620.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$620.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$486.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$620.05
Rate for Payer: Cigna Commercial	$1,215.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$588.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$534.94
Rate for Payer: Qualcare PPO/HMO/WC	$364.73
Rate for Payer: UnitedHealthcare Community & State	$58.60
Rate for Payer: Wellpoint Medicaid Managed Care	$64.44

1.5 LOCKING SCREW 10MM

Facility

$2,431.55

Service Code	HCPCS C1713
Hospital Charge Code	270681691
Hospital Revenue Code	278
Min. Negotiated Rate	$364.73
Max. Negotiated Rate	$588.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$486.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$588.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$534.94
Rate for Payer: Qualcare PPO/HMO/WC	$364.73

1.5 MM CORTEX 14MM

Facility

$179.00

Hospital Charge Code	270662659
Hospital Revenue Code	278
Min. Negotiated Rate	$26.85
Max. Negotiated Rate	$43.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$39.38
Rate for Payer: Qualcare PPO/HMO/WC	$26.85

1.5 MM CORTEX 14MM

Facility

$179.00

Hospital Charge Code	270662659
Hospital Revenue Code	278
Min. Negotiated Rate	$4.31
Max. Negotiated Rate	$89.50
Rate for Payer: Aetna Commercial	$68.02
Rate for Payer: Aetna Medicare Advantage	$53.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.65
Rate for Payer: Cigna Commercial	$89.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$39.38
Rate for Payer: Qualcare PPO/HMO/WC	$26.85
Rate for Payer: UnitedHealthcare Community & State	$4.31
Rate for Payer: Wellpoint Medicaid Managed Care	$4.74

1.5MM DRILL BIT/MINI QC/65MM

Facility

$324.65

Hospital Charge Code	270634487
Hospital Revenue Code	272
Min. Negotiated Rate	$7.82
Max. Negotiated Rate	$162.32
Rate for Payer: Aetna Commercial	$123.37
Rate for Payer: Aetna Medicare Advantage	$97.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.79
Rate for Payer: Cigna Commercial	$162.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.39
Rate for Payer: Oxford Commercial	$64.93
Rate for Payer: Qualcare PPO/HMO/WC	$48.70
Rate for Payer: UnitedHealthcare Commercial	$64.93
Rate for Payer: UnitedHealthcare Community & State	$7.82
Rate for Payer: Wellpoint Medicaid Managed Care	$8.60

1.5MM DRILL BIT/MINI QC/65MM

Facility

$324.65

Hospital Charge Code	270634487
Hospital Revenue Code	272
Min. Negotiated Rate	$48.70
Max. Negotiated Rate	$48.70
Rate for Payer: Qualcare PPO/HMO/WC	$48.70

1.5MM TI CORTX SCRW SLFTAP 9MM

Facility

$152.75

Service Code	HCPCS C1713
Hospital Charge Code	270686788
Hospital Revenue Code	278
Min. Negotiated Rate	$3.68
Max. Negotiated Rate	$76.38
Rate for Payer: Aetna Commercial	$58.05
Rate for Payer: Aetna Medicare Advantage	$45.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.95
Rate for Payer: Cigna Commercial	$76.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.60
Rate for Payer: Qualcare PPO/HMO/WC	$22.91
Rate for Payer: UnitedHealthcare Community & State	$3.68
Rate for Payer: Wellpoint Medicaid Managed Care	$4.05

1.5MM TI CORTX SCRW SLFTAP 9MM

Facility

$152.75

Service Code	HCPCS C1713
Hospital Charge Code	270686788
Hospital Revenue Code	278
Min. Negotiated Rate	$22.91
Max. Negotiated Rate	$36.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.60
Rate for Payer: Qualcare PPO/HMO/WC	$22.91

1.5MM TI CRTX SCRW SLFTAP 13MM

Facility

$152.75

Service Code	HCPCS C1713
Hospital Charge Code	270686789
Hospital Revenue Code	278
Min. Negotiated Rate	$3.68
Max. Negotiated Rate	$76.38
Rate for Payer: Aetna Commercial	$58.05
Rate for Payer: Aetna Medicare Advantage	$45.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.95
Rate for Payer: Cigna Commercial	$76.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.60
Rate for Payer: Qualcare PPO/HMO/WC	$22.91
Rate for Payer: UnitedHealthcare Community & State	$3.68
Rate for Payer: Wellpoint Medicaid Managed Care	$4.05

1.5MM TI CRTX SCRW SLFTAP 13MM

Facility

$152.75

Service Code	HCPCS C1713
Hospital Charge Code	270686789
Hospital Revenue Code	278
Min. Negotiated Rate	$22.91
Max. Negotiated Rate	$36.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.60
Rate for Payer: Qualcare PPO/HMO/WC	$22.91

Know your out-of-pocket cost for care.

All Charges