Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

15MMX30MM STEM EXTENSION

Facility

$5,245.85

Hospital Charge Code	270656851
Hospital Revenue Code	278
Min. Negotiated Rate	$126.42
Max. Negotiated Rate	$2,622.93
Rate for Payer: Aetna Commercial	$1,993.42
Rate for Payer: Aetna Medicare Advantage	$1,573.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,337.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,337.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,049.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,337.69
Rate for Payer: Cigna Commercial	$2,622.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,269.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,154.09
Rate for Payer: Qualcare PPO/HMO/WC	$786.88
Rate for Payer: UnitedHealthcare Community & State	$126.42
Rate for Payer: Wellpoint Medicaid Managed Care	$139.02

15MMX30MM STEM EXTENSION

Facility

$5,245.85

Hospital Charge Code	270656851
Hospital Revenue Code	278
Min. Negotiated Rate	$786.88
Max. Negotiated Rate	$1,269.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,049.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,269.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,154.09
Rate for Payer: Qualcare PPO/HMO/WC	$786.88

1.5 PLATE

Facility

$2,431.55

Service Code	HCPCS C1713
Hospital Charge Code	270681683
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 PLATE

Facility

$2,431.55

Service Code	HCPCS C1713
Hospital Charge Code	270681683
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

15X12X7MM 6DEG CERVICAL SPACER

Facility

$8,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704207
Hospital Revenue Code	278
Min. Negotiated Rate	$192.80
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$3,040.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,760.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$192.80
Rate for Payer: Wellpoint Medicaid Managed Care	$212.00

15X12X7MM 6DEG CERVICAL SPACER

Facility

$8,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704207
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,760.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

15X12X7MM TITANIUM STATIC CAGE

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270704088
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

15X12X7MM TITANIUM STATIC CAGE

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270704088
Hospital Revenue Code	278
Min. Negotiated Rate	$162.68
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$162.68
Rate for Payer: Wellpoint Medicaid Managed Care	$178.88

15X12X8MM TITANIUM STATIC CAGE

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270704089
Hospital Revenue Code	278
Min. Negotiated Rate	$162.68
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$162.68
Rate for Payer: Wellpoint Medicaid Managed Care	$178.88

15X12X8MM TITANIUM STATIC CAGE

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270704089
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

15X17MM COVER PLATE

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705502
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$2,904.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,640.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

15X17MM COVER PLATE

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705502
Hospital Revenue Code	278
Min. Negotiated Rate	$289.20
Max. Negotiated Rate	$6,000.00
Rate for Payer: Aetna Commercial	$4,560.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,640.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Community & State	$289.20
Rate for Payer: Wellpoint Medicaid Managed Care	$318.00

16FR REPLACEMENT G-TUBE

Facility

$138.40

Hospital Charge Code	270663494
Hospital Revenue Code	272
Min. Negotiated Rate	$20.76
Max. Negotiated Rate	$20.76
Rate for Payer: Qualcare PPO/HMO/WC	$20.76

16FR REPLACEMENT G-TUBE

Facility

$138.40

Hospital Charge Code	270663494
Hospital Revenue Code	272
Min. Negotiated Rate	$3.34
Max. Negotiated Rate	$69.20
Rate for Payer: Aetna Commercial	$52.59
Rate for Payer: Aetna Medicare Advantage	$41.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.29
Rate for Payer: Cigna Commercial	$69.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.52
Rate for Payer: Oxford Commercial	$27.68
Rate for Payer: Qualcare PPO/HMO/WC	$20.76
Rate for Payer: UnitedHealthcare Commercial	$27.68
Rate for Payer: UnitedHealthcare Community & State	$3.34
Rate for Payer: Wellpoint Medicaid Managed Care	$3.67

16FX24 CMSPLIT CATH 19 TO CUFF

Facility

$1,540.00

Hospital Charge Code	270681346
Hospital Revenue Code	272
Min. Negotiated Rate	$37.11
Max. Negotiated Rate	$770.00
Rate for Payer: Aetna Commercial	$585.20
Rate for Payer: Aetna Medicare Advantage	$462.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$392.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$392.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$392.70
Rate for Payer: Cigna Commercial	$770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$462.00
Rate for Payer: Oxford Commercial	$308.00
Rate for Payer: Qualcare PPO/HMO/WC	$231.00
Rate for Payer: UnitedHealthcare Commercial	$308.00
Rate for Payer: UnitedHealthcare Community & State	$37.11
Rate for Payer: Wellpoint Medicaid Managed Care	$40.81

16FX24 CMSPLIT CATH 19 TO CUFF

Facility

$1,540.00

Hospital Charge Code	270681346
Hospital Revenue Code	272
Min. Negotiated Rate	$231.00
Max. Negotiated Rate	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$231.00

16FX28CM SPLIT CATH 23 TO CUFF

Facility

$1,540.00

Hospital Charge Code	270681347
Hospital Revenue Code	272
Min. Negotiated Rate	$37.11
Max. Negotiated Rate	$770.00
Rate for Payer: Aetna Commercial	$585.20
Rate for Payer: Aetna Medicare Advantage	$462.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$392.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$392.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$392.70
Rate for Payer: Cigna Commercial	$770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$462.00
Rate for Payer: Oxford Commercial	$308.00
Rate for Payer: Qualcare PPO/HMO/WC	$231.00
Rate for Payer: UnitedHealthcare Commercial	$308.00
Rate for Payer: UnitedHealthcare Community & State	$37.11
Rate for Payer: Wellpoint Medicaid Managed Care	$40.81

16FX28CM SPLIT CATH 23 TO CUFF

Facility

$1,540.00

Hospital Charge Code	270681347
Hospital Revenue Code	272
Min. Negotiated Rate	$231.00
Max. Negotiated Rate	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$231.00

1.6 GUIDE WIRE WITH TIP

Facility

$4,730.00

Service Code	HCPCS C1769
Hospital Charge Code	270680978
Hospital Revenue Code	278
Min. Negotiated Rate	$113.99
Max. Negotiated Rate	$2,365.00
Rate for Payer: Aetna Commercial	$1,797.40
Rate for Payer: Aetna Medicare Advantage	$1,419.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,206.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,206.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$946.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,206.15
Rate for Payer: Cigna Commercial	$2,365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,144.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,040.60
Rate for Payer: Qualcare PPO/HMO/WC	$709.50
Rate for Payer: UnitedHealthcare Community & State	$113.99
Rate for Payer: Wellpoint Medicaid Managed Care	$125.34

1.6 GUIDE WIRE WITH TIP

Facility

$4,730.00

Service Code	HCPCS C1769
Hospital Charge Code	270680978
Hospital Revenue Code	278
Min. Negotiated Rate	$709.50
Max. Negotiated Rate	$1,144.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$946.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,144.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,040.60
Rate for Payer: Qualcare PPO/HMO/WC	$709.50

1.6 K WIRE

Facility

$392.70

Service Code	HCPCS C1713
Hospital Charge Code	270691336
Hospital Revenue Code	278
Min. Negotiated Rate	$58.91
Max. Negotiated Rate	$95.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$78.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$86.39
Rate for Payer: Qualcare PPO/HMO/WC	$58.91

1.6 K WIRE

Facility

$392.70

Service Code	HCPCS C1713
Hospital Charge Code	270691336
Hospital Revenue Code	278
Min. Negotiated Rate	$9.46
Max. Negotiated Rate	$196.35
Rate for Payer: Aetna Commercial	$149.23
Rate for Payer: Aetna Medicare Advantage	$117.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$78.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.14
Rate for Payer: Cigna Commercial	$196.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$86.39
Rate for Payer: Qualcare PPO/HMO/WC	$58.91
Rate for Payer: UnitedHealthcare Community & State	$9.46
Rate for Payer: Wellpoint Medicaid Managed Care	$10.41

1.6 K-WIRE

Facility

$75.00

Service Code	HCPCS C1769
Hospital Charge Code	270656528
Hospital Revenue Code	278
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) NJ Health	$15.00
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	$18.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

1.6 K-WIRE

Facility

$75.00

Service Code	HCPCS C1769
Hospital Charge Code	270656528
Hospital Revenue Code	278
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$18.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

16MM CANNULATED PERC FLEX DRIL

Facility

$4,016.60

Hospital Charge Code	270681682
Hospital Revenue Code	272
Min. Negotiated Rate	$602.49
Max. Negotiated Rate	$602.49
Rate for Payer: Qualcare PPO/HMO/WC	$602.49

Know your out-of-pocket cost for care.

All Charges