Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CITREFIX IMPLANT 2.9X12.5MM

Facility

$3,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270700363
Hospital Revenue Code	278
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$99.38

CITREFIX IMPLANT 2.9X12.5MM

Facility

$3,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270700363
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

CITREFIX IMPLANT 3.5X15.5MM

Facility

$3,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270700361
Hospital Revenue Code	278
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$99.38

CITREFIX IMPLANT 3.5X15.5MM

Facility

$3,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270700361
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

CITREFIX XPRESS IMPL2.9X12.5MM

Facility

$7,855.00

Service Code	HCPCS C1889
Hospital Charge Code	270700362
Hospital Revenue Code	278
Min. Negotiated Rate	$1,178.25
Max. Negotiated Rate	$1,900.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,571.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,900.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,728.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,178.25

CITREFIX XPRESS IMPL2.9X12.5MM

Facility

$7,855.00

Service Code	HCPCS C1889
Hospital Charge Code	270700362
Hospital Revenue Code	278
Min. Negotiated Rate	$189.31
Max. Negotiated Rate	$3,927.50
Rate for Payer: Aetna Commercial	$2,984.90
Rate for Payer: Aetna Medicare Advantage	$2,356.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,003.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,003.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,571.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,003.03
Rate for Payer: Cigna Commercial	$3,927.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,900.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,728.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,178.25
Rate for Payer: UnitedHealthcare Community & State	$189.31
Rate for Payer: Wellpoint Medicaid Managed Care	$208.16

CITREFIX XPRESS IMPL3.5X15.5MM

Facility

$7,855.00

Service Code	HCPCS C1889
Hospital Charge Code	270700364
Hospital Revenue Code	278
Min. Negotiated Rate	$189.31
Max. Negotiated Rate	$3,927.50
Rate for Payer: Aetna Commercial	$2,984.90
Rate for Payer: Aetna Medicare Advantage	$2,356.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,003.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,003.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,571.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,003.03
Rate for Payer: Cigna Commercial	$3,927.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,900.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,728.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,178.25
Rate for Payer: UnitedHealthcare Community & State	$189.31
Rate for Payer: Wellpoint Medicaid Managed Care	$208.16

CITREFIX XPRESS IMPL3.5X15.5MM

Facility

$7,855.00

Service Code	HCPCS C1889
Hospital Charge Code	270700364
Hospital Revenue Code	278
Min. Negotiated Rate	$1,178.25
Max. Negotiated Rate	$1,900.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,571.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,900.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,728.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,178.25

CITREFIX XPRESS SYS 2.9X12.5MM

Facility

$7,855.00

Service Code	HCPCS C1713
Hospital Charge Code	270700346
Hospital Revenue Code	278
Min. Negotiated Rate	$1,178.25
Max. Negotiated Rate	$1,900.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,571.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,900.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,728.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,178.25

CITREFIX XPRESS SYS 2.9X12.5MM

Facility

$7,855.00

Service Code	HCPCS C1713
Hospital Charge Code	270700346
Hospital Revenue Code	278
Min. Negotiated Rate	$189.31
Max. Negotiated Rate	$3,927.50
Rate for Payer: Aetna Commercial	$2,984.90
Rate for Payer: Aetna Medicare Advantage	$2,356.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,003.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,003.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,571.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,003.03
Rate for Payer: Cigna Commercial	$3,927.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,900.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,728.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,178.25
Rate for Payer: UnitedHealthcare Community & State	$189.31
Rate for Payer: Wellpoint Medicaid Managed Care	$208.16

CITREFIX XPRESS SYS 4.5X24MM

Facility

$9,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270700371
Hospital Revenue Code	278
Min. Negotiated Rate	$234.97
Max. Negotiated Rate	$4,875.00
Rate for Payer: Aetna Commercial	$3,705.00
Rate for Payer: Aetna Medicare Advantage	$2,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,486.25
Rate for Payer: Cigna Commercial	$4,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,145.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50
Rate for Payer: UnitedHealthcare Community & State	$234.97
Rate for Payer: Wellpoint Medicaid Managed Care	$258.38

CITREFIX XPRESS SYS 4.5X24MM

Facility

$9,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270700371
Hospital Revenue Code	278
Min. Negotiated Rate	$1,462.50
Max. Negotiated Rate	$2,359.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,145.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50

CITREGEN TENDON SIZING SYSTEM

Facility

$994.85

Hospital Charge Code	270701085
Hospital Revenue Code	279
Min. Negotiated Rate	$149.23
Max. Negotiated Rate	$149.23
Rate for Payer: Qualcare PPO/HMO/WC	$149.23

CITREGEN TENDON SIZING SYSTEM

Facility

$994.85

Hospital Charge Code	270701085
Hospital Revenue Code	279
Min. Negotiated Rate	$23.98
Max. Negotiated Rate	$497.43
Rate for Payer: Aetna Commercial	$378.04
Rate for Payer: Aetna Medicare Advantage	$298.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.69
Rate for Payer: Cigna Commercial	$497.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$298.45
Rate for Payer: Oxford Commercial	$198.97
Rate for Payer: Qualcare PPO/HMO/WC	$149.23
Rate for Payer: UnitedHealthcare Commercial	$198.97
Rate for Payer: UnitedHealthcare Community & State	$23.98
Rate for Payer: Wellpoint Medicaid Managed Care	$26.36

CITRILOCK XPRESS IMPL SYS 5X15

Facility

$7,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270701086
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,540.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

CITRILOCK XPRESS IMPL SYS 5X15

Facility

$7,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270701086
Hospital Revenue Code	278
Min. Negotiated Rate	$168.70
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,660.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,540.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00
Rate for Payer: UnitedHealthcare Community & State	$168.70
Rate for Payer: Wellpoint Medicaid Managed Care	$185.50

CK5/6-IHC

Facility

$2,164.00

Service Code	HCPCS 88342
Hospital Charge Code	4016883424
Hospital Revenue Code	310
Min. Negotiated Rate	$57.35
Max. Negotiated Rate	$730.60
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$730.60
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$649.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$324.60
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$86.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$57.35

CK5/6-IHC

Facility

$2,164.00

Service Code	HCPCS 88342
Hospital Charge Code	4016883424
Hospital Revenue Code	310
Min. Negotiated Rate	$324.60
Max. Negotiated Rate	$324.60
Rate for Payer: Qualcare PPO/HMO/WC	$324.60

CK ISOENZYMES

Facility

$403.00

Service Code	HCPCS 82552
Hospital Charge Code	38472007
Hospital Revenue Code	301
Min. Negotiated Rate	$60.45
Max. Negotiated Rate	$60.45
Rate for Payer: Qualcare PPO/HMO/WC	$60.45

CK ISOENZYMES

Facility

$385.26

Service Code	HCPCS 82550
Hospital Charge Code	3035131B
Hospital Revenue Code	301
Min. Negotiated Rate	$5.21
Max. Negotiated Rate	$192.63
Rate for Payer: Aetna Commercial	$17.71
Rate for Payer: Aetna Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.50
Rate for Payer: Cigna Commercial	$192.63
Rate for Payer: Cigna Medicare Advantage	$6.51
Rate for Payer: Clover Medicare Advantage	$6.18
Rate for Payer: EmblemHealth Commercial	$19.53
Rate for Payer: Humana Medicare Advantage	$6.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.58
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.79
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.51
Rate for Payer: Wellcare Medicare Advantage	$6.51
Rate for Payer: Wellpoint Medicaid Managed Care	$10.21

CK ISOENZYMES

Facility

$385.26

Service Code	HCPCS 82550
Hospital Charge Code	3035131B
Hospital Revenue Code	301
Min. Negotiated Rate	$57.79
Max. Negotiated Rate	$57.79
Rate for Payer: Qualcare PPO/HMO/WC	$57.79

CK ISOENZYMES

Facility

$136.85

Service Code	HCPCS 82552
Hospital Charge Code	3035131A
Hospital Revenue Code	301
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$36.42
Rate for Payer: Aetna Medicare Advantage	$43.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.39
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	$48.33
Rate for Payer: Cigna Commercial	$68.42
Rate for Payer: Cigna Medicare Advantage	$13.39
Rate for Payer: Clover Medicare Advantage	$12.72
Rate for Payer: EmblemHealth Commercial	$40.17
Rate for Payer: Humana Medicare Advantage	$13.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.53
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.39
Rate for Payer: Wellcare Medicare Advantage	$13.39
Rate for Payer: Wellpoint Medicaid Managed Care	$3.63

CK ISOENZYMES

Facility

$403.00

Service Code	HCPCS 82552
Hospital Charge Code	38472007
Hospital Revenue Code	301
Min. Negotiated Rate	$10.68
Max. Negotiated Rate	$201.50
Rate for Payer: Aetna Commercial	$36.42
Rate for Payer: Aetna Medicare Advantage	$43.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.39
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	$48.33
Rate for Payer: Cigna Commercial	$201.50
Rate for Payer: Cigna Medicare Advantage	$13.39
Rate for Payer: Clover Medicare Advantage	$12.72
Rate for Payer: EmblemHealth Commercial	$40.17
Rate for Payer: Humana Medicare Advantage	$13.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.39
Rate for Payer: Wellcare Medicare Advantage	$13.39
Rate for Payer: Wellpoint Medicaid Managed Care	$10.68

CK ISOENZYMES

Facility

$136.85

Service Code	HCPCS 82552
Hospital Charge Code	3035131A
Hospital Revenue Code	301
Min. Negotiated Rate	$20.53
Max. Negotiated Rate	$20.53
Rate for Payer: Qualcare PPO/HMO/WC	$20.53

CK MB

Facility

$807.65

Service Code	HCPCS 82553
Hospital Charge Code	3031432
Hospital Revenue Code	301
Min. Negotiated Rate	$121.15
Max. Negotiated Rate	$121.15
Rate for Payer: Qualcare PPO/HMO/WC	$121.15

Know your out-of-pocket cost for care.

All Charges