Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CONNECTOR OFFSET 12MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698267
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CONNECTOR PERFECT PASSER

Facility

$1,110.00

Hospital Charge Code	270672940
Hospital Revenue Code	272
Min. Negotiated Rate	$26.75
Max. Negotiated Rate	$555.00
Rate for Payer: Aetna Commercial	$421.80
Rate for Payer: Aetna Medicare Advantage	$333.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$283.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$283.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$283.05
Rate for Payer: Cigna Commercial	$555.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.00
Rate for Payer: Oxford Commercial	$222.00
Rate for Payer: Qualcare PPO/HMO/WC	$166.50
Rate for Payer: UnitedHealthcare Commercial	$222.00
Rate for Payer: UnitedHealthcare Community & State	$26.75
Rate for Payer: Wellpoint Medicaid Managed Care	$29.41

CONNECTOR PERFECT PASSER

Facility

$1,110.00

Hospital Charge Code	270672940
Hospital Revenue Code	272
Min. Negotiated Rate	$166.50
Max. Negotiated Rate	$166.50
Rate for Payer: Qualcare PPO/HMO/WC	$166.50

CONNECTOR PREVENA

Facility

$17.50

Hospital Charge Code	270682887
Hospital Revenue Code	272
Min. Negotiated Rate	$2.62
Max. Negotiated Rate	$2.62
Rate for Payer: Qualcare PPO/HMO/WC	$2.62

CONNECTOR PREVENA

Facility

$17.50

Hospital Charge Code	270682887
Hospital Revenue Code	272
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$8.75
Rate for Payer: Aetna Commercial	$6.65
Rate for Payer: Aetna Medicare Advantage	$5.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.46
Rate for Payer: Cigna Commercial	$8.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.25
Rate for Payer: Oxford Commercial	$3.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.62
Rate for Payer: UnitedHealthcare Commercial	$3.50
Rate for Payer: UnitedHealthcare Community & State	$0.42
Rate for Payer: Wellpoint Medicaid Managed Care	$0.46

CONNECTOR RECIRCULAT RC50-33

Facility

$13.65

Hospital Charge Code	270606420
Hospital Revenue Code	270
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.05

CONNECTOR RECIRCULAT RC50-33

Facility

$13.65

Hospital Charge Code	270606420
Hospital Revenue Code	270
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$6.83
Rate for Payer: Aetna Commercial	$5.19
Rate for Payer: Aetna Medicare Advantage	$4.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.48
Rate for Payer: Cigna Commercial	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.09
Rate for Payer: Oxford Commercial	$2.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.05
Rate for Payer: UnitedHealthcare Commercial	$2.73
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

CONNECTOR REG STER 360

Facility

$5.61

Hospital Charge Code	270300720
Hospital Revenue Code	272
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$0.84
Rate for Payer: Qualcare PPO/HMO/WC	$0.84

CONNECTOR REG STER 360

Facility

$5.61

Hospital Charge Code	270300720
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.81
Rate for Payer: Aetna Commercial	$2.13
Rate for Payer: Aetna Medicare Advantage	$1.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.43
Rate for Payer: Cigna Commercial	$2.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.68
Rate for Payer: Oxford Commercial	$1.12
Rate for Payer: Qualcare PPO/HMO/WC	$0.84
Rate for Payer: UnitedHealthcare Commercial	$1.12
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

CONNECTOR RING FA10023

Facility

$620.00

Hospital Charge Code	270632396
Hospital Revenue Code	272
Min. Negotiated Rate	$14.94
Max. Negotiated Rate	$310.00
Rate for Payer: Aetna Commercial	$235.60
Rate for Payer: Aetna Medicare Advantage	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.10
Rate for Payer: Cigna Commercial	$310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.00
Rate for Payer: Oxford Commercial	$124.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.94
Rate for Payer: Wellpoint Medicaid Managed Care	$16.43

CONNECTOR RING FA10023

Facility

$620.00

Hospital Charge Code	270632396
Hospital Revenue Code	272
Min. Negotiated Rate	$93.00
Max. Negotiated Rate	$93.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.00

CONNECTOR RING FF10023

Facility

$620.00

Hospital Charge Code	270632632
Hospital Revenue Code	272
Min. Negotiated Rate	$93.00
Max. Negotiated Rate	$93.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.00

CONNECTOR RING FF10023

Facility

$620.00

Hospital Charge Code	270632632
Hospital Revenue Code	272
Min. Negotiated Rate	$14.94
Max. Negotiated Rate	$310.00
Rate for Payer: Aetna Commercial	$235.60
Rate for Payer: Aetna Medicare Advantage	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.10
Rate for Payer: Cigna Commercial	$310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.00
Rate for Payer: Oxford Commercial	$124.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.94
Rate for Payer: Wellpoint Medicaid Managed Care	$16.43

CONNECTOR ROD A5 F5 TI SFX

Facility

$6,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270679013
Hospital Revenue Code	278
Min. Negotiated Rate	$153.64
Max. Negotiated Rate	$3,187.50
Rate for Payer: Aetna Commercial	$2,422.50
Rate for Payer: Aetna Medicare Advantage	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,625.62
Rate for Payer: Cigna Commercial	$3,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,402.50
Rate for Payer: Qualcare PPO/HMO/WC	$956.25
Rate for Payer: UnitedHealthcare Community & State	$153.64
Rate for Payer: Wellpoint Medicaid Managed Care	$168.94

CONNECTOR ROD A5 F5 TI SFX

Facility

$6,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270679013
Hospital Revenue Code	278
Min. Negotiated Rate	$956.25
Max. Negotiated Rate	$1,542.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,402.50
Rate for Payer: Qualcare PPO/HMO/WC	$956.25

CONNECTOR SMALL SCREW STD

Facility

$2,190.00

Service Code	HCPCS C1713
Hospital Charge Code	270688183
Hospital Revenue Code	278
Min. Negotiated Rate	$52.78
Max. Negotiated Rate	$1,095.00
Rate for Payer: Aetna Commercial	$832.20
Rate for Payer: Aetna Medicare Advantage	$657.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$558.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$558.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$438.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$558.45
Rate for Payer: Cigna Commercial	$1,095.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$529.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$481.80
Rate for Payer: Qualcare PPO/HMO/WC	$328.50
Rate for Payer: UnitedHealthcare Community & State	$52.78
Rate for Payer: Wellpoint Medicaid Managed Care	$58.03

CONNECTOR SMALL SCREW STD

Facility

$2,190.00

Service Code	HCPCS C1713
Hospital Charge Code	270688183
Hospital Revenue Code	278
Min. Negotiated Rate	$328.50
Max. Negotiated Rate	$529.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$438.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$529.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$481.80
Rate for Payer: Qualcare PPO/HMO/WC	$328.50

CONNECTOR STER SIMS TYPE

Facility

$15.00

Hospital Charge Code	270332247
Hospital Revenue Code	272
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

CONNECTOR STER SIMS TYPE

Facility

$15.00

Hospital Charge Code	270332247
Hospital Revenue Code	272
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$5.70
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.50
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$3.00
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

CONNECTOR STR 6-IN-1

Facility

$9.02

Hospital Charge Code	270649673
Hospital Revenue Code	270
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.51
Rate for Payer: Aetna Commercial	$3.43
Rate for Payer: Aetna Medicare Advantage	$2.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.30
Rate for Payer: Cigna Commercial	$4.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.71
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

CONNECTOR STR 6-IN-1

Facility

$9.02

Hospital Charge Code	270649673
Hospital Revenue Code	270
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

CONNECTOR TRANSVERSE 25-31MM

Facility

$2,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270698271
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

CONNECTOR TRANSVERSE 25-31MM

Facility

$2,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270698271
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

CONNECTOR TRANSVERSE 30-36MM

Facility

$2,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270697977
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

CONNECTOR TRANSVERSE 30-36MM

Facility

$2,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270697977
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

Know your out-of-pocket cost for care.

All Charges