Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

18 GAUGE NEEDLE W WIRE

Facility

$375.00

Hospital Charge Code	270693289
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

18 GAUGE NEEDLE W WIRE

Facility

$375.00

Hospital Charge Code	270693289
Hospital Revenue Code	272
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$75.00
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

18-HYDROXYCORTICOSTERONE,BLD

Facility

$585.17

Service Code	HCPCS 83519
Hospital Charge Code	3001615
Hospital Revenue Code	301
Min. Negotiated Rate	$14.72
Max. Negotiated Rate	$292.58
Rate for Payer: Aetna Commercial	$50.05
Rate for Payer: Aetna Medicare Advantage	$59.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.42
Rate for Payer: Cigna Commercial	$292.58
Rate for Payer: Cigna Medicare Advantage	$18.40
Rate for Payer: Clover Medicare Advantage	$17.48
Rate for Payer: EmblemHealth Commercial	$55.20
Rate for Payer: Humana Medicare Advantage	$18.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.55
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.78
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.40
Rate for Payer: Wellcare Medicare Advantage	$18.40
Rate for Payer: Wellpoint Medicaid Managed Care	$15.51

18-HYDROXYCORTICOSTERONE,BLD

Facility

$585.17

Service Code	HCPCS 83519
Hospital Charge Code	3001615
Hospital Revenue Code	301
Min. Negotiated Rate	$87.78
Max. Negotiated Rate	$87.78
Rate for Payer: Qualcare PPO/HMO/WC	$87.78

1.8 KNOTLESS FIBERTAK IMPLANT

Facility

$8,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270705808
Hospital Revenue Code	278
Min. Negotiated Rate	$1,237.50
Max. Negotiated Rate	$1,996.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50

1.8 KNOTLESS FIBERTAK IMPLANT

Facility

$8,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270705808
Hospital Revenue Code	278
Min. Negotiated Rate	$198.82
Max. Negotiated Rate	$4,125.00
Rate for Payer: Aetna Commercial	$3,135.00
Rate for Payer: Aetna Medicare Advantage	$2,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,103.75
Rate for Payer: Cigna Commercial	$4,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50
Rate for Payer: UnitedHealthcare Community & State	$198.82
Rate for Payer: Wellpoint Medicaid Managed Care	$218.62

18MM 1-LVL EMERGE PLATE

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270706198
Hospital Revenue Code	278
Min. Negotiated Rate	$126.53
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,995.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,155.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Community & State	$126.53
Rate for Payer: Wellpoint Medicaid Managed Care	$139.12

18MM 1-LVL EMERGE PLATE

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270706198
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,155.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

1.8MM DRILL BIT W/DEPTH MARK/1

Facility

$652.45

Hospital Charge Code	270661256
Hospital Revenue Code	272
Min. Negotiated Rate	$15.72
Max. Negotiated Rate	$326.23
Rate for Payer: Aetna Commercial	$247.93
Rate for Payer: Aetna Medicare Advantage	$195.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.37
Rate for Payer: Cigna Commercial	$326.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.74
Rate for Payer: Oxford Commercial	$130.49
Rate for Payer: Qualcare PPO/HMO/WC	$97.87
Rate for Payer: UnitedHealthcare Commercial	$130.49
Rate for Payer: UnitedHealthcare Community & State	$15.72
Rate for Payer: Wellpoint Medicaid Managed Care	$17.29

1.8MM DRILL BIT W/DEPTH MARK/1

Facility

$652.45

Hospital Charge Code	270661256
Hospital Revenue Code	272
Min. Negotiated Rate	$97.87
Max. Negotiated Rate	$97.87
Rate for Payer: Qualcare PPO/HMO/WC	$97.87

1.8MM O-FIX IMPLANT

Facility

$2,079.00

Service Code	HCPCS C1713
Hospital Charge Code	270679625
Hospital Revenue Code	278
Min. Negotiated Rate	$311.85
Max. Negotiated Rate	$503.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$415.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$503.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$457.38
Rate for Payer: Qualcare PPO/HMO/WC	$311.85

1.8MM O-FIX IMPLANT

Facility

$2,079.00

Service Code	HCPCS C1713
Hospital Charge Code	270679625
Hospital Revenue Code	278
Min. Negotiated Rate	$50.10
Max. Negotiated Rate	$1,039.50
Rate for Payer: Aetna Commercial	$790.02
Rate for Payer: Aetna Medicare Advantage	$623.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$530.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$530.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$415.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$530.14
Rate for Payer: Cigna Commercial	$1,039.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$503.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$457.38
Rate for Payer: Qualcare PPO/HMO/WC	$311.85
Rate for Payer: UnitedHealthcare Community & State	$50.10
Rate for Payer: Wellpoint Medicaid Managed Care	$55.09

1.8MM Q-FIX DISPOSABLE FLEX DR

Facility

$2,430.00

Hospital Charge Code	2707229011
Hospital Revenue Code	272
Min. Negotiated Rate	$364.50
Max. Negotiated Rate	$364.50
Rate for Payer: Qualcare PPO/HMO/WC	$364.50

1.8MM Q-FIX DISPOSABLE FLEX DR

Facility

$2,430.00

Hospital Charge Code	2707229011
Hospital Revenue Code	272
Min. Negotiated Rate	$58.56
Max. Negotiated Rate	$1,215.00
Rate for Payer: Aetna Commercial	$923.40
Rate for Payer: Aetna Medicare Advantage	$729.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$619.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$619.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$619.65
Rate for Payer: Cigna Commercial	$1,215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$729.00
Rate for Payer: Oxford Commercial	$486.00
Rate for Payer: Qualcare PPO/HMO/WC	$364.50
Rate for Payer: UnitedHealthcare Commercial	$486.00
Rate for Payer: UnitedHealthcare Community & State	$58.56
Rate for Payer: Wellpoint Medicaid Managed Care	$64.39

18MM SCREW

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270679111
Hospital Revenue Code	278
Min. Negotiated Rate	$47.24
Max. Negotiated Rate	$980.00
Rate for Payer: Aetna Commercial	$744.80
Rate for Payer: Aetna Medicare Advantage	$588.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$499.80
Rate for Payer: Cigna Commercial	$980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$431.20
Rate for Payer: Qualcare PPO/HMO/WC	$294.00
Rate for Payer: UnitedHealthcare Community & State	$47.24
Rate for Payer: Wellpoint Medicaid Managed Care	$51.94

18MM SCREW

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270679111
Hospital Revenue Code	278
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$474.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$431.20
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

18MM UNIPLATE

Facility

$5,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270680085
Hospital Revenue Code	278
Min. Negotiated Rate	$843.75
Max. Negotiated Rate	$1,361.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,361.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,237.50
Rate for Payer: Qualcare PPO/HMO/WC	$843.75

18MM UNIPLATE

Facility

$5,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270680085
Hospital Revenue Code	278
Min. Negotiated Rate	$135.56
Max. Negotiated Rate	$2,812.50
Rate for Payer: Aetna Commercial	$2,137.50
Rate for Payer: Aetna Medicare Advantage	$1,687.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,434.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,434.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,434.38
Rate for Payer: Cigna Commercial	$2,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,361.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,237.50
Rate for Payer: Qualcare PPO/HMO/WC	$843.75
Rate for Payer: UnitedHealthcare Community & State	$135.56
Rate for Payer: Wellpoint Medicaid Managed Care	$149.06

1/8 QUICK REL DRL STERILE 2PK

Facility

$480.00

Service Code	HCPCS C1768
Hospital Charge Code	270639355
Hospital Revenue Code	272
Min. Negotiated Rate	$72.00
Max. Negotiated Rate	$72.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.00

1/8 QUICK REL DRL STERILE 2PK

Facility

$480.00

Service Code	HCPCS C1768
Hospital Charge Code	270639355
Hospital Revenue Code	272
Min. Negotiated Rate	$11.57
Max. Negotiated Rate	$240.00
Rate for Payer: Aetna Commercial	$182.40
Rate for Payer: Aetna Medicare Advantage	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.40
Rate for Payer: Cigna Commercial	$240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.00
Rate for Payer: Oxford Commercial	$96.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.00
Rate for Payer: UnitedHealthcare Commercial	$96.00
Rate for Payer: UnitedHealthcare Community & State	$11.57
Rate for Payer: Wellpoint Medicaid Managed Care	$12.72

18X16X8MM STATIC CERVICAL

Facility

$17,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270706195
Hospital Revenue Code	278
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$4,174.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

18X16X8MM STATIC CERVICAL

Facility

$17,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270706195
Hospital Revenue Code	278
Min. Negotiated Rate	$415.73
Max. Negotiated Rate	$8,625.00
Rate for Payer: Aetna Commercial	$6,555.00
Rate for Payer: Aetna Medicare Advantage	$5,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,398.75
Rate for Payer: Cigna Commercial	$8,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50
Rate for Payer: UnitedHealthcare Community & State	$415.73
Rate for Payer: Wellpoint Medicaid Managed Care	$457.12

18X16X9MM STATIC CERVICAL

Facility

$17,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270706196
Hospital Revenue Code	278
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$4,174.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

18X16X9MM STATIC CERVICAL

Facility

$17,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270706196
Hospital Revenue Code	278
Min. Negotiated Rate	$415.73
Max. Negotiated Rate	$8,625.00
Rate for Payer: Aetna Commercial	$6,555.00
Rate for Payer: Aetna Medicare Advantage	$5,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,398.75
Rate for Payer: Cigna Commercial	$8,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50
Rate for Payer: UnitedHealthcare Community & State	$415.73
Rate for Payer: Wellpoint Medicaid Managed Care	$457.12

18 X 30CM STRAIGHT GRAFT

Facility

$3,015.00

Service Code	HCPCS C1768
Hospital Charge Code	270683832
Hospital Revenue Code	278
Min. Negotiated Rate	$452.25
Max. Negotiated Rate	$729.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$603.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$729.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$663.30
Rate for Payer: Qualcare PPO/HMO/WC	$452.25

Know your out-of-pocket cost for care.

All Charges