Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

1STDAYHOSP CARE LOW SEV

Facility

$350.00

Service Code	HCPCS 99221
Hospital Charge Code	83246195
Hospital Revenue Code	919
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$133.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Community & State	$8.44
Rate for Payer: Wellpoint Medicaid Managed Care	$9.28

1STDAYHOSP CARE LOW SEV

Facility

$350.00

Service Code	HCPCS 99221
Hospital Charge Code	83246195
Hospital Revenue Code	919
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

1STDAYHOSP CARE MED SEV

Facility

$350.00

Service Code	HCPCS 99222
Hospital Charge Code	83246200
Hospital Revenue Code	919
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

1STDAYHOSP CARE MED SEV

Facility

$350.00

Service Code	HCPCS 99222
Hospital Charge Code	83246200
Hospital Revenue Code	919
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$133.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Community & State	$8.44
Rate for Payer: Wellpoint Medicaid Managed Care	$9.28

1 STRATAFIX 1

Facility

$141.70

Hospital Charge Code	270686133
Hospital Revenue Code	272
Min. Negotiated Rate	$3.41
Max. Negotiated Rate	$70.85
Rate for Payer: Aetna Commercial	$53.85
Rate for Payer: Aetna Medicare Advantage	$42.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.13
Rate for Payer: Cigna Commercial	$70.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.51
Rate for Payer: Oxford Commercial	$28.34
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$28.34
Rate for Payer: UnitedHealthcare Community & State	$3.41
Rate for Payer: Wellpoint Medicaid Managed Care	$3.76

1 STRATAFIX 1

Facility

$141.70

Hospital Charge Code	270686133
Hospital Revenue Code	272
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

1' SUTR BTH RPTR ANKLE CRL LIG

Facility

$30,651.00

Service Code	HCPCS 27696
Hospital Charge Code	16000626
Hospital Revenue Code	360
Min. Negotiated Rate	$4,597.65
Max. Negotiated Rate	$4,597.65
Rate for Payer: Qualcare PPO/HMO/WC	$4,597.65

1' SUTR BTH RPTR ANKLE CRL LIG

Facility

$30,651.00

Service Code	HCPCS 27696
Hospital Charge Code	16000626
Hospital Revenue Code	360
Min. Negotiated Rate	$738.69
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,195.30
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,597.65
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$738.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,880.57
Rate for Payer: Wellpoint Medicaid Managed Care	$15,569.19

200MM CARBON ROD

Facility

$775.00

Hospital Charge Code	270339507
Hospital Revenue Code	278
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$187.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
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

200MM CARBON ROD

Facility

$775.00

Hospital Charge Code	270339507
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

200MM RODS

Facility

$5,287.00

Service Code	HCPCS C1713
Hospital Charge Code	270688890
Hospital Revenue Code	278
Min. Negotiated Rate	$127.42
Max. Negotiated Rate	$2,643.50
Rate for Payer: Aetna Commercial	$2,009.06
Rate for Payer: Aetna Medicare Advantage	$1,586.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,348.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,348.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,057.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,348.18
Rate for Payer: Cigna Commercial	$2,643.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,279.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,163.14
Rate for Payer: Qualcare PPO/HMO/WC	$793.05
Rate for Payer: UnitedHealthcare Community & State	$127.42
Rate for Payer: Wellpoint Medicaid Managed Care	$140.11

200MM RODS

Facility

$5,287.00

Service Code	HCPCS C1713
Hospital Charge Code	270688890
Hospital Revenue Code	278
Min. Negotiated Rate	$793.05
Max. Negotiated Rate	$1,279.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,057.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,279.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,163.14
Rate for Payer: Qualcare PPO/HMO/WC	$793.05

2019-COVID19 (LABCORP)

Facility

$387.00

Service Code	HCPCS U0002
Hospital Charge Code	4013U0002
Hospital Revenue Code	306
Min. Negotiated Rate	$58.05
Max. Negotiated Rate	$58.05
Rate for Payer: Qualcare PPO/HMO/WC	$58.05

2019-COVID19 (LABCORP)

Facility

$387.00

Service Code	HCPCS U0002
Hospital Charge Code	4013U0002
Hospital Revenue Code	306
Min. Negotiated Rate	$10.26
Max. Negotiated Rate	$193.50
Rate for Payer: Aetna Commercial	$139.56
Rate for Payer: Aetna Medicare Advantage	$166.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$51.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.21
Rate for Payer: Cigna Commercial	$193.50
Rate for Payer: Cigna Medicare Advantage	$51.31
Rate for Payer: Clover Medicare Advantage	$48.74
Rate for Payer: EmblemHealth Commercial	$153.93
Rate for Payer: Humana Medicare Advantage	$52.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$51.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$41.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$51.31
Rate for Payer: Wellcare Medicare Advantage	$51.31
Rate for Payer: Wellpoint Medicaid Managed Care	$10.26

-20. 22MM FEMORAL HEAD

Facility

$2,721.90

Hospital Charge Code	270656853
Hospital Revenue Code	278
Min. Negotiated Rate	$65.60
Max. Negotiated Rate	$1,360.95
Rate for Payer: Aetna Commercial	$1,034.32
Rate for Payer: Aetna Medicare Advantage	$816.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$694.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$694.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$544.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$694.08
Rate for Payer: Cigna Commercial	$1,360.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$658.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$598.82
Rate for Payer: Qualcare PPO/HMO/WC	$408.29
Rate for Payer: UnitedHealthcare Community & State	$65.60
Rate for Payer: Wellpoint Medicaid Managed Care	$72.13

-20. 22MM FEMORAL HEAD

Facility

$2,721.90

Hospital Charge Code	270656853
Hospital Revenue Code	278
Min. Negotiated Rate	$408.29
Max. Negotiated Rate	$658.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$544.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$658.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$598.82
Rate for Payer: Qualcare PPO/HMO/WC	$408.29

20.427

Facility

$250.00

Service Code	HCPCS 7363050
Hospital Charge Code	94270109
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

20.427

Facility

$250.00

Service Code	HCPCS 7363050
Hospital Charge Code	94270109
Hospital Revenue Code	320
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

2.0 ASNIS MICRO CANN SCREW 18/

Facility

$1,421.80

Service Code	HCPCS C1713
Hospital Charge Code	270687827
Hospital Revenue Code	278
Min. Negotiated Rate	$213.27
Max. Negotiated Rate	$344.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$312.80
Rate for Payer: Qualcare PPO/HMO/WC	$213.27

2.0 ASNIS MICRO CANN SCREW 18/

Facility

$1,421.80

Service Code	HCPCS C1713
Hospital Charge Code	270687827
Hospital Revenue Code	278
Min. Negotiated Rate	$34.27
Max. Negotiated Rate	$710.90
Rate for Payer: Aetna Commercial	$540.28
Rate for Payer: Aetna Medicare Advantage	$426.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$362.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$362.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$362.56
Rate for Payer: Cigna Commercial	$710.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$312.80
Rate for Payer: Qualcare PPO/HMO/WC	$213.27
Rate for Payer: UnitedHealthcare Community & State	$34.27
Rate for Payer: Wellpoint Medicaid Managed Care	$37.68

2.0 ASNIS MICRO CANN SCREW 19/

Facility

$1,421.80

Service Code	HCPCS C1713
Hospital Charge Code	270687826
Hospital Revenue Code	278
Min. Negotiated Rate	$34.27
Max. Negotiated Rate	$710.90
Rate for Payer: Aetna Commercial	$540.28
Rate for Payer: Aetna Medicare Advantage	$426.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$362.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$362.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$362.56
Rate for Payer: Cigna Commercial	$710.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$312.80
Rate for Payer: Qualcare PPO/HMO/WC	$213.27
Rate for Payer: UnitedHealthcare Community & State	$34.27
Rate for Payer: Wellpoint Medicaid Managed Care	$37.68

2.0 ASNIS MICRO CANN SCREW 19/

Facility

$1,421.80

Service Code	HCPCS C1713
Hospital Charge Code	270687826
Hospital Revenue Code	278
Min. Negotiated Rate	$213.27
Max. Negotiated Rate	$344.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$312.80
Rate for Payer: Qualcare PPO/HMO/WC	$213.27

2.0 ASNIS MICRO CANN SCREW 20/

Facility

$1,421.80

Service Code	HCPCS C1713
Hospital Charge Code	270687825
Hospital Revenue Code	278
Min. Negotiated Rate	$213.27
Max. Negotiated Rate	$344.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$312.80
Rate for Payer: Qualcare PPO/HMO/WC	$213.27

2.0 ASNIS MICRO CANN SCREW 20/

Facility

$1,421.80

Service Code	HCPCS C1713
Hospital Charge Code	270687825
Hospital Revenue Code	278
Min. Negotiated Rate	$34.27
Max. Negotiated Rate	$710.90
Rate for Payer: Aetna Commercial	$540.28
Rate for Payer: Aetna Medicare Advantage	$426.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$362.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$362.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$362.56
Rate for Payer: Cigna Commercial	$710.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$312.80
Rate for Payer: Qualcare PPO/HMO/WC	$213.27
Rate for Payer: UnitedHealthcare Community & State	$34.27
Rate for Payer: Wellpoint Medicaid Managed Care	$37.68

20 CM RAIL

Facility

$4,345.00

Hospital Charge Code	270656619
Hospital Revenue Code	278
Min. Negotiated Rate	$651.75
Max. Negotiated Rate	$1,051.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$869.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,051.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$955.90
Rate for Payer: Qualcare PPO/HMO/WC	$651.75

Know your out-of-pocket cost for care.

All Charges