Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ENCOMPASS 12MM HA COATED IMPLA

Facility

$11,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270679321
Hospital Revenue Code	278
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$2,662.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

ENCORE 26 INFLATION DEVICE

Facility

$310.10

Hospital Charge Code	270656981
Hospital Revenue Code	272
Min. Negotiated Rate	$46.52
Max. Negotiated Rate	$46.52
Rate for Payer: Qualcare PPO/HMO/WC	$46.52

ENCORE 26 INFLATION DEVICE

Facility

$310.10

Hospital Charge Code	270656981
Hospital Revenue Code	272
Min. Negotiated Rate	$7.47
Max. Negotiated Rate	$155.05
Rate for Payer: Aetna Commercial	$117.84
Rate for Payer: Aetna Medicare Advantage	$93.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.08
Rate for Payer: Cigna Commercial	$155.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.03
Rate for Payer: Oxford Commercial	$62.02
Rate for Payer: Qualcare PPO/HMO/WC	$46.52
Rate for Payer: UnitedHealthcare Commercial	$62.02
Rate for Payer: UnitedHealthcare Community & State	$7.47
Rate for Payer: Wellpoint Medicaid Managed Care	$8.22

ENDARSECTOR WHITE 20 1001-755

Facility

$45.50

Hospital Charge Code	270622089
Hospital Revenue Code	270
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$22.75
Rate for Payer: Aetna Commercial	$17.29
Rate for Payer: Aetna Medicare Advantage	$13.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.60
Rate for Payer: Cigna Commercial	$22.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.65
Rate for Payer: Oxford Commercial	$9.10
Rate for Payer: Qualcare PPO/HMO/WC	$6.83
Rate for Payer: UnitedHealthcare Commercial	$9.10
Rate for Payer: UnitedHealthcare Community & State	$1.10
Rate for Payer: Wellpoint Medicaid Managed Care	$1.21

ENDARSECTOR WHITE 20 1001-755

Facility

$45.50

Hospital Charge Code	270622089
Hospital Revenue Code	270
Min. Negotiated Rate	$6.83
Max. Negotiated Rate	$6.83
Rate for Payer: Qualcare PPO/HMO/WC	$6.83

END CAP 0

Facility

$1,062.20

Hospital Charge Code	270687793
Hospital Revenue Code	272
Min. Negotiated Rate	$25.60
Max. Negotiated Rate	$531.10
Rate for Payer: Aetna Commercial	$403.64
Rate for Payer: Aetna Medicare Advantage	$318.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$270.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$270.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$270.86
Rate for Payer: Cigna Commercial	$531.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.66
Rate for Payer: Oxford Commercial	$212.44
Rate for Payer: Qualcare PPO/HMO/WC	$159.33
Rate for Payer: UnitedHealthcare Commercial	$212.44
Rate for Payer: UnitedHealthcare Community & State	$25.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.15

END CAP 0

Facility

$1,088.95

Hospital Charge Code	270687877
Hospital Revenue Code	272
Min. Negotiated Rate	$26.24
Max. Negotiated Rate	$544.48
Rate for Payer: Aetna Commercial	$413.80
Rate for Payer: Aetna Medicare Advantage	$326.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$277.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$277.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$277.68
Rate for Payer: Cigna Commercial	$544.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$326.69
Rate for Payer: Oxford Commercial	$217.79
Rate for Payer: Qualcare PPO/HMO/WC	$163.34
Rate for Payer: UnitedHealthcare Commercial	$217.79
Rate for Payer: UnitedHealthcare Community & State	$26.24
Rate for Payer: Wellpoint Medicaid Managed Care	$28.86

END CAP 0

Facility

$1,088.95

Hospital Charge Code	270687877
Hospital Revenue Code	272
Min. Negotiated Rate	$163.34
Max. Negotiated Rate	$163.34
Rate for Payer: Qualcare PPO/HMO/WC	$163.34

END CAP 0

Facility

$1,062.20

Hospital Charge Code	270687793
Hospital Revenue Code	272
Min. Negotiated Rate	$159.33
Max. Negotiated Rate	$159.33
Rate for Payer: Qualcare PPO/HMO/WC	$159.33

END CAP 15 MM EXTENTION

Facility

$979.95

Service Code	HCPCS C1713
Hospital Charge Code	270688998
Hospital Revenue Code	278
Min. Negotiated Rate	$146.99
Max. Negotiated Rate	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$215.59
Rate for Payer: Qualcare PPO/HMO/WC	$146.99

END CAP 15 MM EXTENTION

Facility

$979.95

Service Code	HCPCS C1713
Hospital Charge Code	270688998
Hospital Revenue Code	278
Min. Negotiated Rate	$23.62
Max. Negotiated Rate	$489.98
Rate for Payer: Aetna Commercial	$372.38
Rate for Payer: Aetna Medicare Advantage	$293.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.89
Rate for Payer: Cigna Commercial	$489.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$215.59
Rate for Payer: Qualcare PPO/HMO/WC	$146.99
Rate for Payer: UnitedHealthcare Community & State	$23.62
Rate for Payer: Wellpoint Medicaid Managed Care	$25.97

END CAP 1-PIECE ITST 225908

Facility

$720.40

Hospital Charge Code	270634158
Hospital Revenue Code	272
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$108.06
Rate for Payer: Qualcare PPO/HMO/WC	$108.06

END CAP 1-PIECE ITST 225908

Facility

$720.40

Hospital Charge Code	270634158
Hospital Revenue Code	272
Min. Negotiated Rate	$17.36
Max. Negotiated Rate	$360.20
Rate for Payer: Aetna Commercial	$273.75
Rate for Payer: Aetna Medicare Advantage	$216.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.70
Rate for Payer: Cigna Commercial	$360.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.12
Rate for Payer: Oxford Commercial	$144.08
Rate for Payer: Qualcare PPO/HMO/WC	$108.06
Rate for Payer: UnitedHealthcare Commercial	$144.08
Rate for Payer: UnitedHealthcare Community & State	$17.36
Rate for Payer: Wellpoint Medicaid Managed Care	$19.09

END CAP 1-PIECE NAIL 0m 225909

Facility

$720.40

Hospital Charge Code	270633873
Hospital Revenue Code	272
Min. Negotiated Rate	$17.36
Max. Negotiated Rate	$360.20
Rate for Payer: Aetna Commercial	$273.75
Rate for Payer: Aetna Medicare Advantage	$216.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.70
Rate for Payer: Cigna Commercial	$360.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.12
Rate for Payer: Oxford Commercial	$144.08
Rate for Payer: Qualcare PPO/HMO/WC	$108.06
Rate for Payer: UnitedHealthcare Commercial	$144.08
Rate for Payer: UnitedHealthcare Community & State	$17.36
Rate for Payer: Wellpoint Medicaid Managed Care	$19.09

END CAP 1-PIECE NAIL 0m 225909

Facility

$720.40

Hospital Charge Code	270633873
Hospital Revenue Code	272
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$108.06
Rate for Payer: Qualcare PPO/HMO/WC	$108.06

END CAP 8X4MM

Facility

$1,530.00

Hospital Charge Code	270670458
Hospital Revenue Code	272
Min. Negotiated Rate	$229.50
Max. Negotiated Rate	$229.50
Rate for Payer: Qualcare PPO/HMO/WC	$229.50

END CAP 8X4MM

Facility

$1,530.00

Hospital Charge Code	270670458
Hospital Revenue Code	272
Min. Negotiated Rate	$36.87
Max. Negotiated Rate	$765.00
Rate for Payer: Aetna Commercial	$581.40
Rate for Payer: Aetna Medicare Advantage	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$390.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$390.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$390.15
Rate for Payer: Cigna Commercial	$765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.00
Rate for Payer: Oxford Commercial	$306.00
Rate for Payer: Qualcare PPO/HMO/WC	$229.50
Rate for Payer: UnitedHealthcare Commercial	$306.00
Rate for Payer: UnitedHealthcare Community & State	$36.87
Rate for Payer: Wellpoint Medicaid Managed Care	$40.55

END CAPARTHRODESIS NAIL PANTA2

Facility

$8,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270699958
Hospital Revenue Code	278
Min. Negotiated Rate	$1,290.00
Max. Negotiated Rate	$2,081.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,720.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,081.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,892.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,290.00

END CAPARTHRODESIS NAIL PANTA2

Facility

$8,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270699958
Hospital Revenue Code	278
Min. Negotiated Rate	$207.26
Max. Negotiated Rate	$4,300.00
Rate for Payer: Aetna Commercial	$3,268.00
Rate for Payer: Aetna Medicare Advantage	$2,580.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,193.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,193.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,720.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,193.00
Rate for Payer: Cigna Commercial	$4,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,081.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,892.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,290.00
Rate for Payer: UnitedHealthcare Community & State	$207.26
Rate for Payer: Wellpoint Medicaid Managed Care	$227.90

ENDCAP BMT 345211

Facility

$813.65

Hospital Charge Code	270614897
Hospital Revenue Code	278
Min. Negotiated Rate	$122.05
Max. Negotiated Rate	$196.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$179.00
Rate for Payer: Qualcare PPO/HMO/WC	$122.05

ENDCAP BMT 345211

Facility

$813.65

Hospital Charge Code	270614897
Hospital Revenue Code	278
Min. Negotiated Rate	$19.61
Max. Negotiated Rate	$406.82
Rate for Payer: Aetna Commercial	$309.19
Rate for Payer: Aetna Medicare Advantage	$244.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.48
Rate for Payer: Cigna Commercial	$406.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$179.00
Rate for Payer: Qualcare PPO/HMO/WC	$122.05
Rate for Payer: UnitedHealthcare Community & State	$19.61
Rate for Payer: Wellpoint Medicaid Managed Care	$21.56

ENDCAP BMT FEMORAL 345216

Facility

$1,005.00

Hospital Charge Code	270614626
Hospital Revenue Code	278
Min. Negotiated Rate	$24.22
Max. Negotiated Rate	$502.50
Rate for Payer: Aetna Commercial	$381.90
Rate for Payer: Aetna Medicare Advantage	$301.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$256.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$256.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$201.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$256.27
Rate for Payer: Cigna Commercial	$502.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$221.10
Rate for Payer: Qualcare PPO/HMO/WC	$150.75
Rate for Payer: UnitedHealthcare Community & State	$24.22
Rate for Payer: Wellpoint Medicaid Managed Care	$26.63

ENDCAP BMT FEMORAL 345216

Facility

$1,005.00

Hospital Charge Code	270614626
Hospital Revenue Code	278
Min. Negotiated Rate	$150.75
Max. Negotiated Rate	$243.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$201.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$221.10
Rate for Payer: Qualcare PPO/HMO/WC	$150.75

ENDCAP BMT FOR NAIL 345220

Facility

$980.00

Hospital Charge Code	270606462
Hospital Revenue Code	278
Min. Negotiated Rate	$147.00
Max. Negotiated Rate	$237.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$215.60
Rate for Payer: Qualcare PPO/HMO/WC	$147.00

ENDCAP BMT FOR NAIL 345220

Facility

$980.00

Hospital Charge Code	270606462
Hospital Revenue Code	278
Min. Negotiated Rate	$23.62
Max. Negotiated Rate	$490.00
Rate for Payer: Aetna Commercial	$372.40
Rate for Payer: Aetna Medicare Advantage	$294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.90
Rate for Payer: Cigna Commercial	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$215.60
Rate for Payer: Qualcare PPO/HMO/WC	$147.00
Rate for Payer: UnitedHealthcare Community & State	$23.62
Rate for Payer: Wellpoint Medicaid Managed Care	$25.97

Know your out-of-pocket cost for care.

All Charges