Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FITS 3CC AND 5CC PRO-TEC II SY

Facility

$90.00

Hospital Charge Code	270665913
Hospital Revenue Code	270
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

FITS 3CC AND 5CC PRO-TEC II SY

Facility

$90.00

Hospital Charge Code	270665913
Hospital Revenue Code	270
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.00
Rate for Payer: Oxford Commercial	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$18.00
Rate for Payer: UnitedHealthcare Community & State	$2.17
Rate for Payer: Wellpoint Medicaid Managed Care	$2.38

FITZGERALD FACTOR ASSAY

Facility

$198.00

Service Code	HCPCS 85293
Hospital Charge Code	401385293
Hospital Revenue Code	305
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$51.49
Rate for Payer: Aetna Medicare Advantage	$61.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.33
Rate for Payer: Cigna Commercial	$99.00
Rate for Payer: Cigna Medicare Advantage	$18.93
Rate for Payer: Clover Medicare Advantage	$17.98
Rate for Payer: EmblemHealth Commercial	$56.79
Rate for Payer: Humana Medicare Advantage	$19.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$15.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.93
Rate for Payer: Wellcare Medicare Advantage	$18.93
Rate for Payer: Wellpoint Medicaid Managed Care	$5.25

FITZGERALD FACTOR ASSAY

Facility

$198.00

Service Code	HCPCS 85293
Hospital Charge Code	401385293
Hospital Revenue Code	305
Min. Negotiated Rate	$29.70
Max. Negotiated Rate	$29.70
Rate for Payer: Qualcare PPO/HMO/WC	$29.70

FIX ANG ST SCREW 4X14MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270704425
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

FIX ANG ST SCREW 4X14MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270704425
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

FIXATION CANN W/5MM SEA SINGLE

Facility

$43.35

Hospital Charge Code	270659661
Hospital Revenue Code	272
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$6.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.50

FIXATION CANN W/5MM SEA SINGLE

Facility

$43.35

Hospital Charge Code	270659661
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.68
Rate for Payer: Aetna Commercial	$16.47
Rate for Payer: Aetna Medicare Advantage	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.05
Rate for Payer: Cigna Commercial	$21.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.01
Rate for Payer: Oxford Commercial	$8.67
Rate for Payer: Qualcare PPO/HMO/WC	$6.50
Rate for Payer: UnitedHealthcare Commercial	$8.67
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.15

FIXATION DEVICE ABS W/ 30 TACK

Facility

$3,756.26

Hospital Charge Code	270664468
Hospital Revenue Code	272
Min. Negotiated Rate	$90.53
Max. Negotiated Rate	$1,878.13
Rate for Payer: Aetna Commercial	$1,427.38
Rate for Payer: Aetna Medicare Advantage	$1,126.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$957.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$957.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$957.85
Rate for Payer: Cigna Commercial	$1,878.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,126.88
Rate for Payer: Oxford Commercial	$751.25
Rate for Payer: Qualcare PPO/HMO/WC	$563.44
Rate for Payer: UnitedHealthcare Commercial	$751.25
Rate for Payer: UnitedHealthcare Community & State	$90.53
Rate for Payer: Wellpoint Medicaid Managed Care	$99.54

FIXATION DEVICE ABS W/ 30 TACK

Facility

$3,756.26

Hospital Charge Code	270664468
Hospital Revenue Code	272
Min. Negotiated Rate	$563.44
Max. Negotiated Rate	$563.44
Rate for Payer: Qualcare PPO/HMO/WC	$563.44

FIXATION PEEKSWVLK 4.75 X 19.1

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270688456
Hospital Revenue Code	278
Min. Negotiated Rate	$87.36
Max. Negotiated Rate	$1,812.50
Rate for Payer: Aetna Commercial	$1,377.50
Rate for Payer: Aetna Medicare Advantage	$1,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$924.38
Rate for Payer: Cigna Commercial	$1,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$797.50
Rate for Payer: Qualcare PPO/HMO/WC	$543.75
Rate for Payer: UnitedHealthcare Community & State	$87.36
Rate for Payer: Wellpoint Medicaid Managed Care	$96.06

FIXATION PEEKSWVLK 4.75 X 19.1

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270688456
Hospital Revenue Code	278
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$877.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$797.50
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

FIXATION PIN

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	270704426
Hospital Revenue Code	278
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$125.00
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) NJ Health	$50.00
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	$60.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

FIXATION PIN

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	270704426
Hospital Revenue Code	278
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

FIXATOR 220 DIS RAD 03390053S

Facility

$11,100.00

Hospital Charge Code	270638402
Hospital Revenue Code	272
Min. Negotiated Rate	$1,665.00
Max. Negotiated Rate	$1,665.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,665.00

FIXATOR 220 DIS RAD 03390053S

Facility

$11,100.00

Hospital Charge Code	270638402
Hospital Revenue Code	272
Min. Negotiated Rate	$267.51
Max. Negotiated Rate	$5,550.00
Rate for Payer: Aetna Commercial	$4,218.00
Rate for Payer: Aetna Medicare Advantage	$3,330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,830.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,830.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,830.50
Rate for Payer: Cigna Commercial	$5,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,330.00
Rate for Payer: Oxford Commercial	$2,220.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,665.00
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$267.51
Rate for Payer: Wellpoint Medicaid Managed Care	$294.15

FIXATOR BMT WRISTLOC 500000

Facility

$6,307.25

Hospital Charge Code	270624733
Hospital Revenue Code	272
Min. Negotiated Rate	$946.09
Max. Negotiated Rate	$946.09
Rate for Payer: Qualcare PPO/HMO/WC	$946.09

FIXATOR BMT WRISTLOC 500000

Facility

$6,307.25

Hospital Charge Code	270624733
Hospital Revenue Code	272
Min. Negotiated Rate	$152.00
Max. Negotiated Rate	$3,153.62
Rate for Payer: Aetna Commercial	$2,396.76
Rate for Payer: Aetna Medicare Advantage	$1,892.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,608.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,608.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,608.35
Rate for Payer: Cigna Commercial	$3,153.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,892.17
Rate for Payer: Oxford Commercial	$1,261.45
Rate for Payer: Qualcare PPO/HMO/WC	$946.09
Rate for Payer: UnitedHealthcare Commercial	$1,261.45
Rate for Payer: UnitedHealthcare Community & State	$152.00
Rate for Payer: Wellpoint Medicaid Managed Care	$167.14

FIXATOR DISTAL RADIUS 220MM

Facility

$12,706.10

Hospital Charge Code	270650974
Hospital Revenue Code	272
Min. Negotiated Rate	$306.22
Max. Negotiated Rate	$6,353.05
Rate for Payer: Aetna Commercial	$4,828.32
Rate for Payer: Aetna Medicare Advantage	$3,811.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,240.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,240.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,240.06
Rate for Payer: Cigna Commercial	$6,353.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,811.83
Rate for Payer: Oxford Commercial	$2,541.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,905.91
Rate for Payer: UnitedHealthcare Commercial	$2,541.22
Rate for Payer: UnitedHealthcare Community & State	$306.22
Rate for Payer: Wellpoint Medicaid Managed Care	$336.71

FIXATOR DISTAL RADIUS 220MM

Facility

$12,706.10

Hospital Charge Code	270650974
Hospital Revenue Code	272
Min. Negotiated Rate	$1,905.91
Max. Negotiated Rate	$1,905.91
Rate for Payer: Qualcare PPO/HMO/WC	$1,905.91

FIXATOR DISTAL RADIUS 240MM

Facility

$11,547.00

Hospital Charge Code	270677335
Hospital Revenue Code	278
Min. Negotiated Rate	$278.28
Max. Negotiated Rate	$5,773.50
Rate for Payer: Aetna Commercial	$4,387.86
Rate for Payer: Aetna Medicare Advantage	$3,464.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,944.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,944.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,309.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,944.49
Rate for Payer: Cigna Commercial	$5,773.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,794.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,540.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,732.05
Rate for Payer: UnitedHealthcare Community & State	$278.28
Rate for Payer: Wellpoint Medicaid Managed Care	$306.00

FIXATOR DISTAL RADIUS 240MM

Facility

$11,547.00

Hospital Charge Code	270677335
Hospital Revenue Code	278
Min. Negotiated Rate	$1,732.05
Max. Negotiated Rate	$2,794.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,309.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,794.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,540.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,732.05

FIXATOR DISTAL RADIUS 395.842S

Facility

$8,556.00

Hospital Charge Code	270626970
Hospital Revenue Code	272
Min. Negotiated Rate	$206.20
Max. Negotiated Rate	$4,278.00
Rate for Payer: Aetna Commercial	$3,251.28
Rate for Payer: Aetna Medicare Advantage	$2,566.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,181.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,181.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,181.78
Rate for Payer: Cigna Commercial	$4,278.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,566.80
Rate for Payer: Oxford Commercial	$1,711.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,283.40
Rate for Payer: UnitedHealthcare Commercial	$1,711.20
Rate for Payer: UnitedHealthcare Community & State	$206.20
Rate for Payer: Wellpoint Medicaid Managed Care	$226.73

FIXATOR DISTAL RADIUS 395.842S

Facility

$8,556.00

Hospital Charge Code	270626970
Hospital Revenue Code	272
Min. Negotiated Rate	$1,283.40
Max. Negotiated Rate	$1,283.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,283.40

FIXATOR STANDARD COMPLET 01000

Facility

$14,646.95

Hospital Charge Code	270634728
Hospital Revenue Code	272
Min. Negotiated Rate	$352.99
Max. Negotiated Rate	$7,323.48
Rate for Payer: Aetna Commercial	$5,565.84
Rate for Payer: Aetna Medicare Advantage	$4,394.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,734.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,734.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,734.97
Rate for Payer: Cigna Commercial	$7,323.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,394.09
Rate for Payer: Oxford Commercial	$2,929.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,197.04
Rate for Payer: UnitedHealthcare Commercial	$2,929.39
Rate for Payer: UnitedHealthcare Community & State	$352.99
Rate for Payer: Wellpoint Medicaid Managed Care	$388.14

Know your out-of-pocket cost for care.

All Charges