Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HALOTHANE INJ 125MG

Facility

$141.00

Hospital Charge Code	60635256
Hospital Revenue Code	250
Min. Negotiated Rate	$3.40
Max. Negotiated Rate	$70.50
Rate for Payer: Aetna Commercial	$53.58
Rate for Payer: Aetna Medicare Advantage	$42.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.95
Rate for Payer: Cigna Commercial	$70.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.30
Rate for Payer: Oxford Commercial	$28.20
Rate for Payer: Qualcare PPO/HMO/WC	$21.15
Rate for Payer: UnitedHealthcare Commercial	$28.20
Rate for Payer: UnitedHealthcare Community & State	$3.40
Rate for Payer: Wellpoint Medicaid Managed Care	$3.74

HALTER CERVICAL HEAD*****

Facility

$11.00

Hospital Charge Code	8004285
Hospital Revenue Code	279
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.50
Rate for Payer: Aetna Commercial	$4.18
Rate for Payer: Aetna Medicare Advantage	$3.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.81
Rate for Payer: Cigna Commercial	$5.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.30
Rate for Payer: Oxford Commercial	$2.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.65
Rate for Payer: UnitedHealthcare Commercial	$2.20
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

HALTER CERVICAL HEAD*****

Facility

$11.00

Hospital Charge Code	8004285
Hospital Revenue Code	279
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.65

HALTER CHIN

Facility

$16.85

Hospital Charge Code	270606680
Hospital Revenue Code	270
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.43
Rate for Payer: Aetna Commercial	$6.40
Rate for Payer: Aetna Medicare Advantage	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.05
Rate for Payer: Oxford Commercial	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$3.37
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

HALTER CHIN

Facility

$16.85

Hospital Charge Code	270606680
Hospital Revenue Code	270
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

HALTER CHIN CERVICAL

Facility

$13.65

Hospital Charge Code	270606650
Hospital Revenue Code	270
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.05

HALTER CHIN CERVICAL

Facility

$13.65

Hospital Charge Code	270606650
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

HALTER HEAD/CHIN CUP UNIVERSAL

Facility

$226.90

Hospital Charge Code	270676394
Hospital Revenue Code	272
Min. Negotiated Rate	$34.03
Max. Negotiated Rate	$34.03
Rate for Payer: Qualcare PPO/HMO/WC	$34.03

HALTER HEAD/CHIN CUP UNIVERSAL

Facility

$226.90

Hospital Charge Code	270676394
Hospital Revenue Code	272
Min. Negotiated Rate	$5.47
Max. Negotiated Rate	$113.45
Rate for Payer: Aetna Commercial	$86.22
Rate for Payer: Aetna Medicare Advantage	$68.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.86
Rate for Payer: Cigna Commercial	$113.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.07
Rate for Payer: Oxford Commercial	$45.38
Rate for Payer: Qualcare PPO/HMO/WC	$34.03
Rate for Payer: UnitedHealthcare Commercial	$45.38
Rate for Payer: UnitedHealthcare Community & State	$5.47
Rate for Payer: Wellpoint Medicaid Managed Care	$6.01

HALTER HEAD LARGE

Facility

$40.35

Hospital Charge Code	270649522
Hospital Revenue Code	272
Min. Negotiated Rate	$6.05
Max. Negotiated Rate	$6.05
Rate for Payer: Qualcare PPO/HMO/WC	$6.05

HALTER HEAD LARGE

Facility

$40.35

Hospital Charge Code	270649522
Hospital Revenue Code	272
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$20.18
Rate for Payer: Aetna Commercial	$15.33
Rate for Payer: Aetna Medicare Advantage	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.29
Rate for Payer: Cigna Commercial	$20.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.11
Rate for Payer: Oxford Commercial	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$6.05
Rate for Payer: UnitedHealthcare Commercial	$8.07
Rate for Payer: UnitedHealthcare Community & State	$0.97
Rate for Payer: Wellpoint Medicaid Managed Care	$1.07

HALTER HEAD MED

Facility

$43.95

Hospital Charge Code	270649523
Hospital Revenue Code	272
Min. Negotiated Rate	$6.59
Max. Negotiated Rate	$6.59
Rate for Payer: Qualcare PPO/HMO/WC	$6.59

HALTER HEAD MED

Facility

$43.95

Hospital Charge Code	270649523
Hospital Revenue Code	272
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$21.98
Rate for Payer: Aetna Commercial	$16.70
Rate for Payer: Aetna Medicare Advantage	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.21
Rate for Payer: Cigna Commercial	$21.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.19
Rate for Payer: Oxford Commercial	$8.79
Rate for Payer: Qualcare PPO/HMO/WC	$6.59
Rate for Payer: UnitedHealthcare Commercial	$8.79
Rate for Payer: UnitedHealthcare Community & State	$1.06
Rate for Payer: Wellpoint Medicaid Managed Care	$1.16

HAMMER 350 GRAMS

Facility

$1,665.00

Hospital Charge Code	270676858
Hospital Revenue Code	272
Min. Negotiated Rate	$40.13
Max. Negotiated Rate	$832.50
Rate for Payer: Aetna Commercial	$632.70
Rate for Payer: Aetna Medicare Advantage	$499.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$424.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$424.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$424.57
Rate for Payer: Cigna Commercial	$832.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$499.50
Rate for Payer: Oxford Commercial	$333.00
Rate for Payer: Qualcare PPO/HMO/WC	$249.75
Rate for Payer: UnitedHealthcare Commercial	$333.00
Rate for Payer: UnitedHealthcare Community & State	$40.13
Rate for Payer: Wellpoint Medicaid Managed Care	$44.12

HAMMER 350 GRAMS

Facility

$1,665.00

Hospital Charge Code	270676858
Hospital Revenue Code	272
Min. Negotiated Rate	$249.75
Max. Negotiated Rate	$249.75
Rate for Payer: Qualcare PPO/HMO/WC	$249.75

HAMMERFIX DISP SIZING KEY

Facility

$550.00

Hospital Charge Code	270693087
Hospital Revenue Code	271
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.00
Rate for Payer: Oxford Commercial	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$110.00
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

HAMMERFIX DISP SIZING KEY

Facility

$550.00

Hospital Charge Code	270693087
Hospital Revenue Code	271
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

HAMMERFIX IMPLANT MEDIUM

Facility

$11,455.00

Service Code	HCPCS C1713
Hospital Charge Code	270693049
Hospital Revenue Code	278
Min. Negotiated Rate	$276.07
Max. Negotiated Rate	$5,727.50
Rate for Payer: Aetna Commercial	$4,352.90
Rate for Payer: Aetna Medicare Advantage	$3,436.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,921.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,921.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,921.03
Rate for Payer: Cigna Commercial	$5,727.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,772.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,520.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,718.25
Rate for Payer: UnitedHealthcare Community & State	$276.07
Rate for Payer: Wellpoint Medicaid Managed Care	$303.56

HAMMERFIX IMPLANT MEDIUM

Facility

$11,455.00

Service Code	HCPCS C1713
Hospital Charge Code	270693049
Hospital Revenue Code	278
Min. Negotiated Rate	$1,718.25
Max. Negotiated Rate	$2,772.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,291.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,772.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,520.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,718.25

HAMMERFIX INSTRUM SET MED

Facility

$3,420.00

Hospital Charge Code	270693050
Hospital Revenue Code	272
Min. Negotiated Rate	$82.42
Max. Negotiated Rate	$1,710.00
Rate for Payer: Aetna Commercial	$1,299.60
Rate for Payer: Aetna Medicare Advantage	$1,026.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$872.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$872.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$872.10
Rate for Payer: Cigna Commercial	$1,710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,026.00
Rate for Payer: Oxford Commercial	$684.00
Rate for Payer: Qualcare PPO/HMO/WC	$513.00
Rate for Payer: UnitedHealthcare Commercial	$684.00
Rate for Payer: UnitedHealthcare Community & State	$82.42
Rate for Payer: Wellpoint Medicaid Managed Care	$90.63

HAMMERFIX INSTRUM SET MED

Facility

$3,420.00

Hospital Charge Code	270693050
Hospital Revenue Code	272
Min. Negotiated Rate	$513.00
Max. Negotiated Rate	$513.00
Rate for Payer: Qualcare PPO/HMO/WC	$513.00

HAMMERFIX MEDIUM IMPLANT

Facility

$11,455.00

Service Code	HCPCS C1713
Hospital Charge Code	270693086
Hospital Revenue Code	278
Min. Negotiated Rate	$276.07
Max. Negotiated Rate	$5,727.50
Rate for Payer: Aetna Commercial	$4,352.90
Rate for Payer: Aetna Medicare Advantage	$3,436.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,921.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,921.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,921.03
Rate for Payer: Cigna Commercial	$5,727.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,772.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,520.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,718.25
Rate for Payer: UnitedHealthcare Community & State	$276.07
Rate for Payer: Wellpoint Medicaid Managed Care	$303.56

HAMMERFIX MEDIUM IMPLANT

Facility

$11,455.00

Service Code	HCPCS C1713
Hospital Charge Code	270693086
Hospital Revenue Code	278
Min. Negotiated Rate	$1,718.25
Max. Negotiated Rate	$2,772.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,291.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,772.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,520.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,718.25

HAMMERFIX SIZING KEY

Facility

$550.00

Hospital Charge Code	270693053
Hospital Revenue Code	272
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.00
Rate for Payer: Oxford Commercial	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$110.00
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

HAMMERFIX SIZING KEY

Facility

$550.00

Hospital Charge Code	270693053
Hospital Revenue Code	272
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

Know your out-of-pocket cost for care.

All Charges