Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HAMMERTOESYST2.5X16MMSTRIMPKIT

Facility

$9,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693528
Hospital Revenue Code	278
Min. Negotiated Rate	$240.40
Max. Negotiated Rate	$4,987.50
Rate for Payer: Aetna Commercial	$3,790.50
Rate for Payer: Aetna Medicare Advantage	$2,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,543.62
Rate for Payer: Cigna Commercial	$4,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,194.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25
Rate for Payer: UnitedHealthcare Community & State	$240.40
Rate for Payer: Wellpoint Medicaid Managed Care	$264.34

HAMMERTUBE IMPL 2.75X14MM 0D

Facility

$745.00

Service Code	HCPCS C1713
Hospital Charge Code	270694486
Hospital Revenue Code	278
Min. Negotiated Rate	$17.95
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$163.90
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$17.95
Rate for Payer: Wellpoint Medicaid Managed Care	$19.74

HAMMERTUBE IMPL 2.75X14MM 0D

Facility

$745.00

Service Code	HCPCS C1713
Hospital Charge Code	270694486
Hospital Revenue Code	278
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$163.90
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

HAMMER TUBE SYSTEM

Facility

$5,675.00

Service Code	HCPCS C1713
Hospital Charge Code	270687157
Hospital Revenue Code	278
Min. Negotiated Rate	$136.77
Max. Negotiated Rate	$2,837.50
Rate for Payer: Aetna Commercial	$2,156.50
Rate for Payer: Aetna Medicare Advantage	$1,702.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,447.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,447.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,447.12
Rate for Payer: Cigna Commercial	$2,837.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,373.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,248.50
Rate for Payer: Qualcare PPO/HMO/WC	$851.25
Rate for Payer: UnitedHealthcare Community & State	$136.77
Rate for Payer: Wellpoint Medicaid Managed Care	$150.39

HAMMER TUBE SYSTEM

Facility

$5,675.00

Service Code	HCPCS C1713
Hospital Charge Code	270687157
Hospital Revenue Code	278
Min. Negotiated Rate	$851.25
Max. Negotiated Rate	$1,373.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,373.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,248.50
Rate for Payer: Qualcare PPO/HMO/WC	$851.25

HAMRLCK 2DRLKIT W/2.1MM DRLBIT

Facility

$1,350.00

Hospital Charge Code	270672148
Hospital Revenue Code	272
Min. Negotiated Rate	$32.53
Max. Negotiated Rate	$675.00
Rate for Payer: Aetna Commercial	$513.00
Rate for Payer: Aetna Medicare Advantage	$405.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$344.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$344.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$344.25
Rate for Payer: Cigna Commercial	$675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$405.00
Rate for Payer: Oxford Commercial	$270.00
Rate for Payer: Qualcare PPO/HMO/WC	$202.50
Rate for Payer: UnitedHealthcare Commercial	$270.00
Rate for Payer: UnitedHealthcare Community & State	$32.53
Rate for Payer: Wellpoint Medicaid Managed Care	$35.77

HAMRLCK 2DRLKIT W/2.1MM DRLBIT

Facility

$1,350.00

Hospital Charge Code	270672148
Hospital Revenue Code	272
Min. Negotiated Rate	$202.50
Max. Negotiated Rate	$202.50
Rate for Payer: Qualcare PPO/HMO/WC	$202.50

HAMRLCK 2 IMP 15x5MM/0DEG MED

Facility

$4,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270672149
Hospital Revenue Code	278
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

HAMRLCK 2 IMP 15x5MM/0DEG MED

Facility

$4,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270672149
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

HAN 12 X 180

Facility

$7,559.95

Service Code	HCPCS C1713
Hospital Charge Code	270687876
Hospital Revenue Code	278
Min. Negotiated Rate	$1,133.99
Max. Negotiated Rate	$1,829.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,511.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,829.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,663.19
Rate for Payer: Qualcare PPO/HMO/WC	$1,133.99

HAN 12 X 180

Facility

$7,559.95

Service Code	HCPCS C1713
Hospital Charge Code	270687876
Hospital Revenue Code	278
Min. Negotiated Rate	$182.19
Max. Negotiated Rate	$3,779.97
Rate for Payer: Aetna Commercial	$2,872.78
Rate for Payer: Aetna Medicare Advantage	$2,267.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,927.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,927.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,511.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,927.79
Rate for Payer: Cigna Commercial	$3,779.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,829.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,663.19
Rate for Payer: Qualcare PPO/HMO/WC	$1,133.99
Rate for Payer: UnitedHealthcare Community & State	$182.19
Rate for Payer: Wellpoint Medicaid Managed Care	$200.34

HAND****

Facility

$168.00

Hospital Charge Code	8002024
Hospital Revenue Code	279
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$84.00
Rate for Payer: Aetna Commercial	$63.84
Rate for Payer: Aetna Medicare Advantage	$50.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.84
Rate for Payer: Cigna Commercial	$84.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.40
Rate for Payer: Oxford Commercial	$33.60
Rate for Payer: Qualcare PPO/HMO/WC	$25.20
Rate for Payer: UnitedHealthcare Commercial	$33.60
Rate for Payer: UnitedHealthcare Community & State	$4.05
Rate for Payer: Wellpoint Medicaid Managed Care	$4.45

HAND****

Facility

$168.00

Hospital Charge Code	8002024
Hospital Revenue Code	279
Min. Negotiated Rate	$25.20
Max. Negotiated Rate	$25.20
Rate for Payer: Qualcare PPO/HMO/WC	$25.20

HAND 2 VIEWS-BILAT

Facility

$5,100.00

Service Code	HCPCS 7312050
Hospital Charge Code	94061231
Hospital Revenue Code	320
Min. Negotiated Rate	$122.91
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

HAND 2 VIEWS-BILAT

Facility

$5,100.00

Service Code	HCPCS 7312050
Hospital Charge Code	94061231
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

HAND 2 VIEWS-LT

Facility

$5,100.00

Service Code	HCPCS 73120LT
Hospital Charge Code	94061321
Hospital Revenue Code	320
Min. Negotiated Rate	$122.91
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

HAND 2 VIEWS-LT

Facility

$5,100.00

Service Code	HCPCS 73120LT
Hospital Charge Code	94061321
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

HAND 2 VIEWS-RT

Facility

$5,100.00

Service Code	HCPCS 73120RT
Hospital Charge Code	94061323
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

HAND 2 VIEWS-RT

Facility

$5,100.00

Service Code	HCPCS 73120RT
Hospital Charge Code	94061323
Hospital Revenue Code	320
Min. Negotiated Rate	$122.91
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

HAND 3 VIEWS-BILAT

Facility

$6,601.19

Service Code	HCPCS 7313050
Hospital Charge Code	94061233
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

HAND 3 VIEWS-BILAT

Facility

$6,601.19

Service Code	HCPCS 7313050
Hospital Charge Code	94061233
Hospital Revenue Code	320
Min. Negotiated Rate	$159.09
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.36
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$159.09
Rate for Payer: Wellpoint Medicaid Managed Care	$174.93

HAND 3 VIEWS-LT

Facility

$6,601.19

Service Code	HCPCS 73130LT
Hospital Charge Code	94061325
Hospital Revenue Code	320
Min. Negotiated Rate	$159.09
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.36
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$159.09
Rate for Payer: Wellpoint Medicaid Managed Care	$174.93

HAND 3 VIEWS-LT

Facility

$6,601.19

Service Code	HCPCS 73130LT
Hospital Charge Code	94061325
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

HAND 3 VIEWS-RT

Facility

$6,601.19

Service Code	HCPCS 73130RT
Hospital Charge Code	94061327
Hospital Revenue Code	320
Min. Negotiated Rate	$159.09
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.36
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$159.09
Rate for Payer: Wellpoint Medicaid Managed Care	$174.93

HAND 3 VIEWS-RT

Facility

$6,601.19

Service Code	HCPCS 73130RT
Hospital Charge Code	94061327
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

Know your out-of-pocket cost for care.

All Charges