Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HEADLESS SCREW CAN 4.3 X 44

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270688022
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

HEADLESS SCREW CAN 4.3 X 44

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270688022
Hospital Revenue Code	278
Min. Negotiated Rate	$45.19
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$712.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$49.69

HEADLIGHT STAND

Facility

$3,285.00

Hospital Charge Code	270657171
Hospital Revenue Code	278
Min. Negotiated Rate	$79.17
Max. Negotiated Rate	$1,642.50
Rate for Payer: Aetna Commercial	$1,248.30
Rate for Payer: Aetna Medicare Advantage	$985.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$837.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$837.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$657.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$837.67
Rate for Payer: Cigna Commercial	$1,642.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$794.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$722.70
Rate for Payer: Qualcare PPO/HMO/WC	$492.75
Rate for Payer: UnitedHealthcare Community & State	$79.17
Rate for Payer: Wellpoint Medicaid Managed Care	$87.05

HEADLIGHT STAND

Facility

$3,285.00

Hospital Charge Code	270657171
Hospital Revenue Code	278
Min. Negotiated Rate	$492.75
Max. Negotiated Rate	$794.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$657.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$794.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$722.70
Rate for Payer: Qualcare PPO/HMO/WC	$492.75

HEADLSS TROCAR DRILL PIN 75MM

Facility

$1,920.00

Service Code	HCPCS C1713
Hospital Charge Code	270686486
Hospital Revenue Code	278
Min. Negotiated Rate	$288.00
Max. Negotiated Rate	$464.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$384.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$422.40
Rate for Payer: Qualcare PPO/HMO/WC	$288.00

HEADLSS TROCAR DRILL PIN 75MM

Facility

$1,920.00

Service Code	HCPCS C1713
Hospital Charge Code	270686486
Hospital Revenue Code	278
Min. Negotiated Rate	$46.27
Max. Negotiated Rate	$960.00
Rate for Payer: Aetna Commercial	$729.60
Rate for Payer: Aetna Medicare Advantage	$576.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$489.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$489.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$384.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$489.60
Rate for Payer: Cigna Commercial	$960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$422.40
Rate for Payer: Qualcare PPO/HMO/WC	$288.00
Rate for Payer: UnitedHealthcare Community & State	$46.27
Rate for Payer: Wellpoint Medicaid Managed Care	$50.88

HEAD MALLORY CAL 34 11 107

Facility

$52,390.00

Service Code	HCPCS C1776
Hospital Charge Code	270660672
Hospital Revenue Code	278
Min. Negotiated Rate	$1,262.60
Max. Negotiated Rate	$26,195.00
Rate for Payer: Aetna Commercial	$19,908.20
Rate for Payer: Aetna Medicare Advantage	$15,717.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,359.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,359.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,478.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,359.45
Rate for Payer: Cigna Commercial	$26,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,678.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11,525.80
Rate for Payer: Qualcare PPO/HMO/WC	$7,858.50
Rate for Payer: UnitedHealthcare Community & State	$1,262.60
Rate for Payer: Wellpoint Medicaid Managed Care	$1,388.34

HEAD MALLORY CAL 34 11 107

Facility

$52,390.00

Service Code	HCPCS C1776
Hospital Charge Code	270660672
Hospital Revenue Code	278
Min. Negotiated Rate	$7,858.50
Max. Negotiated Rate	$12,678.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,478.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,678.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11,525.80
Rate for Payer: Qualcare PPO/HMO/WC	$7,858.50

HEAD METATARSAL LONG

Facility

$5,000.00

Hospital Charge Code	270672048
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

HEAD METATARSAL LONG

Facility

$5,000.00

Hospital Charge Code	270672048
Hospital Revenue Code	278
Min. Negotiated Rate	$120.50
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$120.50
Rate for Payer: Wellpoint Medicaid Managed Care	$132.50

HEAD MOD 28 Dia +9 NECK 163665

Facility

$4,065.00

Hospital Charge Code	270643037
Hospital Revenue Code	278
Min. Negotiated Rate	$609.75
Max. Negotiated Rate	$983.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$813.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$983.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$894.30
Rate for Payer: Qualcare PPO/HMO/WC	$609.75

HEAD MOD 28 Dia +9 NECK 163665

Facility

$4,065.00

Hospital Charge Code	270643037
Hospital Revenue Code	278
Min. Negotiated Rate	$97.97
Max. Negotiated Rate	$2,032.50
Rate for Payer: Aetna Commercial	$1,544.70
Rate for Payer: Aetna Medicare Advantage	$1,219.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,036.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,036.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$813.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,036.58
Rate for Payer: Cigna Commercial	$2,032.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$983.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$894.30
Rate for Payer: Qualcare PPO/HMO/WC	$609.75
Rate for Payer: UnitedHealthcare Community & State	$97.97
Rate for Payer: Wellpoint Medicaid Managed Care	$107.72

HEAD MOD 36 -3 NECK 11363661

Facility

$3,005.00

Service Code	HCPCS C1776
Hospital Charge Code	270638378
Hospital Revenue Code	278
Min. Negotiated Rate	$72.42
Max. Negotiated Rate	$1,502.50
Rate for Payer: Aetna Commercial	$1,141.90
Rate for Payer: Aetna Medicare Advantage	$901.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$766.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$766.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$601.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$766.27
Rate for Payer: Cigna Commercial	$1,502.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$727.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$661.10
Rate for Payer: Qualcare PPO/HMO/WC	$450.75
Rate for Payer: UnitedHealthcare Community & State	$72.42
Rate for Payer: Wellpoint Medicaid Managed Care	$79.63

HEAD MOD 36 -3 NECK 11363661

Facility

$3,005.00

Service Code	HCPCS C1776
Hospital Charge Code	270638378
Hospital Revenue Code	278
Min. Negotiated Rate	$450.75
Max. Negotiated Rate	$727.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$601.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$727.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$661.10
Rate for Payer: Qualcare PPO/HMO/WC	$450.75

HEAD MOD 52 M2A MAGNUM 157452

Facility

$6,110.00

Hospital Charge Code	270638450
Hospital Revenue Code	278
Min. Negotiated Rate	$916.50
Max. Negotiated Rate	$1,478.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,222.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,478.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,344.20
Rate for Payer: Qualcare PPO/HMO/WC	$916.50

HEAD MOD 52 M2A MAGNUM 157452

Facility

$6,110.00

Hospital Charge Code	270638450
Hospital Revenue Code	278
Min. Negotiated Rate	$147.25
Max. Negotiated Rate	$3,055.00
Rate for Payer: Aetna Commercial	$2,321.80
Rate for Payer: Aetna Medicare Advantage	$1,833.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,558.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,558.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,222.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,558.05
Rate for Payer: Cigna Commercial	$3,055.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,478.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,344.20
Rate for Payer: Qualcare PPO/HMO/WC	$916.50
Rate for Payer: UnitedHealthcare Community & State	$147.25
Rate for Payer: Wellpoint Medicaid Managed Care	$161.91

HEAD MODR 36 STANDARD 11363662

Facility

$3,005.00

Service Code	HCPCS C1776
Hospital Charge Code	270633050
Hospital Revenue Code	278
Min. Negotiated Rate	$72.42
Max. Negotiated Rate	$1,502.50
Rate for Payer: Aetna Commercial	$1,141.90
Rate for Payer: Aetna Medicare Advantage	$901.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$766.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$766.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$601.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$766.27
Rate for Payer: Cigna Commercial	$1,502.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$727.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$661.10
Rate for Payer: Qualcare PPO/HMO/WC	$450.75
Rate for Payer: UnitedHealthcare Community & State	$72.42
Rate for Payer: Wellpoint Medicaid Managed Care	$79.63

HEAD MODR 36 STANDARD 11363662

Facility

$3,005.00

Service Code	HCPCS C1776
Hospital Charge Code	270633050
Hospital Revenue Code	278
Min. Negotiated Rate	$450.75
Max. Negotiated Rate	$727.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$601.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$727.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$661.10
Rate for Payer: Qualcare PPO/HMO/WC	$450.75

HEAD MODR 56mm M2A MAGM 157456

Facility

$5,828.00

Hospital Charge Code	270634575
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$2,914.00
Rate for Payer: Aetna Commercial	$2,214.64
Rate for Payer: Aetna Medicare Advantage	$1,748.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,486.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,486.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,165.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,486.14
Rate for Payer: Cigna Commercial	$2,914.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,410.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,282.16
Rate for Payer: Qualcare PPO/HMO/WC	$874.20
Rate for Payer: UnitedHealthcare Community & State	$140.45
Rate for Payer: Wellpoint Medicaid Managed Care	$154.44

HEAD MODR 56mm M2A MAGM 157456

Facility

$5,828.00

Hospital Charge Code	270634575
Hospital Revenue Code	278
Min. Negotiated Rate	$874.20
Max. Negotiated Rate	$1,410.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,165.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,410.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,282.16
Rate for Payer: Qualcare PPO/HMO/WC	$874.20

HEAD MOD TYPE B 28MM +0MM

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677769
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$60.25
Rate for Payer: Wellpoint Medicaid Managed Care	$66.25

HEAD MOD TYPE B 28MM +0MM

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677769
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

HEAD MODUL 32mm -6 NECK 163667

Facility

$3,125.00

Service Code	HCPCS C1776
Hospital Charge Code	270640901
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

HEAD MODUL 32mm -6 NECK 163667

Facility

$3,125.00

Service Code	HCPCS C1776
Hospital Charge Code	270640901
Hospital Revenue Code	278
Min. Negotiated Rate	$75.31
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$75.31
Rate for Payer: Wellpoint Medicaid Managed Care	$82.81

HEAD MODULA 32mm-3 NECK 163668

Facility

$3,005.00

Service Code	HCPCS C1776
Hospital Charge Code	270640278
Hospital Revenue Code	278
Min. Negotiated Rate	$72.42
Max. Negotiated Rate	$1,502.50
Rate for Payer: Aetna Commercial	$1,141.90
Rate for Payer: Aetna Medicare Advantage	$901.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$766.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$766.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$601.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$766.27
Rate for Payer: Cigna Commercial	$1,502.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$727.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$661.10
Rate for Payer: Qualcare PPO/HMO/WC	$450.75
Rate for Payer: UnitedHealthcare Community & State	$72.42
Rate for Payer: Wellpoint Medicaid Managed Care	$79.63

Know your out-of-pocket cost for care.

All Charges