Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HEAD MODULAR MAGNUM 40 S001140

Facility

$7,045.00

Hospital Charge Code	270644637
Hospital Revenue Code	278
Min. Negotiated Rate	$169.78
Max. Negotiated Rate	$3,522.50
Rate for Payer: Aetna Commercial	$2,677.10
Rate for Payer: Aetna Medicare Advantage	$2,113.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,796.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,796.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,409.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,796.47
Rate for Payer: Cigna Commercial	$3,522.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,704.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,549.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,056.75
Rate for Payer: UnitedHealthcare Community & State	$169.78
Rate for Payer: Wellpoint Medicaid Managed Care	$186.69

HEAD MODULAR MAGNUM 40 S001140

Facility

$7,045.00

Hospital Charge Code	270644637
Hospital Revenue Code	278
Min. Negotiated Rate	$1,056.75
Max. Negotiated Rate	$1,704.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,409.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,704.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,549.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,056.75

HEAD POSITIONER DONUT PEDS

Facility

$355.00

Hospital Charge Code	270651339
Hospital Revenue Code	272
Min. Negotiated Rate	$8.56
Max. Negotiated Rate	$177.50
Rate for Payer: Aetna Commercial	$134.90
Rate for Payer: Aetna Medicare Advantage	$106.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.53
Rate for Payer: Cigna Commercial	$177.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.50
Rate for Payer: Oxford Commercial	$71.00
Rate for Payer: Qualcare PPO/HMO/WC	$53.25
Rate for Payer: UnitedHealthcare Commercial	$71.00
Rate for Payer: UnitedHealthcare Community & State	$8.56
Rate for Payer: Wellpoint Medicaid Managed Care	$9.41

HEAD POSITIONER DONUT PEDS

Facility

$355.00

Hospital Charge Code	270651339
Hospital Revenue Code	272
Min. Negotiated Rate	$53.25
Max. Negotiated Rate	$53.25
Rate for Payer: Qualcare PPO/HMO/WC	$53.25

HEAD PROLINE IMPLANT 20MM

Facility

$9,860.00

Service Code	HCPCS C1776
Hospital Charge Code	270679303
Hospital Revenue Code	278
Min. Negotiated Rate	$1,479.00
Max. Negotiated Rate	$2,386.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,972.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,386.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,169.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,479.00

HEAD PROLINE IMPLANT 20MM

Facility

$9,860.00

Service Code	HCPCS C1776
Hospital Charge Code	270679303
Hospital Revenue Code	278
Min. Negotiated Rate	$237.63
Max. Negotiated Rate	$4,930.00
Rate for Payer: Aetna Commercial	$3,746.80
Rate for Payer: Aetna Medicare Advantage	$2,958.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,514.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,514.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,972.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,514.30
Rate for Payer: Cigna Commercial	$4,930.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,386.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,169.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,479.00
Rate for Payer: UnitedHealthcare Community & State	$237.63
Rate for Payer: Wellpoint Medicaid Managed Care	$261.29

HEAD PROLINE IMPLANT 24MM

Facility

$9,860.00

Hospital Charge Code	270628374
Hospital Revenue Code	278
Min. Negotiated Rate	$237.63
Max. Negotiated Rate	$4,930.00
Rate for Payer: Aetna Commercial	$3,746.80
Rate for Payer: Aetna Medicare Advantage	$2,958.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,514.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,514.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,972.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,514.30
Rate for Payer: Cigna Commercial	$4,930.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,386.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,169.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,479.00
Rate for Payer: UnitedHealthcare Community & State	$237.63
Rate for Payer: Wellpoint Medicaid Managed Care	$261.29

HEAD PROLINE IMPLANT 24MM

Facility

$9,860.00

Hospital Charge Code	270628374
Hospital Revenue Code	278
Min. Negotiated Rate	$1,479.00
Max. Negotiated Rate	$2,386.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,972.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,386.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,169.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,479.00

HEAD PROLINE SZ+2 OD 20MM

Facility

$8,975.00

Service Code	HCPCS C1776
Hospital Charge Code	270686805
Hospital Revenue Code	278
Min. Negotiated Rate	$216.30
Max. Negotiated Rate	$4,487.50
Rate for Payer: Aetna Commercial	$3,410.50
Rate for Payer: Aetna Medicare Advantage	$2,692.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,288.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,288.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,288.62
Rate for Payer: Cigna Commercial	$4,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,171.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,974.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,346.25
Rate for Payer: UnitedHealthcare Community & State	$216.30
Rate for Payer: Wellpoint Medicaid Managed Care	$237.84

HEAD PROLINE SZ+2 OD 20MM

Facility

$8,975.00

Service Code	HCPCS C1776
Hospital Charge Code	270686805
Hospital Revenue Code	278
Min. Negotiated Rate	$1,346.25
Max. Negotiated Rate	$2,171.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,171.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,974.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,346.25

HEAD RADIAL 19X5.5MM STM 9MM

Facility

$17,703.15

Service Code	HCPCS C1776
Hospital Charge Code	270696685
Hospital Revenue Code	278
Min. Negotiated Rate	$426.65
Max. Negotiated Rate	$8,851.58
Rate for Payer: Aetna Commercial	$6,727.20
Rate for Payer: Aetna Medicare Advantage	$5,310.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,514.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,514.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,540.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,514.30
Rate for Payer: Cigna Commercial	$8,851.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,284.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,894.69
Rate for Payer: Qualcare PPO/HMO/WC	$2,655.47
Rate for Payer: UnitedHealthcare Community & State	$426.65
Rate for Payer: Wellpoint Medicaid Managed Care	$469.13

HEAD RADIAL 19X5.5MM STM 9MM

Facility

$17,703.15

Service Code	HCPCS C1776
Hospital Charge Code	270696685
Hospital Revenue Code	278
Min. Negotiated Rate	$2,655.47
Max. Negotiated Rate	$4,284.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,540.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,284.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,894.69
Rate for Payer: Qualcare PPO/HMO/WC	$2,655.47

HEAD RADIAL 22MM RIGT

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270687185
Hospital Revenue Code	278
Min. Negotiated Rate	$449.71
Max. Negotiated Rate	$9,330.00
Rate for Payer: Aetna Commercial	$7,090.80
Rate for Payer: Aetna Medicare Advantage	$5,598.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,758.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,758.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,732.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,758.30
Rate for Payer: Cigna Commercial	$9,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,515.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,105.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,799.00
Rate for Payer: UnitedHealthcare Community & State	$449.71
Rate for Payer: Wellpoint Medicaid Managed Care	$494.49

HEAD RADIAL 22MM RIGT

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270687185
Hospital Revenue Code	278
Min. Negotiated Rate	$2,799.00
Max. Negotiated Rate	$4,515.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,732.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,515.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,105.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,799.00

HEAD RADIAL 22MMX6.5MMX6MM

Facility

$17,703.15

Service Code	HCPCS C1776
Hospital Charge Code	270695502
Hospital Revenue Code	278
Min. Negotiated Rate	$426.65
Max. Negotiated Rate	$8,851.58
Rate for Payer: Aetna Commercial	$6,727.20
Rate for Payer: Aetna Medicare Advantage	$5,310.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,514.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,514.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,540.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,514.30
Rate for Payer: Cigna Commercial	$8,851.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,284.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,894.69
Rate for Payer: Qualcare PPO/HMO/WC	$2,655.47
Rate for Payer: UnitedHealthcare Community & State	$426.65
Rate for Payer: Wellpoint Medicaid Managed Care	$469.13

HEAD RADIAL 22MMX6.5MMX6MM

Facility

$17,703.15

Service Code	HCPCS C1776
Hospital Charge Code	270695502
Hospital Revenue Code	278
Min. Negotiated Rate	$2,655.47
Max. Negotiated Rate	$4,284.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,540.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,284.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,894.69
Rate for Payer: Qualcare PPO/HMO/WC	$2,655.47

HEAD RADIAL 22X5.5X3MM

Facility

$17,700.00

Service Code	HCPCS C1776
Hospital Charge Code	270697683
Hospital Revenue Code	278
Min. Negotiated Rate	$426.57
Max. Negotiated Rate	$8,850.00
Rate for Payer: Aetna Commercial	$6,726.00
Rate for Payer: Aetna Medicare Advantage	$5,310.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,513.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,513.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,513.50
Rate for Payer: Cigna Commercial	$8,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,283.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,894.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,655.00
Rate for Payer: UnitedHealthcare Community & State	$426.57
Rate for Payer: Wellpoint Medicaid Managed Care	$469.05

HEAD RADIAL 22X5.5X3MM

Facility

$17,700.00

Service Code	HCPCS C1776
Hospital Charge Code	270697683
Hospital Revenue Code	278
Min. Negotiated Rate	$2,655.00
Max. Negotiated Rate	$4,283.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,283.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,894.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,655.00

HEAD RADIAl 9.0 X 2.0MM

Facility

$11,585.00

Service Code	HCPCS C1776
Hospital Charge Code	270687186
Hospital Revenue Code	278
Min. Negotiated Rate	$1,737.75
Max. Negotiated Rate	$2,803.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,317.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,803.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,548.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,737.75

HEAD RADIAl 9.0 X 2.0MM

Facility

$11,585.00

Service Code	HCPCS C1776
Hospital Charge Code	270687186
Hospital Revenue Code	278
Min. Negotiated Rate	$279.20
Max. Negotiated Rate	$5,792.50
Rate for Payer: Aetna Commercial	$4,402.30
Rate for Payer: Aetna Medicare Advantage	$3,475.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,954.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,954.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,317.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,954.18
Rate for Payer: Cigna Commercial	$5,792.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,803.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,548.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,737.75
Rate for Payer: UnitedHealthcare Community & State	$279.20
Rate for Payer: Wellpoint Medicaid Managed Care	$307.00

HEAD RADIAL ALIGN 22MM

Facility

$11,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270678336
Hospital Revenue Code	278
Min. Negotiated Rate	$1,762.50
Max. Negotiated Rate	$2,843.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,843.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,585.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,762.50

HEAD RADIAL ALIGN 22MM

Facility

$11,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270678336
Hospital Revenue Code	278
Min. Negotiated Rate	$283.18
Max. Negotiated Rate	$5,875.00
Rate for Payer: Aetna Commercial	$4,465.00
Rate for Payer: Aetna Medicare Advantage	$3,525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,996.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,996.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,996.25
Rate for Payer: Cigna Commercial	$5,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,843.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,585.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,762.50
Rate for Payer: UnitedHealthcare Community & State	$283.18
Rate for Payer: Wellpoint Medicaid Managed Care	$311.38

HEAD RADIAL ELBOW 16x22MM

Facility

$15,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270680735
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

HEAD RADIAL ELBOW 16x22MM

Facility

$15,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270680735
Hospital Revenue Code	278
Min. Negotiated Rate	$361.50
Max. Negotiated Rate	$7,500.00
Rate for Payer: Aetna Commercial	$5,700.00
Rate for Payer: Aetna Medicare Advantage	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,825.00
Rate for Payer: Cigna Commercial	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00
Rate for Payer: UnitedHealthcare Community & State	$361.50
Rate for Payer: Wellpoint Medicaid Managed Care	$397.50

HEAD RADIAL LT SYSTEM 20MM

Facility

$21,765.00

Service Code	HCPCS C1776
Hospital Charge Code	270693319
Hospital Revenue Code	278
Min. Negotiated Rate	$524.54
Max. Negotiated Rate	$10,882.50
Rate for Payer: Aetna Commercial	$8,270.70
Rate for Payer: Aetna Medicare Advantage	$6,529.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,550.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,550.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,353.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,550.07
Rate for Payer: Cigna Commercial	$10,882.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,267.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,788.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,264.75
Rate for Payer: UnitedHealthcare Community & State	$524.54
Rate for Payer: Wellpoint Medicaid Managed Care	$576.77

Know your out-of-pocket cost for care.

All Charges