Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ANCHOR HELIX Ti 5.5mm 222242

Facility

$1,625.00

Hospital Charge Code	270643803
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

ANCHOR HELIX Ti 5.5mm 222242

Facility

$1,625.00

Hospital Charge Code	270643803
Hospital Revenue Code	278
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

ANCHOR HIP BIOCOM 2.9x12.5MM

Facility

$2,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270681510
Hospital Revenue Code	278
Min. Negotiated Rate	$50.61
Max. Negotiated Rate	$1,050.00
Rate for Payer: Aetna Commercial	$798.00
Rate for Payer: Aetna Medicare Advantage	$630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$535.50
Rate for Payer: Cigna Commercial	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$462.00
Rate for Payer: Qualcare PPO/HMO/WC	$315.00
Rate for Payer: UnitedHealthcare Community & State	$50.61
Rate for Payer: Wellpoint Medicaid Managed Care	$55.65

ANCHOR HIP BIOCOM 2.9x12.5MM

Facility

$2,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270681510
Hospital Revenue Code	278
Min. Negotiated Rate	$315.00
Max. Negotiated Rate	$508.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$462.00
Rate for Payer: Qualcare PPO/HMO/WC	$315.00

ANCHOR HTO IBALANCE 6.5X 22 MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270691462
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

ANCHOR HTO IBALANCE 6.5X 22 MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270691462
Hospital Revenue Code	278
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

ANCHOR HTO IBALANCE 6.5X 24 MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270691463
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

ANCHOR HTO IBALANCE 6.5X 24 MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270691463
Hospital Revenue Code	278
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

ANCHOR HTO IBALANCE 6.5X 26 MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270691464
Hospital Revenue Code	278
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

ANCHOR HTO IBALANCE 6.5X 26 MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270691464
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

ANCHOR HTO IBALANCE 6.5X 28 MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270691465
Hospital Revenue Code	278
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

ANCHOR HTO IBALANCE 6.5X 28 MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270691465
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

ANCHOR HTO IBALANCE 6.5X 44 MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270691466
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

ANCHOR HTO IBALANCE 6.5X 44 MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270691466
Hospital Revenue Code	278
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

ANCHOR ICONIX 2.3MM 2.0 XBRAID

Facility

$2,290.70

Service Code	HCPCS C1713
Hospital Charge Code	270676713
Hospital Revenue Code	278
Min. Negotiated Rate	$55.21
Max. Negotiated Rate	$1,145.35
Rate for Payer: Aetna Commercial	$870.47
Rate for Payer: Aetna Medicare Advantage	$687.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$584.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$584.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$458.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$584.13
Rate for Payer: Cigna Commercial	$1,145.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$554.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$503.95
Rate for Payer: Qualcare PPO/HMO/WC	$343.61
Rate for Payer: UnitedHealthcare Community & State	$55.21
Rate for Payer: Wellpoint Medicaid Managed Care	$60.70

ANCHOR ICONIX 2.3MM 2.0 XBRAID

Facility

$2,290.70

Service Code	HCPCS C1713
Hospital Charge Code	270676713
Hospital Revenue Code	278
Min. Negotiated Rate	$343.61
Max. Negotiated Rate	$554.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$458.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$554.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$503.95
Rate for Payer: Qualcare PPO/HMO/WC	$343.61

ANCHOR ICONIX 2.3MM 2 FRC FIBR

Facility

$1,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270680689
Hospital Revenue Code	278
Min. Negotiated Rate	$255.00
Max. Negotiated Rate	$411.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$374.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00

ANCHOR ICONIX 2.3MM 2 FRC FIBR

Facility

$1,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270680689
Hospital Revenue Code	278
Min. Negotiated Rate	$40.97
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$646.00
Rate for Payer: Aetna Medicare Advantage	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$433.50
Rate for Payer: Cigna Commercial	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$374.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00
Rate for Payer: UnitedHealthcare Community & State	$40.97
Rate for Payer: Wellpoint Medicaid Managed Care	$45.05

ANCHOR ICONIX 2.3 MM WITH 2

Facility

$3,689.15

Hospital Charge Code	270701805
Hospital Revenue Code	278
Min. Negotiated Rate	$553.37
Max. Negotiated Rate	$892.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$737.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$892.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$811.61
Rate for Payer: Qualcare PPO/HMO/WC	$553.37

ANCHOR ICONIX 2.3 MM WITH 2

Facility

$3,689.15

Hospital Charge Code	270701805
Hospital Revenue Code	278
Min. Negotiated Rate	$88.91
Max. Negotiated Rate	$1,844.58
Rate for Payer: Aetna Commercial	$1,401.88
Rate for Payer: Aetna Medicare Advantage	$1,106.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$940.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$940.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$737.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$940.73
Rate for Payer: Cigna Commercial	$1,844.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$892.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$811.61
Rate for Payer: Qualcare PPO/HMO/WC	$553.37
Rate for Payer: UnitedHealthcare Community & State	$88.91
Rate for Payer: Wellpoint Medicaid Managed Care	$97.76

ANCHOR ICONIX 2.3MM W/X-BRAID

Facility

$1,700.00

Hospital Charge Code	270676527
Hospital Revenue Code	272
Min. Negotiated Rate	$40.97
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$646.00
Rate for Payer: Aetna Medicare Advantage	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$433.50
Rate for Payer: Cigna Commercial	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$510.00
Rate for Payer: Oxford Commercial	$340.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00
Rate for Payer: UnitedHealthcare Commercial	$340.00
Rate for Payer: UnitedHealthcare Community & State	$40.97
Rate for Payer: Wellpoint Medicaid Managed Care	$45.05

ANCHOR ICONIX 2.3MM W/X-BRAID

Facility

$1,700.00

Hospital Charge Code	270676527
Hospital Revenue Code	272
Min. Negotiated Rate	$255.00
Max. Negotiated Rate	$255.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00

ANCHOR ICONIX KNOTLESS 2.3 MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270701824
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

ANCHOR ICONIX KNOTLESS 2.3 MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270701824
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

ANCHOR ICONIX SELF 2.3MMx1.2MM

Facility

$4,043.85

Service Code	HCPCS C1713
Hospital Charge Code	270689569
Hospital Revenue Code	278
Min. Negotiated Rate	$97.46
Max. Negotiated Rate	$2,021.92
Rate for Payer: Aetna Commercial	$1,536.66
Rate for Payer: Aetna Medicare Advantage	$1,213.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,031.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,031.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,031.18
Rate for Payer: Cigna Commercial	$2,021.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$978.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$889.65
Rate for Payer: Qualcare PPO/HMO/WC	$606.58
Rate for Payer: UnitedHealthcare Community & State	$97.46
Rate for Payer: Wellpoint Medicaid Managed Care	$107.16

Know your out-of-pocket cost for care.

All Charges