Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HIGH OFFSET COLLARED HA CEMENT

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270706145
Hospital Revenue Code	278
Min. Negotiated Rate	$1,725.00
Max. Negotiated Rate	$2,783.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,530.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00

HIGH OFFSET COLLARED HA CEMENT

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270706145
Hospital Revenue Code	278
Min. Negotiated Rate	$277.15
Max. Negotiated Rate	$5,750.00
Rate for Payer: Aetna Commercial	$4,370.00
Rate for Payer: Aetna Medicare Advantage	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,932.50
Rate for Payer: Cigna Commercial	$5,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,530.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00
Rate for Payer: UnitedHealthcare Community & State	$277.15
Rate for Payer: Wellpoint Medicaid Managed Care	$304.75

HIGH PRESSURE TUBING 900 10

Facility

$16.50

Hospital Charge Code	2709002682
Hospital Revenue Code	272
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$8.25
Rate for Payer: Aetna Commercial	$6.27
Rate for Payer: Aetna Medicare Advantage	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.21
Rate for Payer: Cigna Commercial	$8.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.95
Rate for Payer: Oxford Commercial	$3.30
Rate for Payer: Qualcare PPO/HMO/WC	$2.48
Rate for Payer: UnitedHealthcare Commercial	$3.30
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.44

HIGH PRESSURE TUBING 900 10

Facility

$16.50

Hospital Charge Code	2709002682
Hospital Revenue Code	272
Min. Negotiated Rate	$2.48
Max. Negotiated Rate	$2.48
Rate for Payer: Qualcare PPO/HMO/WC	$2.48

HIGH PROTEIN PUDDING

Facility

$18.00

Hospital Charge Code	60634849
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

HIGH PROTEIN PUDDING

Facility

$18.00

Hospital Charge Code	60634849
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.40
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

HIGH TEMP CAUTERY*********

Facility

$43.00

Hospital Charge Code	8004269
Hospital Revenue Code	279
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

HIGH TEMP CAUTERY*********

Facility

$43.00

Hospital Charge Code	8004269
Hospital Revenue Code	279
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$16.34
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.90
Rate for Payer: Oxford Commercial	$8.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$8.60
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

HIGHTOP WALKER SMALL

Facility

$997.00

Hospital Charge Code	270332313
Hospital Revenue Code	272
Min. Negotiated Rate	$24.03
Max. Negotiated Rate	$498.50
Rate for Payer: Aetna Commercial	$378.86
Rate for Payer: Aetna Medicare Advantage	$299.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.24
Rate for Payer: Cigna Commercial	$498.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$299.10
Rate for Payer: Oxford Commercial	$199.40
Rate for Payer: Qualcare PPO/HMO/WC	$149.55
Rate for Payer: UnitedHealthcare Commercial	$199.40
Rate for Payer: UnitedHealthcare Community & State	$24.03
Rate for Payer: Wellpoint Medicaid Managed Care	$26.42

HIGHTOP WALKER SMALL

Facility

$997.00

Hospital Charge Code	270332313
Hospital Revenue Code	272
Min. Negotiated Rate	$149.55
Max. Negotiated Rate	$149.55
Rate for Payer: Qualcare PPO/HMO/WC	$149.55

HIGH WALL G7 36MM E

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270691146
Hospital Revenue Code	278
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$99.38

HIGH WALL G7 36MM E

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270691146
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

HIGHWALL G7 LONGVI 32 MM SZ C

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270691942
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

HIGHWALL G7 LONGVI 32 MM SZ C

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270691942
Hospital Revenue Code	278
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$99.38

HIGHWALL G7 LONGVITY 32 MM

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270691567
Hospital Revenue Code	278
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$99.38

HIGHWALL G7 LONGVITY 32 MM

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270691567
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

HIGH WALL LNR 36MM

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270692412
Hospital Revenue Code	278
Min. Negotiated Rate	$144.60
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$159.00

HIGH WALL LNR 36MM

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270692412
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

HINGED RODS

Facility

$2,925.00

Service Code	HCPCS C1713
Hospital Charge Code	270687812
Hospital Revenue Code	278
Min. Negotiated Rate	$70.49
Max. Negotiated Rate	$1,462.50
Rate for Payer: Aetna Commercial	$1,111.50
Rate for Payer: Aetna Medicare Advantage	$877.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$745.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$745.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$745.88
Rate for Payer: Cigna Commercial	$1,462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$707.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$643.50
Rate for Payer: Qualcare PPO/HMO/WC	$438.75
Rate for Payer: UnitedHealthcare Community & State	$70.49
Rate for Payer: Wellpoint Medicaid Managed Care	$77.51

HINGED RODS

Facility

$2,925.00

Service Code	HCPCS C1713
Hospital Charge Code	270687812
Hospital Revenue Code	278
Min. Negotiated Rate	$438.75
Max. Negotiated Rate	$707.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$707.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$643.50
Rate for Payer: Qualcare PPO/HMO/WC	$438.75

HINGE HALF HOFFMAN II EXT FIX

Facility

$936.35

Service Code	HCPCS C1713
Hospital Charge Code	270699517
Hospital Revenue Code	278
Min. Negotiated Rate	$22.57
Max. Negotiated Rate	$468.18
Rate for Payer: Aetna Commercial	$355.81
Rate for Payer: Aetna Medicare Advantage	$280.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.77
Rate for Payer: Cigna Commercial	$468.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$206.00
Rate for Payer: Qualcare PPO/HMO/WC	$140.45
Rate for Payer: UnitedHealthcare Community & State	$22.57
Rate for Payer: Wellpoint Medicaid Managed Care	$24.81

HINGE HALF HOFFMAN II EXT FIX

Facility

$936.35

Service Code	HCPCS C1713
Hospital Charge Code	270699517
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$226.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$206.00
Rate for Payer: Qualcare PPO/HMO/WC	$140.45

HIP/ANCA TIBIA W/SCREW 100mm

Facility

$26,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270683440
Hospital Revenue Code	278
Min. Negotiated Rate	$3,937.50
Max. Negotiated Rate	$6,352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,352.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,775.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,937.50

HIP/ANCA TIBIA W/SCREW 100mm

Facility

$26,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270683440
Hospital Revenue Code	278
Min. Negotiated Rate	$632.62
Max. Negotiated Rate	$13,125.00
Rate for Payer: Aetna Commercial	$9,975.00
Rate for Payer: Aetna Medicare Advantage	$7,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,693.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,693.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,693.75
Rate for Payer: Cigna Commercial	$13,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,352.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,775.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,937.50
Rate for Payer: UnitedHealthcare Community & State	$632.62
Rate for Payer: Wellpoint Medicaid Managed Care	$695.62

HIP AND FEMUR FRACTURE REPAIR

Facility

$39,464.36

Service Code	APR-DRG 3084
Min. Negotiated Rate	$38,690.55
Max. Negotiated Rate	$39,464.36
Rate for Payer: UnitedHealthcare Community & State	$38,690.55
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$39,464.36
Rate for Payer: Wellpoint Medicaid Managed Care	$38,690.55

Know your out-of-pocket cost for care.

All Charges