Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

INSERT DRILL SLEEVE 2.0/1.5MM

Facility

$1,293.00

Hospital Charge Code	270677032
Hospital Revenue Code	270
Min. Negotiated Rate	$31.16
Max. Negotiated Rate	$646.50
Rate for Payer: Aetna Commercial	$491.34
Rate for Payer: Aetna Medicare Advantage	$387.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$329.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$329.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$329.71
Rate for Payer: Cigna Commercial	$646.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.90
Rate for Payer: Oxford Commercial	$258.60
Rate for Payer: Qualcare PPO/HMO/WC	$193.95
Rate for Payer: UnitedHealthcare Commercial	$258.60
Rate for Payer: UnitedHealthcare Community & State	$31.16
Rate for Payer: Wellpoint Medicaid Managed Care	$34.26

INSERT DRILL SLEEVE 2.0/1.5MM

Facility

$1,293.00

Hospital Charge Code	270677032
Hospital Revenue Code	270
Min. Negotiated Rate	$193.95
Max. Negotiated Rate	$193.95
Rate for Payer: Qualcare PPO/HMO/WC	$193.95

INSERT DRILL SLEEVE 2.4/1.8MM

Facility

$1,293.00

Hospital Charge Code	270677030
Hospital Revenue Code	270
Min. Negotiated Rate	$31.16
Max. Negotiated Rate	$646.50
Rate for Payer: Aetna Commercial	$491.34
Rate for Payer: Aetna Medicare Advantage	$387.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$329.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$329.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$329.71
Rate for Payer: Cigna Commercial	$646.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.90
Rate for Payer: Oxford Commercial	$258.60
Rate for Payer: Qualcare PPO/HMO/WC	$193.95
Rate for Payer: UnitedHealthcare Commercial	$258.60
Rate for Payer: UnitedHealthcare Community & State	$31.16
Rate for Payer: Wellpoint Medicaid Managed Care	$34.26

INSERT DRILL SLEEVE 2.4/1.8MM

Facility

$1,293.00

Hospital Charge Code	270677030
Hospital Revenue Code	270
Min. Negotiated Rate	$193.95
Max. Negotiated Rate	$193.95
Rate for Payer: Qualcare PPO/HMO/WC	$193.95

INSERT DRILL SLEEVE 2.7/2.0MM

Facility

$1,293.00

Hospital Charge Code	270677031
Hospital Revenue Code	270
Min. Negotiated Rate	$193.95
Max. Negotiated Rate	$193.95
Rate for Payer: Qualcare PPO/HMO/WC	$193.95

INSERT DRILL SLEEVE 2.7/2.0MM

Facility

$1,293.00

Hospital Charge Code	270677031
Hospital Revenue Code	270
Min. Negotiated Rate	$31.16
Max. Negotiated Rate	$646.50
Rate for Payer: Aetna Commercial	$491.34
Rate for Payer: Aetna Medicare Advantage	$387.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$329.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$329.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$329.71
Rate for Payer: Cigna Commercial	$646.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.90
Rate for Payer: Oxford Commercial	$258.60
Rate for Payer: Qualcare PPO/HMO/WC	$193.95
Rate for Payer: UnitedHealthcare Commercial	$258.60
Rate for Payer: UnitedHealthcare Community & State	$31.16
Rate for Payer: Wellpoint Medicaid Managed Care	$34.26

INSERT DRILL SLEEVE 3.5/2.5MM

Facility

$478.95

Hospital Charge Code	270613695
Hospital Revenue Code	272
Min. Negotiated Rate	$71.84
Max. Negotiated Rate	$71.84
Rate for Payer: Qualcare PPO/HMO/WC	$71.84

INSERT DRILL SLEEVE 3.5/2.5MM

Facility

$478.95

Hospital Charge Code	270613695
Hospital Revenue Code	272
Min. Negotiated Rate	$11.54
Max. Negotiated Rate	$239.47
Rate for Payer: Aetna Commercial	$182.00
Rate for Payer: Aetna Medicare Advantage	$143.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.13
Rate for Payer: Cigna Commercial	$239.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.69
Rate for Payer: Oxford Commercial	$95.79
Rate for Payer: Qualcare PPO/HMO/WC	$71.84
Rate for Payer: UnitedHealthcare Commercial	$95.79
Rate for Payer: UnitedHealthcare Community & State	$11.54
Rate for Payer: Wellpoint Medicaid Managed Care	$12.69

INSERT DRILL SLEEVE 8.5/2.8MM

Facility

$781.75

Hospital Charge Code	270678289
Hospital Revenue Code	272
Min. Negotiated Rate	$18.84
Max. Negotiated Rate	$390.88
Rate for Payer: Aetna Commercial	$297.06
Rate for Payer: Aetna Medicare Advantage	$234.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.35
Rate for Payer: Cigna Commercial	$390.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.53
Rate for Payer: Oxford Commercial	$156.35
Rate for Payer: Qualcare PPO/HMO/WC	$117.26
Rate for Payer: UnitedHealthcare Commercial	$156.35
Rate for Payer: UnitedHealthcare Community & State	$18.84
Rate for Payer: Wellpoint Medicaid Managed Care	$20.72

INSERT DRILL SLEEVE 8.5/2.8MM

Facility

$781.75

Hospital Charge Code	270678289
Hospital Revenue Code	272
Min. Negotiated Rate	$117.26
Max. Negotiated Rate	$117.26
Rate for Payer: Qualcare PPO/HMO/WC	$117.26

INSERT DRUG IMPLANT

Facility

$1,167.00

Service Code	HCPCS 11981
Hospital Charge Code	16000783
Hospital Revenue Code	360
Min. Negotiated Rate	$28.12
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.10
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$175.05
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$28.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$361.89
Rate for Payer: Wellpoint Medicaid Managed Care	$354.79

INSERT DRUG IMPLANT

Facility

$1,167.00

Service Code	HCPCS 11981
Hospital Charge Code	16000783
Hospital Revenue Code	360
Min. Negotiated Rate	$175.05
Max. Negotiated Rate	$175.05
Rate for Payer: Qualcare PPO/HMO/WC	$175.05

INSERT DRUG IMPLANT DEVICE

Facility

$716.00

Service Code	HCPCS 11981
Hospital Charge Code	87502620
Hospital Revenue Code	761
Min. Negotiated Rate	$107.40
Max. Negotiated Rate	$107.40
Rate for Payer: Qualcare PPO/HMO/WC	$107.40

INSERT DRUG IMPLANT DEVICE

Facility

$716.00

Service Code	HCPCS 11981
Hospital Charge Code	87502620
Hospital Revenue Code	761
Min. Negotiated Rate	$17.26
Max. Negotiated Rate	$570.55
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.80
Rate for Payer: Oxford Commercial	$143.20
Rate for Payer: Qualcare PPO/HMO/WC	$107.40
Rate for Payer: UnitedHealthcare Commercial	$143.20
Rate for Payer: UnitedHealthcare Community & State	$17.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$361.89
Rate for Payer: Wellpoint Medicaid Managed Care	$18.97

INSERT DUAL PM LEADS

Facility

$15,108.00

Service Code	HCPCS 33217
Hospital Charge Code	366833217
Hospital Revenue Code	480
Min. Negotiated Rate	$364.10
Max. Negotiated Rate	$35,488.33
Rate for Payer: Aetna Commercial	$26,741.35
Rate for Payer: Aetna Medicare Advantage	$31,853.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,488.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,488.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,831.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$476.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,488.33
Rate for Payer: Cigna Commercial	$19,706.96
Rate for Payer: Cigna Medicare Advantage	$9,831.38
Rate for Payer: Clover Medicare Advantage	$9,339.81
Rate for Payer: EmblemHealth Commercial	$29,494.14
Rate for Payer: Humana Medicare Advantage	$10,126.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,831.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,532.40
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,266.20
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$364.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,831.38
Rate for Payer: Wellcare Medicare Advantage	$9,831.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,899.11
Rate for Payer: Wellpoint Medicaid Managed Care	$400.36

INSERT DUAL PM LEADS

Facility

$15,108.00

Service Code	HCPCS 33217
Hospital Charge Code	366833217
Hospital Revenue Code	480
Min. Negotiated Rate	$2,266.20
Max. Negotiated Rate	$2,266.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,266.20

INSERT DUAL PM LEADS

Facility

$15,108.00

Service Code	HCPCS 33217
Hospital Charge Code	7411025
Hospital Revenue Code	480
Min. Negotiated Rate	$2,266.20
Max. Negotiated Rate	$2,266.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,266.20

INSERT DUAL PM LEADS

Facility

$15,108.00

Service Code	HCPCS 33217
Hospital Charge Code	7411025
Hospital Revenue Code	480
Min. Negotiated Rate	$364.10
Max. Negotiated Rate	$35,488.33
Rate for Payer: Aetna Commercial	$26,741.35
Rate for Payer: Aetna Medicare Advantage	$31,853.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,488.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,488.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,831.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$476.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,488.33
Rate for Payer: Cigna Commercial	$19,706.96
Rate for Payer: Cigna Medicare Advantage	$9,831.38
Rate for Payer: Clover Medicare Advantage	$9,339.81
Rate for Payer: EmblemHealth Commercial	$29,494.14
Rate for Payer: Humana Medicare Advantage	$10,126.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,831.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,532.40
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,266.20
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$364.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,831.38
Rate for Payer: Wellcare Medicare Advantage	$9,831.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,899.11
Rate for Payer: Wellpoint Medicaid Managed Care	$400.36

INSERTER BONE SCREW 78353000

Facility

$817.65

Hospital Charge Code	270607867
Hospital Revenue Code	272
Min. Negotiated Rate	$19.71
Max. Negotiated Rate	$408.82
Rate for Payer: Aetna Commercial	$310.71
Rate for Payer: Aetna Medicare Advantage	$245.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.50
Rate for Payer: Cigna Commercial	$408.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.29
Rate for Payer: Oxford Commercial	$163.53
Rate for Payer: Qualcare PPO/HMO/WC	$122.65
Rate for Payer: UnitedHealthcare Commercial	$163.53
Rate for Payer: UnitedHealthcare Community & State	$19.71
Rate for Payer: Wellpoint Medicaid Managed Care	$21.67

INSERTER BONE SCREW 78353000

Facility

$817.65

Hospital Charge Code	270607867
Hospital Revenue Code	272
Min. Negotiated Rate	$122.65
Max. Negotiated Rate	$122.65
Rate for Payer: Qualcare PPO/HMO/WC	$122.65

INSERTER CRUCIFORM 2.4mm

Facility

$2,208.00

Hospital Charge Code	270656614
Hospital Revenue Code	272
Min. Negotiated Rate	$331.20
Max. Negotiated Rate	$331.20
Rate for Payer: Qualcare PPO/HMO/WC	$331.20

INSERTER CRUCIFORM 2.4mm

Facility

$2,208.00

Hospital Charge Code	270656614
Hospital Revenue Code	272
Min. Negotiated Rate	$53.21
Max. Negotiated Rate	$1,104.00
Rate for Payer: Aetna Commercial	$839.04
Rate for Payer: Aetna Medicare Advantage	$662.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$563.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$563.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$563.04
Rate for Payer: Cigna Commercial	$1,104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$662.40
Rate for Payer: Oxford Commercial	$441.60
Rate for Payer: Qualcare PPO/HMO/WC	$331.20
Rate for Payer: UnitedHealthcare Commercial	$441.60
Rate for Payer: UnitedHealthcare Community & State	$53.21
Rate for Payer: Wellpoint Medicaid Managed Care	$58.51

INSERTER HELICAL BLADE

Facility

$5,473.00

Hospital Charge Code	270688249
Hospital Revenue Code	272
Min. Negotiated Rate	$131.90
Max. Negotiated Rate	$2,736.50
Rate for Payer: Aetna Commercial	$2,079.74
Rate for Payer: Aetna Medicare Advantage	$1,641.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,395.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,395.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,395.62
Rate for Payer: Cigna Commercial	$2,736.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,641.90
Rate for Payer: Oxford Commercial	$1,094.60
Rate for Payer: Qualcare PPO/HMO/WC	$820.95
Rate for Payer: UnitedHealthcare Commercial	$1,094.60
Rate for Payer: UnitedHealthcare Community & State	$131.90
Rate for Payer: Wellpoint Medicaid Managed Care	$145.03

INSERTER HELICAL BLADE

Facility

$5,473.00

Hospital Charge Code	270688249
Hospital Revenue Code	272
Min. Negotiated Rate	$820.95
Max. Negotiated Rate	$820.95
Rate for Payer: Qualcare PPO/HMO/WC	$820.95

INSERTER SHAFT F/LAGSCR 225860

Facility

$2,797.50

Hospital Charge Code	270632313
Hospital Revenue Code	272
Min. Negotiated Rate	$419.62
Max. Negotiated Rate	$419.62
Rate for Payer: Qualcare PPO/HMO/WC	$419.62

Know your out-of-pocket cost for care.

All Charges