Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

2.5MM HEADED SCREW LENGTH 14MM

Facility

$1,421.80

Service Code	HCPCS C1713
Hospital Charge Code	270687947
Hospital Revenue Code	278
Min. Negotiated Rate	$34.27
Max. Negotiated Rate	$710.90
Rate for Payer: Aetna Commercial	$540.28
Rate for Payer: Aetna Medicare Advantage	$426.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$362.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$362.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$362.56
Rate for Payer: Cigna Commercial	$710.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$312.80
Rate for Payer: Qualcare PPO/HMO/WC	$213.27
Rate for Payer: UnitedHealthcare Community & State	$34.27
Rate for Payer: Wellpoint Medicaid Managed Care	$37.68

2.5MM HEADED SCREW LENGTH 14MM

Facility

$1,421.80

Service Code	HCPCS C1713
Hospital Charge Code	270687947
Hospital Revenue Code	278
Min. Negotiated Rate	$213.27
Max. Negotiated Rate	$344.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$312.80
Rate for Payer: Qualcare PPO/HMO/WC	$213.27

2.5 M MM TI CAN COMPRESSION HE

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270688649
Hospital Revenue Code	278
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$459.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$417.56
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

2.5 M MM TI CAN COMPRESSION HE

Facility

$3,796.00

Service Code	HCPCS C1713
Hospital Charge Code	270688650
Hospital Revenue Code	278
Min. Negotiated Rate	$569.40
Max. Negotiated Rate	$918.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$759.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$835.12
Rate for Payer: Qualcare PPO/HMO/WC	$569.40

2.5 M MM TI CAN COMPRESSION HE

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270688649
Hospital Revenue Code	278
Min. Negotiated Rate	$45.74
Max. Negotiated Rate	$949.00
Rate for Payer: Aetna Commercial	$721.24
Rate for Payer: Aetna Medicare Advantage	$569.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$483.99
Rate for Payer: Cigna Commercial	$949.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$417.56
Rate for Payer: Qualcare PPO/HMO/WC	$284.70
Rate for Payer: UnitedHealthcare Community & State	$45.74
Rate for Payer: Wellpoint Medicaid Managed Care	$50.30

2.5 M MM TI CAN COMPRESSION HE

Facility

$3,796.00

Service Code	HCPCS C1713
Hospital Charge Code	270688650
Hospital Revenue Code	278
Min. Negotiated Rate	$91.48
Max. Negotiated Rate	$1,898.00
Rate for Payer: Aetna Commercial	$1,442.48
Rate for Payer: Aetna Medicare Advantage	$1,138.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$967.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$967.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$759.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$967.98
Rate for Payer: Cigna Commercial	$1,898.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$835.12
Rate for Payer: Qualcare PPO/HMO/WC	$569.40
Rate for Payer: UnitedHealthcare Community & State	$91.48
Rate for Payer: Wellpoint Medicaid Managed Care	$100.59

25MM SCREW

Facility

$6,221.55

Hospital Charge Code	270656870
Hospital Revenue Code	278
Min. Negotiated Rate	$933.23
Max. Negotiated Rate	$1,505.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,244.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,505.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,368.74
Rate for Payer: Qualcare PPO/HMO/WC	$933.23

25MM SCREW

Facility

$6,221.55

Hospital Charge Code	270656870
Hospital Revenue Code	278
Min. Negotiated Rate	$149.94
Max. Negotiated Rate	$3,110.78
Rate for Payer: Aetna Commercial	$2,364.19
Rate for Payer: Aetna Medicare Advantage	$1,866.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,244.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,586.50
Rate for Payer: Cigna Commercial	$3,110.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,505.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,368.74
Rate for Payer: Qualcare PPO/HMO/WC	$933.23
Rate for Payer: UnitedHealthcare Community & State	$149.94
Rate for Payer: Wellpoint Medicaid Managed Care	$164.87

2.5MM THREADED K WIRE

Facility

$254.40

Hospital Charge Code	270687948
Hospital Revenue Code	272
Min. Negotiated Rate	$38.16
Max. Negotiated Rate	$38.16
Rate for Payer: Qualcare PPO/HMO/WC	$38.16

2.5MM THREADED K WIRE

Facility

$254.40

Hospital Charge Code	270687948
Hospital Revenue Code	272
Min. Negotiated Rate	$6.13
Max. Negotiated Rate	$127.20
Rate for Payer: Aetna Commercial	$96.67
Rate for Payer: Aetna Medicare Advantage	$76.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.87
Rate for Payer: Cigna Commercial	$127.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.32
Rate for Payer: Oxford Commercial	$50.88
Rate for Payer: Qualcare PPO/HMO/WC	$38.16
Rate for Payer: UnitedHealthcare Commercial	$50.88
Rate for Payer: UnitedHealthcare Community & State	$6.13
Rate for Payer: Wellpoint Medicaid Managed Care	$6.74

25X10X10 EXPAND CAGE #11-5348

Facility

$25,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705465
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

25X10X10 EXPAND CAGE #11-5348

Facility

$25,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705465
Hospital Revenue Code	278
Min. Negotiated Rate	$602.50
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$9,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00
Rate for Payer: UnitedHealthcare Community & State	$602.50
Rate for Payer: Wellpoint Medicaid Managed Care	$662.50

2.5X15MM OLIVE WIRE

Facility

$5,195.00

Hospital Charge Code	270705553
Hospital Revenue Code	279
Min. Negotiated Rate	$125.20
Max. Negotiated Rate	$2,597.50
Rate for Payer: Aetna Commercial	$1,974.10
Rate for Payer: Aetna Medicare Advantage	$1,558.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,324.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,324.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,324.72
Rate for Payer: Cigna Commercial	$2,597.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,558.50
Rate for Payer: Oxford Commercial	$1,039.00
Rate for Payer: Qualcare PPO/HMO/WC	$779.25
Rate for Payer: UnitedHealthcare Commercial	$1,039.00
Rate for Payer: UnitedHealthcare Community & State	$125.20
Rate for Payer: Wellpoint Medicaid Managed Care	$137.67

2.5X15MM OLIVE WIRE

Facility

$5,195.00

Hospital Charge Code	270705553
Hospital Revenue Code	279
Min. Negotiated Rate	$779.25
Max. Negotiated Rate	$779.25
Rate for Payer: Qualcare PPO/HMO/WC	$779.25

2.5 X 18 HEADLESS SCREW

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270683542
Hospital Revenue Code	278
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

2.5 X 18 HEADLESS SCREW

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270683590
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

2.5 X 18 HEADLESS SCREW

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270683542
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

2.5 X 18 HEADLESS SCREW

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270683590
Hospital Revenue Code	278
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

2.5X225MM K-WIRES

Facility

$200.00

Hospital Charge Code	270656710
Hospital Revenue Code	278
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Community & State	$4.82
Rate for Payer: Wellpoint Medicaid Managed Care	$5.30

2.5X225MM K-WIRES

Facility

$200.00

Hospital Charge Code	270656710
Hospital Revenue Code	278
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$48.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

2.5 X 225MM K-WIRE TORNIER

Facility

$200.00

Hospital Charge Code	270339522
Hospital Revenue Code	278
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$48.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

2.5 X 225MM K-WIRE TORNIER

Facility

$200.00

Hospital Charge Code	270339522
Hospital Revenue Code	278
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Community & State	$4.82
Rate for Payer: Wellpoint Medicaid Managed Care	$5.30

26.5 PLATE

Facility

$7,900.00

Hospital Charge Code	270656335
Hospital Revenue Code	278
Min. Negotiated Rate	$190.39
Max. Negotiated Rate	$3,950.00
Rate for Payer: Aetna Commercial	$3,002.00
Rate for Payer: Aetna Medicare Advantage	$2,370.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,014.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,014.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,580.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,014.50
Rate for Payer: Cigna Commercial	$3,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,911.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,738.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,185.00
Rate for Payer: UnitedHealthcare Community & State	$190.39
Rate for Payer: Wellpoint Medicaid Managed Care	$209.35

26.5 PLATE

Facility

$7,900.00

Hospital Charge Code	270656335
Hospital Revenue Code	278
Min. Negotiated Rate	$1,185.00
Max. Negotiated Rate	$1,911.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,580.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,911.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,738.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,185.00

2.6 CANN DRILL BIT

Facility

$875.00

Hospital Charge Code	270663089
Hospital Revenue Code	272
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

Know your out-of-pocket cost for care.

All Charges