Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

2.6 CANN DRILL BIT

Facility

$875.00

Hospital Charge Code	270663089
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

26MM 2 LEVEL PLATE

Facility

$2,685.00

Service Code	HCPCS C1713
Hospital Charge Code	270693293
Hospital Revenue Code	278
Min. Negotiated Rate	$402.75
Max. Negotiated Rate	$649.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$537.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$649.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$590.70
Rate for Payer: Qualcare PPO/HMO/WC	$402.75

26MM 2 LEVEL PLATE

Facility

$2,685.00

Service Code	HCPCS C1713
Hospital Charge Code	270693293
Hospital Revenue Code	278
Min. Negotiated Rate	$64.71
Max. Negotiated Rate	$1,342.50
Rate for Payer: Aetna Commercial	$1,020.30
Rate for Payer: Aetna Medicare Advantage	$805.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$684.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$684.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$537.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$684.67
Rate for Payer: Cigna Commercial	$1,342.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$649.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$590.70
Rate for Payer: Qualcare PPO/HMO/WC	$402.75
Rate for Payer: UnitedHealthcare Community & State	$64.71
Rate for Payer: Wellpoint Medicaid Managed Care	$71.15

26 MM CAGE

Facility

$29,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270690558
Hospital Revenue Code	278
Min. Negotiated Rate	$710.95
Max. Negotiated Rate	$14,750.00
Rate for Payer: Aetna Commercial	$11,210.00
Rate for Payer: Aetna Medicare Advantage	$8,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,522.50
Rate for Payer: Cigna Commercial	$14,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,139.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,490.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,425.00
Rate for Payer: UnitedHealthcare Community & State	$710.95
Rate for Payer: Wellpoint Medicaid Managed Care	$781.75

26 MM CAGE

Facility

$29,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270690558
Hospital Revenue Code	278
Min. Negotiated Rate	$4,425.00
Max. Negotiated Rate	$7,139.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,139.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,490.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,425.00

26MM PLATE

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270703095
Hospital Revenue Code	270
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$750.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

26MM PLATE

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270703095
Hospital Revenue Code	270
Min. Negotiated Rate	$120.50
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.00
Rate for Payer: Oxford Commercial	$1,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Commercial	$1,000.00
Rate for Payer: UnitedHealthcare Community & State	$120.50
Rate for Payer: Wellpoint Medicaid Managed Care	$132.50

26X32X10-15H HARRIER SA

Facility

$27,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705785
Hospital Revenue Code	278
Min. Negotiated Rate	$662.75
Max. Negotiated Rate	$13,750.00
Rate for Payer: Aetna Commercial	$10,450.00
Rate for Payer: Aetna Medicare Advantage	$8,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,012.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,012.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,012.50
Rate for Payer: Cigna Commercial	$13,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,655.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,125.00
Rate for Payer: UnitedHealthcare Community & State	$662.75
Rate for Payer: Wellpoint Medicaid Managed Care	$728.75

26X32X10-15H HARRIER SA

Facility

$27,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705785
Hospital Revenue Code	278
Min. Negotiated Rate	$4,125.00
Max. Negotiated Rate	$6,655.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,655.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,125.00

26X35MM ALIF CAGE 8 DEGREES

Facility

$32,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704183
Hospital Revenue Code	278
Min. Negotiated Rate	$783.25
Max. Negotiated Rate	$16,250.00
Rate for Payer: Aetna Commercial	$12,350.00
Rate for Payer: Aetna Medicare Advantage	$9,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,287.50
Rate for Payer: Cigna Commercial	$16,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,150.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00
Rate for Payer: UnitedHealthcare Community & State	$783.25
Rate for Payer: Wellpoint Medicaid Managed Care	$861.25

26X35MM ALIF CAGE 8 DEGREES

Facility

$32,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704183
Hospital Revenue Code	278
Min. Negotiated Rate	$4,875.00
Max. Negotiated Rate	$7,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,150.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00

270618636

Facility

$4,767.25

Hospital Charge Code	270618619
Hospital Revenue Code	278
Min. Negotiated Rate	$114.89
Max. Negotiated Rate	$2,383.62
Rate for Payer: Aetna Commercial	$1,811.56
Rate for Payer: Aetna Medicare Advantage	$1,430.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,215.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,215.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$953.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,215.65
Rate for Payer: Cigna Commercial	$2,383.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,153.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,048.80
Rate for Payer: Qualcare PPO/HMO/WC	$715.09
Rate for Payer: UnitedHealthcare Community & State	$114.89
Rate for Payer: Wellpoint Medicaid Managed Care	$126.33

270618636

Facility

$4,767.25

Hospital Charge Code	270618619
Hospital Revenue Code	278
Min. Negotiated Rate	$715.09
Max. Negotiated Rate	$1,153.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$953.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,153.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,048.80
Rate for Payer: Qualcare PPO/HMO/WC	$715.09

270641500

Facility

$46.00

Hospital Charge Code	270641453
Hospital Revenue Code	272
Min. Negotiated Rate	$6.90
Max. Negotiated Rate	$6.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.90

270641500

Facility

$46.00

Hospital Charge Code	270641453
Hospital Revenue Code	272
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$23.00
Rate for Payer: Aetna Commercial	$17.48
Rate for Payer: Aetna Medicare Advantage	$13.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.73
Rate for Payer: Cigna Commercial	$23.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.80
Rate for Payer: Oxford Commercial	$9.20
Rate for Payer: Qualcare PPO/HMO/WC	$6.90
Rate for Payer: UnitedHealthcare Commercial	$9.20
Rate for Payer: UnitedHealthcare Community & State	$1.11
Rate for Payer: Wellpoint Medicaid Managed Care	$1.22

270665585

Facility

$42.55

Hospital Charge Code	270665585
Hospital Revenue Code	272
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$21.27
Rate for Payer: Aetna Commercial	$16.17
Rate for Payer: Aetna Medicare Advantage	$12.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.85
Rate for Payer: Cigna Commercial	$21.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.77
Rate for Payer: Oxford Commercial	$8.51
Rate for Payer: Qualcare PPO/HMO/WC	$6.38
Rate for Payer: UnitedHealthcare Commercial	$8.51
Rate for Payer: UnitedHealthcare Community & State	$1.03
Rate for Payer: Wellpoint Medicaid Managed Care	$1.13

270665585

Facility

$42.55

Hospital Charge Code	270665585
Hospital Revenue Code	272
Min. Negotiated Rate	$6.38
Max. Negotiated Rate	$6.38
Rate for Payer: Qualcare PPO/HMO/WC	$6.38

270674684

Facility

$1,309.00

Hospital Charge Code	3210
Hospital Revenue Code	272
Min. Negotiated Rate	$31.55
Max. Negotiated Rate	$654.50
Rate for Payer: Aetna Commercial	$497.42
Rate for Payer: Aetna Medicare Advantage	$392.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$333.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$333.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$333.80
Rate for Payer: Cigna Commercial	$654.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.70
Rate for Payer: Oxford Commercial	$261.80
Rate for Payer: Qualcare PPO/HMO/WC	$196.35
Rate for Payer: UnitedHealthcare Commercial	$261.80
Rate for Payer: UnitedHealthcare Community & State	$31.55
Rate for Payer: Wellpoint Medicaid Managed Care	$34.69

270674684

Facility

$1,309.00

Hospital Charge Code	3210
Hospital Revenue Code	272
Min. Negotiated Rate	$196.35
Max. Negotiated Rate	$196.35
Rate for Payer: Qualcare PPO/HMO/WC	$196.35

270683467N

Facility

$1,140.00

Service Code	HCPCS C1725
Hospital Charge Code	270683467N
Hospital Revenue Code	278
Min. Negotiated Rate	$171.00
Max. Negotiated Rate	$275.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$250.80
Rate for Payer: Qualcare PPO/HMO/WC	$171.00

270683467N

Facility

$1,140.00

Service Code	HCPCS C1725
Hospital Charge Code	270683467N
Hospital Revenue Code	278
Min. Negotiated Rate	$27.47
Max. Negotiated Rate	$570.00
Rate for Payer: Aetna Commercial	$433.20
Rate for Payer: Aetna Medicare Advantage	$342.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.70
Rate for Payer: Cigna Commercial	$570.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$250.80
Rate for Payer: Qualcare PPO/HMO/WC	$171.00
Rate for Payer: UnitedHealthcare Community & State	$27.47
Rate for Payer: Wellpoint Medicaid Managed Care	$30.21

270698417

Facility

$135.00

Service Code	HCPCS A4649
Hospital Charge Code	270698417
Hospital Revenue Code	272
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$20.25
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

270698417

Facility

$135.00

Service Code	HCPCS A4649
Hospital Charge Code	270698417
Hospital Revenue Code	272
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$51.30
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.42
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.50
Rate for Payer: Oxford Commercial	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.25
Rate for Payer: UnitedHealthcare Commercial	$27.00
Rate for Payer: UnitedHealthcare Community & State	$3.25
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

270701711

Facility

$1,086.25

Service Code	HCPCS C1713
Hospital Charge Code	270701711
Hospital Revenue Code	278
Min. Negotiated Rate	$26.18
Max. Negotiated Rate	$543.12
Rate for Payer: Aetna Commercial	$412.77
Rate for Payer: Aetna Medicare Advantage	$325.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$276.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$276.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$276.99
Rate for Payer: Cigna Commercial	$543.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$238.97
Rate for Payer: Qualcare PPO/HMO/WC	$162.94
Rate for Payer: UnitedHealthcare Community & State	$26.18
Rate for Payer: Wellpoint Medicaid Managed Care	$28.79

270701711

Facility

$1,086.25

Service Code	HCPCS C1713
Hospital Charge Code	270701711
Hospital Revenue Code	278
Min. Negotiated Rate	$162.94
Max. Negotiated Rate	$262.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$238.97
Rate for Payer: Qualcare PPO/HMO/WC	$162.94

Know your out-of-pocket cost for care.

All Charges