Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KWIRE 1.6MM BLUNT TIP 500MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697651
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

KWIRE 1.6MM BLUNT TIP 500MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697651
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

KWIRE 1.6MM L100MM

Facility

$265.00

Service Code	HCPCS C1713
Hospital Charge Code	270661038
Hospital Revenue Code	278
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$132.50
Rate for Payer: Aetna Commercial	$100.70
Rate for Payer: Aetna Medicare Advantage	$79.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.58
Rate for Payer: Cigna Commercial	$132.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$58.30
Rate for Payer: Qualcare PPO/HMO/WC	$39.75
Rate for Payer: UnitedHealthcare Community & State	$6.39
Rate for Payer: Wellpoint Medicaid Managed Care	$7.02

KWIRE 1.6MM L100MM

Facility

$265.00

Service Code	HCPCS C1713
Hospital Charge Code	270661038
Hospital Revenue Code	278
Min. Negotiated Rate	$39.75
Max. Negotiated Rate	$64.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$58.30
Rate for Payer: Qualcare PPO/HMO/WC	$39.75

K-WIRE 1.6MM/L110MM

Facility

$265.00

Service Code	HCPCS C1713
Hospital Charge Code	270667536
Hospital Revenue Code	278
Min. Negotiated Rate	$39.75
Max. Negotiated Rate	$64.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$58.30
Rate for Payer: Qualcare PPO/HMO/WC	$39.75

K-WIRE 1.6MM/L110MM

Facility

$265.00

Service Code	HCPCS C1713
Hospital Charge Code	270667536
Hospital Revenue Code	278
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$132.50
Rate for Payer: Aetna Commercial	$100.70
Rate for Payer: Aetna Medicare Advantage	$79.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.58
Rate for Payer: Cigna Commercial	$132.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$58.30
Rate for Payer: Qualcare PPO/HMO/WC	$39.75
Rate for Payer: UnitedHealthcare Community & State	$6.39
Rate for Payer: Wellpoint Medicaid Managed Care	$7.02

K-WIRE 1.6MM SS

Facility

$385.00

Hospital Charge Code	270638004
Hospital Revenue Code	272
Min. Negotiated Rate	$57.75
Max. Negotiated Rate	$57.75
Rate for Payer: Qualcare PPO/HMO/WC	$57.75

K-WIRE 1.6MM SS

Facility

$385.00

Hospital Charge Code	270638004
Hospital Revenue Code	272
Min. Negotiated Rate	$9.28
Max. Negotiated Rate	$192.50
Rate for Payer: Aetna Commercial	$146.30
Rate for Payer: Aetna Medicare Advantage	$115.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.17
Rate for Payer: Cigna Commercial	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.50
Rate for Payer: Oxford Commercial	$77.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.75
Rate for Payer: UnitedHealthcare Commercial	$77.00
Rate for Payer: UnitedHealthcare Community & State	$9.28
Rate for Payer: Wellpoint Medicaid Managed Care	$10.20

KWIRE 1.6MM TROCAR 150MM

Facility

$1,462.80

Service Code	HCPCS C1713
Hospital Charge Code	270689661
Hospital Revenue Code	278
Min. Negotiated Rate	$219.42
Max. Negotiated Rate	$354.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$321.82
Rate for Payer: Qualcare PPO/HMO/WC	$219.42

KWIRE 1.6MM TROCAR 150MM

Facility

$1,462.80

Service Code	HCPCS C1713
Hospital Charge Code	270689661
Hospital Revenue Code	278
Min. Negotiated Rate	$35.25
Max. Negotiated Rate	$731.40
Rate for Payer: Aetna Commercial	$555.86
Rate for Payer: Aetna Medicare Advantage	$438.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.01
Rate for Payer: Cigna Commercial	$731.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$321.82
Rate for Payer: Qualcare PPO/HMO/WC	$219.42
Rate for Payer: UnitedHealthcare Community & State	$35.25
Rate for Payer: Wellpoint Medicaid Managed Care	$38.76

K-WIRE 1.6mm x150mm KW16150

Facility

$345.00

Hospital Charge Code	270643579
Hospital Revenue Code	272
Min. Negotiated Rate	$51.75
Max. Negotiated Rate	$51.75
Rate for Payer: Qualcare PPO/HMO/WC	$51.75

K-WIRE 1.6mm x150mm KW16150

Facility

$345.00

Hospital Charge Code	270643579
Hospital Revenue Code	272
Min. Negotiated Rate	$8.31
Max. Negotiated Rate	$172.50
Rate for Payer: Aetna Commercial	$131.10
Rate for Payer: Aetna Medicare Advantage	$103.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.97
Rate for Payer: Cigna Commercial	$172.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.50
Rate for Payer: Oxford Commercial	$69.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.75
Rate for Payer: UnitedHealthcare Commercial	$69.00
Rate for Payer: UnitedHealthcare Community & State	$8.31
Rate for Payer: Wellpoint Medicaid Managed Care	$9.14

KWIRE 1.6MMX22.9CM

Facility

$134.95

Service Code	HCPCS C1713
Hospital Charge Code	270665362
Hospital Revenue Code	278
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$67.47
Rate for Payer: Aetna Commercial	$51.28
Rate for Payer: Aetna Medicare Advantage	$40.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.41
Rate for Payer: Cigna Commercial	$67.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.69
Rate for Payer: Qualcare PPO/HMO/WC	$20.24
Rate for Payer: UnitedHealthcare Community & State	$3.25
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

KWIRE 1.6MMX22.9CM

Facility

$134.95

Service Code	HCPCS C1713
Hospital Charge Code	270665362
Hospital Revenue Code	278
Min. Negotiated Rate	$20.24
Max. Negotiated Rate	$32.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.69
Rate for Payer: Qualcare PPO/HMO/WC	$20.24

K- WIRE 1.6MM X TRO TIP

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270703718
Hospital Revenue Code	278
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$6.63
Rate for Payer: Wellpoint Medicaid Managed Care	$7.29

K- WIRE 1.6MM X TRO TIP

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270703718
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$66.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

K-WIRE 1.6x150mm

Facility

$100.00

Hospital Charge Code	270676419
Hospital Revenue Code	272
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

K-WIRE 1.6x150mm

Facility

$100.00

Hospital Charge Code	270676419
Hospital Revenue Code	272
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$38.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.00
Rate for Payer: Oxford Commercial	$20.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$20.00
Rate for Payer: UnitedHealthcare Community & State	$2.41
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

K-WIRE 1.6x150MM

Facility

$115.00

Hospital Charge Code	270656775
Hospital Revenue Code	272
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$57.50
Rate for Payer: Aetna Commercial	$43.70
Rate for Payer: Aetna Medicare Advantage	$34.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.32
Rate for Payer: Cigna Commercial	$57.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.50
Rate for Payer: Oxford Commercial	$23.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.25
Rate for Payer: UnitedHealthcare Commercial	$23.00
Rate for Payer: UnitedHealthcare Community & State	$2.77
Rate for Payer: Wellpoint Medicaid Managed Care	$3.05

K-WIRE 1.6x150MM

Facility

$115.00

Hospital Charge Code	270656775
Hospital Revenue Code	272
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$17.25
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

K-WIRE 1.6 X 230MM

Facility

$126.00

Service Code	HCPCS C1713
Hospital Charge Code	270701482
Hospital Revenue Code	278
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$30.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.72
Rate for Payer: Qualcare PPO/HMO/WC	$18.90

K-WIRE 1.6 X 230MM

Facility

$126.00

Service Code	HCPCS C1713
Hospital Charge Code	270701482
Hospital Revenue Code	278
Min. Negotiated Rate	$3.04
Max. Negotiated Rate	$63.00
Rate for Payer: Aetna Commercial	$47.88
Rate for Payer: Aetna Medicare Advantage	$37.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.13
Rate for Payer: Cigna Commercial	$63.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.72
Rate for Payer: Qualcare PPO/HMO/WC	$18.90
Rate for Payer: UnitedHealthcare Community & State	$3.04
Rate for Payer: Wellpoint Medicaid Managed Care	$3.34

K WIRE 1.7MM

Facility

$75.00

Hospital Charge Code	270705386
Hospital Revenue Code	279
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

K WIRE 1.7MM

Facility

$75.00

Hospital Charge Code	270705386
Hospital Revenue Code	279
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

K WIRE 1.8 MM DIRECT MEASURE

Facility

$4,345.15

Hospital Charge Code	270688278
Hospital Revenue Code	272
Min. Negotiated Rate	$651.77
Max. Negotiated Rate	$651.77
Rate for Payer: Qualcare PPO/HMO/WC	$651.77

Know your out-of-pocket cost for care.

All Charges