Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

K-WIRES TROCAR PT 1 END 16MM X

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	270661150
Hospital Revenue Code	278
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$159.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

K-WIRES TROCAR PT 1 END 16MM X

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	270661150
Hospital Revenue Code	278
Min. Negotiated Rate	$15.91
Max. Negotiated Rate	$330.00
Rate for Payer: Aetna Commercial	$250.80
Rate for Payer: Aetna Medicare Advantage	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.30
Rate for Payer: Cigna Commercial	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.00
Rate for Payer: UnitedHealthcare Community & State	$15.91
Rate for Payer: Wellpoint Medicaid Managed Care	$17.49

KWIRE TC SERIES 2.0/2.5 0.9X 1

Facility

$90.00

Hospital Charge Code	270676510
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

KWIRE TC SERIES 2.0/2.5 0.9X 1

Facility

$90.00

Hospital Charge Code	270676510
Hospital Revenue Code	272
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.00
Rate for Payer: Oxford Commercial	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$18.00
Rate for Payer: UnitedHealthcare Community & State	$2.17
Rate for Payer: Wellpoint Medicaid Managed Care	$2.38

K-WIRE THRD 2.5x150MM

Facility

$80.20

Hospital Charge Code	270601818
Hospital Revenue Code	272
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$40.10
Rate for Payer: Aetna Commercial	$30.48
Rate for Payer: Aetna Medicare Advantage	$24.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.45
Rate for Payer: Cigna Commercial	$40.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.06
Rate for Payer: Oxford Commercial	$16.04
Rate for Payer: Qualcare PPO/HMO/WC	$12.03
Rate for Payer: UnitedHealthcare Commercial	$16.04
Rate for Payer: UnitedHealthcare Community & State	$1.93
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

K-WIRE THRD 2.5x150MM

Facility

$80.20

Hospital Charge Code	270601818
Hospital Revenue Code	272
Min. Negotiated Rate	$12.03
Max. Negotiated Rate	$12.03
Rate for Payer: Qualcare PPO/HMO/WC	$12.03

KWIRE THRD RECON 3.2X400MM

Facility

$1,919.00

Service Code	HCPCS C1713
Hospital Charge Code	270698906
Hospital Revenue Code	278
Min. Negotiated Rate	$287.85
Max. Negotiated Rate	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$422.18
Rate for Payer: Qualcare PPO/HMO/WC	$287.85

KWIRE THRD RECON 3.2X400MM

Facility

$1,919.00

Service Code	HCPCS C1713
Hospital Charge Code	270698906
Hospital Revenue Code	278
Min. Negotiated Rate	$46.25
Max. Negotiated Rate	$959.50
Rate for Payer: Aetna Commercial	$729.22
Rate for Payer: Aetna Medicare Advantage	$575.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$489.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$489.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$489.35
Rate for Payer: Cigna Commercial	$959.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$422.18
Rate for Payer: Qualcare PPO/HMO/WC	$287.85
Rate for Payer: UnitedHealthcare Community & State	$46.25
Rate for Payer: Wellpoint Medicaid Managed Care	$50.85

K-WIRE THREADED 2MMX280MM

Facility

$169.50

Hospital Charge Code	270668424
Hospital Revenue Code	278
Min. Negotiated Rate	$25.43
Max. Negotiated Rate	$41.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$37.29
Rate for Payer: Qualcare PPO/HMO/WC	$25.43

K-WIRE THREADED 2MMX280MM

Facility

$169.50

Hospital Charge Code	270668424
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$84.75
Rate for Payer: Aetna Commercial	$64.41
Rate for Payer: Aetna Medicare Advantage	$50.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.22
Rate for Payer: Cigna Commercial	$84.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$37.29
Rate for Payer: Qualcare PPO/HMO/WC	$25.43
Rate for Payer: UnitedHealthcare Community & State	$4.08
Rate for Payer: Wellpoint Medicaid Managed Care	$4.49

K-WIRE THRED TIP 1.6x100MM

Facility

$2,011.50

Hospital Charge Code	270681557
Hospital Revenue Code	272
Min. Negotiated Rate	$301.73
Max. Negotiated Rate	$301.73
Rate for Payer: Qualcare PPO/HMO/WC	$301.73

K-WIRE THRED TIP 1.6x100MM

Facility

$2,011.50

Hospital Charge Code	270681557
Hospital Revenue Code	272
Min. Negotiated Rate	$48.48
Max. Negotiated Rate	$1,005.75
Rate for Payer: Aetna Commercial	$764.37
Rate for Payer: Aetna Medicare Advantage	$603.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$512.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$512.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$512.93
Rate for Payer: Cigna Commercial	$1,005.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$603.45
Rate for Payer: Oxford Commercial	$402.30
Rate for Payer: Qualcare PPO/HMO/WC	$301.73
Rate for Payer: UnitedHealthcare Commercial	$402.30
Rate for Payer: UnitedHealthcare Community & State	$48.48
Rate for Payer: Wellpoint Medicaid Managed Care	$53.30

K-WIRE TRCR TIP SMTH 1.6X230M

Facility

$1,911.25

Service Code	HCPCS C1713
Hospital Charge Code	270701474
Hospital Revenue Code	278
Min. Negotiated Rate	$46.06
Max. Negotiated Rate	$955.62
Rate for Payer: Aetna Commercial	$726.27
Rate for Payer: Aetna Medicare Advantage	$573.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$487.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$487.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$382.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$487.37
Rate for Payer: Cigna Commercial	$955.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$462.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$420.48
Rate for Payer: Qualcare PPO/HMO/WC	$286.69
Rate for Payer: UnitedHealthcare Community & State	$46.06
Rate for Payer: Wellpoint Medicaid Managed Care	$50.65

K-WIRE TRCR TIP SMTH 1.6X230M

Facility

$1,911.25

Service Code	HCPCS C1713
Hospital Charge Code	270701474
Hospital Revenue Code	278
Min. Negotiated Rate	$286.69
Max. Negotiated Rate	$462.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$382.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$462.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$420.48
Rate for Payer: Qualcare PPO/HMO/WC	$286.69

KWIRE TROCAR 0.8 100 MM

Facility

$235.10

Service Code	HCPCS C1713
Hospital Charge Code	270698350
Hospital Revenue Code	278
Min. Negotiated Rate	$35.27
Max. Negotiated Rate	$56.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$51.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.27

KWIRE TROCAR 0.8 100 MM

Facility

$235.10

Service Code	HCPCS C1713
Hospital Charge Code	270698350
Hospital Revenue Code	278
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$117.55
Rate for Payer: Aetna Commercial	$89.34
Rate for Payer: Aetna Medicare Advantage	$70.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.95
Rate for Payer: Cigna Commercial	$117.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$51.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.27
Rate for Payer: UnitedHealthcare Community & State	$5.67
Rate for Payer: Wellpoint Medicaid Managed Care	$6.23

KWIRE TROCAR 0.8 100 MM

Facility

$235.10

Service Code	HCPCS C1713
Hospital Charge Code	698350
Hospital Revenue Code	278
Min. Negotiated Rate	$35.27
Max. Negotiated Rate	$56.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$51.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.27

KWIRE TROCAR 0.8 100 MM

Facility

$235.10

Service Code	HCPCS C1713
Hospital Charge Code	698350
Hospital Revenue Code	278
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$117.55
Rate for Payer: Aetna Commercial	$89.34
Rate for Payer: Aetna Medicare Advantage	$70.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.95
Rate for Payer: Cigna Commercial	$117.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$51.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.27
Rate for Payer: UnitedHealthcare Community & State	$5.67
Rate for Payer: Wellpoint Medicaid Managed Care	$6.23

K-WIRE TROCAR 1.1x100MM

Facility

$175.00

Hospital Charge Code	270675275
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

K-WIRE TROCAR 1.1x100MM

Facility

$175.00

Hospital Charge Code	270675275
Hospital Revenue Code	272
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.50
Rate for Payer: Oxford Commercial	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$35.00
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.64

K-WIRE TROCAR DOUBLE 0.035X4

Facility

$175.00

Hospital Charge Code	270674922
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

K-WIRE TROCAR DOUBLE 0.035X4

Facility

$175.00

Hospital Charge Code	270674922
Hospital Revenue Code	272
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.50
Rate for Payer: Oxford Commercial	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$35.00
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.64

KWIRE TROCAR TIP 1.4MMX24IN

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270695126
Hospital Revenue Code	278
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

KWIRE TROCAR TIP 1.4MMX24IN

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270695126
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

K-WIRE TROCAR TIP 1.6MM

Facility

$185.00

Hospital Charge Code	270661697
Hospital Revenue Code	272
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$92.50
Rate for Payer: Aetna Commercial	$70.30
Rate for Payer: Aetna Medicare Advantage	$55.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.17
Rate for Payer: Cigna Commercial	$92.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.50
Rate for Payer: Oxford Commercial	$37.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.75
Rate for Payer: UnitedHealthcare Commercial	$37.00
Rate for Payer: UnitedHealthcare Community & State	$4.46
Rate for Payer: Wellpoint Medicaid Managed Care	$4.90

Know your out-of-pocket cost for care.

All Charges