Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LOCKING CAPS SET SCREW

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	270697898
Hospital Revenue Code	278
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

LOCKING CAP TI MATRIX

Facility

$1,840.00

Hospital Charge Code	270656687
Hospital Revenue Code	272
Min. Negotiated Rate	$276.00
Max. Negotiated Rate	$276.00
Rate for Payer: Qualcare PPO/HMO/WC	$276.00

LOCKING CAP TI MATRIX

Facility

$1,840.00

Hospital Charge Code	270656687
Hospital Revenue Code	272
Min. Negotiated Rate	$44.34
Max. Negotiated Rate	$920.00
Rate for Payer: Aetna Commercial	$699.20
Rate for Payer: Aetna Medicare Advantage	$552.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$469.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$469.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$469.20
Rate for Payer: Cigna Commercial	$920.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.00
Rate for Payer: Oxford Commercial	$368.00
Rate for Payer: Qualcare PPO/HMO/WC	$276.00
Rate for Payer: UnitedHealthcare Commercial	$368.00
Rate for Payer: UnitedHealthcare Community & State	$44.34
Rate for Payer: Wellpoint Medicaid Managed Care	$48.76

LOCKING CLIP

Facility

$291.00

Hospital Charge Code	270675630
Hospital Revenue Code	272
Min. Negotiated Rate	$7.01
Max. Negotiated Rate	$145.50
Rate for Payer: Aetna Commercial	$110.58
Rate for Payer: Aetna Medicare Advantage	$87.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.20
Rate for Payer: Cigna Commercial	$145.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.30
Rate for Payer: Oxford Commercial	$58.20
Rate for Payer: Qualcare PPO/HMO/WC	$43.65
Rate for Payer: UnitedHealthcare Commercial	$58.20
Rate for Payer: UnitedHealthcare Community & State	$7.01
Rate for Payer: Wellpoint Medicaid Managed Care	$7.71

LOCKING CLIP

Facility

$291.00

Hospital Charge Code	270675630
Hospital Revenue Code	272
Min. Negotiated Rate	$43.65
Max. Negotiated Rate	$43.65
Rate for Payer: Qualcare PPO/HMO/WC	$43.65

LOCKING COVER INT FUS DEV 7MM

Facility

$500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694458
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

LOCKING COVER INT FUS DEV 7MM

Facility

$500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694458
Hospital Revenue Code	278
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

LOCKING COVER INT FUS DEV 8MM

Facility

$500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694459
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

LOCKING COVER INT FUS DEV 8MM

Facility

$500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694459
Hospital Revenue Code	278
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

LOCKING DEVICE BIOPSY CAP OLYM

Facility

$46.13

Hospital Charge Code	270674005
Hospital Revenue Code	272
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$23.07
Rate for Payer: Aetna Commercial	$17.53
Rate for Payer: Aetna Medicare Advantage	$13.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.76
Rate for Payer: Cigna Commercial	$23.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.84
Rate for Payer: Oxford Commercial	$9.23
Rate for Payer: Qualcare PPO/HMO/WC	$6.92
Rate for Payer: UnitedHealthcare Commercial	$9.23
Rate for Payer: UnitedHealthcare Community & State	$1.11
Rate for Payer: Wellpoint Medicaid Managed Care	$1.22

LOCKING DEVICE BIOPSY CAP OLYM

Facility

$46.13

Hospital Charge Code	270674005
Hospital Revenue Code	272
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$6.92
Rate for Payer: Qualcare PPO/HMO/WC	$6.92

LOCKING GUIDE

Facility

$4,975.00

Hospital Charge Code	270688313
Hospital Revenue Code	272
Min. Negotiated Rate	$119.90
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,890.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,492.50
Rate for Payer: Oxford Commercial	$995.00
Rate for Payer: Qualcare PPO/HMO/WC	$746.25
Rate for Payer: UnitedHealthcare Commercial	$995.00
Rate for Payer: UnitedHealthcare Community & State	$119.90
Rate for Payer: Wellpoint Medicaid Managed Care	$131.84

LOCKING GUIDE

Facility

$4,975.00

Hospital Charge Code	270688313
Hospital Revenue Code	272
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$746.25
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

LOCKING HINGE 42 HOLE

Facility

$1,021.65

Service Code	HCPCS C1713
Hospital Charge Code	270683956
Hospital Revenue Code	278
Min. Negotiated Rate	$24.62
Max. Negotiated Rate	$510.82
Rate for Payer: Aetna Commercial	$388.23
Rate for Payer: Aetna Medicare Advantage	$306.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.52
Rate for Payer: Cigna Commercial	$510.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$224.76
Rate for Payer: Qualcare PPO/HMO/WC	$153.25
Rate for Payer: UnitedHealthcare Community & State	$24.62
Rate for Payer: Wellpoint Medicaid Managed Care	$27.07

LOCKING HINGE 42 HOLE

Facility

$1,021.65

Service Code	HCPCS C1713
Hospital Charge Code	270683956
Hospital Revenue Code	278
Min. Negotiated Rate	$153.25
Max. Negotiated Rate	$247.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$224.76
Rate for Payer: Qualcare PPO/HMO/WC	$153.25

LOCKING INSERT

Facility

$250.00

Hospital Charge Code	270640117
Hospital Revenue Code	278
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

LOCKING INSERT

Facility

$250.00

Hospital Charge Code	270640117
Hospital Revenue Code	278
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

LOCKING NAIL R1.5, TI, RIGHT 1

Facility

$17,580.00

Hospital Charge Code	270664830
Hospital Revenue Code	278
Min. Negotiated Rate	$2,637.00
Max. Negotiated Rate	$4,254.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,516.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,254.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,867.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,637.00

LOCKING NAIL R1.5, TI, RIGHT 1

Facility

$17,580.00

Hospital Charge Code	270664830
Hospital Revenue Code	278
Min. Negotiated Rate	$423.68
Max. Negotiated Rate	$8,790.00
Rate for Payer: Aetna Commercial	$6,680.40
Rate for Payer: Aetna Medicare Advantage	$5,274.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,482.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,482.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,516.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,482.90
Rate for Payer: Cigna Commercial	$8,790.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,254.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,867.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,637.00
Rate for Payer: UnitedHealthcare Community & State	$423.68
Rate for Payer: Wellpoint Medicaid Managed Care	$465.87

LOCKING NUT OCT SYST

Facility

$754.00

Service Code	HCPCS C1713
Hospital Charge Code	270694399
Hospital Revenue Code	278
Min. Negotiated Rate	$18.17
Max. Negotiated Rate	$377.00
Rate for Payer: Aetna Commercial	$286.52
Rate for Payer: Aetna Medicare Advantage	$226.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.27
Rate for Payer: Cigna Commercial	$377.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.88
Rate for Payer: Qualcare PPO/HMO/WC	$113.10
Rate for Payer: UnitedHealthcare Community & State	$18.17
Rate for Payer: Wellpoint Medicaid Managed Care	$19.98

LOCKING NUT OCT SYST

Facility

$754.00

Service Code	HCPCS C1713
Hospital Charge Code	270694399
Hospital Revenue Code	278
Min. Negotiated Rate	$113.10
Max. Negotiated Rate	$182.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.88
Rate for Payer: Qualcare PPO/HMO/WC	$113.10

LOCKING PIN

Facility

$1,190.00

Service Code	HCPCS C1713
Hospital Charge Code	270638569
Hospital Revenue Code	278
Min. Negotiated Rate	$178.50
Max. Negotiated Rate	$287.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$238.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$261.80
Rate for Payer: Qualcare PPO/HMO/WC	$178.50

LOCKING PIN

Facility

$1,190.00

Service Code	HCPCS C1713
Hospital Charge Code	270638569
Hospital Revenue Code	278
Min. Negotiated Rate	$28.68
Max. Negotiated Rate	$595.00
Rate for Payer: Aetna Commercial	$452.20
Rate for Payer: Aetna Medicare Advantage	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$303.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$303.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$238.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$303.45
Rate for Payer: Cigna Commercial	$595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$261.80
Rate for Payer: Qualcare PPO/HMO/WC	$178.50
Rate for Payer: UnitedHealthcare Community & State	$28.68
Rate for Payer: Wellpoint Medicaid Managed Care	$31.54

LOCKING PLATE 6 HOLE

Facility

$3,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270686455
Hospital Revenue Code	278
Min. Negotiated Rate	$93.39
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,472.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$852.50
Rate for Payer: Qualcare PPO/HMO/WC	$581.25
Rate for Payer: UnitedHealthcare Community & State	$93.39
Rate for Payer: Wellpoint Medicaid Managed Care	$102.69

LOCKING PLATE 6 HOLE

Facility

$3,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270686455
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$937.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$852.50
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

Know your out-of-pocket cost for care.

All Charges