Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LONG FEMUR SCREW

Facility

$357.00

Service Code	HCPCS C1713
Hospital Charge Code	270688192
Hospital Revenue Code	278
Min. Negotiated Rate	$8.60
Max. Negotiated Rate	$178.50
Rate for Payer: Aetna Commercial	$135.66
Rate for Payer: Aetna Medicare Advantage	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.03
Rate for Payer: Cigna Commercial	$178.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$78.54
Rate for Payer: Qualcare PPO/HMO/WC	$53.55
Rate for Payer: UnitedHealthcare Community & State	$8.60
Rate for Payer: Wellpoint Medicaid Managed Care	$9.46

LONG FEMUR SCREW

Facility

$357.00

Service Code	HCPCS C1713
Hospital Charge Code	270688192
Hospital Revenue Code	278
Min. Negotiated Rate	$53.55
Max. Negotiated Rate	$86.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$78.54
Rate for Payer: Qualcare PPO/HMO/WC	$53.55

LONG LEFT PERC PLATE

Facility

$5,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270681319
Hospital Revenue Code	278
Min. Negotiated Rate	$821.25
Max. Negotiated Rate	$1,324.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,095.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,204.50
Rate for Payer: Qualcare PPO/HMO/WC	$821.25

LONG LEFT PERC PLATE

Facility

$5,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270681319
Hospital Revenue Code	278
Min. Negotiated Rate	$131.95
Max. Negotiated Rate	$2,737.50
Rate for Payer: Aetna Commercial	$2,080.50
Rate for Payer: Aetna Medicare Advantage	$1,642.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,396.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,396.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,095.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,396.12
Rate for Payer: Cigna Commercial	$2,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,204.50
Rate for Payer: Qualcare PPO/HMO/WC	$821.25
Rate for Payer: UnitedHealthcare Community & State	$131.95
Rate for Payer: Wellpoint Medicaid Managed Care	$145.09

LONG LEG CAST THGH TO TOE

Facility

$618.00

Service Code	HCPCS 29345
Hospital Charge Code	94186050
Hospital Revenue Code	361
Min. Negotiated Rate	$92.70
Max. Negotiated Rate	$92.70
Rate for Payer: Qualcare PPO/HMO/WC	$92.70

LONG LEG CAST THGH TO TOE

Facility

$618.00

Service Code	HCPCS 29345
Hospital Charge Code	94186050
Hospital Revenue Code	361
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$903.80
Rate for Payer: Aetna Medicare Advantage	$1,076.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,199.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,199.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$332.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,199.43
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: Cigna Medicare Advantage	$332.28
Rate for Payer: Clover Medicare Advantage	$315.67
Rate for Payer: EmblemHealth Commercial	$996.84
Rate for Payer: Humana Medicare Advantage	$342.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$332.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.40
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.70
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$14.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$332.28
Rate for Payer: Wellcare Medicare Advantage	$332.28
Rate for Payer: Wellpoint Medicaid Managed Care	$16.38

LONG NAIL 10MMX440MM LEFT 125D

Facility

$18,793.80

Service Code	HCPCS C1713
Hospital Charge Code	270705156
Hospital Revenue Code	278
Min. Negotiated Rate	$2,819.07
Max. Negotiated Rate	$4,548.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,758.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,548.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,134.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,819.07

LONG NAIL 10MMX440MM LEFT 125D

Facility

$18,793.80

Service Code	HCPCS C1713
Hospital Charge Code	270705156
Hospital Revenue Code	278
Min. Negotiated Rate	$452.93
Max. Negotiated Rate	$9,396.90
Rate for Payer: Aetna Commercial	$7,141.64
Rate for Payer: Aetna Medicare Advantage	$5,638.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,792.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,792.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,758.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,792.42
Rate for Payer: Cigna Commercial	$9,396.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,548.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,134.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,819.07
Rate for Payer: UnitedHealthcare Community & State	$452.93
Rate for Payer: Wellpoint Medicaid Managed Care	$498.04

LONG NAIL 10x360MM 130 DEG

Facility

$13,061.10

Service Code	HCPCS C1713
Hospital Charge Code	270673643
Hospital Revenue Code	278
Min. Negotiated Rate	$314.77
Max. Negotiated Rate	$6,530.55
Rate for Payer: Aetna Commercial	$4,963.22
Rate for Payer: Aetna Medicare Advantage	$3,918.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,330.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,330.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,612.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,330.58
Rate for Payer: Cigna Commercial	$6,530.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,160.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,873.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,959.16
Rate for Payer: UnitedHealthcare Community & State	$314.77
Rate for Payer: Wellpoint Medicaid Managed Care	$346.12

LONG NAIL 10x360MM 130 DEG

Facility

$13,061.10

Service Code	HCPCS C1713
Hospital Charge Code	270673643
Hospital Revenue Code	278
Min. Negotiated Rate	$1,959.16
Max. Negotiated Rate	$3,160.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,612.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,160.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,873.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,959.16

LONG NAIL KIT RT 11x340MMx125

Facility

$13,060.00

Hospital Charge Code	270675304
Hospital Revenue Code	278
Min. Negotiated Rate	$314.75
Max. Negotiated Rate	$6,530.00
Rate for Payer: Aetna Commercial	$4,962.80
Rate for Payer: Aetna Medicare Advantage	$3,918.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,330.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,330.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,330.30
Rate for Payer: Cigna Commercial	$6,530.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,160.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,873.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,959.00
Rate for Payer: UnitedHealthcare Community & State	$314.75
Rate for Payer: Wellpoint Medicaid Managed Care	$346.09

LONG NAIL KIT RT 11x340MMx125

Facility

$13,060.00

Hospital Charge Code	270675304
Hospital Revenue Code	278
Min. Negotiated Rate	$1,959.00
Max. Negotiated Rate	$3,160.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,612.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,160.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,873.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,959.00

LONG NAIL LEFT

Facility

$18,793.80

Service Code	HCPCS C1713
Hospital Charge Code	270705862
Hospital Revenue Code	278
Min. Negotiated Rate	$2,819.07
Max. Negotiated Rate	$4,548.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,758.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,548.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,134.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,819.07

LONG NAIL LEFT

Facility

$18,793.80

Service Code	HCPCS C1713
Hospital Charge Code	270705862
Hospital Revenue Code	278
Min. Negotiated Rate	$452.93
Max. Negotiated Rate	$9,396.90
Rate for Payer: Aetna Commercial	$7,141.64
Rate for Payer: Aetna Medicare Advantage	$5,638.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,792.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,792.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,758.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,792.42
Rate for Payer: Cigna Commercial	$9,396.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,548.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,134.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,819.07
Rate for Payer: UnitedHealthcare Community & State	$452.93
Rate for Payer: Wellpoint Medicaid Managed Care	$498.04

LONG NAIL, RIGHT 10X380MMX125D

Facility

$18,793.80

Service Code	HCPCS C1713
Hospital Charge Code	270705682
Hospital Revenue Code	278
Min. Negotiated Rate	$452.93
Max. Negotiated Rate	$9,396.90
Rate for Payer: Aetna Commercial	$7,141.64
Rate for Payer: Aetna Medicare Advantage	$5,638.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,792.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,792.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,758.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,792.42
Rate for Payer: Cigna Commercial	$9,396.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,548.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,134.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,819.07
Rate for Payer: UnitedHealthcare Community & State	$452.93
Rate for Payer: Wellpoint Medicaid Managed Care	$498.04

LONG NAIL, RIGHT 10X380MMX125D

Facility

$18,793.80

Service Code	HCPCS C1713
Hospital Charge Code	270705682
Hospital Revenue Code	278
Min. Negotiated Rate	$2,819.07
Max. Negotiated Rate	$4,548.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,758.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,548.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,134.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,819.07

LONITEN/10MG/TAB

Facility

$11.32

Service Code	NDC 49884025701
Hospital Charge Code	60633314
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.66
Rate for Payer: Aetna Commercial	$4.30
Rate for Payer: Aetna Medicare Advantage	$3.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.89
Rate for Payer: Cigna Commercial	$5.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.40
Rate for Payer: Oxford Commercial	$2.26
Rate for Payer: Qualcare PPO/HMO/WC	$1.70
Rate for Payer: UnitedHealthcare Commercial	$2.26
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

LONITEN/10MG/TAB

Facility

$3.00

Hospital Charge Code	60634383
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

LONITEN/10MG/TAB

Facility

$3.00

Hospital Charge Code	60634383
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

LONITEN/10MG/TAB

Facility

$11.32

Service Code	NDC 49884025701
Hospital Charge Code	60633314
Hospital Revenue Code	250
Min. Negotiated Rate	$1.70
Max. Negotiated Rate	$1.70
Rate for Payer: Qualcare PPO/HMO/WC	$1.70

LONITEN/2.5MG/TAB

Facility

$3.00

Hospital Charge Code	60634382
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

LONITEN/2.5MG/TAB

Facility

$3.00

Hospital Charge Code	60634382
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

LONITEN/2.5MG/TAB

Facility

$4.00

Hospital Charge Code	60633315
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

LONITEN/2.5MG/TAB

Facility

$4.00

Hospital Charge Code	60633315
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

Loop cortical 15mm

Facility

$2,125.00

Hospital Charge Code	270666243
Hospital Revenue Code	272
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$318.75
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

Know your out-of-pocket cost for care.

All Charges