Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MINI BUNION 3.0X22MM SCREW LK

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693368
Hospital Revenue Code	278
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

MINI BUNION INSTRUMENT KIT

Facility

$1,475.00

Hospital Charge Code	270693366
Hospital Revenue Code	272
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$221.25
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

MINI BUNION INSTRUMENT KIT

Facility

$1,475.00

Hospital Charge Code	270693366
Hospital Revenue Code	272
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$442.50
Rate for Payer: Oxford Commercial	$295.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$295.00
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

MINI BUN NAIL 3.5MM OFFS SHORT

Facility

$9,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270690787
Hospital Revenue Code	278
Min. Negotiated Rate	$1,421.25
Max. Negotiated Rate	$2,292.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,292.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,084.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,421.25

MINI BUN NAIL 3.5MM OFFS SHORT

Facility

$9,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270690787
Hospital Revenue Code	278
Min. Negotiated Rate	$228.35
Max. Negotiated Rate	$4,737.50
Rate for Payer: Aetna Commercial	$3,600.50
Rate for Payer: Aetna Medicare Advantage	$2,842.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,416.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,416.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,416.12
Rate for Payer: Cigna Commercial	$4,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,292.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,084.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,421.25
Rate for Payer: UnitedHealthcare Community & State	$228.35
Rate for Payer: Wellpoint Medicaid Managed Care	$251.09

MINI C-ARM

Facility

$38.00

Hospital Charge Code	270339107
Hospital Revenue Code	272
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$19.00
Rate for Payer: Aetna Commercial	$14.44
Rate for Payer: Aetna Medicare Advantage	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.69
Rate for Payer: Cigna Commercial	$19.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.40
Rate for Payer: Oxford Commercial	$7.60
Rate for Payer: Qualcare PPO/HMO/WC	$5.70
Rate for Payer: UnitedHealthcare Commercial	$7.60
Rate for Payer: UnitedHealthcare Community & State	$0.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1.01

MINI C-ARM

Facility

$38.00

Hospital Charge Code	270339107
Hospital Revenue Code	272
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$5.70

MINI FRAGMENT PLATES

Facility

$98.00

Hospital Charge Code	270335004
Hospital Revenue Code	278
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$23.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$21.56
Rate for Payer: Qualcare PPO/HMO/WC	$14.70

MINI FRAGMENT PLATES

Facility

$98.00

Hospital Charge Code	270335004
Hospital Revenue Code	278
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$49.00
Rate for Payer: Aetna Commercial	$37.24
Rate for Payer: Aetna Medicare Advantage	$29.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.99
Rate for Payer: Cigna Commercial	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$21.56
Rate for Payer: Qualcare PPO/HMO/WC	$14.70
Rate for Payer: UnitedHealthcare Community & State	$2.36
Rate for Payer: Wellpoint Medicaid Managed Care	$2.60

MINI FRAGMENT SCREWS

Facility

$170.00

Hospital Charge Code	270335002
Hospital Revenue Code	278
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$85.00
Rate for Payer: Aetna Commercial	$64.60
Rate for Payer: Aetna Medicare Advantage	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.35
Rate for Payer: Cigna Commercial	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$37.40
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Community & State	$4.10
Rate for Payer: Wellpoint Medicaid Managed Care	$4.50

MINI FRAGMENT SCREWS

Facility

$170.00

Hospital Charge Code	270335002
Hospital Revenue Code	278
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$41.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$37.40
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

MINIHIP HIP STEM SZ 5 STD NECK

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270706201
Hospital Revenue Code	278
Min. Negotiated Rate	$1,725.00
Max. Negotiated Rate	$2,783.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,530.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00

MINIHIP HIP STEM SZ 5 STD NECK

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270706201
Hospital Revenue Code	278
Min. Negotiated Rate	$277.15
Max. Negotiated Rate	$5,750.00
Rate for Payer: Aetna Commercial	$4,370.00
Rate for Payer: Aetna Medicare Advantage	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,932.50
Rate for Payer: Cigna Commercial	$5,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,530.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00
Rate for Payer: UnitedHealthcare Community & State	$277.15
Rate for Payer: Wellpoint Medicaid Managed Care	$304.75

MINI LARYGH ********

Facility

$55.00

Hospital Charge Code	8001166
Hospital Revenue Code	279
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$20.90
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.50
Rate for Payer: Oxford Commercial	$11.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$11.00
Rate for Payer: UnitedHealthcare Community & State	$1.33
Rate for Payer: Wellpoint Medicaid Managed Care	$1.46

MINI LARYGH ********

Facility

$55.00

Hospital Charge Code	8001166
Hospital Revenue Code	279
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

MINILOK ANCHORS

Facility

$2,175.00

Hospital Charge Code	270657371
Hospital Revenue Code	278
Min. Negotiated Rate	$326.25
Max. Negotiated Rate	$526.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$435.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$526.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$478.50
Rate for Payer: Qualcare PPO/HMO/WC	$326.25

MINILOK ANCHORS

Facility

$2,175.00

Hospital Charge Code	270657371
Hospital Revenue Code	278
Min. Negotiated Rate	$52.42
Max. Negotiated Rate	$1,087.50
Rate for Payer: Aetna Commercial	$826.50
Rate for Payer: Aetna Medicare Advantage	$652.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$554.62
Rate for Payer: Cigna Commercial	$1,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$526.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$478.50
Rate for Payer: Qualcare PPO/HMO/WC	$326.25
Rate for Payer: UnitedHealthcare Community & State	$52.42
Rate for Payer: Wellpoint Medicaid Managed Care	$57.64

MINI MONOKA TUBE

Facility

$183.00

Hospital Charge Code	270335549
Hospital Revenue Code	278
Min. Negotiated Rate	$27.45
Max. Negotiated Rate	$44.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$40.26
Rate for Payer: Qualcare PPO/HMO/WC	$27.45

MINI MONOKA TUBE

Facility

$183.00

Hospital Charge Code	270335549
Hospital Revenue Code	278
Min. Negotiated Rate	$4.41
Max. Negotiated Rate	$91.50
Rate for Payer: Aetna Commercial	$69.54
Rate for Payer: Aetna Medicare Advantage	$54.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.66
Rate for Payer: Cigna Commercial	$91.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$40.26
Rate for Payer: Qualcare PPO/HMO/WC	$27.45
Rate for Payer: UnitedHealthcare Community & State	$4.41
Rate for Payer: Wellpoint Medicaid Managed Care	$4.85

MINIPRESS/1MG/CAP

Facility

$3.00

Hospital Charge Code	60633435
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

MINIPRESS/1MG/CAP

Facility

$3.00

Hospital Charge Code	60633435
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

MINIPRESS/2MG/CAP

Facility

$6.00

Hospital Charge Code	60633434
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

MINIPRESS/2MG/CAP

Facility

$6.00

Hospital Charge Code	60633434
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

MINIPRESS/5MG/CAP

Facility

$6.00

Hospital Charge Code	60634327
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

MINIPRESS/5MG/CAP

Facility

$6.00

Hospital Charge Code	60634327
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

Know your out-of-pocket cost for care.

All Charges