Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

28-3.5MM FEMORAL HEAD CERAMIC

Facility

$6,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270705863
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

2.8 DRILL

Facility

$543.40

Hospital Charge Code	270656635
Hospital Revenue Code	272
Min. Negotiated Rate	$81.51
Max. Negotiated Rate	$81.51
Rate for Payer: Qualcare PPO/HMO/WC	$81.51

2.8 DRILL

Facility

$543.40

Hospital Charge Code	270656635
Hospital Revenue Code	272
Min. Negotiated Rate	$13.10
Max. Negotiated Rate	$271.70
Rate for Payer: Aetna Commercial	$206.49
Rate for Payer: Aetna Medicare Advantage	$163.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.57
Rate for Payer: Cigna Commercial	$271.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.02
Rate for Payer: Oxford Commercial	$108.68
Rate for Payer: Qualcare PPO/HMO/WC	$81.51
Rate for Payer: UnitedHealthcare Commercial	$108.68
Rate for Payer: UnitedHealthcare Community & State	$13.10
Rate for Payer: Wellpoint Medicaid Managed Care	$14.40

2.8MM COUNTERSINK

Facility

$1,695.00

Hospital Charge Code	270668755
Hospital Revenue Code	272
Min. Negotiated Rate	$254.25
Max. Negotiated Rate	$254.25
Rate for Payer: Qualcare PPO/HMO/WC	$254.25

2.8MM COUNTERSINK

Facility

$1,695.00

Hospital Charge Code	270668755
Hospital Revenue Code	272
Min. Negotiated Rate	$40.85
Max. Negotiated Rate	$847.50
Rate for Payer: Aetna Commercial	$644.10
Rate for Payer: Aetna Medicare Advantage	$508.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$432.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$432.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$432.23
Rate for Payer: Cigna Commercial	$847.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.50
Rate for Payer: Oxford Commercial	$339.00
Rate for Payer: Qualcare PPO/HMO/WC	$254.25
Rate for Payer: UnitedHealthcare Commercial	$339.00
Rate for Payer: UnitedHealthcare Community & State	$40.85
Rate for Payer: Wellpoint Medicaid Managed Care	$44.92

28MM DIA COCR MOD HD-3MMNK

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270606325
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$60.25
Rate for Payer: Wellpoint Medicaid Managed Care	$66.25

28MM DIA COCR MOD HD-3MMNK

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270606325
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

2.8MM THREADED GUIDE WIRE-TROC

Facility

$200.50

Service Code	HCPCS C1769
Hospital Charge Code	270605096
Hospital Revenue Code	278
Min. Negotiated Rate	$30.07
Max. Negotiated Rate	$48.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.11
Rate for Payer: Qualcare PPO/HMO/WC	$30.07

2.8MM THREADED GUIDE WIRE-TROC

Facility

$200.50

Service Code	HCPCS C1769
Hospital Charge Code	270605096
Hospital Revenue Code	278
Min. Negotiated Rate	$4.83
Max. Negotiated Rate	$100.25
Rate for Payer: Aetna Commercial	$76.19
Rate for Payer: Aetna Medicare Advantage	$60.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.13
Rate for Payer: Cigna Commercial	$100.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.11
Rate for Payer: Qualcare PPO/HMO/WC	$30.07
Rate for Payer: UnitedHealthcare Community & State	$4.83
Rate for Payer: Wellpoint Medicaid Managed Care	$5.31

2.8 Q-FIX SUTURE ANCHOR

Facility

$3,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270674271
Hospital Revenue Code	278
Min. Negotiated Rate	$459.75
Max. Negotiated Rate	$741.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$613.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$741.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$674.30
Rate for Payer: Qualcare PPO/HMO/WC	$459.75

2.8 Q-FIX SUTURE ANCHOR

Facility

$3,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270674271
Hospital Revenue Code	278
Min. Negotiated Rate	$73.87
Max. Negotiated Rate	$1,532.50
Rate for Payer: Aetna Commercial	$1,164.70
Rate for Payer: Aetna Medicare Advantage	$919.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$781.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$781.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$613.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$781.58
Rate for Payer: Cigna Commercial	$1,532.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$741.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$674.30
Rate for Payer: Qualcare PPO/HMO/WC	$459.75
Rate for Payer: UnitedHealthcare Community & State	$73.87
Rate for Payer: Wellpoint Medicaid Managed Care	$81.22

2.8 SHOULDER Q-FIX KIT

Facility

$2,550.00

Hospital Charge Code	270674270
Hospital Revenue Code	272
Min. Negotiated Rate	$382.50
Max. Negotiated Rate	$382.50
Rate for Payer: Qualcare PPO/HMO/WC	$382.50

2.8 SHOULDER Q-FIX KIT

Facility

$2,550.00

Hospital Charge Code	270674270
Hospital Revenue Code	272
Min. Negotiated Rate	$61.45
Max. Negotiated Rate	$1,275.00
Rate for Payer: Aetna Commercial	$969.00
Rate for Payer: Aetna Medicare Advantage	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$650.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$650.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$650.25
Rate for Payer: Cigna Commercial	$1,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$765.00
Rate for Payer: Oxford Commercial	$510.00
Rate for Payer: Qualcare PPO/HMO/WC	$382.50
Rate for Payer: UnitedHealthcare Commercial	$510.00
Rate for Payer: UnitedHealthcare Community & State	$61.45
Rate for Payer: Wellpoint Medicaid Managed Care	$67.58

28X40X17MM CAGE 15DEG

Facility

$32,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705503
Hospital Revenue Code	278
Min. Negotiated Rate	$4,875.00
Max. Negotiated Rate	$7,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,150.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00

28X40X17MM CAGE 15DEG

Facility

$32,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705503
Hospital Revenue Code	278
Min. Negotiated Rate	$783.25
Max. Negotiated Rate	$16,250.00
Rate for Payer: Aetna Commercial	$12,350.00
Rate for Payer: Aetna Medicare Advantage	$9,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,287.50
Rate for Payer: Cigna Commercial	$16,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,150.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00
Rate for Payer: UnitedHealthcare Community & State	$783.25
Rate for Payer: Wellpoint Medicaid Managed Care	$861.25

2.9 BC LOOP N TACKTENODESIS IM

Facility

$4,635.00

Service Code	HCPCS C1713
Hospital Charge Code	270704045
Hospital Revenue Code	278
Min. Negotiated Rate	$111.70
Max. Negotiated Rate	$2,317.50
Rate for Payer: Aetna Commercial	$1,761.30
Rate for Payer: Aetna Medicare Advantage	$1,390.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,181.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,181.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$927.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,181.92
Rate for Payer: Cigna Commercial	$2,317.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,121.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,019.70
Rate for Payer: Qualcare PPO/HMO/WC	$695.25
Rate for Payer: UnitedHealthcare Community & State	$111.70
Rate for Payer: Wellpoint Medicaid Managed Care	$122.83

2.9 BC LOOP N TACKTENODESIS IM

Facility

$4,635.00

Service Code	HCPCS C1713
Hospital Charge Code	270704045
Hospital Revenue Code	278
Min. Negotiated Rate	$695.25
Max. Negotiated Rate	$1,121.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$927.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,121.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,019.70
Rate for Payer: Qualcare PPO/HMO/WC	$695.25

2.9MM BIOCOMP PISHLOCK

Facility

$875.00

Hospital Charge Code	270656434
Hospital Revenue Code	271
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

2.9MM BIOCOMP PISHLOCK

Facility

$875.00

Hospital Charge Code	270656434
Hospital Revenue Code	271
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

2.9MM HIP PUSHLOCK DIAP KIT

Facility

$1,375.00

Hospital Charge Code	270681509
Hospital Revenue Code	272
Min. Negotiated Rate	$33.14
Max. Negotiated Rate	$687.50
Rate for Payer: Aetna Commercial	$522.50
Rate for Payer: Aetna Medicare Advantage	$412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.62
Rate for Payer: Cigna Commercial	$687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$412.50
Rate for Payer: Oxford Commercial	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$206.25
Rate for Payer: UnitedHealthcare Commercial	$275.00
Rate for Payer: UnitedHealthcare Community & State	$33.14
Rate for Payer: Wellpoint Medicaid Managed Care	$36.44

2.9MM HIP PUSHLOCK DIAP KIT

Facility

$1,375.00

Hospital Charge Code	270681509
Hospital Revenue Code	272
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$206.25
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

2CC BONE MATRIX

Facility

$4,675.00

Service Code	HCPCS C1765
Hospital Charge Code	270705968
Hospital Revenue Code	278
Min. Negotiated Rate	$112.67
Max. Negotiated Rate	$2,337.50
Rate for Payer: Aetna Commercial	$1,776.50
Rate for Payer: Aetna Medicare Advantage	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,192.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,192.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$935.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,192.12
Rate for Payer: Cigna Commercial	$2,337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,131.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$701.25
Rate for Payer: UnitedHealthcare Community & State	$112.67
Rate for Payer: Wellpoint Medicaid Managed Care	$123.89

2CC BONE MATRIX

Facility

$4,675.00

Service Code	HCPCS C1765
Hospital Charge Code	270705968
Hospital Revenue Code	278
Min. Negotiated Rate	$701.25
Max. Negotiated Rate	$1,131.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$935.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,131.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$701.25

2CC FROZEN FIBER

Facility

$4,250.00

Service Code	HCPCS C1765
Hospital Charge Code	270705126
Hospital Revenue Code	278
Min. Negotiated Rate	$102.42
Max. Negotiated Rate	$2,125.00
Rate for Payer: Aetna Commercial	$1,615.00
Rate for Payer: Aetna Medicare Advantage	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,083.75
Rate for Payer: Cigna Commercial	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$935.00
Rate for Payer: Qualcare PPO/HMO/WC	$637.50
Rate for Payer: UnitedHealthcare Community & State	$102.42
Rate for Payer: Wellpoint Medicaid Managed Care	$112.62

2CC FROZEN FIBER

Facility

$4,250.00

Service Code	HCPCS C1765
Hospital Charge Code	270705126
Hospital Revenue Code	278
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$1,028.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$935.00
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

Know your out-of-pocket cost for care.

All Charges