Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

OSSIFY CORTICAL DBM FIBER 10CC

Facility

$8,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270691875
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,870.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

OSSIFY CORTICAL DBM FIBER 10CC

Facility

$8,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270691875
Hospital Revenue Code	278
Min. Negotiated Rate	$204.85
Max. Negotiated Rate	$4,250.00
Rate for Payer: Aetna Commercial	$3,230.00
Rate for Payer: Aetna Medicare Advantage	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,167.50
Rate for Payer: Cigna Commercial	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,870.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00
Rate for Payer: UnitedHealthcare Community & State	$204.85
Rate for Payer: Wellpoint Medicaid Managed Care	$225.25

OSSIFY CORTICAL FIBER 5CC

Facility

$8,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696783
Hospital Revenue Code	278
Min. Negotiated Rate	$204.85
Max. Negotiated Rate	$4,250.00
Rate for Payer: Aetna Commercial	$3,230.00
Rate for Payer: Aetna Medicare Advantage	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,167.50
Rate for Payer: Cigna Commercial	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,870.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00
Rate for Payer: UnitedHealthcare Community & State	$204.85
Rate for Payer: Wellpoint Medicaid Managed Care	$225.25

OSSIFY CORTICAL FIBER 5CC

Facility

$8,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696783
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,870.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

OSSIMATRIX SMALL PRFM

Facility

$6,475.00

Hospital Charge Code	270702458
Hospital Revenue Code	278
Min. Negotiated Rate	$156.05
Max. Negotiated Rate	$3,237.50
Rate for Payer: Aetna Commercial	$2,460.50
Rate for Payer: Aetna Medicare Advantage	$1,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.12
Rate for Payer: Cigna Commercial	$3,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,424.50
Rate for Payer: Qualcare PPO/HMO/WC	$971.25
Rate for Payer: UnitedHealthcare Community & State	$156.05
Rate for Payer: Wellpoint Medicaid Managed Care	$171.59

OSSIMATRIX SMALL PRFM

Facility

$6,475.00

Hospital Charge Code	270702458
Hospital Revenue Code	278
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$1,566.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,424.50
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

OSS IM STEM WITH SCREW 10MM X

Facility

$9,210.00

Service Code	HCPCS C1713
Hospital Charge Code	270684685
Hospital Revenue Code	278
Min. Negotiated Rate	$221.96
Max. Negotiated Rate	$4,605.00
Rate for Payer: Aetna Commercial	$3,499.80
Rate for Payer: Aetna Medicare Advantage	$2,763.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,348.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,348.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,842.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,348.55
Rate for Payer: Cigna Commercial	$4,605.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,228.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,026.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,381.50
Rate for Payer: UnitedHealthcare Community & State	$221.96
Rate for Payer: Wellpoint Medicaid Managed Care	$244.06

OSS IM STEM WITH SCREW 10MM X

Facility

$9,210.00

Service Code	HCPCS C1713
Hospital Charge Code	270684685
Hospital Revenue Code	278
Min. Negotiated Rate	$1,381.50
Max. Negotiated Rate	$2,228.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,842.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,228.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,026.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,381.50

OSS IM STEM WITH SCREW 11MM X

Facility

$9,210.00

Service Code	HCPCS C1713
Hospital Charge Code	270684689
Hospital Revenue Code	278
Min. Negotiated Rate	$1,381.50
Max. Negotiated Rate	$2,228.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,842.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,228.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,026.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,381.50

OSS IM STEM WITH SCREW 11MM X

Facility

$9,210.00

Service Code	HCPCS C1713
Hospital Charge Code	270684689
Hospital Revenue Code	278
Min. Negotiated Rate	$221.96
Max. Negotiated Rate	$4,605.00
Rate for Payer: Aetna Commercial	$3,499.80
Rate for Payer: Aetna Medicare Advantage	$2,763.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,348.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,348.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,842.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,348.55
Rate for Payer: Cigna Commercial	$4,605.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,228.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,026.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,381.50
Rate for Payer: UnitedHealthcare Community & State	$221.96
Rate for Payer: Wellpoint Medicaid Managed Care	$244.06

OSSIO PUNCH PK 4.75MM

Facility

$2,475.00

Hospital Charge Code	270700791
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

OSSIO PUNCH PK 4.75MM

Facility

$2,475.00

Hospital Charge Code	270700791
Hospital Revenue Code	272
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$742.50
Rate for Payer: Oxford Commercial	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$495.00
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

OSSIO TAP PK 4.75MM

Facility

$2,475.00

Hospital Charge Code	270700790
Hospital Revenue Code	272
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$742.50
Rate for Payer: Oxford Commercial	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$495.00
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

OSSIO TAP PK 4.75MM

Facility

$2,475.00

Hospital Charge Code	270700790
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

OSS MOLDABLE 3CC

Facility

$7,125.00

Hospital Charge Code	270702345
Hospital Revenue Code	278
Min. Negotiated Rate	$171.71
Max. Negotiated Rate	$3,562.50
Rate for Payer: Aetna Commercial	$2,707.50
Rate for Payer: Aetna Medicare Advantage	$2,137.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,816.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,816.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,816.88
Rate for Payer: Cigna Commercial	$3,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,724.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,567.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,068.75
Rate for Payer: UnitedHealthcare Community & State	$171.71
Rate for Payer: Wellpoint Medicaid Managed Care	$188.81

OSS MOLDABLE 3CC

Facility

$7,125.00

Hospital Charge Code	270702345
Hospital Revenue Code	278
Min. Negotiated Rate	$1,068.75
Max. Negotiated Rate	$1,724.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,724.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,567.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,068.75

OSS NON-MOD TIB PLATE LONG 71

Facility

$30,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270681526
Hospital Revenue Code	278
Min. Negotiated Rate	$736.25
Max. Negotiated Rate	$15,275.00
Rate for Payer: Aetna Commercial	$11,609.00
Rate for Payer: Aetna Medicare Advantage	$9,165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,790.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,790.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,790.25
Rate for Payer: Cigna Commercial	$15,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,393.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,721.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,582.50
Rate for Payer: UnitedHealthcare Community & State	$736.25
Rate for Payer: Wellpoint Medicaid Managed Care	$809.58

OSS NON-MOD TIB PLATE LONG 71

Facility

$30,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270681526
Hospital Revenue Code	278
Min. Negotiated Rate	$4,582.50
Max. Negotiated Rate	$7,393.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,393.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,721.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,582.50

OSS RS 8.5CM ELLIP SEG FMRL-LT

Facility

$63,900.00

Service Code	HCPCS C1776
Hospital Charge Code	270689984
Hospital Revenue Code	278
Min. Negotiated Rate	$1,539.99
Max. Negotiated Rate	$31,950.00
Rate for Payer: Aetna Commercial	$24,282.00
Rate for Payer: Aetna Medicare Advantage	$19,170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,294.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,294.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12,780.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16,294.50
Rate for Payer: Cigna Commercial	$31,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,463.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14,058.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,585.00
Rate for Payer: UnitedHealthcare Community & State	$1,539.99
Rate for Payer: Wellpoint Medicaid Managed Care	$1,693.35

OSS RS 8.5CM ELLIP SEG FMRL-LT

Facility

$63,900.00

Service Code	HCPCS C1776
Hospital Charge Code	270689984
Hospital Revenue Code	278
Min. Negotiated Rate	$9,585.00
Max. Negotiated Rate	$15,463.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12,780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,463.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14,058.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,585.00

OSS STAPLE

Facility

$4,475.00

Hospital Charge Code	270656969
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$984.50
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

OSS STAPLE

Facility

$4,475.00

Hospital Charge Code	270656969
Hospital Revenue Code	278
Min. Negotiated Rate	$107.85
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,700.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$984.50
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Community & State	$107.85
Rate for Payer: Wellpoint Medicaid Managed Care	$118.59

OS STAPLE

Facility

$6,975.00

Hospital Charge Code	270657017
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,687.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,534.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

OS STAPLE

Facility

$6,975.00

Hospital Charge Code	270657017
Hospital Revenue Code	278
Min. Negotiated Rate	$168.10
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,650.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,534.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25
Rate for Payer: UnitedHealthcare Community & State	$168.10
Rate for Payer: Wellpoint Medicaid Managed Care	$184.84

OSS TI 5CM DSTL FEMUR RT

Facility

$37,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270684636
Hospital Revenue Code	278
Min. Negotiated Rate	$903.75
Max. Negotiated Rate	$18,750.00
Rate for Payer: Aetna Commercial	$14,250.00
Rate for Payer: Aetna Medicare Advantage	$11,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,562.50
Rate for Payer: Cigna Commercial	$18,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,075.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00
Rate for Payer: UnitedHealthcare Community & State	$903.75
Rate for Payer: Wellpoint Medicaid Managed Care	$993.75

Know your out-of-pocket cost for care.

All Charges