Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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	$5,625.00
Max. Negotiated Rate	$9,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,500.00
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

OSS TI AXLE W CAP AND SCR

Facility

$6,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270684639
Hospital Revenue Code	278
Min. Negotiated Rate	$166.29
Max. Negotiated Rate	$3,450.00
Rate for Payer: Aetna Commercial	$2,622.00
Rate for Payer: Aetna Medicare Advantage	$2,070.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,759.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,759.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,380.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,759.50
Rate for Payer: Cigna Commercial	$3,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,669.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,518.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,035.00
Rate for Payer: UnitedHealthcare Community & State	$166.29
Rate for Payer: Wellpoint Medicaid Managed Care	$182.85

OSS TI AXLE W CAP AND SCR

Facility

$6,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270684639
Hospital Revenue Code	278
Min. Negotiated Rate	$1,035.00
Max. Negotiated Rate	$1,669.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,380.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,669.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,518.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,035.00

OSS TIBIAL POLY BEARING 20MM

Facility

$8,952.00

Service Code	HCPCS C1776
Hospital Charge Code	270691629
Hospital Revenue Code	278
Min. Negotiated Rate	$1,342.80
Max. Negotiated Rate	$2,166.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,790.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,166.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,969.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,342.80

OSS TIBIAL POLY BEARING 20MM

Facility

$8,952.00

Service Code	HCPCS C1776
Hospital Charge Code	270691629
Hospital Revenue Code	278
Min. Negotiated Rate	$215.74
Max. Negotiated Rate	$4,476.00
Rate for Payer: Aetna Commercial	$3,401.76
Rate for Payer: Aetna Medicare Advantage	$2,685.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,282.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,282.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,790.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,282.76
Rate for Payer: Cigna Commercial	$4,476.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,166.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,969.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,342.80
Rate for Payer: UnitedHealthcare Community & State	$215.74
Rate for Payer: Wellpoint Medicaid Managed Care	$237.23

OSTEOAMP FLOWABLE 5.0CC

Facility

$12,639.65

Service Code	HCPCS C1889
Hospital Charge Code	270696321
Hospital Revenue Code	278
Min. Negotiated Rate	$304.62
Max. Negotiated Rate	$6,319.82
Rate for Payer: Aetna Commercial	$4,803.07
Rate for Payer: Aetna Medicare Advantage	$3,791.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,223.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,223.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,527.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,223.11
Rate for Payer: Cigna Commercial	$6,319.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,058.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,780.72
Rate for Payer: Qualcare PPO/HMO/WC	$1,895.95
Rate for Payer: UnitedHealthcare Community & State	$304.62
Rate for Payer: Wellpoint Medicaid Managed Care	$334.95

OSTEOAMP FLOWABLE 5.0CC

Facility

$12,639.65

Service Code	HCPCS C1889
Hospital Charge Code	270696321
Hospital Revenue Code	278
Min. Negotiated Rate	$1,895.95
Max. Negotiated Rate	$3,058.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,527.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,058.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,780.72
Rate for Payer: Qualcare PPO/HMO/WC	$1,895.95

OSTEOAMP GRAFT FIBERS 15 CC OA

Facility

$31,205.00

Service Code	HCPCS C1889
Hospital Charge Code	270691812
Hospital Revenue Code	278
Min. Negotiated Rate	$752.04
Max. Negotiated Rate	$15,602.50
Rate for Payer: Aetna Commercial	$11,857.90
Rate for Payer: Aetna Medicare Advantage	$9,361.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,957.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,957.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,241.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,957.27
Rate for Payer: Cigna Commercial	$15,602.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,551.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,865.10
Rate for Payer: Qualcare PPO/HMO/WC	$4,680.75
Rate for Payer: UnitedHealthcare Community & State	$752.04
Rate for Payer: Wellpoint Medicaid Managed Care	$826.93

OSTEOAMP GRAFT FIBERS 15 CC OA

Facility

$31,205.00

Service Code	HCPCS C1889
Hospital Charge Code	270691812
Hospital Revenue Code	278
Min. Negotiated Rate	$4,680.75
Max. Negotiated Rate	$7,551.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,241.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,551.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,865.10
Rate for Payer: Qualcare PPO/HMO/WC	$4,680.75

OSTEOAMP SEL FIBERS 10CC

Facility

$23,180.00

Service Code	HCPCS C1889
Hospital Charge Code	270691817
Hospital Revenue Code	278
Min. Negotiated Rate	$558.64
Max. Negotiated Rate	$11,590.00
Rate for Payer: Aetna Commercial	$8,808.40
Rate for Payer: Aetna Medicare Advantage	$6,954.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,910.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,910.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,636.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,910.90
Rate for Payer: Cigna Commercial	$11,590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,609.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,099.60
Rate for Payer: Qualcare PPO/HMO/WC	$3,477.00
Rate for Payer: UnitedHealthcare Community & State	$558.64
Rate for Payer: Wellpoint Medicaid Managed Care	$614.27

OSTEOAMP SEL FIBERS 10CC

Facility

$23,180.00

Service Code	HCPCS C1889
Hospital Charge Code	270691817
Hospital Revenue Code	278
Min. Negotiated Rate	$3,477.00
Max. Negotiated Rate	$5,609.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,636.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,609.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,099.60
Rate for Payer: Qualcare PPO/HMO/WC	$3,477.00

OSTEOAMP SEL FIBERS 15CC

Facility

$31,205.00

Service Code	HCPCS C1889
Hospital Charge Code	270691815
Hospital Revenue Code	278
Min. Negotiated Rate	$4,680.75
Max. Negotiated Rate	$7,551.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,241.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,551.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,865.10
Rate for Payer: Qualcare PPO/HMO/WC	$4,680.75

OSTEOAMP SEL FIBERS 15CC

Facility

$31,205.00

Service Code	HCPCS C1889
Hospital Charge Code	270691815
Hospital Revenue Code	278
Min. Negotiated Rate	$752.04
Max. Negotiated Rate	$15,602.50
Rate for Payer: Aetna Commercial	$11,857.90
Rate for Payer: Aetna Medicare Advantage	$9,361.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,957.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,957.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,241.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,957.27
Rate for Payer: Cigna Commercial	$15,602.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,551.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,865.10
Rate for Payer: Qualcare PPO/HMO/WC	$4,680.75
Rate for Payer: UnitedHealthcare Community & State	$752.04
Rate for Payer: Wellpoint Medicaid Managed Care	$826.93

OSTEOAMP SEL FIBERS 5CC

Facility

$13,740.00

Service Code	HCPCS C1889
Hospital Charge Code	270691816
Hospital Revenue Code	278
Min. Negotiated Rate	$331.13
Max. Negotiated Rate	$6,870.00
Rate for Payer: Aetna Commercial	$5,221.20
Rate for Payer: Aetna Medicare Advantage	$4,122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,503.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,503.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,748.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,503.70
Rate for Payer: Cigna Commercial	$6,870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,325.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,022.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,061.00
Rate for Payer: UnitedHealthcare Community & State	$331.13
Rate for Payer: Wellpoint Medicaid Managed Care	$364.11

OSTEOAMP SEL FIBERS 5CC

Facility

$13,740.00

Service Code	HCPCS C1889
Hospital Charge Code	270691816
Hospital Revenue Code	278
Min. Negotiated Rate	$2,061.00
Max. Negotiated Rate	$3,325.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,748.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,325.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,022.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,061.00

OSTEOART ALGRFT W/SURF & B1

Facility

$15,955.20

Service Code	HCPCS 20932
Hospital Charge Code	1600000526
Hospital Revenue Code	360
Min. Negotiated Rate	$384.52
Max. Negotiated Rate	$7,977.60
Rate for Payer: Aetna Commercial	$6,062.98
Rate for Payer: Aetna Medicare Advantage	$4,786.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,068.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,068.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,068.58
Rate for Payer: Cigna Commercial	$7,977.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,786.56
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,393.28
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$384.52
Rate for Payer: Wellpoint Medicaid Managed Care	$422.81

OSTEOART ALGRFT W/SURF & B1

Facility

$15,955.20

Service Code	HCPCS 20932
Hospital Charge Code	1600000526
Hospital Revenue Code	360
Min. Negotiated Rate	$2,393.28
Max. Negotiated Rate	$2,393.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,393.28

OSTEOBOND BOWL SYSTEM *******

Facility

$125.00

Hospital Charge Code	1606342
Hospital Revenue Code	279
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

OSTEOBOND BOWL SYSTEM *******

Facility

$125.00

Hospital Charge Code	1606342
Hospital Revenue Code	279
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$25.00
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

OSTEOBOND CEMENT LOW VISC.

Facility

$369.40

Hospital Charge Code	270656064
Hospital Revenue Code	271
Min. Negotiated Rate	$8.90
Max. Negotiated Rate	$184.70
Rate for Payer: Aetna Commercial	$140.37
Rate for Payer: Aetna Medicare Advantage	$110.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.20
Rate for Payer: Cigna Commercial	$184.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.82
Rate for Payer: Oxford Commercial	$73.88
Rate for Payer: Qualcare PPO/HMO/WC	$55.41
Rate for Payer: UnitedHealthcare Commercial	$73.88
Rate for Payer: UnitedHealthcare Community & State	$8.90
Rate for Payer: Wellpoint Medicaid Managed Care	$9.79

OSTEOBOND CEMENT LOW VISC.

Facility

$369.40

Hospital Charge Code	270656064
Hospital Revenue Code	271
Min. Negotiated Rate	$55.41
Max. Negotiated Rate	$55.41
Rate for Payer: Qualcare PPO/HMO/WC	$55.41

OSTEOBOND VACUM MIXING KIT****

Facility

$215.00

Hospital Charge Code	1606334
Hospital Revenue Code	279
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$107.50
Rate for Payer: Aetna Commercial	$81.70
Rate for Payer: Aetna Medicare Advantage	$64.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.83
Rate for Payer: Cigna Commercial	$107.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.50
Rate for Payer: Oxford Commercial	$43.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.25
Rate for Payer: UnitedHealthcare Commercial	$43.00
Rate for Payer: UnitedHealthcare Community & State	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$5.70

OSTEOBOND VACUM MIXING KIT****

Facility

$215.00

Hospital Charge Code	1606334
Hospital Revenue Code	279
Min. Negotiated Rate	$32.25
Max. Negotiated Rate	$32.25
Rate for Payer: Qualcare PPO/HMO/WC	$32.25

OSTEOCALCIN

Facility

$211.39

Service Code	HCPCS 83937
Hospital Charge Code	38477182
Hospital Revenue Code	301
Min. Negotiated Rate	$31.71
Max. Negotiated Rate	$31.71
Rate for Payer: Qualcare PPO/HMO/WC	$31.71

OSTEOCALCIN

Facility

$211.39

Service Code	HCPCS 83937
Hospital Charge Code	38477182
Hospital Revenue Code	301
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$81.19
Rate for Payer: Aetna Medicare Advantage	$96.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.75
Rate for Payer: Cigna Commercial	$105.69
Rate for Payer: Cigna Medicare Advantage	$29.85
Rate for Payer: Clover Medicare Advantage	$28.36
Rate for Payer: EmblemHealth Commercial	$89.55
Rate for Payer: Humana Medicare Advantage	$30.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.42
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.71
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$23.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.85
Rate for Payer: Wellcare Medicare Advantage	$29.85
Rate for Payer: Wellpoint Medicaid Managed Care	$5.60

Know your out-of-pocket cost for care.

All Charges