Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS

Facility

$10,439.67

Service Code	APR-DRG 3442
Min. Negotiated Rate	$10,234.97
Max. Negotiated Rate	$10,439.67
Rate for Payer: UnitedHealthcare Community & State	$10,234.97
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,439.67
Rate for Payer: Wellpoint Medicaid Managed Care	$10,234.97

OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS

Facility

$8,237.33

Service Code	APR-DRG 3441
Min. Negotiated Rate	$8,075.81
Max. Negotiated Rate	$8,237.33
Rate for Payer: UnitedHealthcare Community & State	$8,075.81
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,237.33
Rate for Payer: Wellpoint Medicaid Managed Care	$8,075.81

OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS

Facility

$23,622.97

Service Code	APR-DRG 3444
Min. Negotiated Rate	$23,159.77
Max. Negotiated Rate	$23,622.97
Rate for Payer: UnitedHealthcare Community & State	$23,159.77
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,622.97
Rate for Payer: Wellpoint Medicaid Managed Care	$23,159.77

OSTEOMYELITIS WITH CC

Facility

$44,032.65

Service Code	MSDRG 540
Min. Negotiated Rate	$13,407.38
Max. Negotiated Rate	$44,032.65
Rate for Payer: Aetna Commercial	$30,512.76
Rate for Payer: Aetna Medicare Advantage	$44,032.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30,239.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30,239.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,113.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30,239.30
Rate for Payer: Cigna Commercial	$24,258.96
Rate for Payer: Cigna Medicare Advantage	$14,113.03
Rate for Payer: Clover Medicare Advantage	$13,407.38
Rate for Payer: EmblemHealth Commercial	$42,339.09
Rate for Payer: Humana Medicare Advantage	$14,536.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,113.03
Rate for Payer: Oxford Commercial	$17,435.24
Rate for Payer: UnitedHealthcare Commercial	$30,573.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,113.03
Rate for Payer: Wellcare Medicare Advantage	$14,113.03

OSTEOMYELITIS WITH MCC

Facility

$65,798.02

Service Code	MSDRG 539
Min. Negotiated Rate	$20,034.65
Max. Negotiated Rate	$65,798.02
Rate for Payer: Aetna Commercial	$45,468.06
Rate for Payer: Aetna Medicare Advantage	$65,798.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46,056.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46,056.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,089.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46,056.78
Rate for Payer: Cigna Commercial	$36,860.97
Rate for Payer: Cigna Medicare Advantage	$21,089.11
Rate for Payer: Clover Medicare Advantage	$20,034.65
Rate for Payer: EmblemHealth Commercial	$63,267.33
Rate for Payer: Humana Medicare Advantage	$21,721.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,089.11
Rate for Payer: Oxford Commercial	$26,492.47
Rate for Payer: UnitedHealthcare Commercial	$46,455.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,089.11
Rate for Payer: Wellcare Medicare Advantage	$21,089.11

OSTEOMYELITIS WITHOUT CC/MCC

Facility

$27,584.17

Service Code	MSDRG 541
Min. Negotiated Rate	$8,399.03
Max. Negotiated Rate	$27,584.17
Rate for Payer: Aetna Commercial	$19,210.79
Rate for Payer: Aetna Medicare Advantage	$27,584.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20,004.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20,004.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,841.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20,004.46
Rate for Payer: Cigna Commercial	$14,437.85
Rate for Payer: Cigna Medicare Advantage	$8,841.08
Rate for Payer: Clover Medicare Advantage	$8,399.03
Rate for Payer: EmblemHealth Commercial	$26,523.24
Rate for Payer: Humana Medicare Advantage	$9,106.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,841.08
Rate for Payer: Oxford Commercial	$10,376.67
Rate for Payer: UnitedHealthcare Commercial	$18,195.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,841.08
Rate for Payer: Wellcare Medicare Advantage	$8,841.08

OSTEO-P BONE GRAFT MATRIX 5CC

Facility

$16,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270697505
Hospital Revenue Code	278
Min. Negotiated Rate	$397.05
Max. Negotiated Rate	$8,237.50
Rate for Payer: Aetna Commercial	$6,260.50
Rate for Payer: Aetna Medicare Advantage	$4,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,201.12
Rate for Payer: Cigna Commercial	$8,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,624.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25
Rate for Payer: UnitedHealthcare Community & State	$397.05
Rate for Payer: Wellpoint Medicaid Managed Care	$436.59

OSTEO-P BONE GRAFT MATRIX 5CC

Facility

$16,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270697505
Hospital Revenue Code	278
Min. Negotiated Rate	$2,471.25
Max. Negotiated Rate	$3,986.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,624.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25

OSTEOSELECT DBM 1CC

Facility

$4,950.00

Hospital Charge Code	270703500
Hospital Revenue Code	278
Min. Negotiated Rate	$742.50
Max. Negotiated Rate	$1,197.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,197.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$742.50

OSTEOSELECT DBM 1CC

Facility

$4,950.00

Hospital Charge Code	270703500
Hospital Revenue Code	278
Min. Negotiated Rate	$119.30
Max. Negotiated Rate	$2,475.00
Rate for Payer: Aetna Commercial	$1,881.00
Rate for Payer: Aetna Medicare Advantage	$1,485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,262.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,262.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,262.25
Rate for Payer: Cigna Commercial	$2,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,197.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$742.50
Rate for Payer: UnitedHealthcare Community & State	$119.30
Rate for Payer: Wellpoint Medicaid Managed Care	$131.18

OSTEOSELECT DBM 2.5CC

Facility

$1,700.00

Service Code	HCPCS C1762
Hospital Charge Code	270704125
Hospital Revenue Code	278
Min. Negotiated Rate	$255.00
Max. Negotiated Rate	$411.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$374.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00

OSTEOSELECT DBM 2.5CC

Facility

$1,700.00

Service Code	HCPCS C1762
Hospital Charge Code	270704125
Hospital Revenue Code	278
Min. Negotiated Rate	$40.97
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$646.00
Rate for Payer: Aetna Medicare Advantage	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$433.50
Rate for Payer: Cigna Commercial	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$374.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00
Rate for Payer: UnitedHealthcare Community & State	$40.97
Rate for Payer: Wellpoint Medicaid Managed Care	$45.05

OSTEOSLIM DBM PUTTY 5.0CC 9085

Facility

$3,283.60

Hospital Charge Code	270633428
Hospital Revenue Code	278
Min. Negotiated Rate	$79.13
Max. Negotiated Rate	$1,641.80
Rate for Payer: Aetna Commercial	$1,247.77
Rate for Payer: Aetna Medicare Advantage	$985.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$837.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$837.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$656.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$837.32
Rate for Payer: Cigna Commercial	$1,641.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$794.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$722.39
Rate for Payer: Qualcare PPO/HMO/WC	$492.54
Rate for Payer: UnitedHealthcare Community & State	$79.13
Rate for Payer: Wellpoint Medicaid Managed Care	$87.02

OSTEOSLIM DBM PUTTY 5.0CC 9085

Facility

$3,283.60

Hospital Charge Code	270633428
Hospital Revenue Code	278
Min. Negotiated Rate	$492.54
Max. Negotiated Rate	$794.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$656.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$794.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$722.39
Rate for Payer: Qualcare PPO/HMO/WC	$492.54

OSTEOSPONGE FILLER 15CC

Facility

$5,735.00

Service Code	HCPCS C1889
Hospital Charge Code	270704120
Hospital Revenue Code	278
Min. Negotiated Rate	$138.21
Max. Negotiated Rate	$2,867.50
Rate for Payer: Aetna Commercial	$2,179.30
Rate for Payer: Aetna Medicare Advantage	$1,720.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,462.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,462.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,147.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,462.42
Rate for Payer: Cigna Commercial	$2,867.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,387.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,261.70
Rate for Payer: Qualcare PPO/HMO/WC	$860.25
Rate for Payer: UnitedHealthcare Community & State	$138.21
Rate for Payer: Wellpoint Medicaid Managed Care	$151.98

OSTEOSPONGE FILLER 15CC

Facility

$5,735.00

Service Code	HCPCS C1889
Hospital Charge Code	270704120
Hospital Revenue Code	278
Min. Negotiated Rate	$860.25
Max. Negotiated Rate	$1,387.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,147.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,387.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,261.70
Rate for Payer: Qualcare PPO/HMO/WC	$860.25

OSTEO SPONGE FILLER 30.00 CC

Facility

$10,837.50

Service Code	HCPCS C1713
Hospital Charge Code	270686303
Hospital Revenue Code	278
Min. Negotiated Rate	$261.18
Max. Negotiated Rate	$5,418.75
Rate for Payer: Aetna Commercial	$4,118.25
Rate for Payer: Aetna Medicare Advantage	$3,251.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,763.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,763.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,763.56
Rate for Payer: Cigna Commercial	$5,418.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,622.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,384.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,625.62
Rate for Payer: UnitedHealthcare Community & State	$261.18
Rate for Payer: Wellpoint Medicaid Managed Care	$287.19

OSTEO SPONGE FILLER 30.00 CC

Facility

$10,837.50

Service Code	HCPCS C1713
Hospital Charge Code	270686303
Hospital Revenue Code	278
Min. Negotiated Rate	$1,625.62
Max. Negotiated Rate	$2,622.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,167.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,622.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,384.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,625.62

OSTEOSPONGEFILLER FINE 30CC

Facility

$10,835.00

Hospital Charge Code	270701851
Hospital Revenue Code	278
Min. Negotiated Rate	$1,625.25
Max. Negotiated Rate	$2,622.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,167.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,622.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,383.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,625.25

OSTEOSPONGEFILLER FINE 30CC

Facility

$10,835.00

Hospital Charge Code	270701851
Hospital Revenue Code	278
Min. Negotiated Rate	$261.12
Max. Negotiated Rate	$5,417.50
Rate for Payer: Aetna Commercial	$4,117.30
Rate for Payer: Aetna Medicare Advantage	$3,250.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,762.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,762.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,167.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,762.93
Rate for Payer: Cigna Commercial	$5,417.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,622.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,383.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,625.25
Rate for Payer: UnitedHealthcare Community & State	$261.12
Rate for Payer: Wellpoint Medicaid Managed Care	$287.13

OSTEOSURGE 300 PUTTY 2.5CC

Facility

$2,995.00

Service Code	HCPCS C1713
Hospital Charge Code	270694152
Hospital Revenue Code	278
Min. Negotiated Rate	$72.18
Max. Negotiated Rate	$1,497.50
Rate for Payer: Aetna Commercial	$1,138.10
Rate for Payer: Aetna Medicare Advantage	$898.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$763.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$763.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$599.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$763.73
Rate for Payer: Cigna Commercial	$1,497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$724.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$658.90
Rate for Payer: Qualcare PPO/HMO/WC	$449.25
Rate for Payer: UnitedHealthcare Community & State	$72.18
Rate for Payer: Wellpoint Medicaid Managed Care	$79.37

OSTEOSURGE 300 PUTTY 2.5CC

Facility

$2,995.00

Service Code	HCPCS C1713
Hospital Charge Code	270694152
Hospital Revenue Code	278
Min. Negotiated Rate	$449.25
Max. Negotiated Rate	$724.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$599.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$724.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$658.90
Rate for Payer: Qualcare PPO/HMO/WC	$449.25

OSTEOSURGE 300 PUTTY 5CC

Facility

$5,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270694151
Hospital Revenue Code	278
Min. Negotiated Rate	$136.65
Max. Negotiated Rate	$2,835.00
Rate for Payer: Aetna Commercial	$2,154.60
Rate for Payer: Aetna Medicare Advantage	$1,701.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,445.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,445.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,134.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,445.85
Rate for Payer: Cigna Commercial	$2,835.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,372.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,247.40
Rate for Payer: Qualcare PPO/HMO/WC	$850.50
Rate for Payer: UnitedHealthcare Community & State	$136.65
Rate for Payer: Wellpoint Medicaid Managed Care	$150.25

OSTEOSURGE 300 PUTTY 5CC

Facility

$5,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270694151
Hospital Revenue Code	278
Min. Negotiated Rate	$850.50
Max. Negotiated Rate	$1,372.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,134.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,372.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,247.40
Rate for Payer: Qualcare PPO/HMO/WC	$850.50

OSTEOSURGE BN MATRIX SYR10CC

Facility

$18,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270672817
Hospital Revenue Code	278
Min. Negotiated Rate	$2,797.50
Max. Negotiated Rate	$4,513.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,730.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,513.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,103.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,797.50

Know your out-of-pocket cost for care.

All Charges