Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

3.0MM ROUBD FLUTED AGGRESSIVE

Facility

$621.00

Hospital Charge Code	270702558
Hospital Revenue Code	279
Min. Negotiated Rate	$93.15
Max. Negotiated Rate	$93.15
Rate for Payer: Qualcare PPO/HMO/WC	$93.15

3.0MM ROUBD FLUTED AGGRESSIVE

Facility

$621.00

Hospital Charge Code	270702558
Hospital Revenue Code	279
Min. Negotiated Rate	$14.97
Max. Negotiated Rate	$310.50
Rate for Payer: Aetna Commercial	$235.98
Rate for Payer: Aetna Medicare Advantage	$186.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.35
Rate for Payer: Cigna Commercial	$310.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.30
Rate for Payer: Oxford Commercial	$124.20
Rate for Payer: Qualcare PPO/HMO/WC	$93.15
Rate for Payer: UnitedHealthcare Commercial	$124.20
Rate for Payer: UnitedHealthcare Community & State	$14.97
Rate for Payer: Wellpoint Medicaid Managed Care	$16.46

3.0X16MM VAL SCREW,TI

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270686390
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

3.0X16MM VAL SCREW,TI

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270686390
Hospital Revenue Code	278
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) NJ Health	$175.00
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	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

3.0X18 PARTIALLY THREADED SCRE

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270656447
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

3.0X18 PARTIALLY THREADED SCRE

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270656447
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

3 1/2 PROTECTORS INSTRUTMENT

Facility

$81.80

Hospital Charge Code	270665051
Hospital Revenue Code	270
Min. Negotiated Rate	$12.27
Max. Negotiated Rate	$12.27
Rate for Payer: Qualcare PPO/HMO/WC	$12.27

3 1/2 PROTECTORS INSTRUTMENT

Facility

$81.80

Hospital Charge Code	270665051
Hospital Revenue Code	270
Min. Negotiated Rate	$1.97
Max. Negotiated Rate	$40.90
Rate for Payer: Aetna Commercial	$31.08
Rate for Payer: Aetna Medicare Advantage	$24.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.86
Rate for Payer: Cigna Commercial	$40.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.54
Rate for Payer: Oxford Commercial	$16.36
Rate for Payer: Qualcare PPO/HMO/WC	$12.27
Rate for Payer: UnitedHealthcare Commercial	$16.36
Rate for Payer: UnitedHealthcare Community & State	$1.97
Rate for Payer: Wellpoint Medicaid Managed Care	$2.17

3.2 3-FLTD DRILL/MOD QC/145

Facility

$3,100.00

Hospital Charge Code	270705554
Hospital Revenue Code	279
Min. Negotiated Rate	$465.00
Max. Negotiated Rate	$465.00
Rate for Payer: Qualcare PPO/HMO/WC	$465.00

3.2 3-FLTD DRILL/MOD QC/145

Facility

$3,100.00

Hospital Charge Code	270705554
Hospital Revenue Code	279
Min. Negotiated Rate	$74.71
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$1,178.00
Rate for Payer: Aetna Medicare Advantage	$930.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$790.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$790.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$790.50
Rate for Payer: Cigna Commercial	$1,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$930.00
Rate for Payer: Oxford Commercial	$620.00
Rate for Payer: Qualcare PPO/HMO/WC	$465.00
Rate for Payer: UnitedHealthcare Commercial	$620.00
Rate for Payer: UnitedHealthcare Community & State	$74.71
Rate for Payer: Wellpoint Medicaid Managed Care	$82.15

326075S

Facility

$1,765.00

Hospital Charge Code	270656408
Hospital Revenue Code	278
Min. Negotiated Rate	$264.75
Max. Negotiated Rate	$427.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$353.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$427.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$388.30
Rate for Payer: Qualcare PPO/HMO/WC	$264.75

326075S

Facility

$1,765.00

Hospital Charge Code	270656408
Hospital Revenue Code	278
Min. Negotiated Rate	$42.54
Max. Negotiated Rate	$882.50
Rate for Payer: Aetna Commercial	$670.70
Rate for Payer: Aetna Medicare Advantage	$529.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$353.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.07
Rate for Payer: Cigna Commercial	$882.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$427.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$388.30
Rate for Payer: Qualcare PPO/HMO/WC	$264.75
Rate for Payer: UnitedHealthcare Community & State	$42.54
Rate for Payer: Wellpoint Medicaid Managed Care	$46.77

32MM 10 LINER 48CUP

Facility

$4,454.05

Hospital Charge Code	270656886
Hospital Revenue Code	278
Min. Negotiated Rate	$668.11
Max. Negotiated Rate	$1,077.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$890.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,077.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$979.89
Rate for Payer: Qualcare PPO/HMO/WC	$668.11

32MM 10 LINER 48CUP

Facility

$4,454.05

Hospital Charge Code	270656886
Hospital Revenue Code	278
Min. Negotiated Rate	$107.34
Max. Negotiated Rate	$2,227.03
Rate for Payer: Aetna Commercial	$1,692.54
Rate for Payer: Aetna Medicare Advantage	$1,336.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,135.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,135.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$890.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,135.78
Rate for Payer: Cigna Commercial	$2,227.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,077.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$979.89
Rate for Payer: Qualcare PPO/HMO/WC	$668.11
Rate for Payer: UnitedHealthcare Community & State	$107.34
Rate for Payer: Wellpoint Medicaid Managed Care	$118.03

32MM 10 LINER 50/52/54

Facility

$4,454.05

Hospital Charge Code	270656887
Hospital Revenue Code	278
Min. Negotiated Rate	$107.34
Max. Negotiated Rate	$2,227.03
Rate for Payer: Aetna Commercial	$1,692.54
Rate for Payer: Aetna Medicare Advantage	$1,336.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,135.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,135.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$890.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,135.78
Rate for Payer: Cigna Commercial	$2,227.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,077.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$979.89
Rate for Payer: Qualcare PPO/HMO/WC	$668.11
Rate for Payer: UnitedHealthcare Community & State	$107.34
Rate for Payer: Wellpoint Medicaid Managed Care	$118.03

32MM 10 LINER 50/52/54

Facility

$4,454.05

Hospital Charge Code	270656887
Hospital Revenue Code	278
Min. Negotiated Rate	$668.11
Max. Negotiated Rate	$1,077.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$890.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,077.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$979.89
Rate for Payer: Qualcare PPO/HMO/WC	$668.11

32MM 2HOLE CERVICAL PLATE

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270704172
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

32MM 2HOLE CERVICAL PLATE

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270704172
Hospital Revenue Code	278
Min. Negotiated Rate	$162.68
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$162.68
Rate for Payer: Wellpoint Medicaid Managed Care	$178.88

3.2MM CALIBRATED DRILL BIT

Facility

$770.00

Hospital Charge Code	270686578
Hospital Revenue Code	272
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$115.50

3.2MM CALIBRATED DRILL BIT

Facility

$700.00

Hospital Charge Code	270680674
Hospital Revenue Code	272
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

3.2MM CALIBRATED DRILL BIT

Facility

$700.00

Hospital Charge Code	270680674
Hospital Revenue Code	272
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Commercial	$140.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

3.2MM CALIBRATED DRILL BIT

Facility

$770.00

Hospital Charge Code	270686578
Hospital Revenue Code	272
Min. Negotiated Rate	$18.56
Max. Negotiated Rate	$385.00
Rate for Payer: Aetna Commercial	$292.60
Rate for Payer: Aetna Medicare Advantage	$231.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.35
Rate for Payer: Cigna Commercial	$385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.00
Rate for Payer: Oxford Commercial	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$115.50
Rate for Payer: UnitedHealthcare Commercial	$154.00
Rate for Payer: UnitedHealthcare Community & State	$18.56
Rate for Payer: Wellpoint Medicaid Managed Care	$20.41

32MM COCR HEAD M

Facility

$2,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270684270
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

32MM COCR HEAD M

Facility

$2,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270684270
Hospital Revenue Code	278
Min. Negotiated Rate	$48.20
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$48.20
Rate for Payer: Wellpoint Medicaid Managed Care	$53.00

3.2MM MEASURING DRILL SLEEVE

Facility

$990.00

Hospital Charge Code	270680675
Hospital Revenue Code	272
Min. Negotiated Rate	$23.86
Max. Negotiated Rate	$495.00
Rate for Payer: Aetna Commercial	$376.20
Rate for Payer: Aetna Medicare Advantage	$297.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.45
Rate for Payer: Cigna Commercial	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$297.00
Rate for Payer: Oxford Commercial	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$148.50
Rate for Payer: UnitedHealthcare Commercial	$198.00
Rate for Payer: UnitedHealthcare Community & State	$23.86
Rate for Payer: Wellpoint Medicaid Managed Care	$26.23

Know your out-of-pocket cost for care.

All Charges