Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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

32MM POLY PATELLA

Facility

$2,297.75

Hospital Charge Code	270656889
Hospital Revenue Code	278
Min. Negotiated Rate	$55.38
Max. Negotiated Rate	$1,148.88
Rate for Payer: Aetna Commercial	$873.14
Rate for Payer: Aetna Medicare Advantage	$689.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$585.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$585.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$459.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$585.93
Rate for Payer: Cigna Commercial	$1,148.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$505.50
Rate for Payer: Qualcare PPO/HMO/WC	$344.66
Rate for Payer: UnitedHealthcare Community & State	$55.38
Rate for Payer: Wellpoint Medicaid Managed Care	$60.89

32MM POLY PATELLA

Facility

$2,297.75

Hospital Charge Code	270656889
Hospital Revenue Code	278
Min. Negotiated Rate	$344.66
Max. Negotiated Rate	$556.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$459.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$505.50
Rate for Payer: Qualcare PPO/HMO/WC	$344.66

3.2MM THREAD PIN, 508MM

Facility

$900.00

Hospital Charge Code	270663166
Hospital Revenue Code	270
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.00
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Commercial	$180.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

3.2MM THREAD PIN, 508MM

Facility

$900.00

Hospital Charge Code	270663166
Hospital Revenue Code	270
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

3.2MM X 560MM COCR THD TIP

Facility

$1,150.00

Service Code	HCPCS C1769
Hospital Charge Code	270681043
Hospital Revenue Code	272
Min. Negotiated Rate	$27.71
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$437.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$345.00
Rate for Payer: Oxford Commercial	$230.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Commercial	$230.00
Rate for Payer: UnitedHealthcare Community & State	$27.71
Rate for Payer: Wellpoint Medicaid Managed Care	$30.48

3.2MM X 560MM COCR THD TIP

Facility

$1,150.00

Service Code	HCPCS C1769
Hospital Charge Code	270681043
Hospital Revenue Code	272
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$172.50
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

3.2MM X 560MM COCR THD TIP

Facility

$1,150.00

Service Code	HCPCS C1776
Hospital Charge Code	270681042
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$278.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$253.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

3.2MM X 560MM COCR THD TIP

Facility

$1,150.00

Service Code	HCPCS C1776
Hospital Charge Code	270681042
Hospital Revenue Code	278
Min. Negotiated Rate	$27.71
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$437.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$253.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Community & State	$27.71
Rate for Payer: Wellpoint Medicaid Managed Care	$30.48

3.3 MM FREE HAND TARG DRILL

Facility

$725.00

Hospital Charge Code	270688153
Hospital Revenue Code	272
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$108.75
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

3.3 MM FREE HAND TARG DRILL

Facility

$725.00

Hospital Charge Code	270688153
Hospital Revenue Code	272
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.50
Rate for Payer: Oxford Commercial	$145.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Commercial	$145.00
Rate for Payer: UnitedHealthcare Community & State	$17.47
Rate for Payer: Wellpoint Medicaid Managed Care	$19.21

34MM AMBASSADOR 2-LVL PLATE

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704977
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

34MM AMBASSADOR 2-LVL PLATE

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704977
Hospital Revenue Code	278
Min. Negotiated Rate	$132.55
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$132.55
Rate for Payer: Wellpoint Medicaid Managed Care	$145.75

-3.5 36MM FEMORAL HEAD

Facility

$3,311.05

Hospital Charge Code	270656874
Hospital Revenue Code	278
Min. Negotiated Rate	$79.80
Max. Negotiated Rate	$1,655.53
Rate for Payer: Aetna Commercial	$1,258.20
Rate for Payer: Aetna Medicare Advantage	$993.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$844.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$844.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$662.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$844.32
Rate for Payer: Cigna Commercial	$1,655.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$801.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$728.43
Rate for Payer: Qualcare PPO/HMO/WC	$496.66
Rate for Payer: UnitedHealthcare Community & State	$79.80
Rate for Payer: Wellpoint Medicaid Managed Care	$87.74

-3.5 36MM FEMORAL HEAD

Facility

$3,311.05

Hospital Charge Code	270656874
Hospital Revenue Code	278
Min. Negotiated Rate	$496.66
Max. Negotiated Rate	$801.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$662.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$801.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$728.43
Rate for Payer: Qualcare PPO/HMO/WC	$496.66

3.5 BONE SCREW 18 MM

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	270665464
Hospital Revenue Code	278
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

3.5 BONE SCREW 18 MM

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	270665464
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

3.5 CONT DUAL COMP PLT 8

Facility

$4,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270704659
Hospital Revenue Code	278
Min. Negotiated Rate	$104.83
Max. Negotiated Rate	$2,175.00
Rate for Payer: Aetna Commercial	$1,653.00
Rate for Payer: Aetna Medicare Advantage	$1,305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,109.25
Rate for Payer: Cigna Commercial	$2,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$957.00
Rate for Payer: Qualcare PPO/HMO/WC	$652.50
Rate for Payer: UnitedHealthcare Community & State	$104.83
Rate for Payer: Wellpoint Medicaid Managed Care	$115.28

3.5 CONT DUAL COMP PLT 8

Facility

$4,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270704659
Hospital Revenue Code	278
Min. Negotiated Rate	$652.50
Max. Negotiated Rate	$1,052.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$957.00
Rate for Payer: Qualcare PPO/HMO/WC	$652.50

3.5 CONT DUAL COMP PLT 9

Facility

$4,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270704664
Hospital Revenue Code	278
Min. Negotiated Rate	$104.83
Max. Negotiated Rate	$2,175.00
Rate for Payer: Aetna Commercial	$1,653.00
Rate for Payer: Aetna Medicare Advantage	$1,305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,109.25
Rate for Payer: Cigna Commercial	$2,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$957.00
Rate for Payer: Qualcare PPO/HMO/WC	$652.50
Rate for Payer: UnitedHealthcare Community & State	$104.83
Rate for Payer: Wellpoint Medicaid Managed Care	$115.28

3.5 CONT DUAL COMP PLT 9

Facility

$4,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270704664
Hospital Revenue Code	278
Min. Negotiated Rate	$652.50
Max. Negotiated Rate	$1,052.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$957.00
Rate for Payer: Qualcare PPO/HMO/WC	$652.50

3.5 CORTEX SCREW 42MM

Facility

$93.10

Service Code	HCPCS C1713
Hospital Charge Code	270675512
Hospital Revenue Code	278
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$46.55
Rate for Payer: Aetna Commercial	$35.38
Rate for Payer: Aetna Medicare Advantage	$27.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.74
Rate for Payer: Cigna Commercial	$46.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$20.48
Rate for Payer: Qualcare PPO/HMO/WC	$13.96
Rate for Payer: UnitedHealthcare Community & State	$2.24
Rate for Payer: Wellpoint Medicaid Managed Care	$2.47

3.5 CORTEX SCREW 42MM

Facility

$93.10

Service Code	HCPCS C1713
Hospital Charge Code	270675512
Hospital Revenue Code	278
Min. Negotiated Rate	$13.96
Max. Negotiated Rate	$22.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$20.48
Rate for Payer: Qualcare PPO/HMO/WC	$13.96

3.5/CORTEX TI SCREW 3.5/L12

Facility

$267.65

Service Code	HCPCS C1713
Hospital Charge Code	270703650
Hospital Revenue Code	278
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$133.82
Rate for Payer: Aetna Commercial	$101.71
Rate for Payer: Aetna Medicare Advantage	$80.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.25
Rate for Payer: Cigna Commercial	$133.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$58.88
Rate for Payer: Qualcare PPO/HMO/WC	$40.15
Rate for Payer: UnitedHealthcare Community & State	$6.45
Rate for Payer: Wellpoint Medicaid Managed Care	$7.09

3.5/CORTEX TI SCREW 3.5/L12

Facility

$267.65

Service Code	HCPCS C1713
Hospital Charge Code	270703650
Hospital Revenue Code	278
Min. Negotiated Rate	$40.15
Max. Negotiated Rate	$64.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$58.88
Rate for Payer: Qualcare PPO/HMO/WC	$40.15

Know your out-of-pocket cost for care.

All Charges