Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PUTTY ALLOFUSE DBM 10CC

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270681848
Hospital Revenue Code	278
Min. Negotiated Rate	$120.50
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$120.50
Rate for Payer: Wellpoint Medicaid Managed Care	$132.50

PUTTY ALLOFUSE DBM 1CC

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270681845
Hospital Revenue Code	278
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

PUTTY ALLOFUSE DBM 1CC

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270681845
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

PUTTY ALLOFUSE DBM 2.5 CC

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270681846
Hospital Revenue Code	278
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

PUTTY ALLOFUSE DBM 2.5 CC

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270681846
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

PUTTY ALLOFUSE DBM 5 CC

Facility

$2,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270681847
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

PUTTY ALLOFUSE DBM 5 CC

Facility

$2,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270681847
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$60.25
Rate for Payer: Wellpoint Medicaid Managed Care	$66.25

PUTTY ALLOMATRIX INJECT 5CC

Facility

$2,615.00

Hospital Charge Code	270665916
Hospital Revenue Code	278
Min. Negotiated Rate	$392.25
Max. Negotiated Rate	$632.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$523.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$632.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$575.30
Rate for Payer: Qualcare PPO/HMO/WC	$392.25

PUTTY ALLOMATRIX INJECT 5CC

Facility

$2,615.00

Hospital Charge Code	270665916
Hospital Revenue Code	278
Min. Negotiated Rate	$63.02
Max. Negotiated Rate	$1,307.50
Rate for Payer: Aetna Commercial	$993.70
Rate for Payer: Aetna Medicare Advantage	$784.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$666.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$666.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$523.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$666.83
Rate for Payer: Cigna Commercial	$1,307.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$632.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$575.30
Rate for Payer: Qualcare PPO/HMO/WC	$392.25
Rate for Payer: UnitedHealthcare Community & State	$63.02
Rate for Payer: Wellpoint Medicaid Managed Care	$69.30

PUTTY BIOACTIVE KINEX 10CC

Facility

$18,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692222
Hospital Revenue Code	278
Min. Negotiated Rate	$2,812.50
Max. Negotiated Rate	$4,537.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,537.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,812.50

PUTTY BIOACTIVE KINEX 10CC

Facility

$18,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692222
Hospital Revenue Code	278
Min. Negotiated Rate	$451.88
Max. Negotiated Rate	$9,375.00
Rate for Payer: Aetna Commercial	$7,125.00
Rate for Payer: Aetna Medicare Advantage	$5,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,781.25
Rate for Payer: Cigna Commercial	$9,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,537.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,812.50
Rate for Payer: UnitedHealthcare Community & State	$451.88
Rate for Payer: Wellpoint Medicaid Managed Care	$496.88

PUTTY BIOACTV KINEX PLUS 10CC

Facility

$18,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695223
Hospital Revenue Code	278
Min. Negotiated Rate	$2,812.50
Max. Negotiated Rate	$4,537.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,537.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,812.50

PUTTY BIOACTV KINEX PLUS 10CC

Facility

$18,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695223
Hospital Revenue Code	278
Min. Negotiated Rate	$451.88
Max. Negotiated Rate	$9,375.00
Rate for Payer: Aetna Commercial	$7,125.00
Rate for Payer: Aetna Medicare Advantage	$5,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,781.25
Rate for Payer: Cigna Commercial	$9,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,537.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,812.50
Rate for Payer: UnitedHealthcare Community & State	$451.88
Rate for Payer: Wellpoint Medicaid Managed Care	$496.88

PUTTY BIOSPHERE 10 CC

Facility

$19,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270691512
Hospital Revenue Code	278
Min. Negotiated Rate	$457.90
Max. Negotiated Rate	$9,500.00
Rate for Payer: Aetna Commercial	$7,220.00
Rate for Payer: Aetna Medicare Advantage	$5,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,845.00
Rate for Payer: Cigna Commercial	$9,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,598.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,180.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00
Rate for Payer: UnitedHealthcare Community & State	$457.90
Rate for Payer: Wellpoint Medicaid Managed Care	$503.50

PUTTY BIOSPHERE 10 CC

Facility

$19,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270691512
Hospital Revenue Code	278
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$4,598.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,598.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,180.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00

PUTTY BIOSPHERE 10CC

Facility

$19,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692137
Hospital Revenue Code	278
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$4,598.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,598.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,180.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00

PUTTY BIOSPHERE 10CC

Facility

$19,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692137
Hospital Revenue Code	278
Min. Negotiated Rate	$457.90
Max. Negotiated Rate	$9,500.00
Rate for Payer: Aetna Commercial	$7,220.00
Rate for Payer: Aetna Medicare Advantage	$5,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,845.00
Rate for Payer: Cigna Commercial	$9,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,598.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,180.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00
Rate for Payer: UnitedHealthcare Community & State	$457.90
Rate for Payer: Wellpoint Medicaid Managed Care	$503.50

PUTTY BN GFT STRIP ATTRAX 10ML

Facility

$15,295.00

Service Code	HCPCS C1713
Hospital Charge Code	270691374
Hospital Revenue Code	278
Min. Negotiated Rate	$2,294.25
Max. Negotiated Rate	$3,701.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,059.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,701.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,364.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,294.25

PUTTY BN GFT STRIP ATTRAX 10ML

Facility

$15,295.00

Service Code	HCPCS C1713
Hospital Charge Code	270691374
Hospital Revenue Code	278
Min. Negotiated Rate	$368.61
Max. Negotiated Rate	$7,647.50
Rate for Payer: Aetna Commercial	$5,812.10
Rate for Payer: Aetna Medicare Advantage	$4,588.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,900.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,900.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,059.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,900.22
Rate for Payer: Cigna Commercial	$7,647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,701.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,364.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,294.25
Rate for Payer: UnitedHealthcare Community & State	$368.61
Rate for Payer: Wellpoint Medicaid Managed Care	$405.32

PUTTY CUSTOM BONE 10CC

Facility

$5,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270673595
Hospital Revenue Code	278
Min. Negotiated Rate	$795.00
Max. Negotiated Rate	$1,282.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,060.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,282.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,166.00
Rate for Payer: Qualcare PPO/HMO/WC	$795.00

PUTTY CUSTOM BONE 10CC

Facility

$5,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270673595
Hospital Revenue Code	278
Min. Negotiated Rate	$127.73
Max. Negotiated Rate	$2,650.00
Rate for Payer: Aetna Commercial	$2,014.00
Rate for Payer: Aetna Medicare Advantage	$1,590.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,351.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,351.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,351.50
Rate for Payer: Cigna Commercial	$2,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,282.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,166.00
Rate for Payer: Qualcare PPO/HMO/WC	$795.00
Rate for Payer: UnitedHealthcare Community & State	$127.73
Rate for Payer: Wellpoint Medicaid Managed Care	$140.45

PUTTY CUSTOM BONE 5CC

Facility

$3,665.00

Service Code	HCPCS C1713
Hospital Charge Code	270671029
Hospital Revenue Code	278
Min. Negotiated Rate	$88.33
Max. Negotiated Rate	$1,832.50
Rate for Payer: Aetna Commercial	$1,392.70
Rate for Payer: Aetna Medicare Advantage	$1,099.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$934.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$934.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$733.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$934.58
Rate for Payer: Cigna Commercial	$1,832.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$886.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$806.30
Rate for Payer: Qualcare PPO/HMO/WC	$549.75
Rate for Payer: UnitedHealthcare Community & State	$88.33
Rate for Payer: Wellpoint Medicaid Managed Care	$97.12

PUTTY CUSTOM BONE 5CC

Facility

$3,665.00

Service Code	HCPCS C1713
Hospital Charge Code	270671029
Hospital Revenue Code	278
Min. Negotiated Rate	$549.75
Max. Negotiated Rate	$886.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$733.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$886.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$806.30
Rate for Payer: Qualcare PPO/HMO/WC	$549.75

PUTTY DBM

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270676537
Hospital Revenue Code	278
Min. Negotiated Rate	$144.60
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$159.00

PUTTY DBM

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270676537
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

Know your out-of-pocket cost for care.

All Charges