Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PUTTY GRAFTON 5CC PRETX 523105

Facility

$3,510.00

Service Code	HCPCS C9359
Hospital Charge Code	270622366
Hospital Revenue Code	278
Min. Negotiated Rate	$526.50
Max. Negotiated Rate	$849.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$702.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$849.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$772.20
Rate for Payer: Qualcare PPO/HMO/WC	$526.50

PUTTY GRAFTON DBM 10CC

Facility

$7,115.00

Service Code	HCPCS C1713
Hospital Charge Code	270692666
Hospital Revenue Code	278
Min. Negotiated Rate	$1,067.25
Max. Negotiated Rate	$1,721.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,423.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,721.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,565.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,067.25

PUTTY GRAFTON DBM 10CC

Facility

$7,115.00

Service Code	HCPCS C1713
Hospital Charge Code	270692666
Hospital Revenue Code	278
Min. Negotiated Rate	$171.47
Max. Negotiated Rate	$3,557.50
Rate for Payer: Aetna Commercial	$2,703.70
Rate for Payer: Aetna Medicare Advantage	$2,134.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,814.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,814.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,423.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,814.33
Rate for Payer: Cigna Commercial	$3,557.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,721.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,565.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,067.25
Rate for Payer: UnitedHealthcare Community & State	$171.47
Rate for Payer: Wellpoint Medicaid Managed Care	$188.55

PUTTY GRAFTON DBM 10CC 123110

Facility

$5,366.75

Hospital Charge Code	270608088
Hospital Revenue Code	278
Min. Negotiated Rate	$129.34
Max. Negotiated Rate	$2,683.38
Rate for Payer: Aetna Commercial	$2,039.37
Rate for Payer: Aetna Medicare Advantage	$1,610.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,368.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,368.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,073.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,368.52
Rate for Payer: Cigna Commercial	$2,683.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,298.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,180.68
Rate for Payer: Qualcare PPO/HMO/WC	$805.01
Rate for Payer: UnitedHealthcare Community & State	$129.34
Rate for Payer: Wellpoint Medicaid Managed Care	$142.22

PUTTY GRAFTON DBM 10CC 123110

Facility

$5,366.75

Hospital Charge Code	270608088
Hospital Revenue Code	278
Min. Negotiated Rate	$805.01
Max. Negotiated Rate	$1,298.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,073.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,298.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,180.68
Rate for Payer: Qualcare PPO/HMO/WC	$805.01

PUTTY H-GENIN 10CC

Facility

$9,975.00

Hospital Charge Code	270648866
Hospital Revenue Code	278
Min. Negotiated Rate	$240.40
Max. Negotiated Rate	$4,987.50
Rate for Payer: Aetna Commercial	$3,790.50
Rate for Payer: Aetna Medicare Advantage	$2,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,543.62
Rate for Payer: Cigna Commercial	$4,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,194.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25
Rate for Payer: UnitedHealthcare Community & State	$240.40
Rate for Payer: Wellpoint Medicaid Managed Care	$264.34

PUTTY H-GENIN 10CC

Facility

$9,975.00

Hospital Charge Code	270648866
Hospital Revenue Code	278
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$2,413.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,194.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

PUTTY H GENIN-2.5CC

Facility

$4,050.00

Service Code	HCPCS C1781
Hospital Charge Code	270704079
Hospital Revenue Code	278
Min. Negotiated Rate	$607.50
Max. Negotiated Rate	$980.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$810.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$980.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$891.00
Rate for Payer: Qualcare PPO/HMO/WC	$607.50

PUTTY H GENIN-2.5CC

Facility

$4,050.00

Service Code	HCPCS C1781
Hospital Charge Code	270704079
Hospital Revenue Code	278
Min. Negotiated Rate	$97.61
Max. Negotiated Rate	$2,025.00
Rate for Payer: Aetna Commercial	$1,539.00
Rate for Payer: Aetna Medicare Advantage	$1,215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,032.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,032.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,032.75
Rate for Payer: Cigna Commercial	$2,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$980.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$891.00
Rate for Payer: Qualcare PPO/HMO/WC	$607.50
Rate for Payer: UnitedHealthcare Community & State	$97.61
Rate for Payer: Wellpoint Medicaid Managed Care	$107.33

PUTTY H-GENIN 5cc

Facility

$29,925.00

Hospital Charge Code	270656130
Hospital Revenue Code	278
Min. Negotiated Rate	$721.19
Max. Negotiated Rate	$14,962.50
Rate for Payer: Aetna Commercial	$11,371.50
Rate for Payer: Aetna Medicare Advantage	$8,977.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,630.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,630.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,985.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,630.88
Rate for Payer: Cigna Commercial	$14,962.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,241.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,583.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,488.75
Rate for Payer: UnitedHealthcare Community & State	$721.19
Rate for Payer: Wellpoint Medicaid Managed Care	$793.01

PUTTY H-GENIN 5cc

Facility

$29,925.00

Hospital Charge Code	270656130
Hospital Revenue Code	278
Min. Negotiated Rate	$4,488.75
Max. Negotiated Rate	$7,241.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,985.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,241.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,583.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,488.75

PUTTY I FACTOR 2.5 CC

Facility

$8,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270687021
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,760.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

PUTTY I FACTOR 2.5 CC

Facility

$8,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270687021
Hospital Revenue Code	278
Min. Negotiated Rate	$192.80
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$3,040.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,760.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$192.80
Rate for Payer: Wellpoint Medicaid Managed Care	$212.00

PUTTY I FACTOR 5.0 CC

Facility

$8,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270687022
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,760.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

PUTTY I FACTOR 5.0 CC

Facility

$8,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270687022
Hospital Revenue Code	278
Min. Negotiated Rate	$192.80
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$3,040.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,760.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$192.80
Rate for Payer: Wellpoint Medicaid Managed Care	$212.00

PUTTY KINEX BIOACTIVE 5CC

Facility

$10,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270695926
Hospital Revenue Code	278
Min. Negotiated Rate	$261.49
Max. Negotiated Rate	$5,425.00
Rate for Payer: Aetna Commercial	$4,123.00
Rate for Payer: Aetna Medicare Advantage	$3,255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,766.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,766.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,766.75
Rate for Payer: Cigna Commercial	$5,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,625.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,387.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,627.50
Rate for Payer: UnitedHealthcare Community & State	$261.49
Rate for Payer: Wellpoint Medicaid Managed Care	$287.52

PUTTY KINEX BIOACTIVE 5CC

Facility

$10,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270695926
Hospital Revenue Code	278
Min. Negotiated Rate	$1,627.50
Max. Negotiated Rate	$2,625.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,625.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,387.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,627.50

PUTTY MAXX PER 1CC

Facility

$3,950.00

Service Code	HCPCS C9359
Hospital Charge Code	270692314
Hospital Revenue Code	278
Min. Negotiated Rate	$592.50
Max. Negotiated Rate	$955.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$790.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$955.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$869.00
Rate for Payer: Qualcare PPO/HMO/WC	$592.50

PUTTY MAXX PER 1CC

Facility

$3,950.00

Service Code	HCPCS C9359
Hospital Charge Code	270692314
Hospital Revenue Code	278
Min. Negotiated Rate	$95.19
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$1,501.00
Rate for Payer: Aetna Medicare Advantage	$1,185.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,007.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,007.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$790.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,007.25
Rate for Payer: Cigna Commercial	$1,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$955.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$869.00
Rate for Payer: Qualcare PPO/HMO/WC	$592.50
Rate for Payer: UnitedHealthcare Community & State	$95.19
Rate for Payer: Wellpoint Medicaid Managed Care	$104.67

PUTTY NEVOS BONE 5CC

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270679088
Hospital Revenue Code	278
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

PUTTY NEVOS BONE 5CC

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270679089
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

PUTTY NEVOS BONE 5CC

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270679089
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 NEVOS BONE 5CC

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270679088
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

PUTTY NEVOS DBM 10CC

Facility

$10,530.00

Service Code	HCPCS C1713
Hospital Charge Code	270692543
Hospital Revenue Code	278
Min. Negotiated Rate	$1,579.50
Max. Negotiated Rate	$2,548.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,106.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,548.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,316.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,579.50

PUTTY NEVOS DBM 10CC

Facility

$10,530.00

Service Code	HCPCS C1713
Hospital Charge Code	270692543
Hospital Revenue Code	278
Min. Negotiated Rate	$253.77
Max. Negotiated Rate	$5,265.00
Rate for Payer: Aetna Commercial	$4,001.40
Rate for Payer: Aetna Medicare Advantage	$3,159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,685.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,685.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,106.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,685.15
Rate for Payer: Cigna Commercial	$5,265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,548.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,316.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,579.50
Rate for Payer: UnitedHealthcare Community & State	$253.77
Rate for Payer: Wellpoint Medicaid Managed Care	$279.05

Know your out-of-pocket cost for care.

All Charges