Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PUTTY OSTEROSURGE 300 10CC

Facility

$10,530.00

Service Code	HCPCS C1713
Hospital Charge Code	270694257
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

PUTTY OSTSLIM 5.0 030769044407

Facility

$3,283.60

Hospital Charge Code	270633640
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

PUTTY OSTSLIM 5.0 030769044407

Facility

$3,283.60

Hospital Charge Code	270633640
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

PUTTY OTPIMUM 5CC

Facility

$3,307.55

Service Code	HCPCS C9359
Hospital Charge Code	270667892
Hospital Revenue Code	278
Min. Negotiated Rate	$79.71
Max. Negotiated Rate	$1,653.78
Rate for Payer: Aetna Commercial	$1,256.87
Rate for Payer: Aetna Medicare Advantage	$992.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$843.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$843.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$661.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$843.43
Rate for Payer: Cigna Commercial	$1,653.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$800.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$727.66
Rate for Payer: Qualcare PPO/HMO/WC	$496.13
Rate for Payer: UnitedHealthcare Community & State	$79.71
Rate for Payer: Wellpoint Medicaid Managed Care	$87.65

PUTTY OTPIMUM 5CC

Facility

$3,307.55

Service Code	HCPCS C9359
Hospital Charge Code	270667892
Hospital Revenue Code	278
Min. Negotiated Rate	$496.13
Max. Negotiated Rate	$800.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$661.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$800.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$727.66
Rate for Payer: Qualcare PPO/HMO/WC	$496.13

PUTTY STIMBLAST

Facility

$4,000.00

Service Code	HCPCS C9359
Hospital Charge Code	270664775
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

PUTTY STIMBLAST

Facility

$4,000.00

Service Code	HCPCS C9359
Hospital Charge Code	270664775
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

PUTTY STIMBLAST 2.5CC

Facility

$2,200.00

Hospital Charge Code	270677565
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$532.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$330.00

PUTTY STIMBLAST 2.5CC

Facility

$2,200.00

Hospital Charge Code	270677565
Hospital Revenue Code	278
Min. Negotiated Rate	$53.02
Max. Negotiated Rate	$1,100.00
Rate for Payer: Aetna Commercial	$836.00
Rate for Payer: Aetna Medicare Advantage	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$561.00
Rate for Payer: Cigna Commercial	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$330.00
Rate for Payer: UnitedHealthcare Community & State	$53.02
Rate for Payer: Wellpoint Medicaid Managed Care	$58.30

PUTTY STIMUBLAST 1CC

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270674925
Hospital Revenue Code	278
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

PUTTY STIMUBLAST 1CC

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270674925
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

PUTTY STIMUBLAST 2.5CC

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270674926
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$532.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$330.00

PUTTY STIMUBLAST 2.5CC

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270674926
Hospital Revenue Code	278
Min. Negotiated Rate	$53.02
Max. Negotiated Rate	$1,100.00
Rate for Payer: Aetna Commercial	$836.00
Rate for Payer: Aetna Medicare Advantage	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$561.00
Rate for Payer: Cigna Commercial	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$330.00
Rate for Payer: UnitedHealthcare Community & State	$53.02
Rate for Payer: Wellpoint Medicaid Managed Care	$58.30

PUTTY STIMUBLAST DBM 5CC

Facility

$4,000.00

Service Code	HCPCS C1765
Hospital Charge Code	27060927
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

PUTTY STIMUBLAST DBM 5CC

Facility

$4,000.00

Service Code	HCPCS C1765
Hospital Charge Code	27060927
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

PUTTY STYLOS BA 2 CC

Facility

$5,840.00

Hospital Charge Code	270701999
Hospital Revenue Code	278
Min. Negotiated Rate	$140.74
Max. Negotiated Rate	$2,920.00
Rate for Payer: Aetna Commercial	$2,219.20
Rate for Payer: Aetna Medicare Advantage	$1,752.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,489.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,489.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,489.20
Rate for Payer: Cigna Commercial	$2,920.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,413.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,284.80
Rate for Payer: Qualcare PPO/HMO/WC	$876.00
Rate for Payer: UnitedHealthcare Community & State	$140.74
Rate for Payer: Wellpoint Medicaid Managed Care	$154.76

PUTTY STYLOS BA 2 CC

Facility

$5,840.00

Hospital Charge Code	270701999
Hospital Revenue Code	278
Min. Negotiated Rate	$876.00
Max. Negotiated Rate	$1,413.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,168.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,413.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,284.80
Rate for Payer: Qualcare PPO/HMO/WC	$876.00

PUTTY STYLOS BA 5 CC

Facility

$10,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270701998
Hospital Revenue Code	278
Min. Negotiated Rate	$1,635.00
Max. Negotiated Rate	$2,637.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,637.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,398.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,635.00

PUTTY STYLOS BA 5 CC

Facility

$10,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270701998
Hospital Revenue Code	278
Min. Negotiated Rate	$262.69
Max. Negotiated Rate	$5,450.00
Rate for Payer: Aetna Commercial	$4,142.00
Rate for Payer: Aetna Medicare Advantage	$3,270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,779.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,779.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,779.50
Rate for Payer: Cigna Commercial	$5,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,637.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,398.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,635.00
Rate for Payer: UnitedHealthcare Community & State	$262.69
Rate for Payer: Wellpoint Medicaid Managed Care	$288.85

PUTY GRAF 2.5cc PRETREAT523103

Facility

$1,985.00

Hospital Charge Code	270634985
Hospital Revenue Code	278
Min. Negotiated Rate	$297.75
Max. Negotiated Rate	$480.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$397.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$480.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$436.70
Rate for Payer: Qualcare PPO/HMO/WC	$297.75

PUTY GRAF 2.5cc PRETREAT523103

Facility

$1,985.00

Hospital Charge Code	270634985
Hospital Revenue Code	278
Min. Negotiated Rate	$47.84
Max. Negotiated Rate	$992.50
Rate for Payer: Aetna Commercial	$754.30
Rate for Payer: Aetna Medicare Advantage	$595.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$506.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$506.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$397.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$506.18
Rate for Payer: Cigna Commercial	$992.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$480.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$436.70
Rate for Payer: Qualcare PPO/HMO/WC	$297.75
Rate for Payer: UnitedHealthcare Community & State	$47.84
Rate for Payer: Wellpoint Medicaid Managed Care	$52.60

PVA, Bearing.355-500 m.100 m

Facility

$2,652.00

Hospital Charge Code	270705187
Hospital Revenue Code	279
Min. Negotiated Rate	$397.80
Max. Negotiated Rate	$397.80
Rate for Payer: Qualcare PPO/HMO/WC	$397.80

PVA, Bearing.355-500 m.100 m

Facility

$2,652.00

Hospital Charge Code	270705187
Hospital Revenue Code	279
Min. Negotiated Rate	$63.91
Max. Negotiated Rate	$1,326.00
Rate for Payer: Aetna Commercial	$1,007.76
Rate for Payer: Aetna Medicare Advantage	$795.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$676.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$676.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$676.26
Rate for Payer: Cigna Commercial	$1,326.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$795.60
Rate for Payer: Oxford Commercial	$530.40
Rate for Payer: Qualcare PPO/HMO/WC	$397.80
Rate for Payer: UnitedHealthcare Commercial	$530.40
Rate for Payer: UnitedHealthcare Community & State	$63.91
Rate for Payer: Wellpoint Medicaid Managed Care	$70.28

PVA, Bearing.45-150 m.100 m

Facility

$2,625.00

Hospital Charge Code	270705189
Hospital Revenue Code	279
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$393.75
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

PVA, Bearing.45-150 m.100 m

Facility

$2,625.00

Hospital Charge Code	270705189
Hospital Revenue Code	279
Min. Negotiated Rate	$63.26
Max. Negotiated Rate	$1,312.50
Rate for Payer: Aetna Commercial	$997.50
Rate for Payer: Aetna Medicare Advantage	$787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.38
Rate for Payer: Cigna Commercial	$1,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$787.50
Rate for Payer: Oxford Commercial	$525.00
Rate for Payer: Qualcare PPO/HMO/WC	$393.75
Rate for Payer: UnitedHealthcare Commercial	$525.00
Rate for Payer: UnitedHealthcare Community & State	$63.26
Rate for Payer: Wellpoint Medicaid Managed Care	$69.56

Know your out-of-pocket cost for care.

All Charges