Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

35MM ROD

Facility

$1,690.65

Service Code	HCPCS C1713
Hospital Charge Code	270691334
Hospital Revenue Code	278
Min. Negotiated Rate	$253.60
Max. Negotiated Rate	$409.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$338.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$409.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$371.94
Rate for Payer: Qualcare PPO/HMO/WC	$253.60

35MM ROD

Facility

$1,690.65

Service Code	HCPCS C1713
Hospital Charge Code	270691334
Hospital Revenue Code	278
Min. Negotiated Rate	$40.74
Max. Negotiated Rate	$845.33
Rate for Payer: Aetna Commercial	$642.45
Rate for Payer: Aetna Medicare Advantage	$507.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$431.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$431.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$338.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$431.12
Rate for Payer: Cigna Commercial	$845.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$409.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$371.94
Rate for Payer: Qualcare PPO/HMO/WC	$253.60
Rate for Payer: UnitedHealthcare Community & State	$40.74
Rate for Payer: Wellpoint Medicaid Managed Care	$44.80

3.5MM TROCAR, SHORT

Facility

$900.00

Hospital Charge Code	270703299
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

3.5MM TROCAR, SHORT

Facility

$900.00

Hospital Charge Code	270703299
Hospital Revenue Code	270
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

3.5MM ULS T-PLT 4H HEAD 6H SHA

Facility

$1,772.50

Service Code	HCPCS C1713
Hospital Charge Code	270684872
Hospital Revenue Code	278
Min. Negotiated Rate	$42.72
Max. Negotiated Rate	$886.25
Rate for Payer: Aetna Commercial	$673.55
Rate for Payer: Aetna Medicare Advantage	$531.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$451.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$451.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$354.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$451.99
Rate for Payer: Cigna Commercial	$886.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$428.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$389.95
Rate for Payer: Qualcare PPO/HMO/WC	$265.88
Rate for Payer: UnitedHealthcare Community & State	$42.72
Rate for Payer: Wellpoint Medicaid Managed Care	$46.97

3.5MM ULS T-PLT 4H HEAD 6H SHA

Facility

$1,772.50

Service Code	HCPCS C1713
Hospital Charge Code	270684872
Hospital Revenue Code	278
Min. Negotiated Rate	$265.88
Max. Negotiated Rate	$428.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$354.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$428.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$389.95
Rate for Payer: Qualcare PPO/HMO/WC	$265.88

3.5MM VAR ANGLE LOCKING 54MM

Facility

$73.45

Service Code	HCPCS C1713
Hospital Charge Code	270665881
Hospital Revenue Code	278
Min. Negotiated Rate	$11.02
Max. Negotiated Rate	$17.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.16
Rate for Payer: Qualcare PPO/HMO/WC	$11.02

3.5MM VAR ANGLE LOCKING 54MM

Facility

$73.45

Service Code	HCPCS C1713
Hospital Charge Code	270665881
Hospital Revenue Code	278
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$36.73
Rate for Payer: Aetna Commercial	$27.91
Rate for Payer: Aetna Medicare Advantage	$22.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.73
Rate for Payer: Cigna Commercial	$36.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.16
Rate for Payer: Qualcare PPO/HMO/WC	$11.02
Rate for Payer: UnitedHealthcare Community & State	$1.77
Rate for Payer: Wellpoint Medicaid Managed Care	$1.95

3.5MM X 12MM CORTICAL SCREW

Facility

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	270660205
Hospital Revenue Code	278
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.64

3.5MM X 12MM CORTICAL SCREW

Facility

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	270660205
Hospital Revenue Code	278
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$42.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

3.5MM X 14MM TI LOCKING SCREW

Facility

$433.50

Service Code	HCPCS C1713
Hospital Charge Code	270679957
Hospital Revenue Code	278
Min. Negotiated Rate	$10.45
Max. Negotiated Rate	$216.75
Rate for Payer: Aetna Commercial	$164.73
Rate for Payer: Aetna Medicare Advantage	$130.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.54
Rate for Payer: Cigna Commercial	$216.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$95.37
Rate for Payer: Qualcare PPO/HMO/WC	$65.03
Rate for Payer: UnitedHealthcare Community & State	$10.45
Rate for Payer: Wellpoint Medicaid Managed Care	$11.49

3.5MM X 14MM TI LOCKING SCREW

Facility

$433.50

Service Code	HCPCS C1713
Hospital Charge Code	270679957
Hospital Revenue Code	278
Min. Negotiated Rate	$65.03
Max. Negotiated Rate	$104.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$95.37
Rate for Payer: Qualcare PPO/HMO/WC	$65.03

3.5MM X 16MM TI LOCKING SCREW

Facility

$433.50

Service Code	HCPCS C1713
Hospital Charge Code	270679958
Hospital Revenue Code	278
Min. Negotiated Rate	$65.03
Max. Negotiated Rate	$104.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$95.37
Rate for Payer: Qualcare PPO/HMO/WC	$65.03

3.5MM X 16MM TI LOCKING SCREW

Facility

$433.50

Service Code	HCPCS C1713
Hospital Charge Code	270679958
Hospital Revenue Code	278
Min. Negotiated Rate	$10.45
Max. Negotiated Rate	$216.75
Rate for Payer: Aetna Commercial	$164.73
Rate for Payer: Aetna Medicare Advantage	$130.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.54
Rate for Payer: Cigna Commercial	$216.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$95.37
Rate for Payer: Qualcare PPO/HMO/WC	$65.03
Rate for Payer: UnitedHealthcare Community & State	$10.45
Rate for Payer: Wellpoint Medicaid Managed Care	$11.49

3.5MM X 40MM TI LOCKING SCREW

Facility

$433.50

Service Code	HCPCS C1713
Hospital Charge Code	270679959
Hospital Revenue Code	278
Min. Negotiated Rate	$65.03
Max. Negotiated Rate	$104.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$95.37
Rate for Payer: Qualcare PPO/HMO/WC	$65.03

3.5MM X 40MM TI LOCKING SCREW

Facility

$433.50

Service Code	HCPCS C1713
Hospital Charge Code	270679959
Hospital Revenue Code	278
Min. Negotiated Rate	$10.45
Max. Negotiated Rate	$216.75
Rate for Payer: Aetna Commercial	$164.73
Rate for Payer: Aetna Medicare Advantage	$130.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.54
Rate for Payer: Cigna Commercial	$216.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$95.37
Rate for Payer: Qualcare PPO/HMO/WC	$65.03
Rate for Payer: UnitedHealthcare Community & State	$10.45
Rate for Payer: Wellpoint Medicaid Managed Care	$11.49

35MM X 42MM HEADLESS CANN SCRE

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270687474
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

35MM X 42MM HEADLESS CANN SCRE

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270687474
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

3.5MM X 60MM TI LOCKING SCREW

Facility

$433.50

Service Code	HCPCS C1713
Hospital Charge Code	270679960
Hospital Revenue Code	278
Min. Negotiated Rate	$10.45
Max. Negotiated Rate	$216.75
Rate for Payer: Aetna Commercial	$164.73
Rate for Payer: Aetna Medicare Advantage	$130.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.54
Rate for Payer: Cigna Commercial	$216.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$95.37
Rate for Payer: Qualcare PPO/HMO/WC	$65.03
Rate for Payer: UnitedHealthcare Community & State	$10.45
Rate for Payer: Wellpoint Medicaid Managed Care	$11.49

3.5MM X 60MM TI LOCKING SCREW

Facility

$433.50

Service Code	HCPCS C1713
Hospital Charge Code	270679960
Hospital Revenue Code	278
Min. Negotiated Rate	$65.03
Max. Negotiated Rate	$104.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$95.37
Rate for Payer: Qualcare PPO/HMO/WC	$65.03

3.5 RIGHT OPEN WEDGE PLATE

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270656453
Hospital Revenue Code	278
Min. Negotiated Rate	$95.80
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,510.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$596.25
Rate for Payer: UnitedHealthcare Community & State	$95.80
Rate for Payer: Wellpoint Medicaid Managed Care	$105.34

3.5 RIGHT OPEN WEDGE PLATE

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270656453
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

3.5 SCREW LOCKING 12MM

Facility

$480.25

Hospital Charge Code	270656885
Hospital Revenue Code	278
Min. Negotiated Rate	$11.57
Max. Negotiated Rate	$240.12
Rate for Payer: Aetna Commercial	$182.50
Rate for Payer: Aetna Medicare Advantage	$144.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.46
Rate for Payer: Cigna Commercial	$240.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$105.66
Rate for Payer: Qualcare PPO/HMO/WC	$72.04
Rate for Payer: UnitedHealthcare Community & State	$11.57
Rate for Payer: Wellpoint Medicaid Managed Care	$12.73

3.5 SCREW LOCKING 12MM

Facility

$480.25

Hospital Charge Code	270656885
Hospital Revenue Code	278
Min. Negotiated Rate	$72.04
Max. Negotiated Rate	$116.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$105.66
Rate for Payer: Qualcare PPO/HMO/WC	$72.04

3.5 X 14 F.A. SCREW

Facility

$5,815.00

Service Code	HCPCS C1713
Hospital Charge Code	270688889
Hospital Revenue Code	278
Min. Negotiated Rate	$140.14
Max. Negotiated Rate	$2,907.50
Rate for Payer: Aetna Commercial	$2,209.70
Rate for Payer: Aetna Medicare Advantage	$1,744.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,482.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,482.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,163.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,482.83
Rate for Payer: Cigna Commercial	$2,907.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,407.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,279.30
Rate for Payer: Qualcare PPO/HMO/WC	$872.25
Rate for Payer: UnitedHealthcare Community & State	$140.14
Rate for Payer: Wellpoint Medicaid Managed Care	$154.10

Know your out-of-pocket cost for care.

All Charges