Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ROD AVATAR LORDOT BUL 5.5X50MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697677
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

ROD BENT TILOCK 45MM

Facility

$2,392.50

Service Code	HCPCS C1713
Hospital Charge Code	270699241
Hospital Revenue Code	278
Min. Negotiated Rate	$358.88
Max. Negotiated Rate	$578.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$478.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$578.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$526.35
Rate for Payer: Qualcare PPO/HMO/WC	$358.88

ROD BENT TILOCK 45MM

Facility

$2,392.50

Service Code	HCPCS C1713
Hospital Charge Code	270699241
Hospital Revenue Code	278
Min. Negotiated Rate	$57.66
Max. Negotiated Rate	$1,196.25
Rate for Payer: Aetna Commercial	$909.15
Rate for Payer: Aetna Medicare Advantage	$717.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$610.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$610.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$478.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$610.09
Rate for Payer: Cigna Commercial	$1,196.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$578.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$526.35
Rate for Payer: Qualcare PPO/HMO/WC	$358.88
Rate for Payer: UnitedHealthcare Community & State	$57.66
Rate for Payer: Wellpoint Medicaid Managed Care	$63.40

ROD BENT TILOCK 50MM

Facility

$2,392.50

Service Code	HCPCS C1713
Hospital Charge Code	270699240
Hospital Revenue Code	278
Min. Negotiated Rate	$57.66
Max. Negotiated Rate	$1,196.25
Rate for Payer: Aetna Commercial	$909.15
Rate for Payer: Aetna Medicare Advantage	$717.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$610.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$610.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$478.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$610.09
Rate for Payer: Cigna Commercial	$1,196.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$578.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$526.35
Rate for Payer: Qualcare PPO/HMO/WC	$358.88
Rate for Payer: UnitedHealthcare Community & State	$57.66
Rate for Payer: Wellpoint Medicaid Managed Care	$63.40

ROD BENT TILOCK 50MM

Facility

$2,392.50

Service Code	HCPCS C1713
Hospital Charge Code	270699240
Hospital Revenue Code	278
Min. Negotiated Rate	$358.88
Max. Negotiated Rate	$578.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$478.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$578.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$526.35
Rate for Payer: Qualcare PPO/HMO/WC	$358.88

ROD BRDGNG/EXT FIXTR 190/239MM

Facility

$1,909.60

Hospital Charge Code	270678524
Hospital Revenue Code	272
Min. Negotiated Rate	$286.44
Max. Negotiated Rate	$286.44
Rate for Payer: Qualcare PPO/HMO/WC	$286.44

ROD BRDGNG/EXT FIXTR 190/239MM

Facility

$1,909.60

Hospital Charge Code	270678524
Hospital Revenue Code	272
Min. Negotiated Rate	$46.02
Max. Negotiated Rate	$954.80
Rate for Payer: Aetna Commercial	$725.65
Rate for Payer: Aetna Medicare Advantage	$572.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$486.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$486.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$486.95
Rate for Payer: Cigna Commercial	$954.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$572.88
Rate for Payer: Oxford Commercial	$381.92
Rate for Payer: Qualcare PPO/HMO/WC	$286.44
Rate for Payer: UnitedHealthcare Commercial	$381.92
Rate for Payer: UnitedHealthcare Community & State	$46.02
Rate for Payer: Wellpoint Medicaid Managed Care	$50.60

ROD BRIDGING 11.0 222MM SHORT

Facility

$1,909.60

Hospital Charge Code	270667998
Hospital Revenue Code	272
Min. Negotiated Rate	$46.02
Max. Negotiated Rate	$954.80
Rate for Payer: Aetna Commercial	$725.65
Rate for Payer: Aetna Medicare Advantage	$572.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$486.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$486.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$486.95
Rate for Payer: Cigna Commercial	$954.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$572.88
Rate for Payer: Oxford Commercial	$381.92
Rate for Payer: Qualcare PPO/HMO/WC	$286.44
Rate for Payer: UnitedHealthcare Commercial	$381.92
Rate for Payer: UnitedHealthcare Community & State	$46.02
Rate for Payer: Wellpoint Medicaid Managed Care	$50.60

ROD BRIDGING 11.0 222MM SHORT

Facility

$1,909.60

Hospital Charge Code	270667998
Hospital Revenue Code	272
Min. Negotiated Rate	$286.44
Max. Negotiated Rate	$286.44
Rate for Payer: Qualcare PPO/HMO/WC	$286.44

ROD BULLET LORDO MERC 5.5X50MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270693127
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

ROD BULLET LORDO MERC 5.5X50MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270693127
Hospital Revenue Code	278
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

ROD BULLET LORDOS MIS 5.5X60MM

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270697717
Hospital Revenue Code	278
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$135.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$123.20
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

ROD BULLET LORDOS MIS 5.5X60MM

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270697717
Hospital Revenue Code	278
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$212.80
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$123.20
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: Wellpoint Medicaid Managed Care	$14.84

ROD BULLET NOSE CURV 5.5X55MM

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270693336
Hospital Revenue Code	278
Min. Negotiated Rate	$45.19
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$712.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$49.69

ROD BULLET NOSE CURV 5.5X55MM

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270693336
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

ROD BULLET NOSE CURV 5.5X65MM

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270694868
Hospital Revenue Code	278
Min. Negotiated Rate	$45.19
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$712.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$49.69

ROD BULLET NOSE CURV 5.5X65MM

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270694868
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

ROD CAP SPINE SOLERA 4.75X35MM

Facility

$6,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270696282
Hospital Revenue Code	278
Min. Negotiated Rate	$165.09
Max. Negotiated Rate	$3,425.00
Rate for Payer: Aetna Commercial	$2,603.00
Rate for Payer: Aetna Medicare Advantage	$2,055.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,746.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,746.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,370.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,746.75
Rate for Payer: Cigna Commercial	$3,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,657.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,507.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,027.50
Rate for Payer: UnitedHealthcare Community & State	$165.09
Rate for Payer: Wellpoint Medicaid Managed Care	$181.53

ROD CAP SPINE SOLERA 4.75X35MM

Facility

$6,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270696282
Hospital Revenue Code	278
Min. Negotiated Rate	$1,027.50
Max. Negotiated Rate	$1,657.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,657.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,507.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,027.50

ROD CARBON 100MM

Facility

$845.00

Service Code	HCPCS C1713
Hospital Charge Code	270699325
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$422.50
Rate for Payer: Aetna Commercial	$321.10
Rate for Payer: Aetna Medicare Advantage	$253.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$215.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$215.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$169.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$215.47
Rate for Payer: Cigna Commercial	$422.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$204.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$185.90
Rate for Payer: Qualcare PPO/HMO/WC	$126.75
Rate for Payer: UnitedHealthcare Community & State	$20.36
Rate for Payer: Wellpoint Medicaid Managed Care	$22.39

ROD CARBON 100MM

Facility

$845.00

Service Code	HCPCS C1713
Hospital Charge Code	270699325
Hospital Revenue Code	278
Min. Negotiated Rate	$126.75
Max. Negotiated Rate	$204.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$169.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$204.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$185.90
Rate for Payer: Qualcare PPO/HMO/WC	$126.75

ROD CARBON 11X250MM

Facility

$2,435.00

Service Code	HCPCS C1713
Hospital Charge Code	270669003
Hospital Revenue Code	278
Min. Negotiated Rate	$365.25
Max. Negotiated Rate	$589.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$487.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$589.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$535.70
Rate for Payer: Qualcare PPO/HMO/WC	$365.25

ROD CARBON 11X250MM

Facility

$2,435.00

Service Code	HCPCS C1713
Hospital Charge Code	270669003
Hospital Revenue Code	278
Min. Negotiated Rate	$58.68
Max. Negotiated Rate	$1,217.50
Rate for Payer: Aetna Commercial	$925.30
Rate for Payer: Aetna Medicare Advantage	$730.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$620.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$620.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$487.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$620.92
Rate for Payer: Cigna Commercial	$1,217.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$589.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$535.70
Rate for Payer: Qualcare PPO/HMO/WC	$365.25
Rate for Payer: UnitedHealthcare Community & State	$58.68
Rate for Payer: Wellpoint Medicaid Managed Care	$64.53

ROD CARBON 11x400

Facility

$3,063.25

Hospital Charge Code	270650715
Hospital Revenue Code	279
Min. Negotiated Rate	$73.82
Max. Negotiated Rate	$1,531.62
Rate for Payer: Aetna Commercial	$1,164.04
Rate for Payer: Aetna Medicare Advantage	$918.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$781.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$781.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$781.13
Rate for Payer: Cigna Commercial	$1,531.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.98
Rate for Payer: Oxford Commercial	$612.65
Rate for Payer: Qualcare PPO/HMO/WC	$459.49
Rate for Payer: UnitedHealthcare Commercial	$612.65
Rate for Payer: UnitedHealthcare Community & State	$73.82
Rate for Payer: Wellpoint Medicaid Managed Care	$81.18

ROD CARBON 11x400

Facility

$3,063.25

Hospital Charge Code	270650715
Hospital Revenue Code	279
Min. Negotiated Rate	$459.49
Max. Negotiated Rate	$459.49
Rate for Payer: Qualcare PPO/HMO/WC	$459.49

Know your out-of-pocket cost for care.

All Charges