Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ROD CURVED 50MM SAVANNAH-T

Facility

$2,380.00

Hospital Charge Code	270660963
Hospital Revenue Code	278
Min. Negotiated Rate	$57.36
Max. Negotiated Rate	$1,190.00
Rate for Payer: Aetna Commercial	$904.40
Rate for Payer: Aetna Medicare Advantage	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$606.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$606.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$476.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$606.90
Rate for Payer: Cigna Commercial	$1,190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$523.60
Rate for Payer: Qualcare PPO/HMO/WC	$357.00
Rate for Payer: UnitedHealthcare Community & State	$57.36
Rate for Payer: Wellpoint Medicaid Managed Care	$63.07

ROD CURVED 50MM SAVANNAH-T

Facility

$2,380.00

Hospital Charge Code	270660963
Hospital Revenue Code	278
Min. Negotiated Rate	$357.00
Max. Negotiated Rate	$575.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$476.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$523.60
Rate for Payer: Qualcare PPO/HMO/WC	$357.00

ROD CURVED 5.5x30mm

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270685028
Hospital Revenue Code	278
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

ROD CURVED 5.5x30mm

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270685028
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

ROD CURVED 5.5X40MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705780
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

ROD CURVED 5.5X40MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705780
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 CURVED 5.5X45MM

Facility

$1,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270698966
Hospital Revenue Code	278
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$266.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

ROD CURVED 5.5X45MM

Facility

$1,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270698966
Hospital Revenue Code	278
Min. Negotiated Rate	$26.51
Max. Negotiated Rate	$550.00
Rate for Payer: Aetna Commercial	$418.00
Rate for Payer: Aetna Medicare Advantage	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.50
Rate for Payer: Cigna Commercial	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00
Rate for Payer: UnitedHealthcare Community & State	$26.51
Rate for Payer: Wellpoint Medicaid Managed Care	$29.15

ROD CURVED 5.5x50

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270680594
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

ROD CURVED 5.5x50

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270680594
Hospital Revenue Code	278
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

ROD CURVED 60 MM

Facility

$1,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270701151
Hospital Revenue Code	278
Min. Negotiated Rate	$25.91
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$408.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.50
Rate for Payer: Qualcare PPO/HMO/WC	$161.25
Rate for Payer: UnitedHealthcare Community & State	$25.91
Rate for Payer: Wellpoint Medicaid Managed Care	$28.49

ROD CURVED 60 MM

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270681463
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

ROD CURVED 60 MM

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270681463
Hospital Revenue Code	278
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

ROD CURVED 60 MM

Facility

$1,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270701151
Hospital Revenue Code	278
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.50
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

ROD CURVED 60MM SAVANNAH-T

Facility

$1,625.00

Hospital Charge Code	270660956
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

ROD CURVED 60MM SAVANNAH-T

Facility

$1,625.00

Hospital Charge Code	270660956
Hospital Revenue Code	278
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

ROD CURVED 65MM

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270696958
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

ROD CURVED 65MM

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270696958
Hospital Revenue Code	278
Min. Negotiated Rate	$66.28
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Community & State	$66.28
Rate for Payer: Wellpoint Medicaid Managed Care	$72.88

ROD CURVED 65MM

Facility

$855.00

Service Code	HCPCS C1713
Hospital Charge Code	270688523
Hospital Revenue Code	278
Min. Negotiated Rate	$128.25
Max. Negotiated Rate	$206.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$188.10
Rate for Payer: Qualcare PPO/HMO/WC	$128.25

ROD CURVED 65MM

Facility

$855.00

Service Code	HCPCS C1713
Hospital Charge Code	270688523
Hospital Revenue Code	278
Min. Negotiated Rate	$20.61
Max. Negotiated Rate	$427.50
Rate for Payer: Aetna Commercial	$324.90
Rate for Payer: Aetna Medicare Advantage	$256.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.03
Rate for Payer: Cigna Commercial	$427.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$188.10
Rate for Payer: Qualcare PPO/HMO/WC	$128.25
Rate for Payer: UnitedHealthcare Community & State	$20.61
Rate for Payer: Wellpoint Medicaid Managed Care	$22.66

ROD CURVED 70 MM

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270680577
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

ROD CURVED 70 MM

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270680577
Hospital Revenue Code	278
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

ROD CURVED 70MM

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270696959
Hospital Revenue Code	278
Min. Negotiated Rate	$66.28
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Community & State	$66.28
Rate for Payer: Wellpoint Medicaid Managed Care	$72.88

ROD CURVED 70MM

Facility

$1,820.00

Service Code	HCPCS C1713
Hospital Charge Code	270681778
Hospital Revenue Code	278
Min. Negotiated Rate	$43.86
Max. Negotiated Rate	$910.00
Rate for Payer: Aetna Commercial	$691.60
Rate for Payer: Aetna Medicare Advantage	$546.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$464.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$464.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$364.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$464.10
Rate for Payer: Cigna Commercial	$910.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$440.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$400.40
Rate for Payer: Qualcare PPO/HMO/WC	$273.00
Rate for Payer: UnitedHealthcare Community & State	$43.86
Rate for Payer: Wellpoint Medicaid Managed Care	$48.23

ROD CURVED 70MM

Facility

$1,820.00

Service Code	HCPCS C1713
Hospital Charge Code	270681778
Hospital Revenue Code	278
Min. Negotiated Rate	$273.00
Max. Negotiated Rate	$440.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$364.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$440.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$400.40
Rate for Payer: Qualcare PPO/HMO/WC	$273.00

Know your out-of-pocket cost for care.

All Charges