Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ROD HUNTER TENDON 4MMX24.5CM

Facility

$12,335.00

Service Code	HCPCS C1713
Hospital Charge Code	270694118
Hospital Revenue Code	278
Min. Negotiated Rate	$297.27
Max. Negotiated Rate	$6,167.50
Rate for Payer: Aetna Commercial	$4,687.30
Rate for Payer: Aetna Medicare Advantage	$3,700.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,145.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,145.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,467.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,145.43
Rate for Payer: Cigna Commercial	$6,167.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,985.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,713.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,850.25
Rate for Payer: UnitedHealthcare Community & State	$297.27
Rate for Payer: Wellpoint Medicaid Managed Care	$326.88

ROD HUNTER TENDON 4MMX24.5CM

Facility

$12,335.00

Service Code	HCPCS C1713
Hospital Charge Code	270694118
Hospital Revenue Code	278
Min. Negotiated Rate	$1,850.25
Max. Negotiated Rate	$2,985.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,467.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,985.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,713.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,850.25

ROD IMPLANT

Facility

$866.25

Service Code	HCPCS C1713
Hospital Charge Code	270675856
Hospital Revenue Code	278
Min. Negotiated Rate	$20.88
Max. Negotiated Rate	$433.12
Rate for Payer: Aetna Commercial	$329.18
Rate for Payer: Aetna Medicare Advantage	$259.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$220.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$220.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$220.89
Rate for Payer: Cigna Commercial	$433.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$190.57
Rate for Payer: Qualcare PPO/HMO/WC	$129.94
Rate for Payer: UnitedHealthcare Community & State	$20.88
Rate for Payer: Wellpoint Medicaid Managed Care	$22.96

ROD IMPLANT

Facility

$866.25

Service Code	HCPCS C1713
Hospital Charge Code	270675856
Hospital Revenue Code	278
Min. Negotiated Rate	$129.94
Max. Negotiated Rate	$209.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$190.57
Rate for Payer: Qualcare PPO/HMO/WC	$129.94

ROD INVICTUS TI LORDOTIC

Facility

$1,125.00

Hospital Charge Code	270703009
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

ROD INVICTUS TI LORDOTIC

Facility

$1,125.00

Hospital Charge Code	270703009
Hospital Revenue Code	278
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

ROD LEGACY 5.5x70mm

Facility

$2,455.00

Service Code	HCPCS C1713
Hospital Charge Code	270685221
Hospital Revenue Code	278
Min. Negotiated Rate	$368.25
Max. Negotiated Rate	$594.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$540.10
Rate for Payer: Qualcare PPO/HMO/WC	$368.25

ROD LEGACY 5.5x70mm

Facility

$2,455.00

Service Code	HCPCS C1713
Hospital Charge Code	270685221
Hospital Revenue Code	278
Min. Negotiated Rate	$59.17
Max. Negotiated Rate	$1,227.50
Rate for Payer: Aetna Commercial	$932.90
Rate for Payer: Aetna Medicare Advantage	$736.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$626.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$626.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$626.02
Rate for Payer: Cigna Commercial	$1,227.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$540.10
Rate for Payer: Qualcare PPO/HMO/WC	$368.25
Rate for Payer: UnitedHealthcare Community & State	$59.17
Rate for Payer: Wellpoint Medicaid Managed Care	$65.06

ROD LINESIDER TI CURV 5.5X65MM

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694920
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$385.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

ROD LINESIDER TI CURV 5.5X65MM

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694920
Hospital Revenue Code	278
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$385.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Community & State	$42.17
Rate for Payer: Wellpoint Medicaid Managed Care	$46.38

ROD LORDOSED 3.5X100MM

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270694467
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

ROD LORDOSED 3.5X100MM

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270694467
Hospital Revenue Code	278
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) NJ Health	$180.00
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	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

ROD LORDOSED 3.5X120MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270697978
Hospital Revenue Code	278
Min. Negotiated Rate	$17.35
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$273.60
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.40
Rate for Payer: Qualcare PPO/HMO/WC	$108.00
Rate for Payer: UnitedHealthcare Community & State	$17.35
Rate for Payer: Wellpoint Medicaid Managed Care	$19.08

ROD LORDOSED 3.5X120MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270697978
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$174.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.40
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

ROD LORDOSED 3.5X60MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270698163
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$174.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.40
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

ROD LORDOSED 3.5X60MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270698163
Hospital Revenue Code	278
Min. Negotiated Rate	$17.35
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$273.60
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.40
Rate for Payer: Qualcare PPO/HMO/WC	$108.00
Rate for Payer: UnitedHealthcare Community & State	$17.35
Rate for Payer: Wellpoint Medicaid Managed Care	$19.08

ROD LORDOSED 3.5X80MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270695316
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$174.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.40
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

ROD LORDOSED 3.5X80MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270695316
Hospital Revenue Code	278
Min. Negotiated Rate	$17.35
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$273.60
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.40
Rate for Payer: Qualcare PPO/HMO/WC	$108.00
Rate for Payer: UnitedHealthcare Community & State	$17.35
Rate for Payer: Wellpoint Medicaid Managed Care	$19.08

ROD LORDOSED 5.5 X 100MM

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270686925
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

ROD LORDOSED 5.5 X 100MM

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270686925
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

ROD LORDOSED BULLET 5.5X55MM

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270697504
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 LORDOSED BULLET 5.5X55MM

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270697504
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 LORDOSED BULLETED 5.5X40MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270695120
Hospital Revenue Code	278
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$271.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$246.40
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

ROD LORDOSED BULLETED 5.5X40MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270695120
Hospital Revenue Code	278
Min. Negotiated Rate	$26.99
Max. Negotiated Rate	$560.00
Rate for Payer: Aetna Commercial	$425.60
Rate for Payer: Aetna Medicare Advantage	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.60
Rate for Payer: Cigna Commercial	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$246.40
Rate for Payer: Qualcare PPO/HMO/WC	$168.00
Rate for Payer: UnitedHealthcare Community & State	$26.99
Rate for Payer: Wellpoint Medicaid Managed Care	$29.68

ROD LORDOSED LOTUS 3.5X30MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270698398
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$174.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.40
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

Know your out-of-pocket cost for care.

All Charges