Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ROD REAMING BALL TIP 2.5x600MM

Facility

$534.65

Hospital Charge Code	270680380
Hospital Revenue Code	272
Min. Negotiated Rate	$12.89
Max. Negotiated Rate	$267.32
Rate for Payer: Aetna Commercial	$203.17
Rate for Payer: Aetna Medicare Advantage	$160.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.34
Rate for Payer: Cigna Commercial	$267.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.40
Rate for Payer: Oxford Commercial	$106.93
Rate for Payer: Qualcare PPO/HMO/WC	$80.20
Rate for Payer: UnitedHealthcare Commercial	$106.93
Rate for Payer: UnitedHealthcare Community & State	$12.89
Rate for Payer: Wellpoint Medicaid Managed Care	$14.17

ROD REAMING BALL TIP 2.5x600MM

Facility

$534.65

Hospital Charge Code	270680380
Hospital Revenue Code	272
Min. Negotiated Rate	$80.20
Max. Negotiated Rate	$80.20
Rate for Payer: Qualcare PPO/HMO/WC	$80.20

ROD REAMING BALL TIP 2.5x950MM

Facility

$502.85

Service Code	HCPCS C1713
Hospital Charge Code	270645687
Hospital Revenue Code	278
Min. Negotiated Rate	$75.43
Max. Negotiated Rate	$121.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.63
Rate for Payer: Qualcare PPO/HMO/WC	$75.43

ROD REAMING BALL TIP 2.5x950MM

Facility

$502.85

Service Code	HCPCS C1713
Hospital Charge Code	270645687
Hospital Revenue Code	278
Min. Negotiated Rate	$12.12
Max. Negotiated Rate	$251.43
Rate for Payer: Aetna Commercial	$191.08
Rate for Payer: Aetna Medicare Advantage	$150.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.23
Rate for Payer: Cigna Commercial	$251.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.63
Rate for Payer: Qualcare PPO/HMO/WC	$75.43
Rate for Payer: UnitedHealthcare Community & State	$12.12
Rate for Payer: Wellpoint Medicaid Managed Care	$13.33

ROD REAMING CALIBR 2.5x850mm

Facility

$666.00

Hospital Charge Code	270656625
Hospital Revenue Code	278
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$333.00
Rate for Payer: Aetna Commercial	$253.08
Rate for Payer: Aetna Medicare Advantage	$199.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.83
Rate for Payer: Cigna Commercial	$333.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.52
Rate for Payer: Qualcare PPO/HMO/WC	$99.90
Rate for Payer: UnitedHealthcare Community & State	$16.05
Rate for Payer: Wellpoint Medicaid Managed Care	$17.65

ROD REAMING CALIBR 2.5x850mm

Facility

$666.00

Hospital Charge Code	270656625
Hospital Revenue Code	278
Min. Negotiated Rate	$99.90
Max. Negotiated Rate	$161.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.52
Rate for Payer: Qualcare PPO/HMO/WC	$99.90

ROD REFORM 30MM 39-LT-5030

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696104
Hospital Revenue Code	278
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$36.15
Rate for Payer: Wellpoint Medicaid Managed Care	$39.75

ROD REFORM 30MM 39-LT-5030

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696104
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

ROD REFORM LORDOT TI 3.5X80MM

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696962
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

ROD REFORM LORDOT TI 3.5X80MM

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696962
Hospital Revenue Code	278
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$36.15
Rate for Payer: Wellpoint Medicaid Managed Care	$39.75

ROD REFORM POCT 3.5X120MM

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270694815
Hospital Revenue Code	278
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$36.15
Rate for Payer: Wellpoint Medicaid Managed Care	$39.75

ROD REFORM POCT 3.5X120MM

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270694815
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

ROD REFORM TI PED 5.5X60MM

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696107
Hospital Revenue Code	278
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$36.15
Rate for Payer: Wellpoint Medicaid Managed Care	$39.75

ROD REFORM TI PED 5.5X60MM

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696107
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

ROD RELINE-O TI LORDO 5.5X35MM

Facility

$3,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270695242
Hospital Revenue Code	278
Min. Negotiated Rate	$95.44
Max. Negotiated Rate	$1,980.00
Rate for Payer: Aetna Commercial	$1,504.80
Rate for Payer: Aetna Medicare Advantage	$1,188.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,009.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,009.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$792.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,009.80
Rate for Payer: Cigna Commercial	$1,980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$958.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$871.20
Rate for Payer: Qualcare PPO/HMO/WC	$594.00
Rate for Payer: UnitedHealthcare Community & State	$95.44
Rate for Payer: Wellpoint Medicaid Managed Care	$104.94

ROD RELINE-O TI LORDO 5.5X35MM

Facility

$3,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270695242
Hospital Revenue Code	278
Min. Negotiated Rate	$594.00
Max. Negotiated Rate	$958.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$792.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$958.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$871.20
Rate for Payer: Qualcare PPO/HMO/WC	$594.00

ROD RELINE TI 5.5X60MM LORDOT

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693812
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 RELINE TI 5.5X60MM LORDOT

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693812
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 RING/THD CONNECTING M6 NUT

Facility

$161.65

Service Code	HCPCS C1713
Hospital Charge Code	270674288
Hospital Revenue Code	272
Min. Negotiated Rate	$24.25
Max. Negotiated Rate	$24.25
Rate for Payer: Qualcare PPO/HMO/WC	$24.25

ROD RING/THD CONNECTING M6 NUT

Facility

$161.65

Service Code	HCPCS C1713
Hospital Charge Code	270674288
Hospital Revenue Code	272
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$80.83
Rate for Payer: Aetna Commercial	$61.43
Rate for Payer: Aetna Medicare Advantage	$48.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.22
Rate for Payer: Cigna Commercial	$80.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.49
Rate for Payer: Oxford Commercial	$32.33
Rate for Payer: Qualcare PPO/HMO/WC	$24.25
Rate for Payer: UnitedHealthcare Commercial	$32.33
Rate for Payer: UnitedHealthcare Community & State	$3.90
Rate for Payer: Wellpoint Medicaid Managed Care	$4.28

RODS 25MM

Facility

$1,880.00

Service Code	HCPCS C1713
Hospital Charge Code	270690487
Hospital Revenue Code	278
Min. Negotiated Rate	$282.00
Max. Negotiated Rate	$454.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$454.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$413.60
Rate for Payer: Qualcare PPO/HMO/WC	$282.00

RODS 25MM

Facility

$1,880.00

Service Code	HCPCS C1713
Hospital Charge Code	270690487
Hospital Revenue Code	278
Min. Negotiated Rate	$45.31
Max. Negotiated Rate	$940.00
Rate for Payer: Aetna Commercial	$714.40
Rate for Payer: Aetna Medicare Advantage	$564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$479.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$479.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$479.40
Rate for Payer: Cigna Commercial	$940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$454.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$413.60
Rate for Payer: Qualcare PPO/HMO/WC	$282.00
Rate for Payer: UnitedHealthcare Community & State	$45.31
Rate for Payer: Wellpoint Medicaid Managed Care	$49.82

ROD SDK 5.5MM 20IN 855-011

Facility

$2,100.00

Hospital Charge Code	270613599
Hospital Revenue Code	278
Min. Negotiated Rate	$50.61
Max. Negotiated Rate	$1,050.00
Rate for Payer: Aetna Commercial	$798.00
Rate for Payer: Aetna Medicare Advantage	$630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$535.50
Rate for Payer: Cigna Commercial	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$462.00
Rate for Payer: Qualcare PPO/HMO/WC	$315.00
Rate for Payer: UnitedHealthcare Community & State	$50.61
Rate for Payer: Wellpoint Medicaid Managed Care	$55.65

ROD SDK 5.5MM 20IN 855-011

Facility

$2,100.00

Hospital Charge Code	270613599
Hospital Revenue Code	278
Min. Negotiated Rate	$315.00
Max. Negotiated Rate	$508.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$462.00
Rate for Payer: Qualcare PPO/HMO/WC	$315.00

ROD SDK 5.5MM 855-012

Facility

$2,054.45

Hospital Charge Code	270616994
Hospital Revenue Code	278
Min. Negotiated Rate	$49.51
Max. Negotiated Rate	$1,027.22
Rate for Payer: Aetna Commercial	$780.69
Rate for Payer: Aetna Medicare Advantage	$616.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$523.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$523.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$410.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$523.88
Rate for Payer: Cigna Commercial	$1,027.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$497.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$451.98
Rate for Payer: Qualcare PPO/HMO/WC	$308.17
Rate for Payer: UnitedHealthcare Community & State	$49.51
Rate for Payer: Wellpoint Medicaid Managed Care	$54.44

Know your out-of-pocket cost for care.

All Charges