Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ROD SDK 5.5MM 855-012

Facility

$2,054.45

Hospital Charge Code	270616994
Hospital Revenue Code	278
Min. Negotiated Rate	$308.17
Max. Negotiated Rate	$497.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$410.89
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

ROD SEMI-CIRC CURVED MRI

Facility

$2,015.00

Hospital Charge Code	270648000
Hospital Revenue Code	272
Min. Negotiated Rate	$48.56
Max. Negotiated Rate	$1,007.50
Rate for Payer: Aetna Commercial	$765.70
Rate for Payer: Aetna Medicare Advantage	$604.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$513.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$513.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$513.83
Rate for Payer: Cigna Commercial	$1,007.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$604.50
Rate for Payer: Oxford Commercial	$403.00
Rate for Payer: Qualcare PPO/HMO/WC	$302.25
Rate for Payer: UnitedHealthcare Commercial	$403.00
Rate for Payer: UnitedHealthcare Community & State	$48.56
Rate for Payer: Wellpoint Medicaid Managed Care	$53.40

ROD SEMI-CIRC CURVED MRI

Facility

$2,015.00

Hospital Charge Code	270648000
Hospital Revenue Code	272
Min. Negotiated Rate	$302.25
Max. Negotiated Rate	$302.25
Rate for Payer: Qualcare PPO/HMO/WC	$302.25

ROD SEMI CIRCULAR 11X220MM

Facility

$3,300.00

Hospital Charge Code	270669874
Hospital Revenue Code	278
Min. Negotiated Rate	$495.00
Max. Negotiated Rate	$798.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$495.00

ROD SEMI CIRCULAR 11X220MM

Facility

$3,300.00

Hospital Charge Code	270669874
Hospital Revenue Code	278
Min. Negotiated Rate	$79.53
Max. Negotiated Rate	$1,650.00
Rate for Payer: Aetna Commercial	$1,254.00
Rate for Payer: Aetna Medicare Advantage	$990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$841.50
Rate for Payer: Cigna Commercial	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$495.00
Rate for Payer: UnitedHealthcare Community & State	$79.53
Rate for Payer: Wellpoint Medicaid Managed Care	$87.45

ROD SEMI CURVED

Facility

$2,165.00

Hospital Charge Code	270662208
Hospital Revenue Code	278
Min. Negotiated Rate	$52.18
Max. Negotiated Rate	$1,082.50
Rate for Payer: Aetna Commercial	$822.70
Rate for Payer: Aetna Medicare Advantage	$649.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$552.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$552.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$433.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$552.08
Rate for Payer: Cigna Commercial	$1,082.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$523.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$476.30
Rate for Payer: Qualcare PPO/HMO/WC	$324.75
Rate for Payer: UnitedHealthcare Community & State	$52.18
Rate for Payer: Wellpoint Medicaid Managed Care	$57.37

ROD SEMI CURVED

Facility

$2,165.00

Hospital Charge Code	270662208
Hospital Revenue Code	278
Min. Negotiated Rate	$324.75
Max. Negotiated Rate	$523.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$433.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$523.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$476.30
Rate for Payer: Qualcare PPO/HMO/WC	$324.75

RODS JOINTED 3.5X12MM 72MM

Facility

$9,303.00

Service Code	HCPCS C1713
Hospital Charge Code	270694401
Hospital Revenue Code	278
Min. Negotiated Rate	$224.20
Max. Negotiated Rate	$4,651.50
Rate for Payer: Aetna Commercial	$3,535.14
Rate for Payer: Aetna Medicare Advantage	$2,790.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,372.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,372.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,860.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,372.26
Rate for Payer: Cigna Commercial	$4,651.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,251.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,046.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,395.45
Rate for Payer: UnitedHealthcare Community & State	$224.20
Rate for Payer: Wellpoint Medicaid Managed Care	$246.53

RODS JOINTED 3.5X12MM 72MM

Facility

$9,303.00

Service Code	HCPCS C1713
Hospital Charge Code	270694401
Hospital Revenue Code	278
Min. Negotiated Rate	$1,395.45
Max. Negotiated Rate	$2,251.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,860.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,251.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,046.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,395.45

ROD SMALL EXT FIX 4.0mm x 80mm

Facility

$139.05

Service Code	HCPCS C1713
Hospital Charge Code	270640372
Hospital Revenue Code	278
Min. Negotiated Rate	$3.35
Max. Negotiated Rate	$69.53
Rate for Payer: Aetna Commercial	$52.84
Rate for Payer: Aetna Medicare Advantage	$41.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.46
Rate for Payer: Cigna Commercial	$69.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.59
Rate for Payer: Qualcare PPO/HMO/WC	$20.86
Rate for Payer: UnitedHealthcare Community & State	$3.35
Rate for Payer: Wellpoint Medicaid Managed Care	$3.68

ROD SMALL EXT FIX 4.0mm x 80mm

Facility

$139.05

Service Code	HCPCS C1713
Hospital Charge Code	270640372
Hospital Revenue Code	278
Min. Negotiated Rate	$20.86
Max. Negotiated Rate	$33.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.59
Rate for Payer: Qualcare PPO/HMO/WC	$20.86

ROD SMALL EXT FIX 4x120mm

Facility

$139.05

Service Code	HCPCS C1713
Hospital Charge Code	270620408
Hospital Revenue Code	278
Min. Negotiated Rate	$20.86
Max. Negotiated Rate	$33.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.59
Rate for Payer: Qualcare PPO/HMO/WC	$20.86

ROD SMALL EXT FIX 4x120mm

Facility

$139.05

Service Code	HCPCS C1713
Hospital Charge Code	270620408
Hospital Revenue Code	278
Min. Negotiated Rate	$3.35
Max. Negotiated Rate	$69.53
Rate for Payer: Aetna Commercial	$52.84
Rate for Payer: Aetna Medicare Advantage	$41.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.46
Rate for Payer: Cigna Commercial	$69.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.59
Rate for Payer: Qualcare PPO/HMO/WC	$20.86
Rate for Payer: UnitedHealthcare Community & State	$3.35
Rate for Payer: Wellpoint Medicaid Managed Care	$3.68

ROD SMALL EXT FX 4.0x140 39574

Facility

$163.75

Hospital Charge Code	270632284
Hospital Revenue Code	278
Min. Negotiated Rate	$3.95
Max. Negotiated Rate	$81.88
Rate for Payer: Aetna Commercial	$62.23
Rate for Payer: Aetna Medicare Advantage	$49.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.76
Rate for Payer: Cigna Commercial	$81.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$36.02
Rate for Payer: Qualcare PPO/HMO/WC	$24.56
Rate for Payer: UnitedHealthcare Community & State	$3.95
Rate for Payer: Wellpoint Medicaid Managed Care	$4.34

ROD SMALL EXT FX 4.0x140 39574

Facility

$163.75

Hospital Charge Code	270632284
Hospital Revenue Code	278
Min. Negotiated Rate	$24.56
Max. Negotiated Rate	$39.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$36.02
Rate for Payer: Qualcare PPO/HMO/WC	$24.56

ROD SMN GUIDE 3.0 900MM 112059

Facility

$668.00

Hospital Charge Code	270621503
Hospital Revenue Code	278
Min. Negotiated Rate	$16.10
Max. Negotiated Rate	$334.00
Rate for Payer: Aetna Commercial	$253.84
Rate for Payer: Aetna Medicare Advantage	$200.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.34
Rate for Payer: Cigna Commercial	$334.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.96
Rate for Payer: Qualcare PPO/HMO/WC	$100.20
Rate for Payer: UnitedHealthcare Community & State	$16.10
Rate for Payer: Wellpoint Medicaid Managed Care	$17.70

ROD SMN GUIDE 3.0 900MM 112059

Facility

$668.00

Hospital Charge Code	270621503
Hospital Revenue Code	278
Min. Negotiated Rate	$100.20
Max. Negotiated Rate	$161.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.96
Rate for Payer: Qualcare PPO/HMO/WC	$100.20

ROD SNR GUIDE BALL 3 71118202

Facility

$562.45

Hospital Charge Code	270613589
Hospital Revenue Code	278
Min. Negotiated Rate	$13.56
Max. Negotiated Rate	$281.23
Rate for Payer: Aetna Commercial	$213.73
Rate for Payer: Aetna Medicare Advantage	$168.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.42
Rate for Payer: Cigna Commercial	$281.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$123.74
Rate for Payer: Qualcare PPO/HMO/WC	$84.37
Rate for Payer: UnitedHealthcare Community & State	$13.56
Rate for Payer: Wellpoint Medicaid Managed Care	$14.90

ROD SNR GUIDE BALL 3 71118202

Facility

$562.45

Hospital Charge Code	270613589
Hospital Revenue Code	278
Min. Negotiated Rate	$84.37
Max. Negotiated Rate	$136.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$123.74
Rate for Payer: Qualcare PPO/HMO/WC	$84.37

ROD SOLERA 5.5CMX35MM

Facility

$6,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270695304
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 SOLERA 5.5CMX35MM

Facility

$6,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270695304
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 SPINAL 5.5mm X 80 mm

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270680579
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 SPINAL 5.5mm X 80 mm

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270680579
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 SPIN CD HORZ 4.75X30MM

Facility

$6,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270697030
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 SPIN CD HORZ 4.75X30MM

Facility

$6,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270697030
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

Know your out-of-pocket cost for care.

All Charges