Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ROD TI MIS CURVED 5.5x45CM

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694781
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 TI MIS CURVED 5.5x45CM

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694781
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 TI MIS CURVED 5.5X70MM

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693914
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 TI MIS CURVED 5.5X70MM

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693914
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 TI MIS LORDOTIC 5.5X40MM

Facility

$1,237.50

Service Code	HCPCS C1713
Hospital Charge Code	270699535
Hospital Revenue Code	278
Min. Negotiated Rate	$185.62
Max. Negotiated Rate	$299.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$299.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$185.62

ROD TI MIS LORDOTIC 5.5X40MM

Facility

$1,237.50

Service Code	HCPCS C1713
Hospital Charge Code	270699535
Hospital Revenue Code	278
Min. Negotiated Rate	$29.82
Max. Negotiated Rate	$618.75
Rate for Payer: Aetna Commercial	$470.25
Rate for Payer: Aetna Medicare Advantage	$371.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$315.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$315.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$315.56
Rate for Payer: Cigna Commercial	$618.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$299.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$185.62
Rate for Payer: UnitedHealthcare Community & State	$29.82
Rate for Payer: Wellpoint Medicaid Managed Care	$32.79

ROD TI MIS LORDOT VI2 5.5X50MM

Facility

$1,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270698055
Hospital Revenue Code	278
Min. Negotiated Rate	$202.50
Max. Negotiated Rate	$326.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$326.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$297.00
Rate for Payer: Qualcare PPO/HMO/WC	$202.50

ROD TI MIS LORDOT VI2 5.5X50MM

Facility

$1,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270698055
Hospital Revenue Code	278
Min. Negotiated Rate	$32.53
Max. Negotiated Rate	$675.00
Rate for Payer: Aetna Commercial	$513.00
Rate for Payer: Aetna Medicare Advantage	$405.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$344.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$344.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$344.25
Rate for Payer: Cigna Commercial	$675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$326.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$297.00
Rate for Payer: Qualcare PPO/HMO/WC	$202.50
Rate for Payer: UnitedHealthcare Community & State	$32.53
Rate for Payer: Wellpoint Medicaid Managed Care	$35.77

ROD TI MIS VI2 LORDOT 5.5X45MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270698059
Hospital Revenue Code	278
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$332.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

ROD TI MIS VI2 LORDOT 5.5X45MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270698059
Hospital Revenue Code	278
Min. Negotiated Rate	$33.14
Max. Negotiated Rate	$687.50
Rate for Payer: Aetna Commercial	$522.50
Rate for Payer: Aetna Medicare Advantage	$412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.62
Rate for Payer: Cigna Commercial	$687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$206.25
Rate for Payer: UnitedHealthcare Community & State	$33.14
Rate for Payer: Wellpoint Medicaid Managed Care	$36.44

ROD TI MIS VI2 LORDOT 5.5X50MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270698058
Hospital Revenue Code	278
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$332.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

ROD TI MIS VI2 LORDOT 5.5X50MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270698058
Hospital Revenue Code	278
Min. Negotiated Rate	$33.14
Max. Negotiated Rate	$687.50
Rate for Payer: Aetna Commercial	$522.50
Rate for Payer: Aetna Medicare Advantage	$412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.62
Rate for Payer: Cigna Commercial	$687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$206.25
Rate for Payer: UnitedHealthcare Community & State	$33.14
Rate for Payer: Wellpoint Medicaid Managed Care	$36.44

ROD TI PREBENT TBOLT 5.5X100MM

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695215
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 TI PREBENT TBOLT 5.5X100MM

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695215
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 TI STR 3.5X60MM

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270694192
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 TI STR 3.5X60MM

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270694192
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 TI STRAIGHT 70MM

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270691934
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 TI STRAIGHT 70MM

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270691934
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 TO ROD 40MM

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270704440
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 TO ROD 40MM

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270704440
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 TO ROD 45MM

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270704439
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 TO ROD 45MM

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270704439
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 TO ROD DELTA COUPLING

Facility

$3,373.90

Service Code	HCPCS C1713
Hospital Charge Code	270648624
Hospital Revenue Code	278
Min. Negotiated Rate	$506.08
Max. Negotiated Rate	$816.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$674.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$816.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$742.26
Rate for Payer: Qualcare PPO/HMO/WC	$506.08

ROD TO ROD DELTA COUPLING

Facility

$3,373.90

Service Code	HCPCS C1713
Hospital Charge Code	270648624
Hospital Revenue Code	278
Min. Negotiated Rate	$81.31
Max. Negotiated Rate	$1,686.95
Rate for Payer: Aetna Commercial	$1,282.08
Rate for Payer: Aetna Medicare Advantage	$1,012.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$674.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.34
Rate for Payer: Cigna Commercial	$1,686.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$816.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$742.26
Rate for Payer: Qualcare PPO/HMO/WC	$506.08
Rate for Payer: UnitedHealthcare Community & State	$81.31
Rate for Payer: Wellpoint Medicaid Managed Care	$89.41

RODVALENBULLNOSECURVE5.5X55MM

Facility

$3,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270698327
Hospital Revenue Code	278
Min. Negotiated Rate	$502.50
Max. Negotiated Rate	$810.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$670.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$810.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$737.00
Rate for Payer: Qualcare PPO/HMO/WC	$502.50

Know your out-of-pocket cost for care.

All Charges