Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

4.0MM CANC SCR FT 40MM NS

Facility

$247.50

Service Code	HCPCS C1713
Hospital Charge Code	270688922
Hospital Revenue Code	278
Min. Negotiated Rate	$5.96
Max. Negotiated Rate	$123.75
Rate for Payer: Aetna Commercial	$94.05
Rate for Payer: Aetna Medicare Advantage	$74.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.11
Rate for Payer: Cigna Commercial	$123.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$37.12
Rate for Payer: UnitedHealthcare Community & State	$5.96
Rate for Payer: Wellpoint Medicaid Managed Care	$6.56

4.0MM CANC SCR FT 40MM NS

Facility

$247.50

Service Code	HCPCS C1713
Hospital Charge Code	270688922
Hospital Revenue Code	278
Min. Negotiated Rate	$37.12
Max. Negotiated Rate	$59.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$37.12

4.0MM CARBON FIBER ROD 100MM

Facility

$181.45

Service Code	HCPCS C1713
Hospital Charge Code	270601808
Hospital Revenue Code	278
Min. Negotiated Rate	$4.37
Max. Negotiated Rate	$90.72
Rate for Payer: Aetna Commercial	$68.95
Rate for Payer: Aetna Medicare Advantage	$54.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.27
Rate for Payer: Cigna Commercial	$90.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$39.92
Rate for Payer: Qualcare PPO/HMO/WC	$27.22
Rate for Payer: UnitedHealthcare Community & State	$4.37
Rate for Payer: Wellpoint Medicaid Managed Care	$4.81

4.0MM CARBON FIBER ROD 100MM

Facility

$181.45

Service Code	HCPCS C1713
Hospital Charge Code	270601808
Hospital Revenue Code	278
Min. Negotiated Rate	$27.22
Max. Negotiated Rate	$43.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$39.92
Rate for Payer: Qualcare PPO/HMO/WC	$27.22

4.0MM CARBON FIBER ROD 120MM

Facility

$181.45

Service Code	HCPCS C1713
Hospital Charge Code	270601813
Hospital Revenue Code	278
Min. Negotiated Rate	$27.22
Max. Negotiated Rate	$43.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$39.92
Rate for Payer: Qualcare PPO/HMO/WC	$27.22

4.0MM CARBON FIBER ROD 120MM

Facility

$181.45

Service Code	HCPCS C1713
Hospital Charge Code	270601813
Hospital Revenue Code	278
Min. Negotiated Rate	$4.37
Max. Negotiated Rate	$90.72
Rate for Payer: Aetna Commercial	$68.95
Rate for Payer: Aetna Medicare Advantage	$54.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.27
Rate for Payer: Cigna Commercial	$90.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$39.92
Rate for Payer: Qualcare PPO/HMO/WC	$27.22
Rate for Payer: UnitedHealthcare Community & State	$4.37
Rate for Payer: Wellpoint Medicaid Managed Care	$4.81

4.0MM CARBON FIBER ROD 140MM

Facility

$249.85

Service Code	HCPCS C1713
Hospital Charge Code	270601809
Hospital Revenue Code	278
Min. Negotiated Rate	$37.48
Max. Negotiated Rate	$60.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.97
Rate for Payer: Qualcare PPO/HMO/WC	$37.48

4.0MM CARBON FIBER ROD 140MM

Facility

$249.85

Service Code	HCPCS C1713
Hospital Charge Code	270601809
Hospital Revenue Code	278
Min. Negotiated Rate	$6.02
Max. Negotiated Rate	$124.92
Rate for Payer: Aetna Commercial	$94.94
Rate for Payer: Aetna Medicare Advantage	$74.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.71
Rate for Payer: Cigna Commercial	$124.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.97
Rate for Payer: Qualcare PPO/HMO/WC	$37.48
Rate for Payer: UnitedHealthcare Community & State	$6.02
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

4.0MM CARBON FIBER ROD 160MM

Facility

$249.85

Service Code	HCPCS C1713
Hospital Charge Code	270601810
Hospital Revenue Code	278
Min. Negotiated Rate	$37.48
Max. Negotiated Rate	$60.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.97
Rate for Payer: Qualcare PPO/HMO/WC	$37.48

4.0MM CARBON FIBER ROD 160MM

Facility

$249.85

Service Code	HCPCS C1713
Hospital Charge Code	270601810
Hospital Revenue Code	278
Min. Negotiated Rate	$6.02
Max. Negotiated Rate	$124.92
Rate for Payer: Aetna Commercial	$94.94
Rate for Payer: Aetna Medicare Advantage	$74.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.71
Rate for Payer: Cigna Commercial	$124.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.97
Rate for Payer: Qualcare PPO/HMO/WC	$37.48
Rate for Payer: UnitedHealthcare Community & State	$6.02
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

4.0MM CARBON FIBER ROD 180MM

Facility

$249.85

Service Code	HCPCS C1713
Hospital Charge Code	270601814
Hospital Revenue Code	278
Min. Negotiated Rate	$6.02
Max. Negotiated Rate	$124.92
Rate for Payer: Aetna Commercial	$94.94
Rate for Payer: Aetna Medicare Advantage	$74.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.71
Rate for Payer: Cigna Commercial	$124.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.97
Rate for Payer: Qualcare PPO/HMO/WC	$37.48
Rate for Payer: UnitedHealthcare Community & State	$6.02
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

4.0MM CARBON FIBER ROD 180MM

Facility

$249.85

Service Code	HCPCS C1713
Hospital Charge Code	270601814
Hospital Revenue Code	278
Min. Negotiated Rate	$37.48
Max. Negotiated Rate	$60.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.97
Rate for Payer: Qualcare PPO/HMO/WC	$37.48

4.0MM CARBON FIBER ROD 200MM

Facility

$249.85

Service Code	HCPCS C1713
Hospital Charge Code	270601811
Hospital Revenue Code	278
Min. Negotiated Rate	$37.48
Max. Negotiated Rate	$60.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.97
Rate for Payer: Qualcare PPO/HMO/WC	$37.48

4.0MM CARBON FIBER ROD 200MM

Facility

$249.85

Service Code	HCPCS C1713
Hospital Charge Code	270601811
Hospital Revenue Code	278
Min. Negotiated Rate	$6.02
Max. Negotiated Rate	$124.92
Rate for Payer: Aetna Commercial	$94.94
Rate for Payer: Aetna Medicare Advantage	$74.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.71
Rate for Payer: Cigna Commercial	$124.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.97
Rate for Payer: Qualcare PPO/HMO/WC	$37.48
Rate for Payer: UnitedHealthcare Community & State	$6.02
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

40MM LORDOTIC BRIDGE PLATE

Facility

$14,406.00

Service Code	HCPCS C1713
Hospital Charge Code	270704086
Hospital Revenue Code	278
Min. Negotiated Rate	$347.18
Max. Negotiated Rate	$7,203.00
Rate for Payer: Aetna Commercial	$5,474.28
Rate for Payer: Aetna Medicare Advantage	$4,321.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,673.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,673.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,881.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,673.53
Rate for Payer: Cigna Commercial	$7,203.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,486.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,169.32
Rate for Payer: Qualcare PPO/HMO/WC	$2,160.90
Rate for Payer: UnitedHealthcare Community & State	$347.18
Rate for Payer: Wellpoint Medicaid Managed Care	$381.76

40MM LORDOTIC BRIDGE PLATE

Facility

$14,406.00

Service Code	HCPCS C1713
Hospital Charge Code	270704086
Hospital Revenue Code	278
Min. Negotiated Rate	$2,160.90
Max. Negotiated Rate	$3,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,881.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,486.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,169.32
Rate for Payer: Qualcare PPO/HMO/WC	$2,160.90

4.0 MM NASAL SHAVER BLADE

Facility

$316.00

Hospital Charge Code	270338799
Hospital Revenue Code	272
Min. Negotiated Rate	$7.62
Max. Negotiated Rate	$158.00
Rate for Payer: Aetna Commercial	$120.08
Rate for Payer: Aetna Medicare Advantage	$94.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.58
Rate for Payer: Cigna Commercial	$158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.80
Rate for Payer: Oxford Commercial	$63.20
Rate for Payer: Qualcare PPO/HMO/WC	$47.40
Rate for Payer: UnitedHealthcare Commercial	$63.20
Rate for Payer: UnitedHealthcare Community & State	$7.62
Rate for Payer: Wellpoint Medicaid Managed Care	$8.37

4.0 MM NASAL SHAVER BLADE

Facility

$316.00

Hospital Charge Code	270338799
Hospital Revenue Code	272
Min. Negotiated Rate	$47.40
Max. Negotiated Rate	$47.40
Rate for Payer: Qualcare PPO/HMO/WC	$47.40

40MM ROD

Facility

$1,690.65

Service Code	HCPCS C1713
Hospital Charge Code	270669384
Hospital Revenue Code	278
Min. Negotiated Rate	$253.60
Max. Negotiated Rate	$409.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$338.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$409.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$371.94
Rate for Payer: Qualcare PPO/HMO/WC	$253.60

40MM ROD

Facility

$1,690.65

Service Code	HCPCS C1713
Hospital Charge Code	270669384
Hospital Revenue Code	278
Min. Negotiated Rate	$40.74
Max. Negotiated Rate	$845.33
Rate for Payer: Aetna Commercial	$642.45
Rate for Payer: Aetna Medicare Advantage	$507.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$431.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$431.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$338.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$431.12
Rate for Payer: Cigna Commercial	$845.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$409.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$371.94
Rate for Payer: Qualcare PPO/HMO/WC	$253.60
Rate for Payer: UnitedHealthcare Community & State	$40.74
Rate for Payer: Wellpoint Medicaid Managed Care	$44.80

40MM ROD #11-3040

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705466
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

40MM ROD #11-3040

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705466
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

40MM RODS

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270703565
Hospital Revenue Code	278
Min. Negotiated Rate	$28.32
Max. Negotiated Rate	$587.50
Rate for Payer: Aetna Commercial	$446.50
Rate for Payer: Aetna Medicare Advantage	$352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.62
Rate for Payer: Cigna Commercial	$587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$258.50
Rate for Payer: Qualcare PPO/HMO/WC	$176.25
Rate for Payer: UnitedHealthcare Community & State	$28.32
Rate for Payer: Wellpoint Medicaid Managed Care	$31.14

40MM RODS

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270703565
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$284.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$258.50
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

4.0MM ROUBD FLUTED AGGRESSIVE

Facility

$620.00

Hospital Charge Code	270702862
Hospital Revenue Code	270
Min. Negotiated Rate	$14.94
Max. Negotiated Rate	$310.00
Rate for Payer: Aetna Commercial	$235.60
Rate for Payer: Aetna Medicare Advantage	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.10
Rate for Payer: Cigna Commercial	$310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.00
Rate for Payer: Oxford Commercial	$124.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.94
Rate for Payer: Wellpoint Medicaid Managed Care	$16.43

Know your out-of-pocket cost for care.

All Charges