Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SPEED IMPLANT 11X10X10MM

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270669876
Hospital Revenue Code	278
Min. Negotiated Rate	$120.50
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$120.50
Rate for Payer: Wellpoint Medicaid Managed Care	$132.50

SPEED IMPLANT 11X10X10MM

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270669876
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

SPEED IMPLANT 11x12x10mm

Facility

$7,000.00

Hospital Charge Code	270672298
Hospital Revenue Code	278
Min. Negotiated Rate	$168.70
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,660.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,540.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00
Rate for Payer: UnitedHealthcare Community & State	$168.70
Rate for Payer: Wellpoint Medicaid Managed Care	$185.50

SPEED IMPLANT 11x12x10mm

Facility

$7,000.00

Hospital Charge Code	270672298
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,540.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

SPEED IMPLANT 13x10x10MM

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270677251
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

SPEED IMPLANT 13x10x10MM

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270677251
Hospital Revenue Code	278
Min. Negotiated Rate	$120.50
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$120.50
Rate for Payer: Wellpoint Medicaid Managed Care	$132.50

SPEED IMPLANT 20x20x20MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270659687
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SPEED IMPLANT 20x20x20MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270659687
Hospital Revenue Code	278
Min. Negotiated Rate	$259.07
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$4,085.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50
Rate for Payer: UnitedHealthcare Community & State	$259.07
Rate for Payer: Wellpoint Medicaid Managed Care	$284.88

SPEED IMPLANT 25x20x20MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270673177
Hospital Revenue Code	278
Min. Negotiated Rate	$259.07
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$4,085.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50
Rate for Payer: UnitedHealthcare Community & State	$259.07
Rate for Payer: Wellpoint Medicaid Managed Care	$284.88

SPEED IMPLANT 25x20x20MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270673177
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SPEED IMPLANT 9x10x10MM

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270674296
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

SPEED IMPLANT 9x10x10MM

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270674296
Hospital Revenue Code	278
Min. Negotiated Rate	$120.50
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$120.50
Rate for Payer: Wellpoint Medicaid Managed Care	$132.50

SPEED IMPLANT TITAN 15x15x15MM

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270679102
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

SPEED IMPLANT TITAN 15x15x15MM

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270679102
Hospital Revenue Code	278
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00
Rate for Payer: UnitedHealthcare Community & State	$180.75
Rate for Payer: Wellpoint Medicaid Managed Care	$198.75

SPEED IMPLANT TITAN 18x18x18MM

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270679103
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

SPEED IMPLANT TITAN 18x18x18MM

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270679103
Hospital Revenue Code	278
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00
Rate for Payer: UnitedHealthcare Community & State	$180.75
Rate for Payer: Wellpoint Medicaid Managed Care	$198.75

SPEEDLOCK KNOTLESS FIXATION

Facility

$5,410.00

Service Code	HCPCS C1713
Hospital Charge Code	270668394
Hospital Revenue Code	278
Min. Negotiated Rate	$130.38
Max. Negotiated Rate	$2,705.00
Rate for Payer: Aetna Commercial	$2,055.80
Rate for Payer: Aetna Medicare Advantage	$1,623.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,379.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,379.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,379.55
Rate for Payer: Cigna Commercial	$2,705.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,309.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,190.20
Rate for Payer: Qualcare PPO/HMO/WC	$811.50
Rate for Payer: UnitedHealthcare Community & State	$130.38
Rate for Payer: Wellpoint Medicaid Managed Care	$143.37

SPEEDLOCK KNOTLESS FIXATION

Facility

$5,410.00

Service Code	HCPCS C1713
Hospital Charge Code	270668394
Hospital Revenue Code	278
Min. Negotiated Rate	$811.50
Max. Negotiated Rate	$1,309.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,082.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,309.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,190.20
Rate for Payer: Qualcare PPO/HMO/WC	$811.50

SPEED MTP 3.5 HEADLESS SCREW

Facility

$3,285.00

Service Code	HCPCS C1713
Hospital Charge Code	270704033
Hospital Revenue Code	278
Min. Negotiated Rate	$79.17
Max. Negotiated Rate	$1,642.50
Rate for Payer: Aetna Commercial	$1,248.30
Rate for Payer: Aetna Medicare Advantage	$985.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$837.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$837.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$657.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$837.67
Rate for Payer: Cigna Commercial	$1,642.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$794.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$722.70
Rate for Payer: Qualcare PPO/HMO/WC	$492.75
Rate for Payer: UnitedHealthcare Community & State	$79.17
Rate for Payer: Wellpoint Medicaid Managed Care	$87.05

SPEED MTP 3.5 HEADLESS SCREW

Facility

$3,285.00

Service Code	HCPCS C1713
Hospital Charge Code	270704033
Hospital Revenue Code	278
Min. Negotiated Rate	$492.75
Max. Negotiated Rate	$794.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$657.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$794.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$722.70
Rate for Payer: Qualcare PPO/HMO/WC	$492.75

SPEED MTP FAST PITCH SCREW

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270704032
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

SPEED MTP FAST PITCH SCREW

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270704032
Hospital Revenue Code	278
Min. Negotiated Rate	$75.31
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$75.31
Rate for Payer: Wellpoint Medicaid Managed Care	$82.81

SPEED MTP IMPLANT

Facility

$18,745.00

Service Code	HCPCS C1713
Hospital Charge Code	270704031
Hospital Revenue Code	278
Min. Negotiated Rate	$451.75
Max. Negotiated Rate	$9,372.50
Rate for Payer: Aetna Commercial	$7,123.10
Rate for Payer: Aetna Medicare Advantage	$5,623.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,779.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,779.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,749.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,779.98
Rate for Payer: Cigna Commercial	$9,372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,536.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,123.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,811.75
Rate for Payer: UnitedHealthcare Community & State	$451.75
Rate for Payer: Wellpoint Medicaid Managed Care	$496.74

SPEED MTP IMPLANT

Facility

$18,745.00

Service Code	HCPCS C1713
Hospital Charge Code	270704031
Hospital Revenue Code	278
Min. Negotiated Rate	$2,811.75
Max. Negotiated Rate	$4,536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,749.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,536.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,123.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,811.75

SPEEDPLATE LAPIPLASTY 18X17MM

Facility

$16,870.00

Service Code	HCPCS C1713
Hospital Charge Code	270700192
Hospital Revenue Code	278
Min. Negotiated Rate	$406.57
Max. Negotiated Rate	$8,435.00
Rate for Payer: Aetna Commercial	$6,410.60
Rate for Payer: Aetna Medicare Advantage	$5,061.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,301.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,301.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,374.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,301.85
Rate for Payer: Cigna Commercial	$8,435.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,082.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,711.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,530.50
Rate for Payer: UnitedHealthcare Community & State	$406.57
Rate for Payer: Wellpoint Medicaid Managed Care	$447.06

Know your out-of-pocket cost for care.

All Charges