Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STAPLE ARCUS 10X8MM

Facility

$4,840.00

Service Code	HCPCS C1713
Hospital Charge Code	270694777
Hospital Revenue Code	278
Min. Negotiated Rate	$726.00
Max. Negotiated Rate	$1,171.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$968.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,171.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,064.80
Rate for Payer: Qualcare PPO/HMO/WC	$726.00

STAPLE ARCUS 10X8MM

Facility

$4,840.00

Service Code	HCPCS C1713
Hospital Charge Code	270694777
Hospital Revenue Code	278
Min. Negotiated Rate	$116.64
Max. Negotiated Rate	$2,420.00
Rate for Payer: Aetna Commercial	$1,839.20
Rate for Payer: Aetna Medicare Advantage	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,234.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,234.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,234.20
Rate for Payer: Cigna Commercial	$2,420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,171.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,064.80
Rate for Payer: Qualcare PPO/HMO/WC	$726.00
Rate for Payer: UnitedHealthcare Community & State	$116.64
Rate for Payer: Wellpoint Medicaid Managed Care	$128.26

STAPLE BONE 11X10X10

Facility

$4,475.00

Hospital Charge Code	270656971
Hospital Revenue Code	278
Min. Negotiated Rate	$107.85
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,700.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$984.50
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Community & State	$107.85
Rate for Payer: Wellpoint Medicaid Managed Care	$118.59

STAPLE BONE 11X10X10

Facility

$4,475.00

Hospital Charge Code	270656971
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$984.50
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

STAPLE BONE 15/15/15 mm

Facility

$6,250.00

Hospital Charge Code	270681062
Hospital Revenue Code	272
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$937.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

STAPLE BONE 15/15/15 mm

Facility

$6,250.00

Hospital Charge Code	270681062
Hospital Revenue Code	272
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.00
Rate for Payer: Oxford Commercial	$1,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Commercial	$1,250.00
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

STAPLE BONE 15MMx12MMx12MM

Facility

$6,250.00

Hospital Charge Code	270681059
Hospital Revenue Code	272
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$937.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

STAPLE BONE 15MMx12MMx12MM

Facility

$6,250.00

Hospital Charge Code	270681059
Hospital Revenue Code	272
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.00
Rate for Payer: Oxford Commercial	$1,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Commercial	$1,250.00
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

STAPLE BONE 18/16/16 mm

Facility

$6,250.00

Hospital Charge Code	270681063
Hospital Revenue Code	272
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.00
Rate for Payer: Oxford Commercial	$1,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Commercial	$1,250.00
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

STAPLE BONE 18/16/16 mm

Facility

$6,250.00

Hospital Charge Code	270681063
Hospital Revenue Code	272
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$937.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

STAPLE BONE 20/20/20 mm

Facility

$6,250.00

Hospital Charge Code	270681064
Hospital Revenue Code	272
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$937.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

STAPLE BONE 20/20/20 mm

Facility

$6,250.00

Hospital Charge Code	270681064
Hospital Revenue Code	272
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.00
Rate for Payer: Oxford Commercial	$1,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Commercial	$1,250.00
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

STAPLE BONE 9X7X7

Facility

$4,475.00

Hospital Charge Code	270656973
Hospital Revenue Code	278
Min. Negotiated Rate	$107.85
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,700.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$984.50
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Community & State	$107.85
Rate for Payer: Wellpoint Medicaid Managed Care	$118.59

STAPLE BONE 9X7X7

Facility

$4,475.00

Hospital Charge Code	270656973
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$984.50
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

STAPLE DOUBLE N

Facility

$1,760.85

Hospital Charge Code	270670927
Hospital Revenue Code	272
Min. Negotiated Rate	$42.44
Max. Negotiated Rate	$880.42
Rate for Payer: Aetna Commercial	$669.12
Rate for Payer: Aetna Medicare Advantage	$528.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$449.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$449.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$449.02
Rate for Payer: Cigna Commercial	$880.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$528.25
Rate for Payer: Oxford Commercial	$352.17
Rate for Payer: Qualcare PPO/HMO/WC	$264.13
Rate for Payer: UnitedHealthcare Commercial	$352.17
Rate for Payer: UnitedHealthcare Community & State	$42.44
Rate for Payer: Wellpoint Medicaid Managed Care	$46.66

STAPLE DOUBLE N

Facility

$1,760.85

Hospital Charge Code	270670927
Hospital Revenue Code	272
Min. Negotiated Rate	$264.13
Max. Negotiated Rate	$264.13
Rate for Payer: Qualcare PPO/HMO/WC	$264.13

STAPLE DYNANITE 11X10 W/INSTR

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270699540
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,644.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

STAPLE DYNANITE 11X10 W/INSTR

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270699540
Hospital Revenue Code	278
Min. Negotiated Rate	$180.15
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,644.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Community & State	$180.15
Rate for Payer: Wellpoint Medicaid Managed Care	$198.09

STAPLE DYNANITE 9X10 W/INSTRU

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270699541
Hospital Revenue Code	278
Min. Negotiated Rate	$180.15
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,644.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Community & State	$180.15
Rate for Payer: Wellpoint Medicaid Managed Care	$198.09

STAPLE DYNANITE 9X10 W/INSTRU

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270699541
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,644.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

STAPLE DYNANITE NITI W/INSTRS

Facility

$7,475.00

Hospital Charge Code	270684944
Hospital Revenue Code	272
Min. Negotiated Rate	$180.15
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,242.50
Rate for Payer: Oxford Commercial	$1,495.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Commercial	$1,495.00
Rate for Payer: UnitedHealthcare Community & State	$180.15
Rate for Payer: Wellpoint Medicaid Managed Care	$198.09

STAPLE DYNANITE NITI W/INSTRS

Facility

$7,475.00

Hospital Charge Code	270684944
Hospital Revenue Code	272
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,121.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

STAPLE EASYFUSE 18X15MM

Facility

$7,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270700661
Hospital Revenue Code	278
Min. Negotiated Rate	$1,181.25
Max. Negotiated Rate	$1,905.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,905.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,732.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25

STAPLE EASYFUSE 18X15MM

Facility

$7,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270700661
Hospital Revenue Code	278
Min. Negotiated Rate	$189.79
Max. Negotiated Rate	$3,937.50
Rate for Payer: Aetna Commercial	$2,992.50
Rate for Payer: Aetna Medicare Advantage	$2,362.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,008.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,008.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,008.12
Rate for Payer: Cigna Commercial	$3,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,905.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,732.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25
Rate for Payer: UnitedHealthcare Community & State	$189.79
Rate for Payer: Wellpoint Medicaid Managed Care	$208.69

STAPLE FUSEFORCE 15x15MM

Facility

$6,425.00

Hospital Charge Code	270678361
Hospital Revenue Code	272
Min. Negotiated Rate	$963.75
Max. Negotiated Rate	$963.75
Rate for Payer: Qualcare PPO/HMO/WC	$963.75

Know your out-of-pocket cost for care.

All Charges