Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

1181-20 HIP FIXATION

Facility

$560.30

Hospital Charge Code	270656836
Hospital Revenue Code	278
Min. Negotiated Rate	$84.05
Max. Negotiated Rate	$135.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$123.27
Rate for Payer: Qualcare PPO/HMO/WC	$84.05

1181-20 HIP FIXATION

Facility

$560.30

Hospital Charge Code	270656836
Hospital Revenue Code	278
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$280.15
Rate for Payer: Aetna Commercial	$212.91
Rate for Payer: Aetna Medicare Advantage	$168.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.88
Rate for Payer: Cigna Commercial	$280.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$123.27
Rate for Payer: Qualcare PPO/HMO/WC	$84.05
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: Wellpoint Medicaid Managed Care	$14.85

11-DEOXYCORTISOL,LC/MS/MS

Facility

$199.70

Service Code	HCPCS 82634
Hospital Charge Code	39900512
Hospital Revenue Code	301
Min. Negotiated Rate	$29.95
Max. Negotiated Rate	$29.95
Rate for Payer: Qualcare PPO/HMO/WC	$29.95

11-DEOXYCORTISOL,LC/MS/MS

Facility

$199.70

Service Code	HCPCS 82634
Hospital Charge Code	39900512
Hospital Revenue Code	301
Min. Negotiated Rate	$5.29
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$79.64
Rate for Payer: Aetna Medicare Advantage	$94.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$83.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.69
Rate for Payer: Cigna Commercial	$99.85
Rate for Payer: Cigna Medicare Advantage	$29.28
Rate for Payer: Clover Medicare Advantage	$27.82
Rate for Payer: EmblemHealth Commercial	$87.84
Rate for Payer: Humana Medicare Advantage	$30.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.91
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.95
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$23.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.28
Rate for Payer: Wellcare Medicare Advantage	$29.28
Rate for Payer: Wellpoint Medicaid Managed Care	$5.29

1.1 DOUBLE G/WIRE

Facility

$100.00

Hospital Charge Code	270684631
Hospital Revenue Code	272
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$38.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.00
Rate for Payer: Oxford Commercial	$20.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$20.00
Rate for Payer: UnitedHealthcare Community & State	$2.41
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

1.1 DOUBLE G/WIRE

Facility

$100.00

Hospital Charge Code	270684631
Hospital Revenue Code	272
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

1.1 GUIDEWIRE

Facility

$2,360.00

Service Code	HCPCS C1769
Hospital Charge Code	270666242
Hospital Revenue Code	278
Min. Negotiated Rate	$56.88
Max. Negotiated Rate	$1,180.00
Rate for Payer: Aetna Commercial	$896.80
Rate for Payer: Aetna Medicare Advantage	$708.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$601.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$601.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$472.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$601.80
Rate for Payer: Cigna Commercial	$1,180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$571.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$519.20
Rate for Payer: Qualcare PPO/HMO/WC	$354.00
Rate for Payer: UnitedHealthcare Community & State	$56.88
Rate for Payer: Wellpoint Medicaid Managed Care	$62.54

1.1 GUIDEWIRE

Facility

$2,360.00

Service Code	HCPCS C1769
Hospital Charge Code	270666242
Hospital Revenue Code	278
Min. Negotiated Rate	$354.00
Max. Negotiated Rate	$571.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$472.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$571.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$519.20
Rate for Payer: Qualcare PPO/HMO/WC	$354.00

1.1 GUIDEWIRE

Facility

$475.00

Service Code	HCPCS C1769
Hospital Charge Code	270664042
Hospital Revenue Code	278
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$180.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Community & State	$11.45
Rate for Payer: Wellpoint Medicaid Managed Care	$12.59

1.1 GUIDEWIRE

Facility

$205.00

Service Code	HCPCS C1769
Hospital Charge Code	270664015
Hospital Revenue Code	278
Min. Negotiated Rate	$4.94
Max. Negotiated Rate	$102.50
Rate for Payer: Aetna Commercial	$77.90
Rate for Payer: Aetna Medicare Advantage	$61.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.27
Rate for Payer: Cigna Commercial	$102.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$45.10
Rate for Payer: Qualcare PPO/HMO/WC	$30.75
Rate for Payer: UnitedHealthcare Community & State	$4.94
Rate for Payer: Wellpoint Medicaid Managed Care	$5.43

1.1 GUIDEWIRE

Facility

$205.00

Service Code	HCPCS C1769
Hospital Charge Code	270664015
Hospital Revenue Code	278
Min. Negotiated Rate	$30.75
Max. Negotiated Rate	$49.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$45.10
Rate for Payer: Qualcare PPO/HMO/WC	$30.75

1.1 GUIDEWIRE

Facility

$475.00

Service Code	HCPCS C1769
Hospital Charge Code	270664042
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

11MM/125DEG TI CANN TFNA 320MM

Facility

$14,063.00

Service Code	HCPCS C1713
Hospital Charge Code	278704757
Hospital Revenue Code	278
Min. Negotiated Rate	$338.92
Max. Negotiated Rate	$7,031.50
Rate for Payer: Aetna Commercial	$5,343.94
Rate for Payer: Aetna Medicare Advantage	$4,218.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,586.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,586.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,812.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,586.07
Rate for Payer: Cigna Commercial	$7,031.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,403.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,093.86
Rate for Payer: Qualcare PPO/HMO/WC	$2,109.45
Rate for Payer: UnitedHealthcare Community & State	$338.92
Rate for Payer: Wellpoint Medicaid Managed Care	$372.67

11MM/125DEG TI CANN TFNA 320MM

Facility

$14,063.00

Service Code	HCPCS C1781
Hospital Charge Code	270704757
Hospital Revenue Code	278
Min. Negotiated Rate	$2,109.45
Max. Negotiated Rate	$3,403.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,812.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,403.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,093.86
Rate for Payer: Qualcare PPO/HMO/WC	$2,109.45

11MM/125DEG TI CANN TFNA 320MM

Facility

$14,063.00

Service Code	HCPCS C1713
Hospital Charge Code	278704757
Hospital Revenue Code	278
Min. Negotiated Rate	$2,109.45
Max. Negotiated Rate	$3,403.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,812.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,403.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,093.86
Rate for Payer: Qualcare PPO/HMO/WC	$2,109.45

11MM/125DEG TI CANN TFNA 320MM

Facility

$14,063.00

Service Code	HCPCS C1781
Hospital Charge Code	270704757
Hospital Revenue Code	278
Min. Negotiated Rate	$338.92
Max. Negotiated Rate	$7,031.50
Rate for Payer: Aetna Commercial	$5,343.94
Rate for Payer: Aetna Medicare Advantage	$4,218.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,586.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,586.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,812.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,586.07
Rate for Payer: Cigna Commercial	$7,031.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,403.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,093.86
Rate for Payer: Qualcare PPO/HMO/WC	$2,109.45
Rate for Payer: UnitedHealthcare Community & State	$338.92
Rate for Payer: Wellpoint Medicaid Managed Care	$372.67

11MM/125DEG TI CANN TNFA

Facility

$14,213.00

Service Code	HCPCS C1713
Hospital Charge Code	270704346
Hospital Revenue Code	278
Min. Negotiated Rate	$342.53
Max. Negotiated Rate	$7,106.50
Rate for Payer: Aetna Commercial	$5,400.94
Rate for Payer: Aetna Medicare Advantage	$4,263.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,624.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,624.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,842.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,624.32
Rate for Payer: Cigna Commercial	$7,106.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,439.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,126.86
Rate for Payer: Qualcare PPO/HMO/WC	$2,131.95
Rate for Payer: UnitedHealthcare Community & State	$342.53
Rate for Payer: Wellpoint Medicaid Managed Care	$376.64

11MM/125DEG TI CANN TNFA

Facility

$14,213.00

Service Code	HCPCS C1713
Hospital Charge Code	270704346
Hospital Revenue Code	278
Min. Negotiated Rate	$2,131.95
Max. Negotiated Rate	$3,439.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,842.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,439.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,126.86
Rate for Payer: Qualcare PPO/HMO/WC	$2,131.95

11MM/130DEG TI CANN TFNA360MM/

Facility

$9,653.15

Service Code	HCPCS C1713
Hospital Charge Code	270675364
Hospital Revenue Code	278
Min. Negotiated Rate	$232.64
Max. Negotiated Rate	$4,826.57
Rate for Payer: Aetna Commercial	$3,668.20
Rate for Payer: Aetna Medicare Advantage	$2,895.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,461.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,461.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,930.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,461.55
Rate for Payer: Cigna Commercial	$4,826.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,336.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,123.69
Rate for Payer: Qualcare PPO/HMO/WC	$1,447.97
Rate for Payer: UnitedHealthcare Community & State	$232.64
Rate for Payer: Wellpoint Medicaid Managed Care	$255.81

11MM/130DEG TI CANN TFNA360MM/

Facility

$9,653.15

Service Code	HCPCS C1713
Hospital Charge Code	270675364
Hospital Revenue Code	278
Min. Negotiated Rate	$1,447.97
Max. Negotiated Rate	$2,336.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,930.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,336.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,123.69
Rate for Payer: Qualcare PPO/HMO/WC	$1,447.97

11MM/130 DEG TI CANN THN 400

Facility

$9,942.75

Service Code	HCPCS C1713
Hospital Charge Code	270683137
Hospital Revenue Code	278
Min. Negotiated Rate	$1,491.41
Max. Negotiated Rate	$2,406.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,988.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,406.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,187.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,491.41

11MM/130 DEG TI CANN THN 400

Facility

$9,942.75

Service Code	HCPCS C1713
Hospital Charge Code	270683137
Hospital Revenue Code	278
Min. Negotiated Rate	$239.62
Max. Negotiated Rate	$4,971.38
Rate for Payer: Aetna Commercial	$3,778.24
Rate for Payer: Aetna Medicare Advantage	$2,982.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,535.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,535.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,988.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,535.40
Rate for Payer: Cigna Commercial	$4,971.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,406.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,187.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,491.41
Rate for Payer: UnitedHealthcare Community & State	$239.62
Rate for Payer: Wellpoint Medicaid Managed Care	$263.48

11MM/130DEG TI CAN TFNA340MM/R

Facility

$9,942.75

Service Code	HCPCS C1713
Hospital Charge Code	270678928
Hospital Revenue Code	278
Min. Negotiated Rate	$239.62
Max. Negotiated Rate	$4,971.38
Rate for Payer: Aetna Commercial	$3,778.24
Rate for Payer: Aetna Medicare Advantage	$2,982.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,535.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,535.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,988.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,535.40
Rate for Payer: Cigna Commercial	$4,971.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,406.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,187.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,491.41
Rate for Payer: UnitedHealthcare Community & State	$239.62
Rate for Payer: Wellpoint Medicaid Managed Care	$263.48

11MM/130DEG TI CAN TFNA340MM/R

Facility

$9,942.75

Service Code	HCPCS C1713
Hospital Charge Code	270678928
Hospital Revenue Code	278
Min. Negotiated Rate	$1,491.41
Max. Negotiated Rate	$2,406.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,988.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,406.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,187.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,491.41

11 MM DRILL BIT 4MM STP

Facility

$795.00

Hospital Charge Code	270656599
Hospital Revenue Code	272
Min. Negotiated Rate	$19.16
Max. Negotiated Rate	$397.50
Rate for Payer: Aetna Commercial	$302.10
Rate for Payer: Aetna Medicare Advantage	$238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$202.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$202.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$202.72
Rate for Payer: Cigna Commercial	$397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.50
Rate for Payer: Oxford Commercial	$159.00
Rate for Payer: Qualcare PPO/HMO/WC	$119.25
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$19.16
Rate for Payer: Wellpoint Medicaid Managed Care	$21.07

Know your out-of-pocket cost for care.

All Charges