Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

4.5X50MM BONE SCREW

Facility

$525.00

Hospital Charge Code	270656733
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

4.5X50MM BONE SCREW

Facility

$525.00

Hospital Charge Code	270656733
Hospital Revenue Code	278
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

4.5 X 50MM BONE SCREW TORNIER

Facility

$525.00

Hospital Charge Code	270339521
Hospital Revenue Code	278
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

4.5 X 50MM BONE SCREW TORNIER

Facility

$525.00

Hospital Charge Code	270339521
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

4.75 KNOTLESSBC LOOP N TACK SY

Facility

$4,429.00

Hospital Charge Code	270703222
Hospital Revenue Code	278
Min. Negotiated Rate	$664.35
Max. Negotiated Rate	$1,071.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$885.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,071.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$974.38
Rate for Payer: Qualcare PPO/HMO/WC	$664.35

4.75 KNOTLESSBC LOOP N TACK SY

Facility

$4,429.00

Hospital Charge Code	270703222
Hospital Revenue Code	278
Min. Negotiated Rate	$106.74
Max. Negotiated Rate	$2,214.50
Rate for Payer: Aetna Commercial	$1,683.02
Rate for Payer: Aetna Medicare Advantage	$1,328.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,129.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,129.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$885.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,129.39
Rate for Payer: Cigna Commercial	$2,214.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,071.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$974.38
Rate for Payer: Qualcare PPO/HMO/WC	$664.35
Rate for Payer: UnitedHealthcare Community & State	$106.74
Rate for Payer: Wellpoint Medicaid Managed Care	$117.37

4.75 KNOTLESS BC LOOP N TACK T

Facility

$4,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270706173
Hospital Revenue Code	278
Min. Negotiated Rate	$611.25
Max. Negotiated Rate	$986.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$815.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$986.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$896.50
Rate for Payer: Qualcare PPO/HMO/WC	$611.25

4.75 KNOTLESS BC LOOP N TACK T

Facility

$4,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270706173
Hospital Revenue Code	278
Min. Negotiated Rate	$98.21
Max. Negotiated Rate	$2,037.50
Rate for Payer: Aetna Commercial	$1,548.50
Rate for Payer: Aetna Medicare Advantage	$1,222.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,039.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,039.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,039.12
Rate for Payer: Cigna Commercial	$2,037.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$986.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$896.50
Rate for Payer: Qualcare PPO/HMO/WC	$611.25
Rate for Payer: UnitedHealthcare Community & State	$98.21
Rate for Payer: Wellpoint Medicaid Managed Care	$107.99

4.75MM KNOTLESSSWIVEL ANCHOR

Facility

$2,549.25

Service Code	HCPCS C1713
Hospital Charge Code	270704694
Hospital Revenue Code	278
Min. Negotiated Rate	$382.39
Max. Negotiated Rate	$616.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$509.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$616.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$560.84
Rate for Payer: Qualcare PPO/HMO/WC	$382.39

4.75MM KNOTLESSSWIVEL ANCHOR

Facility

$2,549.25

Service Code	HCPCS C1713
Hospital Charge Code	270704694
Hospital Revenue Code	278
Min. Negotiated Rate	$61.44
Max. Negotiated Rate	$1,274.62
Rate for Payer: Aetna Commercial	$968.72
Rate for Payer: Aetna Medicare Advantage	$764.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$650.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$650.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$509.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$650.06
Rate for Payer: Cigna Commercial	$1,274.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$616.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$560.84
Rate for Payer: Qualcare PPO/HMO/WC	$382.39
Rate for Payer: UnitedHealthcare Community & State	$61.44
Rate for Payer: Wellpoint Medicaid Managed Care	$67.56

480MM ROD

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270659158
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

480MM ROD

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270659158
Hospital Revenue Code	278
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

4.8 DRILL BIT

Facility

$625.00

Hospital Charge Code	270339502
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

4.8 DRILL BIT

Facility

$625.00

Hospital Charge Code	270339502
Hospital Revenue Code	272
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$125.00
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

4.8MM CANC SCRW NONSTRL 32MM

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270685091
Hospital Revenue Code	278
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$218.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$126.50
Rate for Payer: Qualcare PPO/HMO/WC	$86.25
Rate for Payer: UnitedHealthcare Community & State	$13.86
Rate for Payer: Wellpoint Medicaid Managed Care	$15.24

4.8MM CANC SCRW NONSTRL 32MM

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270685091
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$126.50
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

4 COLOSTOMY FLANGE

Facility

$11.04

Hospital Charge Code	270650996
Hospital Revenue Code	270
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.52
Rate for Payer: Aetna Commercial	$4.20
Rate for Payer: Aetna Medicare Advantage	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.82
Rate for Payer: Cigna Commercial	$5.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.31
Rate for Payer: Oxford Commercial	$2.21
Rate for Payer: Qualcare PPO/HMO/WC	$1.66
Rate for Payer: UnitedHealthcare Commercial	$2.21
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

4 COLOSTOMY FLANGE

Facility

$11.04

Hospital Charge Code	270650996
Hospital Revenue Code	270
Min. Negotiated Rate	$1.66
Max. Negotiated Rate	$1.66
Rate for Payer: Qualcare PPO/HMO/WC	$1.66

4 HOLE DISTAL LATERAL PLATE

Facility

$17,345.00

Service Code	HCPCS C1713
Hospital Charge Code	270705007
Hospital Revenue Code	278
Min. Negotiated Rate	$2,601.75
Max. Negotiated Rate	$4,197.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,469.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,197.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,815.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,601.75

4 HOLE DISTAL LATERAL PLATE

Facility

$17,345.00

Service Code	HCPCS C1713
Hospital Charge Code	270705007
Hospital Revenue Code	278
Min. Negotiated Rate	$418.01
Max. Negotiated Rate	$8,672.50
Rate for Payer: Aetna Commercial	$6,591.10
Rate for Payer: Aetna Medicare Advantage	$5,203.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,422.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,422.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,469.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,422.98
Rate for Payer: Cigna Commercial	$8,672.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,197.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,815.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,601.75
Rate for Payer: UnitedHealthcare Community & State	$418.01
Rate for Payer: Wellpoint Medicaid Managed Care	$459.64

4-HOLE PROX LATERAL TIBIA PLAT

Facility

$9,190.00

Hospital Charge Code	270656449
Hospital Revenue Code	278
Min. Negotiated Rate	$221.48
Max. Negotiated Rate	$4,595.00
Rate for Payer: Aetna Commercial	$3,492.20
Rate for Payer: Aetna Medicare Advantage	$2,757.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,838.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.45
Rate for Payer: Cigna Commercial	$4,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,223.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,021.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,378.50
Rate for Payer: UnitedHealthcare Community & State	$221.48
Rate for Payer: Wellpoint Medicaid Managed Care	$243.53

4-HOLE PROX LATERAL TIBIA PLAT

Facility

$9,190.00

Hospital Charge Code	270656449
Hospital Revenue Code	278
Min. Negotiated Rate	$1,378.50
Max. Negotiated Rate	$2,223.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,838.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,223.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,021.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,378.50

4-HOLE PROX.LAT.TIBIA PLT.

Facility

$6,860.00

Hospital Charge Code	270656451
Hospital Revenue Code	278
Min. Negotiated Rate	$165.33
Max. Negotiated Rate	$3,430.00
Rate for Payer: Aetna Commercial	$2,606.80
Rate for Payer: Aetna Medicare Advantage	$2,058.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,749.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,749.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,372.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,749.30
Rate for Payer: Cigna Commercial	$3,430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,660.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,509.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,029.00
Rate for Payer: UnitedHealthcare Community & State	$165.33
Rate for Payer: Wellpoint Medicaid Managed Care	$181.79

4-HOLE PROX.LAT.TIBIA PLT.

Facility

$6,860.00

Hospital Charge Code	270656451
Hospital Revenue Code	278
Min. Negotiated Rate	$1,029.00
Max. Negotiated Rate	$1,660.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,372.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,660.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,509.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,029.00

4 HOLE UDR PLATE NARROW (L)

Facility

$9,075.00

Hospital Charge Code	270703216
Hospital Revenue Code	278
Min. Negotiated Rate	$1,361.25
Max. Negotiated Rate	$2,196.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,815.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,196.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,996.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,361.25

Know your out-of-pocket cost for care.

All Charges