Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SYNOVIAL URIC ACID

Facility

$201.00

Service Code	HCPCS 83986
Hospital Charge Code	38479479
Hospital Revenue Code	301
Min. Negotiated Rate	$30.15
Max. Negotiated Rate	$30.15
Rate for Payer: Qualcare PPO/HMO/WC	$30.15

SYNOVIAL URIC ACID

Facility

$201.00

Service Code	HCPCS 83986
Hospital Charge Code	38479479
Hospital Revenue Code	301
Min. Negotiated Rate	$2.86
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$9.74
Rate for Payer: Aetna Medicare Advantage	$11.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.92
Rate for Payer: Cigna Commercial	$100.50
Rate for Payer: Cigna Medicare Advantage	$3.58
Rate for Payer: Clover Medicare Advantage	$3.40
Rate for Payer: EmblemHealth Commercial	$10.74
Rate for Payer: Humana Medicare Advantage	$3.69
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.58
Rate for Payer: Wellcare Medicare Advantage	$3.58
Rate for Payer: Wellpoint Medicaid Managed Care	$5.33

SYNOVIAL URIC ACID

Facility

$201.00

Service Code	HCPCS 83986
Hospital Charge Code	38479478
Hospital Revenue Code	301
Min. Negotiated Rate	$30.15
Max. Negotiated Rate	$30.15
Rate for Payer: Qualcare PPO/HMO/WC	$30.15

SYNTHES 2.5MM REAMING ROD

Facility

$242.00

Hospital Charge Code	270335921
Hospital Revenue Code	278
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$121.00
Rate for Payer: Aetna Commercial	$91.96
Rate for Payer: Aetna Medicare Advantage	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.71
Rate for Payer: Cigna Commercial	$121.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.24
Rate for Payer: Qualcare PPO/HMO/WC	$36.30
Rate for Payer: UnitedHealthcare Community & State	$5.83
Rate for Payer: Wellpoint Medicaid Managed Care	$6.41

SYNTHES 2.5MM REAMING ROD

Facility

$242.00

Hospital Charge Code	270335921
Hospital Revenue Code	278
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$58.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.24
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

SYNTHES 4.0 CALIBRATD DRILL BI

Facility

$381.00

Hospital Charge Code	270335923
Hospital Revenue Code	272
Min. Negotiated Rate	$9.18
Max. Negotiated Rate	$190.50
Rate for Payer: Aetna Commercial	$144.78
Rate for Payer: Aetna Medicare Advantage	$114.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.16
Rate for Payer: Cigna Commercial	$190.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.30
Rate for Payer: Oxford Commercial	$76.20
Rate for Payer: Qualcare PPO/HMO/WC	$57.15
Rate for Payer: UnitedHealthcare Commercial	$76.20
Rate for Payer: UnitedHealthcare Community & State	$9.18
Rate for Payer: Wellpoint Medicaid Managed Care	$10.10

SYNTHES 4.0 CALIBRATD DRILL BI

Facility

$381.00

Hospital Charge Code	270335923
Hospital Revenue Code	272
Min. Negotiated Rate	$57.15
Max. Negotiated Rate	$57.15
Rate for Payer: Qualcare PPO/HMO/WC	$57.15

SYNTHES 5.0 DRILL

Facility

$650.00

Hospital Charge Code	270335939
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

SYNTHES 5.0 DRILL

Facility

$650.00

Hospital Charge Code	270335939
Hospital Revenue Code	272
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$130.00
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

SYNTHES 5.0 SCREW 16 TO 45

Facility

$310.00

Hospital Charge Code	270335947
Hospital Revenue Code	278
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$75.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$68.20
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

SYNTHES 5.0 SCREW 16 TO 45

Facility

$310.00

Hospital Charge Code	270335947
Hospital Revenue Code	278
Min. Negotiated Rate	$7.47
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$117.80
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$68.20
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Community & State	$7.47
Rate for Payer: Wellpoint Medicaid Managed Care	$8.21

SYNTHES 5.0 SCREW 50, 60

Facility

$350.00

Hospital Charge Code	270335948
Hospital Revenue Code	278
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$133.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$77.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Community & State	$8.44
Rate for Payer: Wellpoint Medicaid Managed Care	$9.28

SYNTHES 5.0 SCREW 50, 60

Facility

$350.00

Hospital Charge Code	270335948
Hospital Revenue Code	278
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$84.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$77.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

SYNTHES ANKLE SCREWS

Facility

$975.00

Hospital Charge Code	270335985
Hospital Revenue Code	278
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

SYNTHES ANKLE SCREWS

Facility

$975.00

Hospital Charge Code	270335985
Hospital Revenue Code	278
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$235.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

SYNTHES LOCKING SCREW 5.0 X 34

Facility

$3,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270656648
Hospital Revenue Code	278
Min. Negotiated Rate	$498.75
Max. Negotiated Rate	$804.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$731.50
Rate for Payer: Qualcare PPO/HMO/WC	$498.75

SYNTHES LOCKING SCREW 5.0 X 34

Facility

$3,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270656648
Hospital Revenue Code	278
Min. Negotiated Rate	$80.13
Max. Negotiated Rate	$1,662.50
Rate for Payer: Aetna Commercial	$1,263.50
Rate for Payer: Aetna Medicare Advantage	$997.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$847.88
Rate for Payer: Cigna Commercial	$1,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$731.50
Rate for Payer: Qualcare PPO/HMO/WC	$498.75
Rate for Payer: UnitedHealthcare Community & State	$80.13
Rate for Payer: Wellpoint Medicaid Managed Care	$88.11

SYNTHES LOCKING SCREW 5.0 X 42

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270677266
Hospital Revenue Code	278
Min. Negotiated Rate	$22.94
Max. Negotiated Rate	$475.85
Rate for Payer: Aetna Commercial	$361.65
Rate for Payer: Aetna Medicare Advantage	$285.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.68
Rate for Payer: Cigna Commercial	$475.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.37
Rate for Payer: Qualcare PPO/HMO/WC	$142.75
Rate for Payer: UnitedHealthcare Community & State	$22.94
Rate for Payer: Wellpoint Medicaid Managed Care	$25.22

SYNTHES LOCKING SCREW 5.0 X 42

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270677266
Hospital Revenue Code	278
Min. Negotiated Rate	$142.75
Max. Negotiated Rate	$230.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.37
Rate for Payer: Qualcare PPO/HMO/WC	$142.75

SYNTHES LOCKING SCREW 5.0 X 46

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270645684
Hospital Revenue Code	278
Min. Negotiated Rate	$22.94
Max. Negotiated Rate	$475.85
Rate for Payer: Aetna Commercial	$361.65
Rate for Payer: Aetna Medicare Advantage	$285.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.68
Rate for Payer: Cigna Commercial	$475.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.37
Rate for Payer: Qualcare PPO/HMO/WC	$142.75
Rate for Payer: UnitedHealthcare Community & State	$22.94
Rate for Payer: Wellpoint Medicaid Managed Care	$25.22

SYNTHES LOCKING SCREW 5.0 X 46

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270645684
Hospital Revenue Code	278
Min. Negotiated Rate	$142.75
Max. Negotiated Rate	$230.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.37
Rate for Payer: Qualcare PPO/HMO/WC	$142.75

SYNTHES MINI LOCK COLONEAL PLT

Facility

$997.50

Hospital Charge Code	270335984
Hospital Revenue Code	278
Min. Negotiated Rate	$149.62
Max. Negotiated Rate	$241.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$241.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$219.45
Rate for Payer: Qualcare PPO/HMO/WC	$149.62

SYNTHES MINI LOCK COLONEAL PLT

Facility

$997.50

Hospital Charge Code	270335984
Hospital Revenue Code	278
Min. Negotiated Rate	$24.04
Max. Negotiated Rate	$498.75
Rate for Payer: Aetna Commercial	$379.05
Rate for Payer: Aetna Medicare Advantage	$299.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.36
Rate for Payer: Cigna Commercial	$498.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$241.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$219.45
Rate for Payer: Qualcare PPO/HMO/WC	$149.62
Rate for Payer: UnitedHealthcare Community & State	$24.04
Rate for Payer: Wellpoint Medicaid Managed Care	$26.43

SYNTHES THREADED GUID WIRE 2.5

Facility

$82.00

Hospital Charge Code	270335924
Hospital Revenue Code	278
Min. Negotiated Rate	$12.30
Max. Negotiated Rate	$19.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.04
Rate for Payer: Qualcare PPO/HMO/WC	$12.30

SYNTHES THREADED GUID WIRE 2.5

Facility

$82.00

Hospital Charge Code	270335924
Hospital Revenue Code	278
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$41.00
Rate for Payer: Aetna Commercial	$31.16
Rate for Payer: Aetna Medicare Advantage	$24.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.91
Rate for Payer: Cigna Commercial	$41.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.04
Rate for Payer: Qualcare PPO/HMO/WC	$12.30
Rate for Payer: UnitedHealthcare Community & State	$1.98
Rate for Payer: Wellpoint Medicaid Managed Care	$2.17

Know your out-of-pocket cost for care.

All Charges