Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TFNA FENESTRATED SCREW 95 MM

Facility

$3,172.00

Service Code	HCPCS C1713
Hospital Charge Code	270687809
Hospital Revenue Code	278
Min. Negotiated Rate	$76.45
Max. Negotiated Rate	$1,586.00
Rate for Payer: Aetna Commercial	$1,205.36
Rate for Payer: Aetna Medicare Advantage	$951.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$808.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$808.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$634.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$808.86
Rate for Payer: Cigna Commercial	$1,586.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$767.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$697.84
Rate for Payer: Qualcare PPO/HMO/WC	$475.80
Rate for Payer: UnitedHealthcare Community & State	$76.45
Rate for Payer: Wellpoint Medicaid Managed Care	$84.06

TFNA FENESTRATED SCREW 95 MM

Facility

$3,172.00

Service Code	HCPCS C1713
Hospital Charge Code	270687809
Hospital Revenue Code	278
Min. Negotiated Rate	$475.80
Max. Negotiated Rate	$767.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$634.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$767.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$697.84
Rate for Payer: Qualcare PPO/HMO/WC	$475.80

TFNA FENSTRD HELICALBLADE 75MM

Facility

$3,389.60

Service Code	HCPCS C1713
Hospital Charge Code	270686548
Hospital Revenue Code	278
Min. Negotiated Rate	$508.44
Max. Negotiated Rate	$820.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$677.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$820.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$745.71
Rate for Payer: Qualcare PPO/HMO/WC	$508.44

TFNA FENSTRD HELICALBLADE 75MM

Facility

$3,389.60

Service Code	HCPCS C1713
Hospital Charge Code	270686548
Hospital Revenue Code	278
Min. Negotiated Rate	$81.69
Max. Negotiated Rate	$1,694.80
Rate for Payer: Aetna Commercial	$1,288.05
Rate for Payer: Aetna Medicare Advantage	$1,016.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$864.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$864.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$677.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$864.35
Rate for Payer: Cigna Commercial	$1,694.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$820.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$745.71
Rate for Payer: Qualcare PPO/HMO/WC	$508.44
Rate for Payer: UnitedHealthcare Community & State	$81.69
Rate for Payer: Wellpoint Medicaid Managed Care	$89.82

TFNA HELICAL BLADE 120MM

Facility

$3,290.85

Hospital Charge Code	270679723
Hospital Revenue Code	272
Min. Negotiated Rate	$493.63
Max. Negotiated Rate	$493.63
Rate for Payer: Qualcare PPO/HMO/WC	$493.63

TFNA HELICAL BLADE 120MM

Facility

$3,290.85

Hospital Charge Code	270679723
Hospital Revenue Code	272
Min. Negotiated Rate	$79.31
Max. Negotiated Rate	$1,645.42
Rate for Payer: Aetna Commercial	$1,250.52
Rate for Payer: Aetna Medicare Advantage	$987.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$839.17
Rate for Payer: Cigna Commercial	$1,645.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$987.25
Rate for Payer: Oxford Commercial	$658.17
Rate for Payer: Qualcare PPO/HMO/WC	$493.63
Rate for Payer: UnitedHealthcare Commercial	$658.17
Rate for Payer: UnitedHealthcare Community & State	$79.31
Rate for Payer: Wellpoint Medicaid Managed Care	$87.21

TFNA NAIL 10MM/125D 340MM RT

Facility

$28,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270699642
Hospital Revenue Code	278
Min. Negotiated Rate	$691.67
Max. Negotiated Rate	$14,350.00
Rate for Payer: Aetna Commercial	$10,906.00
Rate for Payer: Aetna Medicare Advantage	$8,610.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,318.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,318.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,740.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,318.50
Rate for Payer: Cigna Commercial	$14,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,945.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,314.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,305.00
Rate for Payer: UnitedHealthcare Community & State	$691.67
Rate for Payer: Wellpoint Medicaid Managed Care	$760.55

TFNA NAIL 10MM/125D 340MM RT

Facility

$28,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270699642
Hospital Revenue Code	278
Min. Negotiated Rate	$4,305.00
Max. Negotiated Rate	$6,945.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,740.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,945.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,314.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,305.00

TFNA NAIL 11MM/125D TI 170MM

Facility

$19,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270699732
Hospital Revenue Code	278
Min. Negotiated Rate	$2,876.25
Max. Negotiated Rate	$4,640.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,835.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,640.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,218.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,876.25

TFNA NAIL 11MM/125D TI 170MM

Facility

$19,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270699732
Hospital Revenue Code	278
Min. Negotiated Rate	$462.12
Max. Negotiated Rate	$9,587.50
Rate for Payer: Aetna Commercial	$7,286.50
Rate for Payer: Aetna Medicare Advantage	$5,752.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,889.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,889.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,835.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,889.62
Rate for Payer: Cigna Commercial	$9,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,640.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,218.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,876.25
Rate for Payer: UnitedHealthcare Community & State	$462.12
Rate for Payer: Wellpoint Medicaid Managed Care	$508.14

TFNA SCREW 100MM STERILE

Facility

$3,230.45

Service Code	HCPCS C1713
Hospital Charge Code	270678460
Hospital Revenue Code	278
Min. Negotiated Rate	$77.85
Max. Negotiated Rate	$1,615.22
Rate for Payer: Aetna Commercial	$1,227.57
Rate for Payer: Aetna Medicare Advantage	$969.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$823.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$823.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$646.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$823.76
Rate for Payer: Cigna Commercial	$1,615.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$781.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$710.70
Rate for Payer: Qualcare PPO/HMO/WC	$484.57
Rate for Payer: UnitedHealthcare Community & State	$77.85
Rate for Payer: Wellpoint Medicaid Managed Care	$85.61

TFNA SCREW 100MM STERILE

Facility

$3,230.45

Service Code	HCPCS C1713
Hospital Charge Code	270678460
Hospital Revenue Code	278
Min. Negotiated Rate	$484.57
Max. Negotiated Rate	$781.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$646.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$781.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$710.70
Rate for Payer: Qualcare PPO/HMO/WC	$484.57

TFNA SCREW 90MM

Facility

$8,555.00

Service Code	HCPCS C1713
Hospital Charge Code	270696754
Hospital Revenue Code	278
Min. Negotiated Rate	$1,283.25
Max. Negotiated Rate	$2,070.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,711.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,070.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,882.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,283.25

TFNA SCREW 90MM

Facility

$8,555.00

Service Code	HCPCS C1713
Hospital Charge Code	270696754
Hospital Revenue Code	278
Min. Negotiated Rate	$206.18
Max. Negotiated Rate	$4,277.50
Rate for Payer: Aetna Commercial	$3,250.90
Rate for Payer: Aetna Medicare Advantage	$2,566.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,711.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,181.53
Rate for Payer: Cigna Commercial	$4,277.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,070.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,882.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,283.25
Rate for Payer: UnitedHealthcare Community & State	$206.18
Rate for Payer: Wellpoint Medicaid Managed Care	$226.71

TFNA SCREW 95MM

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270676459
Hospital Revenue Code	278
Min. Negotiated Rate	$470.45
Max. Negotiated Rate	$759.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$690.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45

TFNA SCREW 95MM

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270676459
Hospital Revenue Code	278
Min. Negotiated Rate	$75.59
Max. Negotiated Rate	$1,568.17
Rate for Payer: Aetna Commercial	$1,191.81
Rate for Payer: Aetna Medicare Advantage	$940.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$799.77
Rate for Payer: Cigna Commercial	$1,568.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$690.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45
Rate for Payer: UnitedHealthcare Community & State	$75.59
Rate for Payer: Wellpoint Medicaid Managed Care	$83.11

TFNA SCREW FENESTRATED 80MM

Facility

$8,555.00

Service Code	HCPCS C1713
Hospital Charge Code	270699643
Hospital Revenue Code	278
Min. Negotiated Rate	$206.18
Max. Negotiated Rate	$4,277.50
Rate for Payer: Aetna Commercial	$3,250.90
Rate for Payer: Aetna Medicare Advantage	$2,566.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,711.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,181.53
Rate for Payer: Cigna Commercial	$4,277.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,070.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,882.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,283.25
Rate for Payer: UnitedHealthcare Community & State	$206.18
Rate for Payer: Wellpoint Medicaid Managed Care	$226.71

TFNA SCREW FENESTRATED 80MM

Facility

$8,555.00

Service Code	HCPCS C1713
Hospital Charge Code	270699643
Hospital Revenue Code	278
Min. Negotiated Rate	$1,283.25
Max. Negotiated Rate	$2,070.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,711.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,070.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,882.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,283.25

TFNA TI 10MM/130D 340MM LT

Facility

$10,969.10

Service Code	HCPCS C1776
Hospital Charge Code	270693674
Hospital Revenue Code	278
Min. Negotiated Rate	$1,645.37
Max. Negotiated Rate	$2,654.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,193.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,654.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,413.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,645.37

TFNA TI 10MM/130D 340MM LT

Facility

$10,969.10

Service Code	HCPCS C1776
Hospital Charge Code	270693674
Hospital Revenue Code	278
Min. Negotiated Rate	$264.36
Max. Negotiated Rate	$5,484.55
Rate for Payer: Aetna Commercial	$4,168.26
Rate for Payer: Aetna Medicare Advantage	$3,290.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,797.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,797.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,193.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,797.12
Rate for Payer: Cigna Commercial	$5,484.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,654.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,413.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,645.37
Rate for Payer: UnitedHealthcare Community & State	$264.36
Rate for Payer: Wellpoint Medicaid Managed Care	$290.68

TF ULTRA 2 UBRAID & NDLS 4.5mm

Facility

$1,520.00

Hospital Charge Code	270649965
Hospital Revenue Code	272
Min. Negotiated Rate	$36.63
Max. Negotiated Rate	$760.00
Rate for Payer: Aetna Commercial	$577.60
Rate for Payer: Aetna Medicare Advantage	$456.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$387.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$387.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$387.60
Rate for Payer: Cigna Commercial	$760.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$456.00
Rate for Payer: Oxford Commercial	$304.00
Rate for Payer: Qualcare PPO/HMO/WC	$228.00
Rate for Payer: UnitedHealthcare Commercial	$304.00
Rate for Payer: UnitedHealthcare Community & State	$36.63
Rate for Payer: Wellpoint Medicaid Managed Care	$40.28

TF ULTRA 2 UBRAID & NDLS 4.5mm

Facility

$1,520.00

Hospital Charge Code	270649965
Hospital Revenue Code	272
Min. Negotiated Rate	$228.00
Max. Negotiated Rate	$228.00
Rate for Payer: Qualcare PPO/HMO/WC	$228.00

THALLIUM, 24 HOUR URINE

Facility

$152.25

Service Code	HCPCS 83018
Hospital Charge Code	3000362
Hospital Revenue Code	301
Min. Negotiated Rate	$4.03
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$59.73
Rate for Payer: Aetna Medicare Advantage	$71.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.96
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	$79.27
Rate for Payer: Cigna Commercial	$76.12
Rate for Payer: Cigna Medicare Advantage	$21.96
Rate for Payer: Clover Medicare Advantage	$20.86
Rate for Payer: EmblemHealth Commercial	$65.88
Rate for Payer: Humana Medicare Advantage	$22.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.67
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.84
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$17.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.96
Rate for Payer: Wellcare Medicare Advantage	$21.96
Rate for Payer: Wellpoint Medicaid Managed Care	$4.03

THALLIUM, 24 HOUR URINE

Facility

$152.25

Service Code	HCPCS 83018
Hospital Charge Code	3000362
Hospital Revenue Code	301
Min. Negotiated Rate	$22.84
Max. Negotiated Rate	$22.84
Rate for Payer: Qualcare PPO/HMO/WC	$22.84

THALLIUM BLOOD

Facility

$152.25

Service Code	HCPCS 83018
Hospital Charge Code	3000364
Hospital Revenue Code	301
Min. Negotiated Rate	$22.84
Max. Negotiated Rate	$22.84
Rate for Payer: Qualcare PPO/HMO/WC	$22.84

Know your out-of-pocket cost for care.

All Charges