Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TIBIAL NAIL 10MM X 30CM

Facility

$9,415.50

Hospital Charge Code	270657802
Hospital Revenue Code	278
Min. Negotiated Rate	$1,412.33
Max. Negotiated Rate	$2,278.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,883.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,278.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,071.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,412.33

TIBIAL NAIL 10X 315

Facility

$6,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270656597
Hospital Revenue Code	278
Min. Negotiated Rate	$927.00
Max. Negotiated Rate	$1,495.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,236.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,495.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,359.60
Rate for Payer: Qualcare PPO/HMO/WC	$927.00

TIBIAL NAIL 10X 315

Facility

$6,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270656597
Hospital Revenue Code	278
Min. Negotiated Rate	$148.94
Max. Negotiated Rate	$3,090.00
Rate for Payer: Aetna Commercial	$2,348.40
Rate for Payer: Aetna Medicare Advantage	$1,854.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,575.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,575.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,236.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,575.90
Rate for Payer: Cigna Commercial	$3,090.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,495.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,359.60
Rate for Payer: Qualcare PPO/HMO/WC	$927.00
Rate for Payer: UnitedHealthcare Community & State	$148.94
Rate for Payer: Wellpoint Medicaid Managed Care	$163.77

TIBIAL NAIL 8X330

Facility

$6,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270679170
Hospital Revenue Code	278
Min. Negotiated Rate	$927.00
Max. Negotiated Rate	$1,495.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,236.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,495.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,359.60
Rate for Payer: Qualcare PPO/HMO/WC	$927.00

TIBIAL NAIL 8X330

Facility

$6,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270679170
Hospital Revenue Code	278
Min. Negotiated Rate	$148.94
Max. Negotiated Rate	$3,090.00
Rate for Payer: Aetna Commercial	$2,348.40
Rate for Payer: Aetna Medicare Advantage	$1,854.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,575.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,575.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,236.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,575.90
Rate for Payer: Cigna Commercial	$3,090.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,495.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,359.60
Rate for Payer: Qualcare PPO/HMO/WC	$927.00
Rate for Payer: UnitedHealthcare Community & State	$148.94
Rate for Payer: Wellpoint Medicaid Managed Care	$163.77

TIBIAL NAIL 9MMX 300MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270683794
Hospital Revenue Code	278
Min. Negotiated Rate	$160.75
Max. Negotiated Rate	$3,335.00
Rate for Payer: Aetna Commercial	$2,534.60
Rate for Payer: Aetna Medicare Advantage	$2,001.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,700.85
Rate for Payer: Cigna Commercial	$3,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,467.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50
Rate for Payer: UnitedHealthcare Community & State	$160.75
Rate for Payer: Wellpoint Medicaid Managed Care	$176.75

TIBIAL NAIL 9MMX 300MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270683794
Hospital Revenue Code	278
Min. Negotiated Rate	$1,000.50
Max. Negotiated Rate	$1,614.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,467.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50

TIBIAL NAIL 9X320MM

Facility

$14,300.00

Hospital Charge Code	270702712
Hospital Revenue Code	278
Min. Negotiated Rate	$344.63
Max. Negotiated Rate	$7,150.00
Rate for Payer: Aetna Commercial	$5,434.00
Rate for Payer: Aetna Medicare Advantage	$4,290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,646.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,646.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,646.50
Rate for Payer: Cigna Commercial	$7,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,460.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,146.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,145.00
Rate for Payer: UnitedHealthcare Community & State	$344.63
Rate for Payer: Wellpoint Medicaid Managed Care	$378.95

TIBIAL NAIL 9X320MM

Facility

$14,300.00

Hospital Charge Code	270702712
Hospital Revenue Code	278
Min. Negotiated Rate	$2,145.00
Max. Negotiated Rate	$3,460.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,460.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,146.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,145.00

TIBIAL NAIL EXPRX BND 10X285MM

Facility

$19,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270699731
Hospital Revenue Code	278
Min. Negotiated Rate	$475.98
Max. Negotiated Rate	$9,875.00
Rate for Payer: Aetna Commercial	$7,505.00
Rate for Payer: Aetna Medicare Advantage	$5,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,036.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,036.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,036.25
Rate for Payer: Cigna Commercial	$9,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,779.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,345.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,962.50
Rate for Payer: UnitedHealthcare Community & State	$475.98
Rate for Payer: Wellpoint Medicaid Managed Care	$523.38

TIBIAL NAIL EXPRX BND 10X285MM

Facility

$19,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270699731
Hospital Revenue Code	278
Min. Negotiated Rate	$2,962.50
Max. Negotiated Rate	$4,779.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,779.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,345.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,962.50

TIBIAL NAIL STD 9x310MM

Facility

$11,980.00

Service Code	HCPCS C1713
Hospital Charge Code	270673976
Hospital Revenue Code	278
Min. Negotiated Rate	$288.72
Max. Negotiated Rate	$5,990.00
Rate for Payer: Aetna Commercial	$4,552.40
Rate for Payer: Aetna Medicare Advantage	$3,594.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,054.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,054.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,396.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,054.90
Rate for Payer: Cigna Commercial	$5,990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,899.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,635.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,797.00
Rate for Payer: UnitedHealthcare Community & State	$288.72
Rate for Payer: Wellpoint Medicaid Managed Care	$317.47

TIBIAL NAIL STD 9x310MM

Facility

$11,980.00

Service Code	HCPCS C1713
Hospital Charge Code	270673976
Hospital Revenue Code	278
Min. Negotiated Rate	$1,797.00
Max. Negotiated Rate	$2,899.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,396.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,899.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,635.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,797.00

TIBIAL NAIL TI CANNU 300 MM

Facility

$6,365.40

Service Code	HCPCS C1713
Hospital Charge Code	270686005
Hospital Revenue Code	278
Min. Negotiated Rate	$954.81
Max. Negotiated Rate	$1,540.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,273.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,540.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,400.39
Rate for Payer: Qualcare PPO/HMO/WC	$954.81

TIBIAL NAIL TI CANNU 300 MM

Facility

$6,365.40

Service Code	HCPCS C1713
Hospital Charge Code	270686005
Hospital Revenue Code	278
Min. Negotiated Rate	$153.41
Max. Negotiated Rate	$3,182.70
Rate for Payer: Aetna Commercial	$2,418.85
Rate for Payer: Aetna Medicare Advantage	$1,909.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,623.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,623.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,273.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,623.18
Rate for Payer: Cigna Commercial	$3,182.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,540.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,400.39
Rate for Payer: Qualcare PPO/HMO/WC	$954.81
Rate for Payer: UnitedHealthcare Community & State	$153.41
Rate for Payer: Wellpoint Medicaid Managed Care	$168.68

TIBIAL NAIL TI STD 10x345MM

Facility

$7,913.45

Service Code	HCPCS C1713
Hospital Charge Code	270651325
Hospital Revenue Code	278
Min. Negotiated Rate	$190.71
Max. Negotiated Rate	$3,956.72
Rate for Payer: Aetna Commercial	$3,007.11
Rate for Payer: Aetna Medicare Advantage	$2,374.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,017.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,017.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,582.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,017.93
Rate for Payer: Cigna Commercial	$3,956.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,915.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,740.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.02
Rate for Payer: UnitedHealthcare Community & State	$190.71
Rate for Payer: Wellpoint Medicaid Managed Care	$209.71

TIBIAL NAIL TI STD 10x345MM

Facility

$7,913.45

Service Code	HCPCS C1713
Hospital Charge Code	270651325
Hospital Revenue Code	278
Min. Negotiated Rate	$1,187.02
Max. Negotiated Rate	$1,915.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,582.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,915.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,740.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.02

TIBIAL PLATE NEXGEN PRECOAT

Facility

$6,156.25

Hospital Charge Code	270660844
Hospital Revenue Code	278
Min. Negotiated Rate	$923.44
Max. Negotiated Rate	$1,489.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,231.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,489.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,354.38
Rate for Payer: Qualcare PPO/HMO/WC	$923.44

TIBIAL PLATE NEXGEN PRECOAT

Facility

$6,156.25

Hospital Charge Code	270660844
Hospital Revenue Code	278
Min. Negotiated Rate	$148.37
Max. Negotiated Rate	$3,078.12
Rate for Payer: Aetna Commercial	$2,339.38
Rate for Payer: Aetna Medicare Advantage	$1,846.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,569.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,569.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,569.84
Rate for Payer: Cigna Commercial	$3,078.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,489.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,354.38
Rate for Payer: Qualcare PPO/HMO/WC	$923.44
Rate for Payer: UnitedHealthcare Community & State	$148.37
Rate for Payer: Wellpoint Medicaid Managed Care	$163.14

TIBIAL PLATE STEMMED SZ 1

Facility

$6,156.70

Hospital Charge Code	270657858
Hospital Revenue Code	278
Min. Negotiated Rate	$923.50
Max. Negotiated Rate	$1,489.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,231.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,489.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,354.47
Rate for Payer: Qualcare PPO/HMO/WC	$923.50

TIBIAL PLATE STEMMED SZ 1

Facility

$6,156.70

Hospital Charge Code	270657858
Hospital Revenue Code	278
Min. Negotiated Rate	$148.38
Max. Negotiated Rate	$3,078.35
Rate for Payer: Aetna Commercial	$2,339.55
Rate for Payer: Aetna Medicare Advantage	$1,847.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,569.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,569.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,231.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,569.96
Rate for Payer: Cigna Commercial	$3,078.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,489.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,354.47
Rate for Payer: Qualcare PPO/HMO/WC	$923.50
Rate for Payer: UnitedHealthcare Community & State	$148.38
Rate for Payer: Wellpoint Medicaid Managed Care	$163.15

TIBIAL PLATFORM COMPONENT S

Facility

$11,675.00

Hospital Charge Code	270666804
Hospital Revenue Code	278
Min. Negotiated Rate	$281.37
Max. Negotiated Rate	$5,837.50
Rate for Payer: Aetna Commercial	$4,436.50
Rate for Payer: Aetna Medicare Advantage	$3,502.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,977.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,977.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,335.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,977.12
Rate for Payer: Cigna Commercial	$5,837.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,825.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,568.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,751.25
Rate for Payer: UnitedHealthcare Community & State	$281.37
Rate for Payer: Wellpoint Medicaid Managed Care	$309.39

TIBIAL PLATFORM COMPONENT S

Facility

$11,675.00

Hospital Charge Code	270666804
Hospital Revenue Code	278
Min. Negotiated Rate	$1,751.25
Max. Negotiated Rate	$2,825.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,825.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,568.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,751.25

TIBIAL POROUS TITM CONSTRUCT

Facility

$11,060.00

Hospital Charge Code	270668334
Hospital Revenue Code	278
Min. Negotiated Rate	$266.55
Max. Negotiated Rate	$5,530.00
Rate for Payer: Aetna Commercial	$4,202.80
Rate for Payer: Aetna Medicare Advantage	$3,318.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,820.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,820.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,212.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,820.30
Rate for Payer: Cigna Commercial	$5,530.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,676.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,433.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,659.00
Rate for Payer: UnitedHealthcare Community & State	$266.55
Rate for Payer: Wellpoint Medicaid Managed Care	$293.09

TIBIAL POROUS TITM CONSTRUCT

Facility

$11,060.00

Hospital Charge Code	270668334
Hospital Revenue Code	278
Min. Negotiated Rate	$1,659.00
Max. Negotiated Rate	$2,676.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,212.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,676.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,433.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,659.00

Know your out-of-pocket cost for care.

All Charges