Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TROCAR XCEL BLADELESS 5-11mm

Facility

$115.00

Hospital Charge Code	270635613
Hospital Revenue Code	272
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$17.25
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

TROCAR XCEL BLADELESS 5-12mm

Facility

$145.00

Hospital Charge Code	270647919
Hospital Revenue Code	272
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$21.75
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

TROCAR XCEL BLADELESS 5-12mm

Facility

$145.00

Hospital Charge Code	270647919
Hospital Revenue Code	272
Min. Negotiated Rate	$3.49
Max. Negotiated Rate	$72.50
Rate for Payer: Aetna Commercial	$55.10
Rate for Payer: Aetna Medicare Advantage	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.98
Rate for Payer: Cigna Commercial	$72.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.50
Rate for Payer: Oxford Commercial	$29.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.75
Rate for Payer: UnitedHealthcare Commercial	$29.00
Rate for Payer: UnitedHealthcare Community & State	$3.49
Rate for Payer: Wellpoint Medicaid Managed Care	$3.84

TROCAR XCEL BLADELESS 5x150MM

Facility

$125.00

Hospital Charge Code	270665377
Hospital Revenue Code	272
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$25.00
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

TROCAR XCEL BLADELESS 5x150MM

Facility

$125.00

Hospital Charge Code	270665377
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

TROCAR Z THREAD 12X100 CANNULA

Facility

$125.00

Hospital Charge Code	270662257
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

TROCAR Z THREAD 12X100 CANNULA

Facility

$125.00

Hospital Charge Code	270662257
Hospital Revenue Code	272
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$25.00
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

TROCAR Z THREAD 12X100 NON

Facility

$1,678.60

Hospital Charge Code	270662255
Hospital Revenue Code	270
Min. Negotiated Rate	$251.79
Max. Negotiated Rate	$251.79
Rate for Payer: Qualcare PPO/HMO/WC	$251.79

TROCAR Z THREAD 12X100 NON

Facility

$1,678.60

Hospital Charge Code	270662255
Hospital Revenue Code	270
Min. Negotiated Rate	$40.45
Max. Negotiated Rate	$839.30
Rate for Payer: Aetna Commercial	$637.87
Rate for Payer: Aetna Medicare Advantage	$503.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$428.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$428.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$428.04
Rate for Payer: Cigna Commercial	$839.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$503.58
Rate for Payer: Oxford Commercial	$335.72
Rate for Payer: Qualcare PPO/HMO/WC	$251.79
Rate for Payer: UnitedHealthcare Commercial	$335.72
Rate for Payer: UnitedHealthcare Community & State	$40.45
Rate for Payer: Wellpoint Medicaid Managed Care	$44.48

TROCHANTER HOOK COCR MEDIUM

Facility

$3,910.00

Service Code	HCPCS C1776
Hospital Charge Code	270611650
Hospital Revenue Code	278
Min. Negotiated Rate	$94.23
Max. Negotiated Rate	$1,955.00
Rate for Payer: Aetna Commercial	$1,485.80
Rate for Payer: Aetna Medicare Advantage	$1,173.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$997.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$997.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$782.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$997.05
Rate for Payer: Cigna Commercial	$1,955.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$946.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$860.20
Rate for Payer: Qualcare PPO/HMO/WC	$586.50
Rate for Payer: UnitedHealthcare Community & State	$94.23
Rate for Payer: Wellpoint Medicaid Managed Care	$103.61

TROCHANTER HOOK COCR MEDIUM

Facility

$3,910.00

Service Code	HCPCS C1776
Hospital Charge Code	270611650
Hospital Revenue Code	278
Min. Negotiated Rate	$586.50
Max. Negotiated Rate	$946.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$782.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$946.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$860.20
Rate for Payer: Qualcare PPO/HMO/WC	$586.50

TROCHANTERIC GRIP LG 2MM CABLE

Facility

$10,020.00

Service Code	HCPCS C1713
Hospital Charge Code	270675953
Hospital Revenue Code	278
Min. Negotiated Rate	$241.48
Max. Negotiated Rate	$5,010.00
Rate for Payer: Aetna Commercial	$3,807.60
Rate for Payer: Aetna Medicare Advantage	$3,006.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,555.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,555.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,004.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,555.10
Rate for Payer: Cigna Commercial	$5,010.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,424.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,204.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,503.00
Rate for Payer: UnitedHealthcare Community & State	$241.48
Rate for Payer: Wellpoint Medicaid Managed Care	$265.53

TROCHANTERIC GRIP LG 2MM CABLE

Facility

$10,020.00

Service Code	HCPCS C1713
Hospital Charge Code	270675953
Hospital Revenue Code	278
Min. Negotiated Rate	$1,503.00
Max. Negotiated Rate	$2,424.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,004.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,424.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,204.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,503.00

TROCHANTERIC MED GRIP W/2 CBL

Facility

$16,038.00

Hospital Charge Code	270670722
Hospital Revenue Code	272
Min. Negotiated Rate	$386.52
Max. Negotiated Rate	$8,019.00
Rate for Payer: Aetna Commercial	$6,094.44
Rate for Payer: Aetna Medicare Advantage	$4,811.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,089.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,089.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,089.69
Rate for Payer: Cigna Commercial	$8,019.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,811.40
Rate for Payer: Oxford Commercial	$3,207.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,405.70
Rate for Payer: UnitedHealthcare Commercial	$3,207.60
Rate for Payer: UnitedHealthcare Community & State	$386.52
Rate for Payer: Wellpoint Medicaid Managed Care	$425.01

TROCHANTERIC MED GRIP W/2 CBL

Facility

$16,038.00

Hospital Charge Code	270670722
Hospital Revenue Code	272
Min. Negotiated Rate	$2,405.70
Max. Negotiated Rate	$2,405.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,405.70

TROCHANTERIC NAIL 10X170MM 125

Facility

$11,735.00

Service Code	HCPCS 11735
Hospital Charge Code	270705029
Hospital Revenue Code	278
Min. Negotiated Rate	$282.81
Max. Negotiated Rate	$5,867.50
Rate for Payer: Aetna Commercial	$4,459.30
Rate for Payer: Aetna Medicare Advantage	$3,520.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,992.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,992.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,347.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,992.43
Rate for Payer: Cigna Commercial	$5,867.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,839.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,581.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,760.25
Rate for Payer: UnitedHealthcare Community & State	$282.81
Rate for Payer: Wellpoint Medicaid Managed Care	$310.98

TROCHANTERIC NAIL 10X170MM 125

Facility

$11,735.00

Service Code	HCPCS 11735
Hospital Charge Code	270705029
Hospital Revenue Code	278
Min. Negotiated Rate	$1,760.25
Max. Negotiated Rate	$2,839.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,347.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,839.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,581.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,760.25

TROCHANTERIC REATTACH DEV LNG

Facility

$11,893.40

Service Code	HCPCS C1713
Hospital Charge Code	270674368
Hospital Revenue Code	278
Min. Negotiated Rate	$286.63
Max. Negotiated Rate	$5,946.70
Rate for Payer: Aetna Commercial	$4,519.49
Rate for Payer: Aetna Medicare Advantage	$3,568.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,032.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,032.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,378.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,032.82
Rate for Payer: Cigna Commercial	$5,946.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,878.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,616.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,784.01
Rate for Payer: UnitedHealthcare Community & State	$286.63
Rate for Payer: Wellpoint Medicaid Managed Care	$315.18

TROCHANTERIC REATTACH DEV LNG

Facility

$11,893.40

Service Code	HCPCS C1713
Hospital Charge Code	270674368
Hospital Revenue Code	278
Min. Negotiated Rate	$1,784.01
Max. Negotiated Rate	$2,878.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,378.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,878.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,616.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,784.01

TROCHANTERIC REATTACH DEV STD

Facility

$8,253.40

Service Code	HCPCS C1713
Hospital Charge Code	270674358
Hospital Revenue Code	278
Min. Negotiated Rate	$198.91
Max. Negotiated Rate	$4,126.70
Rate for Payer: Aetna Commercial	$3,136.29
Rate for Payer: Aetna Medicare Advantage	$2,476.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,104.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,104.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,104.62
Rate for Payer: Cigna Commercial	$4,126.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,997.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,815.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,238.01
Rate for Payer: UnitedHealthcare Community & State	$198.91
Rate for Payer: Wellpoint Medicaid Managed Care	$218.72

TROCHANTERIC REATTACH DEV STD

Facility

$8,253.40

Service Code	HCPCS C1713
Hospital Charge Code	270674358
Hospital Revenue Code	278
Min. Negotiated Rate	$1,238.01
Max. Negotiated Rate	$1,997.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,997.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,815.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,238.01

TROCH FIT NAIL

Facility

$5,574.00

Service Code	HCPCS C1713
Hospital Charge Code	270656702
Hospital Revenue Code	278
Min. Negotiated Rate	$836.10
Max. Negotiated Rate	$1,348.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,114.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,348.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,226.28
Rate for Payer: Qualcare PPO/HMO/WC	$836.10

TROCH FIT NAIL

Facility

$5,574.00

Service Code	HCPCS C1713
Hospital Charge Code	270656702
Hospital Revenue Code	278
Min. Negotiated Rate	$134.33
Max. Negotiated Rate	$2,787.00
Rate for Payer: Aetna Commercial	$2,118.12
Rate for Payer: Aetna Medicare Advantage	$1,672.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,421.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,421.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,114.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,421.37
Rate for Payer: Cigna Commercial	$2,787.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,348.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,226.28
Rate for Payer: Qualcare PPO/HMO/WC	$836.10
Rate for Payer: UnitedHealthcare Community & State	$134.33
Rate for Payer: Wellpoint Medicaid Managed Care	$147.71

TROCH GRIP PLATE 100MM

Facility

$8,019.00

Service Code	HCPCS C1713
Hospital Charge Code	270669263
Hospital Revenue Code	278
Min. Negotiated Rate	$193.26
Max. Negotiated Rate	$4,009.50
Rate for Payer: Aetna Commercial	$3,047.22
Rate for Payer: Aetna Medicare Advantage	$2,405.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,044.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,044.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,603.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,044.85
Rate for Payer: Cigna Commercial	$4,009.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,940.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,764.18
Rate for Payer: Qualcare PPO/HMO/WC	$1,202.85
Rate for Payer: UnitedHealthcare Community & State	$193.26
Rate for Payer: Wellpoint Medicaid Managed Care	$212.50

TROCH GRIP PLATE 100MM

Facility

$8,019.00

Service Code	HCPCS C1713
Hospital Charge Code	270669263
Hospital Revenue Code	278
Min. Negotiated Rate	$1,202.85
Max. Negotiated Rate	$1,940.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,603.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,940.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,764.18
Rate for Payer: Qualcare PPO/HMO/WC	$1,202.85

Know your out-of-pocket cost for care.

All Charges