Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

WEDGE ALLOGRAFT LAPIDUS 5MM 5D

Facility

$14,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270699356
Hospital Revenue Code	278
Min. Negotiated Rate	$355.48
Max. Negotiated Rate	$7,375.00
Rate for Payer: Aetna Commercial	$5,605.00
Rate for Payer: Aetna Medicare Advantage	$4,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,761.25
Rate for Payer: Cigna Commercial	$7,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,569.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,245.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,212.50
Rate for Payer: UnitedHealthcare Community & State	$355.48
Rate for Payer: Wellpoint Medicaid Managed Care	$390.88

WEDGE ANGLE 45DEG 7X24X7

Facility

$785.00

Hospital Charge Code	270646188
Hospital Revenue Code	272
Min. Negotiated Rate	$18.92
Max. Negotiated Rate	$392.50
Rate for Payer: Aetna Commercial	$298.30
Rate for Payer: Aetna Medicare Advantage	$235.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.18
Rate for Payer: Cigna Commercial	$392.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.50
Rate for Payer: Oxford Commercial	$157.00
Rate for Payer: Qualcare PPO/HMO/WC	$117.75
Rate for Payer: UnitedHealthcare Commercial	$157.00
Rate for Payer: UnitedHealthcare Community & State	$18.92
Rate for Payer: Wellpoint Medicaid Managed Care	$20.80

WEDGE ANGLE 45DEG 7X24X7

Facility

$785.00

Hospital Charge Code	270646188
Hospital Revenue Code	272
Min. Negotiated Rate	$117.75
Max. Negotiated Rate	$117.75
Rate for Payer: Qualcare PPO/HMO/WC	$117.75

WEDGE AVITRAC MTP CORE 11 MM

Facility

$6,632.50

Hospital Charge Code	270701752
Hospital Revenue Code	278
Min. Negotiated Rate	$994.88
Max. Negotiated Rate	$1,605.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,326.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,605.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,459.15
Rate for Payer: Qualcare PPO/HMO/WC	$994.88

WEDGE AVITRAC MTP CORE 11 MM

Facility

$6,632.50

Hospital Charge Code	270701752
Hospital Revenue Code	278
Min. Negotiated Rate	$159.84
Max. Negotiated Rate	$3,316.25
Rate for Payer: Aetna Commercial	$2,520.35
Rate for Payer: Aetna Medicare Advantage	$1,989.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,691.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,691.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,326.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,691.29
Rate for Payer: Cigna Commercial	$3,316.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,605.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,459.15
Rate for Payer: Qualcare PPO/HMO/WC	$994.88
Rate for Payer: UnitedHealthcare Community & State	$159.84
Rate for Payer: Wellpoint Medicaid Managed Care	$175.76

WEDGE AVITRAC MTP CORE 13 MM

Facility

$6,632.50

Hospital Charge Code	270701751
Hospital Revenue Code	278
Min. Negotiated Rate	$994.88
Max. Negotiated Rate	$1,605.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,326.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,605.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,459.15
Rate for Payer: Qualcare PPO/HMO/WC	$994.88

WEDGE AVITRAC MTP CORE 13 MM

Facility

$6,632.50

Hospital Charge Code	270701751
Hospital Revenue Code	278
Min. Negotiated Rate	$159.84
Max. Negotiated Rate	$3,316.25
Rate for Payer: Aetna Commercial	$2,520.35
Rate for Payer: Aetna Medicare Advantage	$1,989.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,691.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,691.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,326.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,691.29
Rate for Payer: Cigna Commercial	$3,316.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,605.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,459.15
Rate for Payer: Qualcare PPO/HMO/WC	$994.88
Rate for Payer: UnitedHealthcare Community & State	$159.84
Rate for Payer: Wellpoint Medicaid Managed Care	$175.76

WEDGE BIOCORTICAL COTTON 6MM

Facility

$7,155.00

Service Code	HCPCS C1713
Hospital Charge Code	270684863
Hospital Revenue Code	278
Min. Negotiated Rate	$1,073.25
Max. Negotiated Rate	$1,731.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,431.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,731.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,574.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,073.25

WEDGE BIOCORTICAL COTTON 6MM

Facility

$7,155.00

Service Code	HCPCS C1713
Hospital Charge Code	270684863
Hospital Revenue Code	278
Min. Negotiated Rate	$172.44
Max. Negotiated Rate	$3,577.50
Rate for Payer: Aetna Commercial	$2,718.90
Rate for Payer: Aetna Medicare Advantage	$2,146.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,824.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,824.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,431.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,824.53
Rate for Payer: Cigna Commercial	$3,577.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,731.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,574.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,073.25
Rate for Payer: UnitedHealthcare Community & State	$172.44
Rate for Payer: Wellpoint Medicaid Managed Care	$189.61

WEDGE BIOCORTICAL EVANS 8MM

Facility

$8,745.00

Service Code	HCPCS C1713
Hospital Charge Code	270684862
Hospital Revenue Code	278
Min. Negotiated Rate	$1,311.75
Max. Negotiated Rate	$2,116.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,749.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,116.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,923.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,311.75

WEDGE BIOCORTICAL EVANS 8MM

Facility

$8,745.00

Service Code	HCPCS C1713
Hospital Charge Code	270684862
Hospital Revenue Code	278
Min. Negotiated Rate	$210.75
Max. Negotiated Rate	$4,372.50
Rate for Payer: Aetna Commercial	$3,323.10
Rate for Payer: Aetna Medicare Advantage	$2,623.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,229.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,229.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,749.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,229.97
Rate for Payer: Cigna Commercial	$4,372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,116.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,923.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,311.75
Rate for Payer: UnitedHealthcare Community & State	$210.75
Rate for Payer: Wellpoint Medicaid Managed Care	$231.74

WEDGE BIOFOAM 16X4.5MM

Facility

$11,795.00

Service Code	HCPCS C1713
Hospital Charge Code	270700553
Hospital Revenue Code	278
Min. Negotiated Rate	$284.26
Max. Negotiated Rate	$5,897.50
Rate for Payer: Aetna Commercial	$4,482.10
Rate for Payer: Aetna Medicare Advantage	$3,538.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,007.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,007.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,007.72
Rate for Payer: Cigna Commercial	$5,897.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,854.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,594.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,769.25
Rate for Payer: UnitedHealthcare Community & State	$284.26
Rate for Payer: Wellpoint Medicaid Managed Care	$312.57

WEDGE BIOFOAM 16X4.5MM

Facility

$11,795.00

Service Code	HCPCS C1713
Hospital Charge Code	270700553
Hospital Revenue Code	278
Min. Negotiated Rate	$1,769.25
Max. Negotiated Rate	$2,854.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,854.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,594.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,769.25

WEDGE BIOSYNC 18X18X8MM

Facility

$10,975.00

Service Code	HCPCS C1776
Hospital Charge Code	270693396
Hospital Revenue Code	278
Min. Negotiated Rate	$264.50
Max. Negotiated Rate	$5,487.50
Rate for Payer: Aetna Commercial	$4,170.50
Rate for Payer: Aetna Medicare Advantage	$3,292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,798.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,798.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,798.62
Rate for Payer: Cigna Commercial	$5,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,655.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,414.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,646.25
Rate for Payer: UnitedHealthcare Community & State	$264.50
Rate for Payer: Wellpoint Medicaid Managed Care	$290.84

WEDGE BIOSYNC 18X18X8MM

Facility

$10,975.00

Service Code	HCPCS C1776
Hospital Charge Code	270693396
Hospital Revenue Code	278
Min. Negotiated Rate	$1,646.25
Max. Negotiated Rate	$2,655.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,655.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,414.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,646.25

WEDGE BIOSYNC 20X 5.5MM

Facility

$9,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270690273
Hospital Revenue Code	278
Min. Negotiated Rate	$240.40
Max. Negotiated Rate	$4,987.50
Rate for Payer: Aetna Commercial	$3,790.50
Rate for Payer: Aetna Medicare Advantage	$2,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,543.62
Rate for Payer: Cigna Commercial	$4,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,194.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25
Rate for Payer: UnitedHealthcare Community & State	$240.40
Rate for Payer: Wellpoint Medicaid Managed Care	$264.34

WEDGE BIOSYNC 20X 5.5MM

Facility

$9,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270690273
Hospital Revenue Code	278
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$2,413.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,194.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

WEDGE BIOSYNC SET

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270687871
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

WEDGE BIOSYNC SET

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270687871
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

WEDGE BONE TANGNT 10X26 171026

Facility

$6,834.45

Hospital Charge Code	270618697
Hospital Revenue Code	278
Min. Negotiated Rate	$164.71
Max. Negotiated Rate	$3,417.22
Rate for Payer: Aetna Commercial	$2,597.09
Rate for Payer: Aetna Medicare Advantage	$2,050.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,742.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,742.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,366.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,742.78
Rate for Payer: Cigna Commercial	$3,417.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,653.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,503.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,025.17
Rate for Payer: UnitedHealthcare Community & State	$164.71
Rate for Payer: Wellpoint Medicaid Managed Care	$181.11

WEDGE BONE TANGNT 10X26 171026

Facility

$6,834.45

Hospital Charge Code	270618697
Hospital Revenue Code	278
Min. Negotiated Rate	$1,025.17
Max. Negotiated Rate	$1,653.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,366.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,653.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,503.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,025.17

WEDGE BONE TANGNT 8X20 170820

Facility

$6,834.45

Hospital Charge Code	270618696
Hospital Revenue Code	278
Min. Negotiated Rate	$164.71
Max. Negotiated Rate	$3,417.22
Rate for Payer: Aetna Commercial	$2,597.09
Rate for Payer: Aetna Medicare Advantage	$2,050.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,742.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,742.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,366.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,742.78
Rate for Payer: Cigna Commercial	$3,417.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,653.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,503.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,025.17
Rate for Payer: UnitedHealthcare Community & State	$164.71
Rate for Payer: Wellpoint Medicaid Managed Care	$181.11

WEDGE BONE TANGNT 8X20 170820

Facility

$6,834.45

Hospital Charge Code	270618696
Hospital Revenue Code	278
Min. Negotiated Rate	$1,025.17
Max. Negotiated Rate	$1,653.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,366.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,653.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,503.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,025.17

WEDGE CANCELLOUS BONE 206002

Facility

$5,456.00

Hospital Charge Code	270630021
Hospital Revenue Code	278
Min. Negotiated Rate	$818.40
Max. Negotiated Rate	$1,320.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,091.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,320.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,200.32
Rate for Payer: Qualcare PPO/HMO/WC	$818.40

WEDGE CANCELLOUS BONE 206002

Facility

$5,456.00

Hospital Charge Code	270630021
Hospital Revenue Code	278
Min. Negotiated Rate	$131.49
Max. Negotiated Rate	$2,728.00
Rate for Payer: Aetna Commercial	$2,073.28
Rate for Payer: Aetna Medicare Advantage	$1,636.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,391.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,391.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,091.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,391.28
Rate for Payer: Cigna Commercial	$2,728.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,320.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,200.32
Rate for Payer: Qualcare PPO/HMO/WC	$818.40
Rate for Payer: UnitedHealthcare Community & State	$131.49
Rate for Payer: Wellpoint Medicaid Managed Care	$144.58

Know your out-of-pocket cost for care.

All Charges