Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

WEDGE EVANS PURP 18x18MM 8MM

Facility

$8,905.00

Service Code	HCPCS C1713
Hospital Charge Code	270675133
Hospital Revenue Code	278
Min. Negotiated Rate	$1,335.75
Max. Negotiated Rate	$2,155.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,781.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,155.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,959.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,335.75

WEDGE FEMORAL DISTAL 3 X 5MM

Facility

$60.00

Service Code	HCPCS C1713
Hospital Charge Code	270687753
Hospital Revenue Code	278
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$14.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

WEDGE FEMORAL DISTAL 3 X 5MM

Facility

$60.00

Service Code	HCPCS C1713
Hospital Charge Code	270687753
Hospital Revenue Code	278
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Community & State	$1.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

WEDGE FIBULAR 6MM 500418

Facility

$1,900.00

Hospital Charge Code	270616214
Hospital Revenue Code	278
Min. Negotiated Rate	$45.79
Max. Negotiated Rate	$950.00
Rate for Payer: Aetna Commercial	$722.00
Rate for Payer: Aetna Medicare Advantage	$570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$484.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$484.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$380.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$484.50
Rate for Payer: Cigna Commercial	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$418.00
Rate for Payer: Qualcare PPO/HMO/WC	$285.00
Rate for Payer: UnitedHealthcare Community & State	$45.79
Rate for Payer: Wellpoint Medicaid Managed Care	$50.35

WEDGE FIBULAR 6MM 500418

Facility

$1,900.00

Hospital Charge Code	270616214
Hospital Revenue Code	278
Min. Negotiated Rate	$285.00
Max. Negotiated Rate	$459.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$380.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$418.00
Rate for Payer: Qualcare PPO/HMO/WC	$285.00

WEDGE GRAFT LAPIDUS 8X8X10MM

Facility

$10,312.50

Service Code	HCPCS C1713
Hospital Charge Code	270700161
Hospital Revenue Code	278
Min. Negotiated Rate	$248.53
Max. Negotiated Rate	$5,156.25
Rate for Payer: Aetna Commercial	$3,918.75
Rate for Payer: Aetna Medicare Advantage	$3,093.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,629.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,629.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,062.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,629.69
Rate for Payer: Cigna Commercial	$5,156.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,495.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,268.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,546.88
Rate for Payer: UnitedHealthcare Community & State	$248.53
Rate for Payer: Wellpoint Medicaid Managed Care	$273.28

WEDGE GRAFT LAPIDUS 8X8X10MM

Facility

$10,312.50

Service Code	HCPCS C1713
Hospital Charge Code	270700161
Hospital Revenue Code	278
Min. Negotiated Rate	$1,546.88
Max. Negotiated Rate	$2,495.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,495.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,268.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,546.88

WEDGE ILIAC CREST 12X6

Facility

$3,532.50

Service Code	HCPCS C1776
Hospital Charge Code	270686434
Hospital Revenue Code	278
Min. Negotiated Rate	$529.88
Max. Negotiated Rate	$854.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$706.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$854.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$777.15
Rate for Payer: Qualcare PPO/HMO/WC	$529.88

WEDGE ILIAC CREST 12X6

Facility

$3,532.50

Service Code	HCPCS C1776
Hospital Charge Code	270686434
Hospital Revenue Code	278
Min. Negotiated Rate	$85.13
Max. Negotiated Rate	$1,766.25
Rate for Payer: Aetna Commercial	$1,342.35
Rate for Payer: Aetna Medicare Advantage	$1,059.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$900.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$900.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$706.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$900.79
Rate for Payer: Cigna Commercial	$1,766.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$854.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$777.15
Rate for Payer: Qualcare PPO/HMO/WC	$529.88
Rate for Payer: UnitedHealthcare Community & State	$85.13
Rate for Payer: Wellpoint Medicaid Managed Care	$93.61

WEDGE OSFERION 7MMX30 MMX12 MM

Facility

$2,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270691442
Hospital Revenue Code	278
Min. Negotiated Rate	$58.44
Max. Negotiated Rate	$1,212.50
Rate for Payer: Aetna Commercial	$921.50
Rate for Payer: Aetna Medicare Advantage	$727.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$618.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$618.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$618.38
Rate for Payer: Cigna Commercial	$1,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$586.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$533.50
Rate for Payer: Qualcare PPO/HMO/WC	$363.75
Rate for Payer: UnitedHealthcare Community & State	$58.44
Rate for Payer: Wellpoint Medicaid Managed Care	$64.26

WEDGE OSFERION 7MMX30 MMX12 MM

Facility

$2,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270691442
Hospital Revenue Code	278
Min. Negotiated Rate	$363.75
Max. Negotiated Rate	$586.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$586.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$533.50
Rate for Payer: Qualcare PPO/HMO/WC	$363.75

WEDGE OSFERION OSTEOTOMY 10MM

Facility

$2,475.00

Service Code	HCPCS C1776
Hospital Charge Code	270675921
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

WEDGE OSFERION OSTEOTOMY 10MM

Facility

$2,475.00

Service Code	HCPCS C1776
Hospital Charge Code	270675921
Hospital Revenue Code	278
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

WEDGE OSTEHON OSTEOTOMY

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270683945
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

WEDGE OSTEHON OSTEOTOMY

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270683945
Hospital Revenue Code	278
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

WEDGE PILLOW LRG DISPOSABLE

Facility

$160.00

Hospital Charge Code	270666211
Hospital Revenue Code	270
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

WEDGE PILLOW LRG DISPOSABLE

Facility

$160.00

Hospital Charge Code	270666211
Hospital Revenue Code	270
Min. Negotiated Rate	$3.86
Max. Negotiated Rate	$80.00
Rate for Payer: Aetna Commercial	$60.80
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.00
Rate for Payer: Oxford Commercial	$32.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$32.00
Rate for Payer: UnitedHealthcare Community & State	$3.86
Rate for Payer: Wellpoint Medicaid Managed Care	$4.24

WEDGE PLATE 3MM LEFT

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270687965
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

WEDGE PLATE 3MM LEFT

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270687965
Hospital Revenue Code	278
Min. Negotiated Rate	$95.80
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,510.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$596.25
Rate for Payer: UnitedHealthcare Community & State	$95.80
Rate for Payer: Wellpoint Medicaid Managed Care	$105.34

WEDGE PLATE 5MM SPACER STER

Facility

$4,005.00

Hospital Charge Code	270676153
Hospital Revenue Code	278
Min. Negotiated Rate	$96.52
Max. Negotiated Rate	$2,002.50
Rate for Payer: Aetna Commercial	$1,521.90
Rate for Payer: Aetna Medicare Advantage	$1,201.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,021.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,021.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$801.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,021.27
Rate for Payer: Cigna Commercial	$2,002.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$969.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$881.10
Rate for Payer: Qualcare PPO/HMO/WC	$600.75
Rate for Payer: UnitedHealthcare Community & State	$96.52
Rate for Payer: Wellpoint Medicaid Managed Care	$106.13

WEDGE PLATE 5MM SPACER STER

Facility

$4,005.00

Hospital Charge Code	270676153
Hospital Revenue Code	278
Min. Negotiated Rate	$600.75
Max. Negotiated Rate	$969.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$801.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$969.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$881.10
Rate for Payer: Qualcare PPO/HMO/WC	$600.75

WEDGE RESECT OF LUNG INITIAL

Facility

$36,520.38

Service Code	HCPCS 32505
Hospital Charge Code	160000366
Hospital Revenue Code	360
Min. Negotiated Rate	$5,478.06
Max. Negotiated Rate	$5,478.06
Rate for Payer: Qualcare PPO/HMO/WC	$5,478.06

WEDGE RESECT OF LUNG INITIAL

Facility

$36,520.38

Service Code	HCPCS 32505
Hospital Charge Code	160000366
Hospital Revenue Code	360
Min. Negotiated Rate	$880.14
Max. Negotiated Rate	$18,260.19
Rate for Payer: Aetna Commercial	$13,877.74
Rate for Payer: Aetna Medicare Advantage	$10,956.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,312.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,312.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,312.70
Rate for Payer: Cigna Commercial	$18,260.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,956.11
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,478.06
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$880.14
Rate for Payer: Wellpoint Medicaid Managed Care	$967.79

WEDGE SCREW UNIVERSAL 9x20MM

Facility

$955.00

Service Code	HCPCS C1713
Hospital Charge Code	270675670
Hospital Revenue Code	278
Min. Negotiated Rate	$23.02
Max. Negotiated Rate	$477.50
Rate for Payer: Aetna Commercial	$362.90
Rate for Payer: Aetna Medicare Advantage	$286.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$243.53
Rate for Payer: Cigna Commercial	$477.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$210.10
Rate for Payer: Qualcare PPO/HMO/WC	$143.25
Rate for Payer: UnitedHealthcare Community & State	$23.02
Rate for Payer: Wellpoint Medicaid Managed Care	$25.31

WEDGE SCREW UNIVERSAL 9x20MM

Facility

$955.00

Service Code	HCPCS C1713
Hospital Charge Code	270675670
Hospital Revenue Code	278
Min. Negotiated Rate	$143.25
Max. Negotiated Rate	$231.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$210.10
Rate for Payer: Qualcare PPO/HMO/WC	$143.25

Know your out-of-pocket cost for care.

All Charges