Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

11 MM DRILL BIT 4MM STP

Facility

$795.00

Hospital Charge Code	270656599
Hospital Revenue Code	272
Min. Negotiated Rate	$19.16
Max. Negotiated Rate	$397.50
Rate for Payer: Aetna Commercial	$302.10
Rate for Payer: Aetna Medicare Advantage	$238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$202.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$202.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$202.72
Rate for Payer: Cigna Commercial	$397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.50
Rate for Payer: Oxford Commercial	$159.00
Rate for Payer: Qualcare PPO/HMO/WC	$119.25
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$19.16
Rate for Payer: Wellpoint Medicaid Managed Care	$21.07

11 MM FEMORAL NAIL

Facility

$7,054.45

Service Code	HCPCS C1713
Hospital Charge Code	270678564
Hospital Revenue Code	278
Min. Negotiated Rate	$170.01
Max. Negotiated Rate	$3,527.22
Rate for Payer: Aetna Commercial	$2,680.69
Rate for Payer: Aetna Medicare Advantage	$2,116.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,798.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,798.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,798.88
Rate for Payer: Cigna Commercial	$3,527.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,707.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,551.98
Rate for Payer: Qualcare PPO/HMO/WC	$1,058.17
Rate for Payer: UnitedHealthcare Community & State	$170.01
Rate for Payer: Wellpoint Medicaid Managed Care	$186.94

11 MM FEMORAL NAIL

Facility

$7,054.45

Service Code	HCPCS C1713
Hospital Charge Code	270678564
Hospital Revenue Code	278
Min. Negotiated Rate	$1,058.17
Max. Negotiated Rate	$1,707.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,707.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,551.98
Rate for Payer: Qualcare PPO/HMO/WC	$1,058.17

1.1 MM GUIDE WIRE/ 150MM LENGT

Facility

$936.00

Service Code	HCPCS C1713
Hospital Charge Code	270688651
Hospital Revenue Code	278
Min. Negotiated Rate	$140.40
Max. Negotiated Rate	$226.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$205.92
Rate for Payer: Qualcare PPO/HMO/WC	$140.40

1.1 MM GUIDE WIRE/ 150MM LENGT

Facility

$936.00

Service Code	HCPCS C1713
Hospital Charge Code	270688651
Hospital Revenue Code	278
Min. Negotiated Rate	$22.56
Max. Negotiated Rate	$468.00
Rate for Payer: Aetna Commercial	$355.68
Rate for Payer: Aetna Medicare Advantage	$280.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.68
Rate for Payer: Cigna Commercial	$468.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$205.92
Rate for Payer: Qualcare PPO/HMO/WC	$140.40
Rate for Payer: UnitedHealthcare Community & State	$22.56
Rate for Payer: Wellpoint Medicaid Managed Care	$24.80

1.1MM NON-THREADED GUIDE WIRE

Facility

$122.20

Service Code	HCPCS C1769
Hospital Charge Code	270661769
Hospital Revenue Code	278
Min. Negotiated Rate	$18.33
Max. Negotiated Rate	$29.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.88
Rate for Payer: Qualcare PPO/HMO/WC	$18.33

1.1MM NON-THREADED GUIDE WIRE

Facility

$122.20

Service Code	HCPCS C1769
Hospital Charge Code	270661769
Hospital Revenue Code	278
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$61.10
Rate for Payer: Aetna Commercial	$46.44
Rate for Payer: Aetna Medicare Advantage	$36.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.16
Rate for Payer: Cigna Commercial	$61.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.88
Rate for Payer: Qualcare PPO/HMO/WC	$18.33
Rate for Payer: UnitedHealthcare Community & State	$2.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.24

11MM POLY PLUG

Facility

$376.65

Hospital Charge Code	270656844
Hospital Revenue Code	278
Min. Negotiated Rate	$9.08
Max. Negotiated Rate	$188.32
Rate for Payer: Aetna Commercial	$143.13
Rate for Payer: Aetna Medicare Advantage	$113.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.05
Rate for Payer: Cigna Commercial	$188.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.86
Rate for Payer: Qualcare PPO/HMO/WC	$56.50
Rate for Payer: UnitedHealthcare Community & State	$9.08
Rate for Payer: Wellpoint Medicaid Managed Care	$9.98

11MM POLY PLUG

Facility

$376.65

Hospital Charge Code	270656844
Hospital Revenue Code	278
Min. Negotiated Rate	$56.50
Max. Negotiated Rate	$91.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.86
Rate for Payer: Qualcare PPO/HMO/WC	$56.50

1.1MM THREADED GUIDE WIRE 110M

Facility

$129.70

Service Code	HCPCS C1769
Hospital Charge Code	270663959
Hospital Revenue Code	278
Min. Negotiated Rate	$19.45
Max. Negotiated Rate	$31.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$28.53
Rate for Payer: Qualcare PPO/HMO/WC	$19.45

1.1MM THREADED GUIDE WIRE 110M

Facility

$129.70

Service Code	HCPCS C1769
Hospital Charge Code	270663959
Hospital Revenue Code	278
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$64.85
Rate for Payer: Aetna Commercial	$49.29
Rate for Payer: Aetna Medicare Advantage	$38.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.07
Rate for Payer: Cigna Commercial	$64.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$28.53
Rate for Payer: Qualcare PPO/HMO/WC	$19.45
Rate for Payer: UnitedHealthcare Community & State	$3.13
Rate for Payer: Wellpoint Medicaid Managed Care	$3.44

1.1 TEMP.FIXATION PIN

Facility

$530.00

Service Code	HCPCS C1713
Hospital Charge Code	270656773
Hospital Revenue Code	278
Min. Negotiated Rate	$79.50
Max. Negotiated Rate	$128.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.60
Rate for Payer: Qualcare PPO/HMO/WC	$79.50

1.1 TEMP.FIXATION PIN

Facility

$530.00

Service Code	HCPCS C1713
Hospital Charge Code	270656773
Hospital Revenue Code	278
Min. Negotiated Rate	$12.77
Max. Negotiated Rate	$265.00
Rate for Payer: Aetna Commercial	$201.40
Rate for Payer: Aetna Medicare Advantage	$159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.15
Rate for Payer: Cigna Commercial	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.60
Rate for Payer: Qualcare PPO/HMO/WC	$79.50
Rate for Payer: UnitedHealthcare Community & State	$12.77
Rate for Payer: Wellpoint Medicaid Managed Care	$14.04

11X38X28MM ALIF SPACER 10DEG

Facility

$33,125.00

Service Code	HCPCS C1889
Hospital Charge Code	270703770
Hospital Revenue Code	278
Min. Negotiated Rate	$4,968.75
Max. Negotiated Rate	$8,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,016.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,287.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,968.75

11X38X28MM ALIF SPACER 10DEG

Facility

$33,125.00

Service Code	HCPCS C1889
Hospital Charge Code	270703770
Hospital Revenue Code	278
Min. Negotiated Rate	$798.31
Max. Negotiated Rate	$16,562.50
Rate for Payer: Aetna Commercial	$12,587.50
Rate for Payer: Aetna Medicare Advantage	$9,937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,446.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,446.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,446.88
Rate for Payer: Cigna Commercial	$16,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,016.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,287.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,968.75
Rate for Payer: UnitedHealthcare Community & State	$798.31
Rate for Payer: Wellpoint Medicaid Managed Care	$877.81

11X42X30MM 10DEGREE ALIF SPACE

Facility

$33,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270704084
Hospital Revenue Code	278
Min. Negotiated Rate	$4,968.75
Max. Negotiated Rate	$8,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,016.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,287.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,968.75

11X42X30MM 10DEGREE ALIF SPACE

Facility

$33,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270704084
Hospital Revenue Code	278
Min. Negotiated Rate	$798.31
Max. Negotiated Rate	$16,562.50
Rate for Payer: Aetna Commercial	$12,587.50
Rate for Payer: Aetna Medicare Advantage	$9,937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,446.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,446.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,446.88
Rate for Payer: Cigna Commercial	$16,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,016.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,287.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,968.75
Rate for Payer: UnitedHealthcare Community & State	$798.31
Rate for Payer: Wellpoint Medicaid Managed Care	$877.81

12/14 COCR FEMORAL HEAD 22MM +

Facility

$2,721.90

Hospital Charge Code	270665071
Hospital Revenue Code	278
Min. Negotiated Rate	$65.60
Max. Negotiated Rate	$1,360.95
Rate for Payer: Aetna Commercial	$1,034.32
Rate for Payer: Aetna Medicare Advantage	$816.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$694.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$694.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$544.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$694.08
Rate for Payer: Cigna Commercial	$1,360.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$658.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$598.82
Rate for Payer: Qualcare PPO/HMO/WC	$408.29
Rate for Payer: UnitedHealthcare Community & State	$65.60
Rate for Payer: Wellpoint Medicaid Managed Care	$72.13

12/14 COCR FEMORAL HEAD 22MM +

Facility

$2,721.90

Hospital Charge Code	270665071
Hospital Revenue Code	278
Min. Negotiated Rate	$408.29
Max. Negotiated Rate	$658.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$544.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$658.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$598.82
Rate for Payer: Qualcare PPO/HMO/WC	$408.29

1.25MM K-WIRE W/TRO PNT 150MM

Facility

$38.83

Hospital Charge Code	270604111
Hospital Revenue Code	272
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$19.41
Rate for Payer: Aetna Commercial	$14.76
Rate for Payer: Aetna Medicare Advantage	$11.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.90
Rate for Payer: Cigna Commercial	$19.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.65
Rate for Payer: Oxford Commercial	$7.77
Rate for Payer: Qualcare PPO/HMO/WC	$5.82
Rate for Payer: UnitedHealthcare Commercial	$7.77
Rate for Payer: UnitedHealthcare Community & State	$0.94
Rate for Payer: Wellpoint Medicaid Managed Care	$1.03

1.25MM K-WIRE W/TRO PNT 150MM

Facility

$38.83

Hospital Charge Code	270604111
Hospital Revenue Code	272
Min. Negotiated Rate	$5.82
Max. Negotiated Rate	$5.82
Rate for Payer: Qualcare PPO/HMO/WC	$5.82

12.5MM TAP

Facility

$830.00

Hospital Charge Code	270607102
Hospital Revenue Code	272
Min. Negotiated Rate	$20.00
Max. Negotiated Rate	$415.00
Rate for Payer: Aetna Commercial	$315.40
Rate for Payer: Aetna Medicare Advantage	$249.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.65
Rate for Payer: Cigna Commercial	$415.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.00
Rate for Payer: Oxford Commercial	$166.00
Rate for Payer: Qualcare PPO/HMO/WC	$124.50
Rate for Payer: UnitedHealthcare Commercial	$166.00
Rate for Payer: UnitedHealthcare Community & State	$20.00
Rate for Payer: Wellpoint Medicaid Managed Care	$22.00

12.5MM TAP

Facility

$830.00

Hospital Charge Code	270607102
Hospital Revenue Code	272
Min. Negotiated Rate	$124.50
Max. Negotiated Rate	$124.50
Rate for Payer: Qualcare PPO/HMO/WC	$124.50

1.25 WIRE

Facility

$6,395.00

Hospital Charge Code	270700450
Hospital Revenue Code	272
Min. Negotiated Rate	$959.25
Max. Negotiated Rate	$959.25
Rate for Payer: Qualcare PPO/HMO/WC	$959.25

1.25 WIRE

Facility

$356.50

Hospital Charge Code	270683435
Hospital Revenue Code	272
Min. Negotiated Rate	$53.48
Max. Negotiated Rate	$53.48
Rate for Payer: Qualcare PPO/HMO/WC	$53.48

Know your out-of-pocket cost for care.

All Charges