Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

6Fr Neuron Max sheath 90 Str

Facility

$2,475.00

Hospital Charge Code	270685062N
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

6Fr Neuron Max sheath 90 Str

Facility

$2,475.00

Hospital Charge Code	270685062S
Hospital Revenue Code	272
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) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$742.50
Rate for Payer: Oxford Commercial	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$495.00
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

6Fr Neuron Max sheath 90 Str

Facility

$2,475.00

Hospital Charge Code	270685062S
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

6Fr Neuron Max sheath 90 Str

Facility

$2,475.00

Hospital Charge Code	270685062N
Hospital Revenue Code	272
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) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$742.50
Rate for Payer: Oxford Commercial	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$495.00
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

6F STRAIGHT PIGTAIL

Facility

$40.00

Hospital Charge Code	2709000324
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.00
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$8.00
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

6F STRAIGHT PIGTAIL

Facility

$40.00

Hospital Charge Code	2709000324
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

6 HOLE CLAVICLE PLATE

Facility

$5,610.00

Hospital Charge Code	270656020
Hospital Revenue Code	278
Min. Negotiated Rate	$135.20
Max. Negotiated Rate	$2,805.00
Rate for Payer: Aetna Commercial	$2,131.80
Rate for Payer: Aetna Medicare Advantage	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,430.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,430.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,430.55
Rate for Payer: Cigna Commercial	$2,805.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,357.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,234.20
Rate for Payer: Qualcare PPO/HMO/WC	$841.50
Rate for Payer: UnitedHealthcare Community & State	$135.20
Rate for Payer: Wellpoint Medicaid Managed Care	$148.66

6 HOLE CLAVICLE PLATE

Facility

$5,610.00

Hospital Charge Code	270656020
Hospital Revenue Code	278
Min. Negotiated Rate	$841.50
Max. Negotiated Rate	$1,357.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,122.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,357.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,234.20
Rate for Payer: Qualcare PPO/HMO/WC	$841.50

6 HOLE COMPRESSION PLATE

Facility

$1,315.00

Hospital Charge Code	270664729
Hospital Revenue Code	278
Min. Negotiated Rate	$197.25
Max. Negotiated Rate	$318.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$289.30
Rate for Payer: Qualcare PPO/HMO/WC	$197.25

6 HOLE COMPRESSION PLATE

Facility

$1,315.00

Hospital Charge Code	270664729
Hospital Revenue Code	278
Min. Negotiated Rate	$31.69
Max. Negotiated Rate	$657.50
Rate for Payer: Aetna Commercial	$499.70
Rate for Payer: Aetna Medicare Advantage	$394.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.32
Rate for Payer: Cigna Commercial	$657.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$289.30
Rate for Payer: Qualcare PPO/HMO/WC	$197.25
Rate for Payer: UnitedHealthcare Community & State	$31.69
Rate for Payer: Wellpoint Medicaid Managed Care	$34.85

6 HOLE DISTAL FIBULA PLATE

Facility

$3,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270687752
Hospital Revenue Code	278
Min. Negotiated Rate	$93.39
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,472.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$852.50
Rate for Payer: Qualcare PPO/HMO/WC	$581.25
Rate for Payer: UnitedHealthcare Community & State	$93.39
Rate for Payer: Wellpoint Medicaid Managed Care	$102.69

6 HOLE DISTAL FIBULA PLATE

Facility

$3,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270687752
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$937.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$852.50
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

6 HOLE DUAL COMPRESSION PLATE

Facility

$1,533.45

Hospital Charge Code	270656917
Hospital Revenue Code	278
Min. Negotiated Rate	$230.02
Max. Negotiated Rate	$371.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$306.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$371.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$337.36
Rate for Payer: Qualcare PPO/HMO/WC	$230.02

6 HOLE DUAL COMPRESSION PLATE

Facility

$1,533.45

Hospital Charge Code	270656917
Hospital Revenue Code	278
Min. Negotiated Rate	$36.96
Max. Negotiated Rate	$766.73
Rate for Payer: Aetna Commercial	$582.71
Rate for Payer: Aetna Medicare Advantage	$460.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$391.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$391.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$306.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$391.03
Rate for Payer: Cigna Commercial	$766.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$371.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$337.36
Rate for Payer: Qualcare PPO/HMO/WC	$230.02
Rate for Payer: UnitedHealthcare Community & State	$36.96
Rate for Payer: Wellpoint Medicaid Managed Care	$40.64

6 HOLE HEAD 2 SHAFT 2 COL PLAT

Facility

$6,983.40

Service Code	HCPCS C1713
Hospital Charge Code	270686606
Hospital Revenue Code	278
Min. Negotiated Rate	$168.30
Max. Negotiated Rate	$3,491.70
Rate for Payer: Aetna Commercial	$2,653.69
Rate for Payer: Aetna Medicare Advantage	$2,095.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,780.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,780.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,396.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,780.77
Rate for Payer: Cigna Commercial	$3,491.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,689.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,536.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,047.51
Rate for Payer: UnitedHealthcare Community & State	$168.30
Rate for Payer: Wellpoint Medicaid Managed Care	$185.06

6 HOLE HEAD 2 SHAFT 2 COL PLAT

Facility

$6,983.40

Service Code	HCPCS C1713
Hospital Charge Code	270686606
Hospital Revenue Code	278
Min. Negotiated Rate	$1,047.51
Max. Negotiated Rate	$1,689.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,396.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,689.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,536.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,047.51

6 HOLE PROXIMAL HUMERAL PLATE

Facility

$7,428.40

Service Code	HCPCS C1713
Hospital Charge Code	270686347
Hospital Revenue Code	278
Min. Negotiated Rate	$1,114.26
Max. Negotiated Rate	$1,797.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,485.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,797.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,634.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,114.26

6 HOLE PROXIMAL HUMERAL PLATE

Facility

$7,428.40

Service Code	HCPCS C1713
Hospital Charge Code	270686347
Hospital Revenue Code	278
Min. Negotiated Rate	$179.02
Max. Negotiated Rate	$3,714.20
Rate for Payer: Aetna Commercial	$2,822.79
Rate for Payer: Aetna Medicare Advantage	$2,228.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,894.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,894.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,485.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,894.24
Rate for Payer: Cigna Commercial	$3,714.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,797.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,634.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,114.26
Rate for Payer: UnitedHealthcare Community & State	$179.02
Rate for Payer: Wellpoint Medicaid Managed Care	$196.85

6 HOLE STRAIGHT PLATE

Facility

$2,920.00

Service Code	HCPCS C1713
Hospital Charge Code	270703884
Hospital Revenue Code	278
Min. Negotiated Rate	$70.37
Max. Negotiated Rate	$1,460.00
Rate for Payer: Aetna Commercial	$1,109.60
Rate for Payer: Aetna Medicare Advantage	$876.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$744.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$744.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$584.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$744.60
Rate for Payer: Cigna Commercial	$1,460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$706.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$642.40
Rate for Payer: Qualcare PPO/HMO/WC	$438.00
Rate for Payer: UnitedHealthcare Community & State	$70.37
Rate for Payer: Wellpoint Medicaid Managed Care	$77.38

6 HOLE STRAIGHT PLATE

Facility

$2,920.00

Service Code	HCPCS C1713
Hospital Charge Code	270703884
Hospital Revenue Code	278
Min. Negotiated Rate	$438.00
Max. Negotiated Rate	$706.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$584.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$706.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$642.40
Rate for Payer: Qualcare PPO/HMO/WC	$438.00

#6 MATRIX CONNECTOR

Facility

$5,926.25

Service Code	HCPCS C1713
Hospital Charge Code	270691893
Hospital Revenue Code	278
Min. Negotiated Rate	$142.82
Max. Negotiated Rate	$2,963.12
Rate for Payer: Aetna Commercial	$2,251.97
Rate for Payer: Aetna Medicare Advantage	$1,777.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,511.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,511.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,185.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,511.19
Rate for Payer: Cigna Commercial	$2,963.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,434.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,303.78
Rate for Payer: Qualcare PPO/HMO/WC	$888.94
Rate for Payer: UnitedHealthcare Community & State	$142.82
Rate for Payer: Wellpoint Medicaid Managed Care	$157.05

#6 MATRIX CONNECTOR

Facility

$5,926.25

Service Code	HCPCS C1713
Hospital Charge Code	270691893
Hospital Revenue Code	278
Min. Negotiated Rate	$888.94
Max. Negotiated Rate	$1,434.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,185.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,434.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,303.78
Rate for Payer: Qualcare PPO/HMO/WC	$888.94

6MM DRILL BIT

Facility

$1,500.00

Hospital Charge Code	270680775
Hospital Revenue Code	272
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

6MM DRILL BIT

Facility

$1,500.00

Hospital Charge Code	270680775
Hospital Revenue Code	272
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$450.00
Rate for Payer: Oxford Commercial	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Commercial	$300.00
Rate for Payer: UnitedHealthcare Community & State	$36.15
Rate for Payer: Wellpoint Medicaid Managed Care	$39.75

6MM SMALL SPIRA C

Facility

$8,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270703918
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

Know your out-of-pocket cost for care.

All Charges