Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BOLT IM NAIL CONNECTING

Facility

$903.85

Service Code	HCPCS C1713
Hospital Charge Code	270700140
Hospital Revenue Code	278
Min. Negotiated Rate	$21.78
Max. Negotiated Rate	$451.93
Rate for Payer: Aetna Commercial	$343.46
Rate for Payer: Aetna Medicare Advantage	$271.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.48
Rate for Payer: Cigna Commercial	$451.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.85
Rate for Payer: Qualcare PPO/HMO/WC	$135.58
Rate for Payer: UnitedHealthcare Community & State	$21.78
Rate for Payer: Wellpoint Medicaid Managed Care	$23.95

BOLT IM NAIL CONNECTING

Facility

$903.85

Service Code	HCPCS C1713
Hospital Charge Code	270700140
Hospital Revenue Code	278
Min. Negotiated Rate	$135.58
Max. Negotiated Rate	$218.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.85
Rate for Payer: Qualcare PPO/HMO/WC	$135.58

BOLT JIG FLEXIBLE 8MM

Facility

$8,610.00

Hospital Charge Code	270702100
Hospital Revenue Code	278
Min. Negotiated Rate	$207.50
Max. Negotiated Rate	$4,305.00
Rate for Payer: Aetna Commercial	$3,271.80
Rate for Payer: Aetna Medicare Advantage	$2,583.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,195.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,195.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,722.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,195.55
Rate for Payer: Cigna Commercial	$4,305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,083.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,894.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,291.50
Rate for Payer: UnitedHealthcare Community & State	$207.50
Rate for Payer: Wellpoint Medicaid Managed Care	$228.16

BOLT JIG FLEXIBLE 8MM

Facility

$8,610.00

Hospital Charge Code	270702100
Hospital Revenue Code	278
Min. Negotiated Rate	$1,291.50
Max. Negotiated Rate	$2,083.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,722.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,083.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,894.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,291.50

BOLT LOCKING 41MM

Facility

$1,150.00

Service Code	HCPCS C1776
Hospital Charge Code	270677752
Hospital Revenue Code	278
Min. Negotiated Rate	$27.71
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$437.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$253.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Community & State	$27.71
Rate for Payer: Wellpoint Medicaid Managed Care	$30.48

BOLT LOCKING 41MM

Facility

$1,150.00

Service Code	HCPCS C1776
Hospital Charge Code	270677752
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$278.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$253.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

BOLT LOCKING 4.9x32mm ST

Facility

$976.45

Hospital Charge Code	270651639
Hospital Revenue Code	272
Min. Negotiated Rate	$146.47
Max. Negotiated Rate	$146.47
Rate for Payer: Qualcare PPO/HMO/WC	$146.47

BOLT LOCKING 4.9x32mm ST

Facility

$976.45

Hospital Charge Code	270651639
Hospital Revenue Code	272
Min. Negotiated Rate	$23.53
Max. Negotiated Rate	$488.23
Rate for Payer: Aetna Commercial	$371.05
Rate for Payer: Aetna Medicare Advantage	$292.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.99
Rate for Payer: Cigna Commercial	$488.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.94
Rate for Payer: Oxford Commercial	$195.29
Rate for Payer: Qualcare PPO/HMO/WC	$146.47
Rate for Payer: UnitedHealthcare Commercial	$195.29
Rate for Payer: UnitedHealthcare Community & State	$23.53
Rate for Payer: Wellpoint Medicaid Managed Care	$25.88

BOLT LOCKING 4.9x34mm ST

Facility

$976.45

Hospital Charge Code	270651640
Hospital Revenue Code	272
Min. Negotiated Rate	$23.53
Max. Negotiated Rate	$488.23
Rate for Payer: Aetna Commercial	$371.05
Rate for Payer: Aetna Medicare Advantage	$292.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.99
Rate for Payer: Cigna Commercial	$488.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.94
Rate for Payer: Oxford Commercial	$195.29
Rate for Payer: Qualcare PPO/HMO/WC	$146.47
Rate for Payer: UnitedHealthcare Commercial	$195.29
Rate for Payer: UnitedHealthcare Community & State	$23.53
Rate for Payer: Wellpoint Medicaid Managed Care	$25.88

BOLT LOCKING 4.9x34mm ST

Facility

$976.45

Hospital Charge Code	270651640
Hospital Revenue Code	272
Min. Negotiated Rate	$146.47
Max. Negotiated Rate	$146.47
Rate for Payer: Qualcare PPO/HMO/WC	$146.47

BOLT LOCKING 4.9x36mm ST

Facility

$976.45

Hospital Charge Code	270651641
Hospital Revenue Code	278
Min. Negotiated Rate	$23.53
Max. Negotiated Rate	$488.23
Rate for Payer: Aetna Commercial	$371.05
Rate for Payer: Aetna Medicare Advantage	$292.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.99
Rate for Payer: Cigna Commercial	$488.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.82
Rate for Payer: Qualcare PPO/HMO/WC	$146.47
Rate for Payer: UnitedHealthcare Community & State	$23.53
Rate for Payer: Wellpoint Medicaid Managed Care	$25.88

BOLT LOCKING 4.9x36mm ST

Facility

$976.45

Hospital Charge Code	270651641
Hospital Revenue Code	278
Min. Negotiated Rate	$146.47
Max. Negotiated Rate	$236.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.82
Rate for Payer: Qualcare PPO/HMO/WC	$146.47

BOLT LOCKING 4.9x60mm ST

Facility

$976.45

Hospital Charge Code	270651643
Hospital Revenue Code	278
Min. Negotiated Rate	$146.47
Max. Negotiated Rate	$236.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.82
Rate for Payer: Qualcare PPO/HMO/WC	$146.47

BOLT LOCKING 4.9x60mm ST

Facility

$976.45

Hospital Charge Code	270651643
Hospital Revenue Code	278
Min. Negotiated Rate	$23.53
Max. Negotiated Rate	$488.23
Rate for Payer: Aetna Commercial	$371.05
Rate for Payer: Aetna Medicare Advantage	$292.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.99
Rate for Payer: Cigna Commercial	$488.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.82
Rate for Payer: Qualcare PPO/HMO/WC	$146.47
Rate for Payer: UnitedHealthcare Community & State	$23.53
Rate for Payer: Wellpoint Medicaid Managed Care	$25.88

BOLT PEDICLE 6.15x35 177016235

Facility

$2,703.25

Hospital Charge Code	270632109
Hospital Revenue Code	278
Min. Negotiated Rate	$405.49
Max. Negotiated Rate	$654.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$654.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$594.72
Rate for Payer: Qualcare PPO/HMO/WC	$405.49

BOLT PEDICLE 6.15x35 177016235

Facility

$2,703.25

Hospital Charge Code	270632109
Hospital Revenue Code	278
Min. Negotiated Rate	$65.15
Max. Negotiated Rate	$1,351.62
Rate for Payer: Aetna Commercial	$1,027.23
Rate for Payer: Aetna Medicare Advantage	$810.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$689.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$689.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$689.33
Rate for Payer: Cigna Commercial	$1,351.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$654.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$594.72
Rate for Payer: Qualcare PPO/HMO/WC	$405.49
Rate for Payer: UnitedHealthcare Community & State	$65.15
Rate for Payer: Wellpoint Medicaid Managed Care	$71.64

BOLT PEDICLE 6.25x40 177016240

Facility

$2,703.25

Hospital Charge Code	270632110
Hospital Revenue Code	278
Min. Negotiated Rate	$65.15
Max. Negotiated Rate	$1,351.62
Rate for Payer: Aetna Commercial	$1,027.23
Rate for Payer: Aetna Medicare Advantage	$810.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$689.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$689.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$689.33
Rate for Payer: Cigna Commercial	$1,351.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$654.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$594.72
Rate for Payer: Qualcare PPO/HMO/WC	$405.49
Rate for Payer: UnitedHealthcare Community & State	$65.15
Rate for Payer: Wellpoint Medicaid Managed Care	$71.64

BOLT PEDICLE 6.25x40 177016240

Facility

$2,703.25

Hospital Charge Code	270632110
Hospital Revenue Code	278
Min. Negotiated Rate	$405.49
Max. Negotiated Rate	$654.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$654.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$594.72
Rate for Payer: Qualcare PPO/HMO/WC	$405.49

BOLT PIN HOLDER LG 15 100165

Facility

$248.00

Hospital Charge Code	270632651
Hospital Revenue Code	278
Min. Negotiated Rate	$37.20
Max. Negotiated Rate	$60.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.56
Rate for Payer: Qualcare PPO/HMO/WC	$37.20

BOLT PIN HOLDER LG 15 100165

Facility

$248.00

Hospital Charge Code	270632651
Hospital Revenue Code	278
Min. Negotiated Rate	$5.98
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$94.24
Rate for Payer: Aetna Medicare Advantage	$74.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.24
Rate for Payer: Cigna Commercial	$124.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.56
Rate for Payer: Qualcare PPO/HMO/WC	$37.20
Rate for Payer: UnitedHealthcare Community & State	$5.98
Rate for Payer: Wellpoint Medicaid Managed Care	$6.57

BOLT SALVATION 5. X 120MM

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270700897
Hospital Revenue Code	278
Min. Negotiated Rate	$241.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$241.00
Rate for Payer: Wellpoint Medicaid Managed Care	$265.00

BOLT SALVATION 5. X 120MM

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270700897
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

BOLT SALVATION 6.5x100MM

Facility

$8,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270674307
Hospital Revenue Code	278
Min. Negotiated Rate	$1,291.50
Max. Negotiated Rate	$2,083.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,722.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,083.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,894.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,291.50

BOLT SALVATION 6.5x100MM

Facility

$8,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270674307
Hospital Revenue Code	278
Min. Negotiated Rate	$207.50
Max. Negotiated Rate	$4,305.00
Rate for Payer: Aetna Commercial	$3,271.80
Rate for Payer: Aetna Medicare Advantage	$2,583.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,195.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,195.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,722.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,195.55
Rate for Payer: Cigna Commercial	$4,305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,083.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,894.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,291.50
Rate for Payer: UnitedHealthcare Community & State	$207.50
Rate for Payer: Wellpoint Medicaid Managed Care	$228.16

BOLT SALVATION 6.5x130MM

Facility

$8,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270674306
Hospital Revenue Code	278
Min. Negotiated Rate	$207.50
Max. Negotiated Rate	$4,305.00
Rate for Payer: Aetna Commercial	$3,271.80
Rate for Payer: Aetna Medicare Advantage	$2,583.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,195.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,195.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,722.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,195.55
Rate for Payer: Cigna Commercial	$4,305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,083.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,894.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,291.50
Rate for Payer: UnitedHealthcare Community & State	$207.50
Rate for Payer: Wellpoint Medicaid Managed Care	$228.16

Know your out-of-pocket cost for care.

All Charges