Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BONE ANCHORS 3 W ARTHRO DEL SY

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688655
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,045.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

BONE ASP NEEDLE

Facility

$875.00

Hospital Charge Code	270703140
Hospital Revenue Code	278
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

BONE ASP NEEDLE

Facility

$875.00

Hospital Charge Code	270703140
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

BONE AWL 30 DEGREE

Facility

$2,266.05

Hospital Charge Code	270683646
Hospital Revenue Code	272
Min. Negotiated Rate	$339.91
Max. Negotiated Rate	$339.91
Rate for Payer: Qualcare PPO/HMO/WC	$339.91

BONE AWL 30 DEGREE

Facility

$2,266.05

Hospital Charge Code	270683646
Hospital Revenue Code	272
Min. Negotiated Rate	$54.61
Max. Negotiated Rate	$1,133.03
Rate for Payer: Aetna Commercial	$861.10
Rate for Payer: Aetna Medicare Advantage	$679.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$577.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$577.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$577.84
Rate for Payer: Cigna Commercial	$1,133.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$679.82
Rate for Payer: Oxford Commercial	$453.21
Rate for Payer: Qualcare PPO/HMO/WC	$339.91
Rate for Payer: UnitedHealthcare Commercial	$453.21
Rate for Payer: UnitedHealthcare Community & State	$54.61
Rate for Payer: Wellpoint Medicaid Managed Care	$60.05

BONE AWL 45 DEGREE

Facility

$2,266.05

Hospital Charge Code	270683647
Hospital Revenue Code	272
Min. Negotiated Rate	$54.61
Max. Negotiated Rate	$1,133.03
Rate for Payer: Aetna Commercial	$861.10
Rate for Payer: Aetna Medicare Advantage	$679.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$577.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$577.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$577.84
Rate for Payer: Cigna Commercial	$1,133.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$679.82
Rate for Payer: Oxford Commercial	$453.21
Rate for Payer: Qualcare PPO/HMO/WC	$339.91
Rate for Payer: UnitedHealthcare Commercial	$453.21
Rate for Payer: UnitedHealthcare Community & State	$54.61
Rate for Payer: Wellpoint Medicaid Managed Care	$60.05

BONE AWL 45 DEGREE

Facility

$2,266.05

Hospital Charge Code	270683647
Hospital Revenue Code	272
Min. Negotiated Rate	$339.91
Max. Negotiated Rate	$339.91
Rate for Payer: Qualcare PPO/HMO/WC	$339.91

BONE AWL 90 DEGREEE

Facility

$2,266.05

Hospital Charge Code	270683648
Hospital Revenue Code	272
Min. Negotiated Rate	$339.91
Max. Negotiated Rate	$339.91
Rate for Payer: Qualcare PPO/HMO/WC	$339.91

BONE AWL 90 DEGREEE

Facility

$2,266.05

Hospital Charge Code	270683648
Hospital Revenue Code	272
Min. Negotiated Rate	$54.61
Max. Negotiated Rate	$1,133.03
Rate for Payer: Aetna Commercial	$861.10
Rate for Payer: Aetna Medicare Advantage	$679.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$577.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$577.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$577.84
Rate for Payer: Cigna Commercial	$1,133.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$679.82
Rate for Payer: Oxford Commercial	$453.21
Rate for Payer: Qualcare PPO/HMO/WC	$339.91
Rate for Payer: UnitedHealthcare Commercial	$453.21
Rate for Payer: UnitedHealthcare Community & State	$54.61
Rate for Payer: Wellpoint Medicaid Managed Care	$60.05

BONE BIOPSY SET 10.8 G03385

Facility

$1,625.00

Hospital Charge Code	270627836
Hospital Revenue Code	272
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$243.75
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

BONE BIOPSY SET 10.8 G03385

Facility

$1,625.00

Hospital Charge Code	270627836
Hospital Revenue Code	272
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.50
Rate for Payer: Oxford Commercial	$325.00
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Commercial	$325.00
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

BONE BIOPSY SET 18.3 CM G03386

Facility

$1,625.00

Hospital Charge Code	270627835
Hospital Revenue Code	272
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$243.75
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

BONE BIOPSY SET 18.3 CM G03386

Facility

$1,625.00

Hospital Charge Code	270627835
Hospital Revenue Code	272
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.50
Rate for Payer: Oxford Commercial	$325.00
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Commercial	$325.00
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

BONE BX TR/NDL; SUPERF

Facility

$6,876.40

Service Code	HCPCS 20220
Hospital Charge Code	16000299
Hospital Revenue Code	360
Min. Negotiated Rate	$1,031.46
Max. Negotiated Rate	$1,031.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,031.46

BONE BX TR/NDL; SUPERF

Facility

$6,876.40

Service Code	HCPCS 20220
Hospital Charge Code	16000299
Hospital Revenue Code	360
Min. Negotiated Rate	$165.72
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,062.92
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,031.46
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$165.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$182.22

BONE CEMENT 10CC STABILIT

Facility

$803.23

Hospital Charge Code	270670676
Hospital Revenue Code	272
Min. Negotiated Rate	$19.36
Max. Negotiated Rate	$401.62
Rate for Payer: Aetna Commercial	$305.23
Rate for Payer: Aetna Medicare Advantage	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.82
Rate for Payer: Cigna Commercial	$401.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.97
Rate for Payer: Oxford Commercial	$160.65
Rate for Payer: Qualcare PPO/HMO/WC	$120.48
Rate for Payer: UnitedHealthcare Commercial	$160.65
Rate for Payer: UnitedHealthcare Community & State	$19.36
Rate for Payer: Wellpoint Medicaid Managed Care	$21.29

BONE CEMENT 10CC STABILIT

Facility

$803.23

Hospital Charge Code	270670676
Hospital Revenue Code	272
Min. Negotiated Rate	$120.48
Max. Negotiated Rate	$120.48
Rate for Payer: Qualcare PPO/HMO/WC	$120.48

BONE CEMENT 40G SIMPLEX SPDSET

Facility

$390.00

Service Code	HCPCS C1713
Hospital Charge Code	270673760
Hospital Revenue Code	278
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$94.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$78.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$85.80
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BONE CEMENT 40G SIMPLEX SPDSET

Facility

$355.00

Service Code	HCPCS C1713
Hospital Charge Code	270673761
Hospital Revenue Code	278
Min. Negotiated Rate	$8.56
Max. Negotiated Rate	$177.50
Rate for Payer: Aetna Commercial	$134.90
Rate for Payer: Aetna Medicare Advantage	$106.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.53
Rate for Payer: Cigna Commercial	$177.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$78.10
Rate for Payer: Qualcare PPO/HMO/WC	$53.25
Rate for Payer: UnitedHealthcare Community & State	$8.56
Rate for Payer: Wellpoint Medicaid Managed Care	$9.41

BONE CEMENT 40G SIMPLEX SPDSET

Facility

$355.00

Service Code	HCPCS C1713
Hospital Charge Code	270673761
Hospital Revenue Code	278
Min. Negotiated Rate	$53.25
Max. Negotiated Rate	$85.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$78.10
Rate for Payer: Qualcare PPO/HMO/WC	$53.25

BONE CEMENT 40G SIMPLEX SPDSET

Facility

$390.00

Service Code	HCPCS C1713
Hospital Charge Code	270673760
Hospital Revenue Code	278
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$78.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$85.80
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Community & State	$9.40
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

BONE CEMENT HIGH VIS

Facility

$650.00

Hospital Charge Code	270651645
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

BONE CEMENT HIGH VIS

Facility

$650.00

Hospital Charge Code	270651645
Hospital Revenue Code	272
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$130.00
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

BONE CEMENT MIXER MIXEVAC 3

Facility

$332.20

Hospital Charge Code	270668624
Hospital Revenue Code	272
Min. Negotiated Rate	$8.01
Max. Negotiated Rate	$166.10
Rate for Payer: Aetna Commercial	$126.24
Rate for Payer: Aetna Medicare Advantage	$99.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.71
Rate for Payer: Cigna Commercial	$166.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.66
Rate for Payer: Oxford Commercial	$66.44
Rate for Payer: Qualcare PPO/HMO/WC	$49.83
Rate for Payer: UnitedHealthcare Commercial	$66.44
Rate for Payer: UnitedHealthcare Community & State	$8.01
Rate for Payer: Wellpoint Medicaid Managed Care	$8.80

BONE CEMENT MIXER MIXEVAC 3

Facility

$332.20

Hospital Charge Code	270668624
Hospital Revenue Code	272
Min. Negotiated Rate	$49.83
Max. Negotiated Rate	$49.83
Rate for Payer: Qualcare PPO/HMO/WC	$49.83

Know your out-of-pocket cost for care.

All Charges