Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BONE CERAMENT BONE FILLER 5CC

Facility

$9,080.00

Service Code	HCPCS C1713
Hospital Charge Code	270651533
Hospital Revenue Code	278
Min. Negotiated Rate	$218.83
Max. Negotiated Rate	$4,540.00
Rate for Payer: Aetna Commercial	$3,450.40
Rate for Payer: Aetna Medicare Advantage	$2,724.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,315.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,315.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,816.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,315.40
Rate for Payer: Cigna Commercial	$4,540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,197.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,997.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,362.00
Rate for Payer: UnitedHealthcare Community & State	$218.83
Rate for Payer: Wellpoint Medicaid Managed Care	$240.62

BONE CHIP CANCELLOUS,1-8MM

Facility

$1,221.50

Service Code	HCPCS C1762
Hospital Charge Code	270659902
Hospital Revenue Code	278
Min. Negotiated Rate	$183.22
Max. Negotiated Rate	$295.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$268.73
Rate for Payer: Qualcare PPO/HMO/WC	$183.22

BONE CHIP CANCELLOUS,1-8MM

Facility

$1,221.50

Service Code	HCPCS C1762
Hospital Charge Code	270659902
Hospital Revenue Code	278
Min. Negotiated Rate	$29.44
Max. Negotiated Rate	$610.75
Rate for Payer: Aetna Commercial	$464.17
Rate for Payer: Aetna Medicare Advantage	$366.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.48
Rate for Payer: Cigna Commercial	$610.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$268.73
Rate for Payer: Qualcare PPO/HMO/WC	$183.22
Rate for Payer: UnitedHealthcare Community & State	$29.44
Rate for Payer: Wellpoint Medicaid Managed Care	$32.37

BONE CHIPS CANCELLOUS 30CC

Facility

$2,130.00

Service Code	HCPCS C1713
Hospital Charge Code	270673109
Hospital Revenue Code	278
Min. Negotiated Rate	$51.33
Max. Negotiated Rate	$1,065.00
Rate for Payer: Aetna Commercial	$809.40
Rate for Payer: Aetna Medicare Advantage	$639.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$543.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$543.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$543.15
Rate for Payer: Cigna Commercial	$1,065.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$468.60
Rate for Payer: Qualcare PPO/HMO/WC	$319.50
Rate for Payer: UnitedHealthcare Community & State	$51.33
Rate for Payer: Wellpoint Medicaid Managed Care	$56.45

BONE CHIPS CANCELLOUS 30CC

Facility

$2,130.00

Service Code	HCPCS C1713
Hospital Charge Code	270673109
Hospital Revenue Code	278
Min. Negotiated Rate	$319.50
Max. Negotiated Rate	$515.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$468.60
Rate for Payer: Qualcare PPO/HMO/WC	$319.50

BONE CHIPS CANCELLOUS 30CC 4MM

Facility

$2,800.00

Hospital Charge Code	270673970
Hospital Revenue Code	272
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

BONE CHIPS CANCELLOUS 30CC 4MM

Facility

$2,800.00

Hospital Charge Code	270673970
Hospital Revenue Code	272
Min. Negotiated Rate	$67.48
Max. Negotiated Rate	$1,400.00
Rate for Payer: Aetna Commercial	$1,064.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.00
Rate for Payer: Oxford Commercial	$560.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$560.00
Rate for Payer: UnitedHealthcare Community & State	$67.48
Rate for Payer: Wellpoint Medicaid Managed Care	$74.20

BONE CHIPS CANCELLOUS 5CC

Facility

$670.00

Hospital Charge Code	270673108
Hospital Revenue Code	278
Min. Negotiated Rate	$100.50
Max. Negotiated Rate	$162.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.40
Rate for Payer: Qualcare PPO/HMO/WC	$100.50

BONE CHIPS CANCELLOUS 5CC

Facility

$670.00

Hospital Charge Code	270673108
Hospital Revenue Code	278
Min. Negotiated Rate	$16.15
Max. Negotiated Rate	$335.00
Rate for Payer: Aetna Commercial	$254.60
Rate for Payer: Aetna Medicare Advantage	$201.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.85
Rate for Payer: Cigna Commercial	$335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.40
Rate for Payer: Qualcare PPO/HMO/WC	$100.50
Rate for Payer: UnitedHealthcare Community & State	$16.15
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

BONE CLAMP W MARKER-MEDIUM

Facility

$7,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270698381
Hospital Revenue Code	278
Min. Negotiated Rate	$1,113.75
Max. Negotiated Rate	$1,796.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,796.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,113.75

BONE CLAMP W MARKER-MEDIUM

Facility

$7,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270698381
Hospital Revenue Code	278
Min. Negotiated Rate	$178.94
Max. Negotiated Rate	$3,712.50
Rate for Payer: Aetna Commercial	$2,821.50
Rate for Payer: Aetna Medicare Advantage	$2,227.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,893.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,893.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,893.38
Rate for Payer: Cigna Commercial	$3,712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,796.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,113.75
Rate for Payer: UnitedHealthcare Community & State	$178.94
Rate for Payer: Wellpoint Medicaid Managed Care	$196.76

BONE CORTICAL CANC CHIPS 15CC

Facility

$1,555.00

Service Code	HCPCS C1713
Hospital Charge Code	270673112
Hospital Revenue Code	278
Min. Negotiated Rate	$37.48
Max. Negotiated Rate	$777.50
Rate for Payer: Aetna Commercial	$590.90
Rate for Payer: Aetna Medicare Advantage	$466.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$396.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$396.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$311.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$396.52
Rate for Payer: Cigna Commercial	$777.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$376.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$342.10
Rate for Payer: Qualcare PPO/HMO/WC	$233.25
Rate for Payer: UnitedHealthcare Community & State	$37.48
Rate for Payer: Wellpoint Medicaid Managed Care	$41.21

BONE CORTICAL CANC CHIPS 15CC

Facility

$1,555.00

Service Code	HCPCS C1713
Hospital Charge Code	270673112
Hospital Revenue Code	278
Min. Negotiated Rate	$233.25
Max. Negotiated Rate	$376.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$311.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$376.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$342.10
Rate for Payer: Qualcare PPO/HMO/WC	$233.25

BONE CORTICAL CANC CRUSH 15CC

Facility

$1,245.00

Service Code	HCPCS C1713
Hospital Charge Code	270673111
Hospital Revenue Code	278
Min. Negotiated Rate	$186.75
Max. Negotiated Rate	$301.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.90
Rate for Payer: Qualcare PPO/HMO/WC	$186.75

BONE CORTICAL CANC CRUSH 15CC

Facility

$1,245.00

Service Code	HCPCS C1713
Hospital Charge Code	270673111
Hospital Revenue Code	278
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$622.50
Rate for Payer: Aetna Commercial	$473.10
Rate for Payer: Aetna Medicare Advantage	$373.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$317.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$317.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$317.48
Rate for Payer: Cigna Commercial	$622.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.90
Rate for Payer: Qualcare PPO/HMO/WC	$186.75
Rate for Payer: UnitedHealthcare Community & State	$30.00
Rate for Payer: Wellpoint Medicaid Managed Care	$32.99

BONE CRUSH CANCELLOUS 15CC

Facility

$1,890.00

Hospital Charge Code	270673110
Hospital Revenue Code	278
Min. Negotiated Rate	$45.55
Max. Negotiated Rate	$945.00
Rate for Payer: Aetna Commercial	$718.20
Rate for Payer: Aetna Medicare Advantage	$567.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$481.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$481.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$378.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$481.95
Rate for Payer: Cigna Commercial	$945.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$415.80
Rate for Payer: Qualcare PPO/HMO/WC	$283.50
Rate for Payer: UnitedHealthcare Community & State	$45.55
Rate for Payer: Wellpoint Medicaid Managed Care	$50.09

BONE CRUSH CANCELLOUS 15CC

Facility

$1,890.00

Hospital Charge Code	270673110
Hospital Revenue Code	278
Min. Negotiated Rate	$283.50
Max. Negotiated Rate	$457.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$378.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$415.80
Rate for Payer: Qualcare PPO/HMO/WC	$283.50

BONE CUBE CONFORM 13MM

Facility

$3,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270665054
Hospital Revenue Code	278
Min. Negotiated Rate	$86.76
Max. Negotiated Rate	$1,800.00
Rate for Payer: Aetna Commercial	$1,368.00
Rate for Payer: Aetna Medicare Advantage	$1,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$918.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$918.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$918.00
Rate for Payer: Cigna Commercial	$1,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$792.00
Rate for Payer: Qualcare PPO/HMO/WC	$540.00
Rate for Payer: UnitedHealthcare Community & State	$86.76
Rate for Payer: Wellpoint Medicaid Managed Care	$95.40

BONE CUBE CONFORM 13MM

Facility

$3,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270665054
Hospital Revenue Code	278
Min. Negotiated Rate	$540.00
Max. Negotiated Rate	$871.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$792.00
Rate for Payer: Qualcare PPO/HMO/WC	$540.00

BONE CUTTER 4 MM X 13 CM

Facility

$330.00

Hospital Charge Code	270688459
Hospital Revenue Code	272
Min. Negotiated Rate	$49.50
Max. Negotiated Rate	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$49.50

BONE CUTTER 4 MM X 13 CM

Facility

$330.00

Hospital Charge Code	270688459
Hospital Revenue Code	272
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$165.00
Rate for Payer: Aetna Commercial	$125.40
Rate for Payer: Aetna Medicare Advantage	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.15
Rate for Payer: Cigna Commercial	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.00
Rate for Payer: Oxford Commercial	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.50
Rate for Payer: UnitedHealthcare Commercial	$66.00
Rate for Payer: UnitedHealthcare Community & State	$7.95
Rate for Payer: Wellpoint Medicaid Managed Care	$8.74

BONE CUTTER HL 4.2 MM x 19 CM

Facility

$330.00

Hospital Charge Code	270681363
Hospital Revenue Code	272
Min. Negotiated Rate	$49.50
Max. Negotiated Rate	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$49.50

BONE CUTTER HL 4.2 MM x 19 CM

Facility

$330.00

Hospital Charge Code	270681363
Hospital Revenue Code	272
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$165.00
Rate for Payer: Aetna Commercial	$125.40
Rate for Payer: Aetna Medicare Advantage	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.15
Rate for Payer: Cigna Commercial	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.00
Rate for Payer: Oxford Commercial	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.50
Rate for Payer: UnitedHealthcare Commercial	$66.00
Rate for Payer: UnitedHealthcare Community & State	$7.95
Rate for Payer: Wellpoint Medicaid Managed Care	$8.74

BONE CUTTER TUBESET

Facility

$250.00

Hospital Charge Code	270663411
Hospital Revenue Code	272
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.00
Rate for Payer: Oxford Commercial	$50.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$50.00
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

BONE CUTTER TUBESET

Facility

$250.00

Hospital Charge Code	270663411
Hospital Revenue Code	272
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

Know your out-of-pocket cost for care.

All Charges