Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BONE DEMINERALIZED BONE PUTT

Facility

$1,270.00

Service Code	HCPCS C1713
Hospital Charge Code	270655823
Hospital Revenue Code	278
Min. Negotiated Rate	$30.61
Max. Negotiated Rate	$635.00
Rate for Payer: Aetna Commercial	$482.60
Rate for Payer: Aetna Medicare Advantage	$381.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$323.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$323.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$323.85
Rate for Payer: Cigna Commercial	$635.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$279.40
Rate for Payer: Qualcare PPO/HMO/WC	$190.50
Rate for Payer: UnitedHealthcare Community & State	$30.61
Rate for Payer: Wellpoint Medicaid Managed Care	$33.66

BONE DEMINERALIZED BONE PUTT

Facility

$1,270.00

Service Code	HCPCS C1713
Hospital Charge Code	270655823
Hospital Revenue Code	278
Min. Negotiated Rate	$190.50
Max. Negotiated Rate	$307.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$279.40
Rate for Payer: Qualcare PPO/HMO/WC	$190.50

BONE DENSI DEXA AXIAL SKELETON

Facility

$1,571.90

Service Code	HCPCS 77080
Hospital Charge Code	2709002
Hospital Revenue Code	320
Min. Negotiated Rate	$235.78
Max. Negotiated Rate	$235.78
Rate for Payer: Qualcare PPO/HMO/WC	$235.78

BONE DENSI DEXA AXIAL SKELETON

Facility

$1,571.90

Service Code	HCPCS 77080
Hospital Charge Code	2709002
Hospital Revenue Code	320
Min. Negotiated Rate	$37.88
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.57
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$235.78
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$37.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$41.66

BONE DENSITY

Facility

$5,100.00

Service Code	HCPCS 77080
Hospital Charge Code	94061199
Hospital Revenue Code	320
Min. Negotiated Rate	$86.94
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

BONE DENSITY

Facility

$5,100.00

Service Code	HCPCS 77080
Hospital Charge Code	94061199
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

BONE DENSITY DEXA APP SKELETON

Facility

$607.50

Service Code	HCPCS 77081
Hospital Charge Code	2709001
Hospital Revenue Code	320
Min. Negotiated Rate	$14.64
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$281.22
Rate for Payer: Aetna Medicare Advantage	$334.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$103.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.21
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: Cigna Medicare Advantage	$72.37
Rate for Payer: Clover Medicare Advantage	$98.22
Rate for Payer: EmblemHealth Commercial	$310.17
Rate for Payer: Humana Medicare Advantage	$106.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$103.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.25
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.12
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$14.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$103.39
Rate for Payer: Wellcare Medicare Advantage	$103.39
Rate for Payer: Wellpoint Medicaid Managed Care	$16.10

BONE DENSITY DEXA APP SKELETON

Facility

$607.50

Service Code	HCPCS 77081
Hospital Charge Code	2709001
Hospital Revenue Code	320
Min. Negotiated Rate	$91.12
Max. Negotiated Rate	$91.12
Rate for Payer: Qualcare PPO/HMO/WC	$91.12

BONE DENSITY DEXA FOREARM BMD

Facility

$607.50

Service Code	HCPCS 77081
Hospital Charge Code	2709003
Hospital Revenue Code	320
Min. Negotiated Rate	$91.12
Max. Negotiated Rate	$91.12
Rate for Payer: Qualcare PPO/HMO/WC	$91.12

BONE DENSITY DEXA FOREARM BMD

Facility

$607.50

Service Code	HCPCS 77081
Hospital Charge Code	2709003
Hospital Revenue Code	320
Min. Negotiated Rate	$14.64
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$281.22
Rate for Payer: Aetna Medicare Advantage	$334.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$103.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.21
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: Cigna Medicare Advantage	$72.37
Rate for Payer: Clover Medicare Advantage	$98.22
Rate for Payer: EmblemHealth Commercial	$310.17
Rate for Payer: Humana Medicare Advantage	$106.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$103.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.25
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.12
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$14.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$103.39
Rate for Payer: Wellcare Medicare Advantage	$103.39
Rate for Payer: Wellpoint Medicaid Managed Care	$16.10

BONE DISEASES AND ARTHROPATHIES WITH MCC

Facility

$44,032.65

Service Code	MSDRG 553
Min. Negotiated Rate	$13,407.38
Max. Negotiated Rate	$44,032.65
Rate for Payer: Aetna Commercial	$30,512.76
Rate for Payer: Aetna Medicare Advantage	$44,032.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,402.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,402.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,113.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,402.35
Rate for Payer: Cigna Commercial	$24,258.96
Rate for Payer: Cigna Medicare Advantage	$14,113.03
Rate for Payer: Clover Medicare Advantage	$13,407.38
Rate for Payer: EmblemHealth Commercial	$42,339.09
Rate for Payer: Humana Medicare Advantage	$14,536.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,113.03
Rate for Payer: Oxford Commercial	$17,435.24
Rate for Payer: UnitedHealthcare Commercial	$30,573.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,113.03
Rate for Payer: Wellcare Medicare Advantage	$14,113.03

BONE DISEASES AND ARTHROPATHIES WITHOUT MCC

Facility

$28,964.27

Service Code	MSDRG 554
Min. Negotiated Rate	$8,819.25
Max. Negotiated Rate	$28,964.27
Rate for Payer: Aetna Commercial	$20,159.09
Rate for Payer: Aetna Medicare Advantage	$28,964.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,074.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,074.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,283.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19,074.02
Rate for Payer: Cigna Commercial	$15,534.49
Rate for Payer: Cigna Medicare Advantage	$9,283.42
Rate for Payer: Clover Medicare Advantage	$8,819.25
Rate for Payer: EmblemHealth Commercial	$27,850.26
Rate for Payer: Humana Medicare Advantage	$9,561.92
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,283.42
Rate for Payer: Oxford Commercial	$11,164.84
Rate for Payer: UnitedHealthcare Commercial	$19,577.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,283.42
Rate for Payer: Wellcare Medicare Advantage	$9,283.42

BONE DOWEL 10MM

Facility

$4,887.50

Service Code	HCPCS C1713
Hospital Charge Code	270686213
Hospital Revenue Code	278
Min. Negotiated Rate	$117.79
Max. Negotiated Rate	$2,443.75
Rate for Payer: Aetna Commercial	$1,857.25
Rate for Payer: Aetna Medicare Advantage	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,246.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,246.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$977.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,246.31
Rate for Payer: Cigna Commercial	$2,443.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,182.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,075.25
Rate for Payer: Qualcare PPO/HMO/WC	$733.12
Rate for Payer: UnitedHealthcare Community & State	$117.79
Rate for Payer: Wellpoint Medicaid Managed Care	$129.52

BONE DOWEL 10MM

Facility

$4,887.50

Service Code	HCPCS C1713
Hospital Charge Code	270686213
Hospital Revenue Code	278
Min. Negotiated Rate	$733.12
Max. Negotiated Rate	$1,182.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,182.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,075.25
Rate for Payer: Qualcare PPO/HMO/WC	$733.12

BONE DOWEL 9MM

Facility

$4,887.50

Service Code	HCPCS C1713
Hospital Charge Code	270686212
Hospital Revenue Code	278
Min. Negotiated Rate	$733.12
Max. Negotiated Rate	$1,182.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,182.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,075.25
Rate for Payer: Qualcare PPO/HMO/WC	$733.12

BONE DOWEL 9MM

Facility

$4,887.50

Service Code	HCPCS C1713
Hospital Charge Code	270686212
Hospital Revenue Code	278
Min. Negotiated Rate	$117.79
Max. Negotiated Rate	$2,443.75
Rate for Payer: Aetna Commercial	$1,857.25
Rate for Payer: Aetna Medicare Advantage	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,246.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,246.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$977.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,246.31
Rate for Payer: Cigna Commercial	$2,443.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,182.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,075.25
Rate for Payer: Qualcare PPO/HMO/WC	$733.12
Rate for Payer: UnitedHealthcare Community & State	$117.79
Rate for Payer: Wellpoint Medicaid Managed Care	$129.52

BONE DOWEL REVISION KIT 18MM

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695354
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

BONE DOWEL REVISION KIT 18MM

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695354
Hospital Revenue Code	278
Min. Negotiated Rate	$66.28
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Community & State	$66.28
Rate for Payer: Wellpoint Medicaid Managed Care	$72.88

BONE DRILL 3.0

Facility

$676.40

Hospital Charge Code	270670675
Hospital Revenue Code	272
Min. Negotiated Rate	$16.30
Max. Negotiated Rate	$338.20
Rate for Payer: Aetna Commercial	$257.03
Rate for Payer: Aetna Medicare Advantage	$202.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.48
Rate for Payer: Cigna Commercial	$338.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.92
Rate for Payer: Oxford Commercial	$135.28
Rate for Payer: Qualcare PPO/HMO/WC	$101.46
Rate for Payer: UnitedHealthcare Commercial	$135.28
Rate for Payer: UnitedHealthcare Community & State	$16.30
Rate for Payer: Wellpoint Medicaid Managed Care	$17.92

BONE DRILL 3.0

Facility

$676.40

Hospital Charge Code	270670675
Hospital Revenue Code	272
Min. Negotiated Rate	$101.46
Max. Negotiated Rate	$101.46
Rate for Payer: Qualcare PPO/HMO/WC	$101.46

BONE EBI MORS CORT 20CC 450692

Facility

$1,271.10

Hospital Charge Code	270628790
Hospital Revenue Code	272
Min. Negotiated Rate	$30.63
Max. Negotiated Rate	$635.55
Rate for Payer: Aetna Commercial	$483.02
Rate for Payer: Aetna Medicare Advantage	$381.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$324.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$324.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$324.13
Rate for Payer: Cigna Commercial	$635.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$381.33
Rate for Payer: Oxford Commercial	$254.22
Rate for Payer: Qualcare PPO/HMO/WC	$190.66
Rate for Payer: UnitedHealthcare Commercial	$254.22
Rate for Payer: UnitedHealthcare Community & State	$30.63
Rate for Payer: Wellpoint Medicaid Managed Care	$33.68

BONE EBI MORS CORT 20CC 450692

Facility

$1,271.10

Hospital Charge Code	270628790
Hospital Revenue Code	272
Min. Negotiated Rate	$190.66
Max. Negotiated Rate	$190.66
Rate for Payer: Qualcare PPO/HMO/WC	$190.66

BONE FENESTRATION PERFORATOR

Facility

$877.50

Hospital Charge Code	270699686
Hospital Revenue Code	278
Min. Negotiated Rate	$21.15
Max. Negotiated Rate	$438.75
Rate for Payer: Aetna Commercial	$333.45
Rate for Payer: Aetna Medicare Advantage	$263.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.76
Rate for Payer: Cigna Commercial	$438.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$193.05
Rate for Payer: Qualcare PPO/HMO/WC	$131.62
Rate for Payer: UnitedHealthcare Community & State	$21.15
Rate for Payer: Wellpoint Medicaid Managed Care	$23.25

BONE FENESTRATION PERFORATOR

Facility

$877.50

Hospital Charge Code	270699686
Hospital Revenue Code	278
Min. Negotiated Rate	$131.62
Max. Negotiated Rate	$212.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$193.05
Rate for Payer: Qualcare PPO/HMO/WC	$131.62

BONE FILLER 10 CC

Facility

$19,337.50

Service Code	HCPCS C1713
Hospital Charge Code	270701671
Hospital Revenue Code	278
Min. Negotiated Rate	$2,900.62
Max. Negotiated Rate	$4,679.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,867.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,679.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,254.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,900.62

Know your out-of-pocket cost for care.

All Charges