Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BONE MATRIX 5.0 CC

Facility

$18,750.00

Hospital Charge Code	270702738
Hospital Revenue Code	278
Min. Negotiated Rate	$2,812.50
Max. Negotiated Rate	$4,537.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,537.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,812.50

BONE MATRIX 5.0 CC

Facility

$18,750.00

Hospital Charge Code	270702738
Hospital Revenue Code	278
Min. Negotiated Rate	$451.88
Max. Negotiated Rate	$9,375.00
Rate for Payer: Aetna Commercial	$7,125.00
Rate for Payer: Aetna Medicare Advantage	$5,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,781.25
Rate for Payer: Cigna Commercial	$9,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,537.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,812.50
Rate for Payer: UnitedHealthcare Community & State	$451.88
Rate for Payer: Wellpoint Medicaid Managed Care	$496.88

BONE MATRIX 5CC

Facility

$17,055.00

Service Code	HCPCS C1713
Hospital Charge Code	270692583
Hospital Revenue Code	278
Min. Negotiated Rate	$2,558.25
Max. Negotiated Rate	$4,127.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,411.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,127.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,752.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,558.25

BONE MATRIX 5CC

Facility

$17,055.00

Service Code	HCPCS C1713
Hospital Charge Code	270692583
Hospital Revenue Code	278
Min. Negotiated Rate	$411.03
Max. Negotiated Rate	$8,527.50
Rate for Payer: Aetna Commercial	$6,480.90
Rate for Payer: Aetna Medicare Advantage	$5,116.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,349.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,349.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,411.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,349.02
Rate for Payer: Cigna Commercial	$8,527.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,127.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,752.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,558.25
Rate for Payer: UnitedHealthcare Community & State	$411.03
Rate for Payer: Wellpoint Medicaid Managed Care	$451.96

BONE MATRIX ALLOGRAFT 10CC

Facility

$12,006.25

Hospital Charge Code	270680534
Hospital Revenue Code	278
Min. Negotiated Rate	$289.35
Max. Negotiated Rate	$6,003.12
Rate for Payer: Aetna Commercial	$4,562.38
Rate for Payer: Aetna Medicare Advantage	$3,601.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,061.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,061.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,401.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,061.59
Rate for Payer: Cigna Commercial	$6,003.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,905.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,641.38
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.94
Rate for Payer: UnitedHealthcare Community & State	$289.35
Rate for Payer: Wellpoint Medicaid Managed Care	$318.17

BONE MATRIX ALLOGRAFT 10CC

Facility

$12,006.30

Hospital Charge Code	270670534
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.94
Max. Negotiated Rate	$2,905.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,401.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,905.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,641.39
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.94

BONE MATRIX ALLOGRAFT 10CC

Facility

$12,006.30

Hospital Charge Code	270670534
Hospital Revenue Code	278
Min. Negotiated Rate	$289.35
Max. Negotiated Rate	$6,003.15
Rate for Payer: Aetna Commercial	$4,562.39
Rate for Payer: Aetna Medicare Advantage	$3,601.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,061.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,061.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,401.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,061.61
Rate for Payer: Cigna Commercial	$6,003.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,905.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,641.39
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.94
Rate for Payer: UnitedHealthcare Community & State	$289.35
Rate for Payer: Wellpoint Medicaid Managed Care	$318.17

BONE MATRIX ALLOGRAFT 10CC

Facility

$12,006.25

Hospital Charge Code	270680534
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.94
Max. Negotiated Rate	$2,905.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,401.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,905.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,641.38
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.94

BONE MATRIX ALLOGRAFT 1CC

Facility

$1,200.00

Service Code	HCPCS C1762
Hospital Charge Code	270673101
Hospital Revenue Code	278
Min. Negotiated Rate	$28.92
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$456.00
Rate for Payer: Aetna Medicare Advantage	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$306.00
Rate for Payer: Cigna Commercial	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$264.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.00
Rate for Payer: UnitedHealthcare Community & State	$28.92
Rate for Payer: Wellpoint Medicaid Managed Care	$31.80

BONE MATRIX ALLOGRAFT 1CC

Facility

$1,200.00

Service Code	HCPCS C1762
Hospital Charge Code	270673101
Hospital Revenue Code	278
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$290.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$264.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.00

BONE MATRIX ALLOGRAFT 20CC

Facility

$21,335.00

Hospital Charge Code	270670533
Hospital Revenue Code	278
Min. Negotiated Rate	$514.17
Max. Negotiated Rate	$10,667.50
Rate for Payer: Aetna Commercial	$8,107.30
Rate for Payer: Aetna Medicare Advantage	$6,400.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,440.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,440.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,440.43
Rate for Payer: Cigna Commercial	$10,667.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,163.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,693.70
Rate for Payer: Qualcare PPO/HMO/WC	$3,200.25
Rate for Payer: UnitedHealthcare Community & State	$514.17
Rate for Payer: Wellpoint Medicaid Managed Care	$565.38

BONE MATRIX ALLOGRAFT 20CC

Facility

$21,335.00

Hospital Charge Code	270670533
Hospital Revenue Code	278
Min. Negotiated Rate	$3,200.25
Max. Negotiated Rate	$5,163.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,267.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,163.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,693.70
Rate for Payer: Qualcare PPO/HMO/WC	$3,200.25

BONE MATRIX ALLOGRAFT 2CC RT

Facility

$2,362.50

Hospital Charge Code	270674031
Hospital Revenue Code	278
Min. Negotiated Rate	$56.94
Max. Negotiated Rate	$1,181.25
Rate for Payer: Aetna Commercial	$897.75
Rate for Payer: Aetna Medicare Advantage	$708.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$602.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$602.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$472.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$602.44
Rate for Payer: Cigna Commercial	$1,181.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$571.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$519.75
Rate for Payer: Qualcare PPO/HMO/WC	$354.38
Rate for Payer: UnitedHealthcare Community & State	$56.94
Rate for Payer: Wellpoint Medicaid Managed Care	$62.61

BONE MATRIX ALLOGRAFT 2CC RT

Facility

$2,362.50

Hospital Charge Code	270674031
Hospital Revenue Code	278
Min. Negotiated Rate	$354.38
Max. Negotiated Rate	$571.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$472.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$571.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$519.75
Rate for Payer: Qualcare PPO/HMO/WC	$354.38

BONE MATRIX ALLOGRAFT 5CC

Facility

$6,318.75

Service Code	HCPCS C1713
Hospital Charge Code	270675888
Hospital Revenue Code	278
Min. Negotiated Rate	$152.28
Max. Negotiated Rate	$3,159.38
Rate for Payer: Aetna Commercial	$2,401.12
Rate for Payer: Aetna Medicare Advantage	$1,895.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,611.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,611.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,263.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,611.28
Rate for Payer: Cigna Commercial	$3,159.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,529.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,390.12
Rate for Payer: Qualcare PPO/HMO/WC	$947.81
Rate for Payer: UnitedHealthcare Community & State	$152.28
Rate for Payer: Wellpoint Medicaid Managed Care	$167.45

BONE MATRIX ALLOGRAFT 5CC

Facility

$6,318.75

Service Code	HCPCS C1713
Hospital Charge Code	270675888
Hospital Revenue Code	278
Min. Negotiated Rate	$947.81
Max. Negotiated Rate	$1,529.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,263.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,529.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,390.12
Rate for Payer: Qualcare PPO/HMO/WC	$947.81

BONE MATRIX BIO4 5CC

Facility

$11,254.50

Service Code	HCPCS C1713
Hospital Charge Code	270692780
Hospital Revenue Code	278
Min. Negotiated Rate	$1,688.17
Max. Negotiated Rate	$2,723.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,250.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,723.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,475.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,688.17

BONE MATRIX BIO4 5CC

Facility

$11,254.50

Service Code	HCPCS C1713
Hospital Charge Code	270692780
Hospital Revenue Code	278
Min. Negotiated Rate	$271.23
Max. Negotiated Rate	$5,627.25
Rate for Payer: Aetna Commercial	$4,276.71
Rate for Payer: Aetna Medicare Advantage	$3,376.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,869.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,869.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,250.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,869.90
Rate for Payer: Cigna Commercial	$5,627.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,723.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,475.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,688.17
Rate for Payer: UnitedHealthcare Community & State	$271.23
Rate for Payer: Wellpoint Medicaid Managed Care	$298.24

BONE MATRIX GEL 10CC

Facility

$9,375.00

Hospital Charge Code	270672815
Hospital Revenue Code	278
Min. Negotiated Rate	$1,406.25
Max. Negotiated Rate	$2,268.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,268.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,062.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,406.25

BONE MATRIX GEL 10CC

Facility

$9,375.00

Hospital Charge Code	270672815
Hospital Revenue Code	278
Min. Negotiated Rate	$225.94
Max. Negotiated Rate	$4,687.50
Rate for Payer: Aetna Commercial	$3,562.50
Rate for Payer: Aetna Medicare Advantage	$2,812.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,390.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,390.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,390.62
Rate for Payer: Cigna Commercial	$4,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,268.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,062.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,406.25
Rate for Payer: UnitedHealthcare Community & State	$225.94
Rate for Payer: Wellpoint Medicaid Managed Care	$248.44

BONE MILL BLADES MEDIUM

Facility

$2,000.00

Hospital Charge Code	270673057
Hospital Revenue Code	270
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

BONE MILL BLADES MEDIUM

Facility

$2,000.00

Hospital Charge Code	270673057
Hospital Revenue Code	270
Min. Negotiated Rate	$48.20
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.00
Rate for Payer: Oxford Commercial	$400.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Commercial	$400.00
Rate for Payer: UnitedHealthcare Community & State	$48.20
Rate for Payer: Wellpoint Medicaid Managed Care	$53.00

BONE NUT EXTERNAL FIXAT

Facility

$416.35

Hospital Charge Code	270693745
Hospital Revenue Code	272
Min. Negotiated Rate	$10.03
Max. Negotiated Rate	$208.18
Rate for Payer: Aetna Commercial	$158.21
Rate for Payer: Aetna Medicare Advantage	$124.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.17
Rate for Payer: Cigna Commercial	$208.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.91
Rate for Payer: Oxford Commercial	$83.27
Rate for Payer: Qualcare PPO/HMO/WC	$62.45
Rate for Payer: UnitedHealthcare Commercial	$83.27
Rate for Payer: UnitedHealthcare Community & State	$10.03
Rate for Payer: Wellpoint Medicaid Managed Care	$11.03

BONE NUT EXTERNAL FIXAT

Facility

$416.35

Hospital Charge Code	270693745
Hospital Revenue Code	272
Min. Negotiated Rate	$62.45
Max. Negotiated Rate	$62.45
Rate for Payer: Qualcare PPO/HMO/WC	$62.45

BONE OSTEO-LINK CUBE 12MM

Facility

$7,775.00

Service Code	HCPCS C1713
Hospital Charge Code	270699215
Hospital Revenue Code	278
Min. Negotiated Rate	$1,166.25
Max. Negotiated Rate	$1,881.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,555.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,881.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,710.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,166.25

Know your out-of-pocket cost for care.

All Charges