Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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

BONE OSTEO-LINK MATRIX 5CC

Facility

$5,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270699237
Hospital Revenue Code	278
Min. Negotiated Rate	$850.50
Max. Negotiated Rate	$1,372.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,134.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,372.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,247.40
Rate for Payer: Qualcare PPO/HMO/WC	$850.50

BONE OSTEO-LINK MATRIX 5CC

Facility

$5,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270699237
Hospital Revenue Code	278
Min. Negotiated Rate	$136.65
Max. Negotiated Rate	$2,835.00
Rate for Payer: Aetna Commercial	$2,154.60
Rate for Payer: Aetna Medicare Advantage	$1,701.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,445.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,445.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,134.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,445.85
Rate for Payer: Cigna Commercial	$2,835.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,372.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,247.40
Rate for Payer: Qualcare PPO/HMO/WC	$850.50
Rate for Payer: UnitedHealthcare Community & State	$136.65
Rate for Payer: Wellpoint Medicaid Managed Care	$150.25

BONE PASTE OSTEOFIL 10CC 02410

Facility

$3,387.25

Hospital Charge Code	270614975
Hospital Revenue Code	272
Min. Negotiated Rate	$81.63
Max. Negotiated Rate	$1,693.62
Rate for Payer: Aetna Commercial	$1,287.15
Rate for Payer: Aetna Medicare Advantage	$1,016.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$863.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$863.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$863.75
Rate for Payer: Cigna Commercial	$1,693.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,016.17
Rate for Payer: Oxford Commercial	$677.45
Rate for Payer: Qualcare PPO/HMO/WC	$508.09
Rate for Payer: UnitedHealthcare Commercial	$677.45
Rate for Payer: UnitedHealthcare Community & State	$81.63
Rate for Payer: Wellpoint Medicaid Managed Care	$89.76

BONE PASTE OSTEOFIL 10CC 02410

Facility

$3,387.25

Hospital Charge Code	270614975
Hospital Revenue Code	272
Min. Negotiated Rate	$508.09
Max. Negotiated Rate	$508.09
Rate for Payer: Qualcare PPO/HMO/WC	$508.09

BONE PASTE OSTEOFIL 1CC 002401

Facility

$996.85

Hospital Charge Code	270614654
Hospital Revenue Code	272
Min. Negotiated Rate	$24.02
Max. Negotiated Rate	$498.43
Rate for Payer: Aetna Commercial	$378.80
Rate for Payer: Aetna Medicare Advantage	$299.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.20
Rate for Payer: Cigna Commercial	$498.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$299.06
Rate for Payer: Oxford Commercial	$199.37
Rate for Payer: Qualcare PPO/HMO/WC	$149.53
Rate for Payer: UnitedHealthcare Commercial	$199.37
Rate for Payer: UnitedHealthcare Community & State	$24.02
Rate for Payer: Wellpoint Medicaid Managed Care	$26.42

BONE PASTE OSTEOFIL 1CC 002401

Facility

$996.85

Hospital Charge Code	270614654
Hospital Revenue Code	272
Min. Negotiated Rate	$149.53
Max. Negotiated Rate	$149.53
Rate for Payer: Qualcare PPO/HMO/WC	$149.53

BONE PINS 3.2X140MM

Facility

$1,140.75

Service Code	HCPCS C1713
Hospital Charge Code	270690847
Hospital Revenue Code	278
Min. Negotiated Rate	$27.49
Max. Negotiated Rate	$570.38
Rate for Payer: Aetna Commercial	$433.49
Rate for Payer: Aetna Medicare Advantage	$342.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.89
Rate for Payer: Cigna Commercial	$570.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$250.97
Rate for Payer: Qualcare PPO/HMO/WC	$171.11
Rate for Payer: UnitedHealthcare Community & State	$27.49
Rate for Payer: Wellpoint Medicaid Managed Care	$30.23

BONE PINS 3.2X140MM

Facility

$1,140.75

Service Code	HCPCS C1713
Hospital Charge Code	270690847
Hospital Revenue Code	278
Min. Negotiated Rate	$171.11
Max. Negotiated Rate	$276.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$250.97
Rate for Payer: Qualcare PPO/HMO/WC	$171.11

BONE PLUG SUTURE

Facility

$633.75

Hospital Charge Code	270673444
Hospital Revenue Code	272
Min. Negotiated Rate	$15.27
Max. Negotiated Rate	$316.88
Rate for Payer: Aetna Commercial	$240.82
Rate for Payer: Aetna Medicare Advantage	$190.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.61
Rate for Payer: Cigna Commercial	$316.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$190.12
Rate for Payer: Oxford Commercial	$126.75
Rate for Payer: Qualcare PPO/HMO/WC	$95.06
Rate for Payer: UnitedHealthcare Commercial	$126.75
Rate for Payer: UnitedHealthcare Community & State	$15.27
Rate for Payer: Wellpoint Medicaid Managed Care	$16.79

BONE PLUG SUTURE

Facility

$633.75

Hospital Charge Code	270673444
Hospital Revenue Code	272
Min. Negotiated Rate	$95.06
Max. Negotiated Rate	$95.06
Rate for Payer: Qualcare PPO/HMO/WC	$95.06

BONE PUTTY 2.5CC

Facility

$10,402.50

Service Code	HCPCS C1713
Hospital Charge Code	270696527
Hospital Revenue Code	278
Min. Negotiated Rate	$1,560.38
Max. Negotiated Rate	$2,517.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,080.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,517.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,288.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,560.38

BONE PUTTY 2.5CC

Facility

$10,402.50

Service Code	HCPCS C1713
Hospital Charge Code	270696527
Hospital Revenue Code	278
Min. Negotiated Rate	$250.70
Max. Negotiated Rate	$5,201.25
Rate for Payer: Aetna Commercial	$3,952.95
Rate for Payer: Aetna Medicare Advantage	$3,120.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,652.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,652.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,080.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,652.64
Rate for Payer: Cigna Commercial	$5,201.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,517.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,288.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,560.38
Rate for Payer: UnitedHealthcare Community & State	$250.70
Rate for Payer: Wellpoint Medicaid Managed Care	$275.67

BONE REVISION DOWLS 14

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270680643
Hospital Revenue Code	278
Min. Negotiated Rate	$162.68
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$162.68
Rate for Payer: Wellpoint Medicaid Managed Care	$178.88

BONE REVISION DOWLS 14

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270680643
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

BONE REVISION DOWLS 16

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270680644
Hospital Revenue Code	278
Min. Negotiated Rate	$162.68
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$162.68
Rate for Payer: Wellpoint Medicaid Managed Care	$178.88

BONE REVISION DOWLS 16

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270680644
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

BONE REVISION DOWLS 18

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270680645
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

BONE REVISION DOWLS 18

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270680645
Hospital Revenue Code	278
Min. Negotiated Rate	$162.68
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$162.68
Rate for Payer: Wellpoint Medicaid Managed Care	$178.88

BONE SCAN, 3-PHASE

Facility

$12,000.00

Service Code	HCPCS 78315
Hospital Charge Code	4500542
Hospital Revenue Code	341
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$1,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

BONE SCAN, 3-PHASE

Facility

$12,000.00

Service Code	HCPCS 78315
Hospital Charge Code	4500542
Hospital Revenue Code	341
Min. Negotiated Rate	$240.64
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$1,291.84
Rate for Payer: Aetna Medicare Advantage	$1,538.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$474.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,714.39
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: Cigna Medicare Advantage	$332.46
Rate for Payer: Clover Medicare Advantage	$451.19
Rate for Payer: EmblemHealth Commercial	$1,424.82
Rate for Payer: Humana Medicare Advantage	$489.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$474.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,600.00
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$289.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$474.94
Rate for Payer: Wellcare Medicare Advantage	$474.94
Rate for Payer: Wellpoint Medicaid Managed Care	$318.00

BONE SCREW 16 THD 6.5x75MM

Facility

$135.00

Service Code	HCPCS C1713
Hospital Charge Code	270675136
Hospital Revenue Code	278
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$51.30
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.42
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.25
Rate for Payer: UnitedHealthcare Community & State	$3.25
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

BONE SCREW 16 THD 6.5x75MM

Facility

$135.00

Service Code	HCPCS C1713
Hospital Charge Code	270675136
Hospital Revenue Code	278
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$32.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

BONE SCREW 1.7MMx7MM 58-17007E

Facility

$550.00

Hospital Charge Code	270655361
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

BONE SCREW 1.7MMx7MM 58-17007E

Facility

$550.00

Hospital Charge Code	270655361
Hospital Revenue Code	278
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

Know your out-of-pocket cost for care.

All Charges