Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BONE SUBSTUTE 10CC

Facility

$20,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270687085
Hospital Revenue Code	278
Min. Negotiated Rate	$490.44
Max. Negotiated Rate	$10,175.00
Rate for Payer: Aetna Commercial	$7,733.00
Rate for Payer: Aetna Medicare Advantage	$6,105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,189.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,189.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,070.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,189.25
Rate for Payer: Cigna Commercial	$10,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,924.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,477.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,052.50
Rate for Payer: UnitedHealthcare Community & State	$490.44
Rate for Payer: Wellpoint Medicaid Managed Care	$539.27

BONE SUBSUTE HATRIC AR13000B10

Facility

$4,216.00

Hospital Charge Code	270636942
Hospital Revenue Code	272
Min. Negotiated Rate	$632.40
Max. Negotiated Rate	$632.40
Rate for Payer: Qualcare PPO/HMO/WC	$632.40

BONE SUBSUTE HATRIC AR13000B10

Facility

$4,216.00

Hospital Charge Code	270636942
Hospital Revenue Code	272
Min. Negotiated Rate	$101.61
Max. Negotiated Rate	$2,108.00
Rate for Payer: Aetna Commercial	$1,602.08
Rate for Payer: Aetna Medicare Advantage	$1,264.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,075.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,075.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,075.08
Rate for Payer: Cigna Commercial	$2,108.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,264.80
Rate for Payer: Oxford Commercial	$843.20
Rate for Payer: Qualcare PPO/HMO/WC	$632.40
Rate for Payer: UnitedHealthcare Commercial	$843.20
Rate for Payer: UnitedHealthcare Community & State	$101.61
Rate for Payer: Wellpoint Medicaid Managed Care	$111.72

BONE SURVEY COMPL

Facility

$5,100.00

Service Code	HCPCS 77075
Hospital Charge Code	94061197
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

BONE SURVEY COMPL

Facility

$5,100.00

Service Code	HCPCS 77075
Hospital Charge Code	94061197
Hospital Revenue Code	320
Min. Negotiated Rate	$54.23
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	$54.23
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: Wellcare New Jersey Medicaid/Family Care	$407.88
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

BONESYNC 3CC

Facility

$6,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270687862
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

BONESYNC 3CC

Facility

$6,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270687862
Hospital Revenue Code	278
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

BONESYNC BIOACTIVE

Facility

$15,500.00

Service Code	HCPCS C1765
Hospital Charge Code	270706176
Hospital Revenue Code	278
Min. Negotiated Rate	$373.55
Max. Negotiated Rate	$7,750.00
Rate for Payer: Aetna Commercial	$5,890.00
Rate for Payer: Aetna Medicare Advantage	$4,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,952.50
Rate for Payer: Cigna Commercial	$7,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,751.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,410.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,325.00
Rate for Payer: UnitedHealthcare Community & State	$373.55
Rate for Payer: Wellpoint Medicaid Managed Care	$410.75

BONESYNC BIOACTIVE

Facility

$15,500.00

Service Code	HCPCS C1765
Hospital Charge Code	270706176
Hospital Revenue Code	278
Min. Negotiated Rate	$2,325.00
Max. Negotiated Rate	$3,751.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,751.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,410.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,325.00

BONE TAMP INFLATABLE 15/3 K09A

Facility

$5,381.65

Hospital Charge Code	270633786
Hospital Revenue Code	272
Min. Negotiated Rate	$129.70
Max. Negotiated Rate	$2,690.82
Rate for Payer: Aetna Commercial	$2,045.03
Rate for Payer: Aetna Medicare Advantage	$1,614.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,372.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,372.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,372.32
Rate for Payer: Cigna Commercial	$2,690.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.49
Rate for Payer: Oxford Commercial	$1,076.33
Rate for Payer: Qualcare PPO/HMO/WC	$807.25
Rate for Payer: UnitedHealthcare Commercial	$1,076.33
Rate for Payer: UnitedHealthcare Community & State	$129.70
Rate for Payer: Wellpoint Medicaid Managed Care	$142.61

BONE TAMP INFLATABLE 15/3 K09A

Facility

$5,381.65

Hospital Charge Code	270633786
Hospital Revenue Code	272
Min. Negotiated Rate	$807.25
Max. Negotiated Rate	$807.25
Rate for Payer: Qualcare PPO/HMO/WC	$807.25

BONE TAMP INFLATABLE 20/3 K08A

Facility

$5,451.10

Hospital Charge Code	270631258
Hospital Revenue Code	272
Min. Negotiated Rate	$817.66
Max. Negotiated Rate	$817.66
Rate for Payer: Qualcare PPO/HMO/WC	$817.66

BONE TAMP INFLATABLE 20/3 K08A

Facility

$5,451.10

Hospital Charge Code	270631258
Hospital Revenue Code	272
Min. Negotiated Rate	$131.37
Max. Negotiated Rate	$2,725.55
Rate for Payer: Aetna Commercial	$2,071.42
Rate for Payer: Aetna Medicare Advantage	$1,635.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,390.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,390.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,390.03
Rate for Payer: Cigna Commercial	$2,725.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,635.33
Rate for Payer: Oxford Commercial	$1,090.22
Rate for Payer: Qualcare PPO/HMO/WC	$817.66
Rate for Payer: UnitedHealthcare Commercial	$1,090.22
Rate for Payer: UnitedHealthcare Community & State	$131.37
Rate for Payer: Wellpoint Medicaid Managed Care	$144.45

BONE TAMP/KYPHON EXPRESS II 15

Facility

$14,962.50

Service Code	HCPCS C1713
Hospital Charge Code	270669630
Hospital Revenue Code	278
Min. Negotiated Rate	$2,244.38
Max. Negotiated Rate	$3,620.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,992.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,620.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,291.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,244.38

BONE TAMP/KYPHON EXPRESS II 15

Facility

$14,962.50

Service Code	HCPCS C1713
Hospital Charge Code	270669630
Hospital Revenue Code	278
Min. Negotiated Rate	$360.60
Max. Negotiated Rate	$7,481.25
Rate for Payer: Aetna Commercial	$5,685.75
Rate for Payer: Aetna Medicare Advantage	$4,488.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,815.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,815.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,815.44
Rate for Payer: Cigna Commercial	$7,481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,620.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,291.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,244.38
Rate for Payer: UnitedHealthcare Community & State	$360.60
Rate for Payer: Wellpoint Medicaid Managed Care	$396.51

BONE TAP

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688421
Hospital Revenue Code	278
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

BONE TAP

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688421
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

BONE TAP 3.5MM X100MM

Facility

$1,030.00

Service Code	HCPCS C1713
Hospital Charge Code	270704606
Hospital Revenue Code	278
Min. Negotiated Rate	$154.50
Max. Negotiated Rate	$249.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$226.60
Rate for Payer: Qualcare PPO/HMO/WC	$154.50

BONE TAP 3.5MM X100MM

Facility

$1,030.00

Service Code	HCPCS C1713
Hospital Charge Code	270704606
Hospital Revenue Code	278
Min. Negotiated Rate	$24.82
Max. Negotiated Rate	$515.00
Rate for Payer: Aetna Commercial	$391.40
Rate for Payer: Aetna Medicare Advantage	$309.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$262.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$262.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$262.65
Rate for Payer: Cigna Commercial	$515.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$226.60
Rate for Payer: Qualcare PPO/HMO/WC	$154.50
Rate for Payer: UnitedHealthcare Community & State	$24.82
Rate for Payer: Wellpoint Medicaid Managed Care	$27.30

BONE TAP 5.5 MM

Facility

$0.01

Service Code	HCPCS C1713
Hospital Charge Code	270690565
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

BONE TAP 5.5 MM

Facility

$0.01

Service Code	HCPCS C1713
Hospital Charge Code	270690565
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

BONE TAP SYMPHONY 4.0

Facility

$2,160.00

Hospital Charge Code	270693361
Hospital Revenue Code	272
Min. Negotiated Rate	$52.06
Max. Negotiated Rate	$1,080.00
Rate for Payer: Aetna Commercial	$820.80
Rate for Payer: Aetna Medicare Advantage	$648.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$550.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$550.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$550.80
Rate for Payer: Cigna Commercial	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.00
Rate for Payer: Oxford Commercial	$432.00
Rate for Payer: Qualcare PPO/HMO/WC	$324.00
Rate for Payer: UnitedHealthcare Commercial	$432.00
Rate for Payer: UnitedHealthcare Community & State	$52.06
Rate for Payer: Wellpoint Medicaid Managed Care	$57.24

BONE TAP SYMPHONY 4.0

Facility

$2,160.00

Hospital Charge Code	270693361
Hospital Revenue Code	272
Min. Negotiated Rate	$324.00
Max. Negotiated Rate	$324.00
Rate for Payer: Qualcare PPO/HMO/WC	$324.00

BONE TAP SYMPHONY 4.5

Facility

$2,160.00

Hospital Charge Code	270693362
Hospital Revenue Code	272
Min. Negotiated Rate	$52.06
Max. Negotiated Rate	$1,080.00
Rate for Payer: Aetna Commercial	$820.80
Rate for Payer: Aetna Medicare Advantage	$648.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$550.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$550.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$550.80
Rate for Payer: Cigna Commercial	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.00
Rate for Payer: Oxford Commercial	$432.00
Rate for Payer: Qualcare PPO/HMO/WC	$324.00
Rate for Payer: UnitedHealthcare Commercial	$432.00
Rate for Payer: UnitedHealthcare Community & State	$52.06
Rate for Payer: Wellpoint Medicaid Managed Care	$57.24

BONE TAP SYMPHONY 4.5

Facility

$2,160.00

Hospital Charge Code	270693362
Hospital Revenue Code	272
Min. Negotiated Rate	$324.00
Max. Negotiated Rate	$324.00
Rate for Payer: Qualcare PPO/HMO/WC	$324.00

Know your out-of-pocket cost for care.

All Charges