Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

132 CEMENTED HIP STEM

Facility

$22,305.00

Hospital Charge Code	270656398
Hospital Revenue Code	278
Min. Negotiated Rate	$537.55
Max. Negotiated Rate	$11,152.50
Rate for Payer: Aetna Commercial	$8,475.90
Rate for Payer: Aetna Medicare Advantage	$6,691.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,687.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,687.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,461.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,687.77
Rate for Payer: Cigna Commercial	$11,152.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,397.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,907.10
Rate for Payer: Qualcare PPO/HMO/WC	$3,345.75
Rate for Payer: UnitedHealthcare Community & State	$537.55
Rate for Payer: Wellpoint Medicaid Managed Care	$591.08

132 NECK ANGLE HIP STEM

Facility

$307.85

Service Code	HCPCS C1776
Hospital Charge Code	270686734
Hospital Revenue Code	278
Min. Negotiated Rate	$7.42
Max. Negotiated Rate	$153.93
Rate for Payer: Aetna Commercial	$116.98
Rate for Payer: Aetna Medicare Advantage	$92.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.50
Rate for Payer: Cigna Commercial	$153.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$67.73
Rate for Payer: Qualcare PPO/HMO/WC	$46.18
Rate for Payer: UnitedHealthcare Community & State	$7.42
Rate for Payer: Wellpoint Medicaid Managed Care	$8.16

132 NECK ANGLE HIP STEM

Facility

$307.85

Service Code	HCPCS C1776
Hospital Charge Code	270686734
Hospital Revenue Code	278
Min. Negotiated Rate	$46.18
Max. Negotiated Rate	$74.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$67.73
Rate for Payer: Qualcare PPO/HMO/WC	$46.18

1.35 K WIRE

Facility

$100.00

Service Code	HCPCS C1769
Hospital Charge Code	270659329
Hospital Revenue Code	278
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$24.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

1.35 K WIRE

Facility

$100.00

Service Code	HCPCS C1769
Hospital Charge Code	270659329
Hospital Revenue Code	278
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$38.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Community & State	$2.41
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

1.3MM TI CORTEX SCREW SELF-TAP

Facility

$337.40

Service Code	HCPCS C1713
Hospital Charge Code	270682225
Hospital Revenue Code	278
Min. Negotiated Rate	$8.13
Max. Negotiated Rate	$168.70
Rate for Payer: Aetna Commercial	$128.21
Rate for Payer: Aetna Medicare Advantage	$101.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.04
Rate for Payer: Cigna Commercial	$168.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$74.23
Rate for Payer: Qualcare PPO/HMO/WC	$50.61
Rate for Payer: UnitedHealthcare Community & State	$8.13
Rate for Payer: Wellpoint Medicaid Managed Care	$8.94

1.3MM TI CORTEX SCREW SELF-TAP

Facility

$337.40

Service Code	HCPCS C1713
Hospital Charge Code	270682225
Hospital Revenue Code	278
Min. Negotiated Rate	$50.61
Max. Negotiated Rate	$81.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$74.23
Rate for Payer: Qualcare PPO/HMO/WC	$50.61

1.3MM TI CORTEX SRW SLF-TAP 10

Facility

$337.40

Service Code	HCPCS C1713
Hospital Charge Code	270681697
Hospital Revenue Code	278
Min. Negotiated Rate	$8.13
Max. Negotiated Rate	$168.70
Rate for Payer: Aetna Commercial	$128.21
Rate for Payer: Aetna Medicare Advantage	$101.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.04
Rate for Payer: Cigna Commercial	$168.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$74.23
Rate for Payer: Qualcare PPO/HMO/WC	$50.61
Rate for Payer: UnitedHealthcare Community & State	$8.13
Rate for Payer: Wellpoint Medicaid Managed Care	$8.94

1.3MM TI CORTEX SRW SLF-TAP 10

Facility

$337.40

Service Code	HCPCS C1713
Hospital Charge Code	270681697
Hospital Revenue Code	278
Min. Negotiated Rate	$50.61
Max. Negotiated Rate	$81.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$74.23
Rate for Payer: Qualcare PPO/HMO/WC	$50.61

1.3MM TI CORTEX SRW SLF-TAP 11

Facility

$337.40

Service Code	HCPCS C1713
Hospital Charge Code	270681698
Hospital Revenue Code	278
Min. Negotiated Rate	$50.61
Max. Negotiated Rate	$81.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$74.23
Rate for Payer: Qualcare PPO/HMO/WC	$50.61

1.3MM TI CORTEX SRW SLF-TAP 11

Facility

$337.40

Service Code	HCPCS C1713
Hospital Charge Code	270681698
Hospital Revenue Code	278
Min. Negotiated Rate	$8.13
Max. Negotiated Rate	$168.70
Rate for Payer: Aetna Commercial	$128.21
Rate for Payer: Aetna Medicare Advantage	$101.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.04
Rate for Payer: Cigna Commercial	$168.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$74.23
Rate for Payer: Qualcare PPO/HMO/WC	$50.61
Rate for Payer: UnitedHealthcare Community & State	$8.13
Rate for Payer: Wellpoint Medicaid Managed Care	$8.94

1.3MM TI CORTEX SRW SLF-TAP 12

Facility

$337.40

Service Code	HCPCS C1713
Hospital Charge Code	270681699
Hospital Revenue Code	278
Min. Negotiated Rate	$8.13
Max. Negotiated Rate	$168.70
Rate for Payer: Aetna Commercial	$128.21
Rate for Payer: Aetna Medicare Advantage	$101.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.04
Rate for Payer: Cigna Commercial	$168.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$74.23
Rate for Payer: Qualcare PPO/HMO/WC	$50.61
Rate for Payer: UnitedHealthcare Community & State	$8.13
Rate for Payer: Wellpoint Medicaid Managed Care	$8.94

1.3MM TI CORTEX SRW SLF-TAP 12

Facility

$337.40

Service Code	HCPCS C1713
Hospital Charge Code	270681699
Hospital Revenue Code	278
Min. Negotiated Rate	$50.61
Max. Negotiated Rate	$81.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$74.23
Rate for Payer: Qualcare PPO/HMO/WC	$50.61

1.3MM TI CORTX SCRW SLFTAP 6MM

Facility

$337.40

Service Code	HCPCS C1713
Hospital Charge Code	270686786
Hospital Revenue Code	278
Min. Negotiated Rate	$8.13
Max. Negotiated Rate	$168.70
Rate for Payer: Aetna Commercial	$128.21
Rate for Payer: Aetna Medicare Advantage	$101.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.04
Rate for Payer: Cigna Commercial	$168.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$74.23
Rate for Payer: Qualcare PPO/HMO/WC	$50.61
Rate for Payer: UnitedHealthcare Community & State	$8.13
Rate for Payer: Wellpoint Medicaid Managed Care	$8.94

1.3MM TI CORTX SCRW SLFTAP 6MM

Facility

$337.40

Service Code	HCPCS C1713
Hospital Charge Code	270686786
Hospital Revenue Code	278
Min. Negotiated Rate	$50.61
Max. Negotiated Rate	$81.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$74.23
Rate for Payer: Qualcare PPO/HMO/WC	$50.61

1.3MM TI CORTX SCRW SLFTAP 7MM

Facility

$337.40

Service Code	HCPCS C1713
Hospital Charge Code	270686787
Hospital Revenue Code	278
Min. Negotiated Rate	$50.61
Max. Negotiated Rate	$81.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$74.23
Rate for Payer: Qualcare PPO/HMO/WC	$50.61

1.3MM TI CORTX SCRW SLFTAP 7MM

Facility

$337.40

Service Code	HCPCS C1713
Hospital Charge Code	270686787
Hospital Revenue Code	278
Min. Negotiated Rate	$8.13
Max. Negotiated Rate	$168.70
Rate for Payer: Aetna Commercial	$128.21
Rate for Payer: Aetna Medicare Advantage	$101.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.04
Rate for Payer: Cigna Commercial	$168.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$74.23
Rate for Payer: Qualcare PPO/HMO/WC	$50.61
Rate for Payer: UnitedHealthcare Community & State	$8.13
Rate for Payer: Wellpoint Medicaid Managed Care	$8.94

13MMX100MM STEM EXTENSION

Facility

$5,245.85

Hospital Charge Code	270656848
Hospital Revenue Code	278
Min. Negotiated Rate	$126.42
Max. Negotiated Rate	$2,622.93
Rate for Payer: Aetna Commercial	$1,993.42
Rate for Payer: Aetna Medicare Advantage	$1,573.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,337.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,337.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,049.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,337.69
Rate for Payer: Cigna Commercial	$2,622.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,269.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,154.09
Rate for Payer: Qualcare PPO/HMO/WC	$786.88
Rate for Payer: UnitedHealthcare Community & State	$126.42
Rate for Payer: Wellpoint Medicaid Managed Care	$139.02

13MMX100MM STEM EXTENSION

Facility

$5,245.85

Hospital Charge Code	270656848
Hospital Revenue Code	278
Min. Negotiated Rate	$786.88
Max. Negotiated Rate	$1,269.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,049.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,269.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,154.09
Rate for Payer: Qualcare PPO/HMO/WC	$786.88

13MM X 8 DEGREE PLATE

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704185
Hospital Revenue Code	278
Min. Negotiated Rate	$289.20
Max. Negotiated Rate	$6,000.00
Rate for Payer: Aetna Commercial	$4,560.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,640.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Community & State	$289.20
Rate for Payer: Wellpoint Medicaid Managed Care	$318.00

13MM X 8 DEGREE PLATE

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704185
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$2,904.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,640.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

140/80 HA PINS

Facility

$720.00

Hospital Charge Code	270339495
Hospital Revenue Code	272
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$108.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

140/80 HA PINS

Facility

$720.00

Hospital Charge Code	270339495
Hospital Revenue Code	272
Min. Negotiated Rate	$17.35
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$273.60
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.00
Rate for Payer: Oxford Commercial	$144.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.00
Rate for Payer: UnitedHealthcare Commercial	$144.00
Rate for Payer: UnitedHealthcare Community & State	$17.35
Rate for Payer: Wellpoint Medicaid Managed Care	$19.08

14.3.3 ETA PROTEIN (SERUM)

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	3032492
Hospital Revenue Code	306
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$46.97
Rate for Payer: Aetna Medicare Advantage	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.34
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.27
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Medicare Advantage	$17.27
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

14.3.3 ETA PROTEIN (SERUM)

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	3032492
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges