Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CANNULA T15 HEXALOBE

Facility

$975.00

Hospital Charge Code	270691764
Hospital Revenue Code	272
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

CANNULA T15 HEXALOBE

Facility

$975.00

Hospital Charge Code	270691764
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CANNULATED DRILL 3MM

Facility

$1,262.25

Hospital Charge Code	270705562
Hospital Revenue Code	279
Min. Negotiated Rate	$30.42
Max. Negotiated Rate	$631.12
Rate for Payer: Aetna Commercial	$479.65
Rate for Payer: Aetna Medicare Advantage	$378.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$321.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$321.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$321.87
Rate for Payer: Cigna Commercial	$631.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$378.68
Rate for Payer: Oxford Commercial	$252.45
Rate for Payer: Qualcare PPO/HMO/WC	$189.34
Rate for Payer: UnitedHealthcare Commercial	$252.45
Rate for Payer: UnitedHealthcare Community & State	$30.42
Rate for Payer: Wellpoint Medicaid Managed Care	$33.45

CANNULATED DRILL 3MM

Facility

$1,262.25

Hospital Charge Code	270705562
Hospital Revenue Code	279
Min. Negotiated Rate	$189.34
Max. Negotiated Rate	$189.34
Rate for Payer: Qualcare PPO/HMO/WC	$189.34

CANNULATED DRILL 4.5 MM

Facility

$975.00

Hospital Charge Code	270684324
Hospital Revenue Code	272
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

CANNULATED DRILL 4.5 MM

Facility

$975.00

Hospital Charge Code	270684324
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CANNULATED DRILL 7MM X 200MM

Facility

$1,180.00

Hospital Charge Code	270659841
Hospital Revenue Code	272
Min. Negotiated Rate	$28.44
Max. Negotiated Rate	$590.00
Rate for Payer: Aetna Commercial	$448.40
Rate for Payer: Aetna Medicare Advantage	$354.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$300.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$300.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$300.90
Rate for Payer: Cigna Commercial	$590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.00
Rate for Payer: Oxford Commercial	$236.00
Rate for Payer: Qualcare PPO/HMO/WC	$177.00
Rate for Payer: UnitedHealthcare Commercial	$236.00
Rate for Payer: UnitedHealthcare Community & State	$28.44
Rate for Payer: Wellpoint Medicaid Managed Care	$31.27

CANNULATED DRILL 7MM X 200MM

Facility

$1,180.00

Hospital Charge Code	270659841
Hospital Revenue Code	272
Min. Negotiated Rate	$177.00
Max. Negotiated Rate	$177.00
Rate for Payer: Qualcare PPO/HMO/WC	$177.00

CANNULATED DRILL BIT

Facility

$1,445.50

Hospital Charge Code	270656401
Hospital Revenue Code	272
Min. Negotiated Rate	$216.82
Max. Negotiated Rate	$216.82
Rate for Payer: Qualcare PPO/HMO/WC	$216.82

CANNULATED DRILL BIT

Facility

$1,445.50

Hospital Charge Code	270656401
Hospital Revenue Code	272
Min. Negotiated Rate	$34.84
Max. Negotiated Rate	$722.75
Rate for Payer: Aetna Commercial	$549.29
Rate for Payer: Aetna Medicare Advantage	$433.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$368.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$368.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$368.60
Rate for Payer: Cigna Commercial	$722.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.65
Rate for Payer: Oxford Commercial	$289.10
Rate for Payer: Qualcare PPO/HMO/WC	$216.82
Rate for Payer: UnitedHealthcare Commercial	$289.10
Rate for Payer: UnitedHealthcare Community & State	$34.84
Rate for Payer: Wellpoint Medicaid Managed Care	$38.31

CANNULATED DRILL BIT 7.0MM

Facility

$2,870.00

Hospital Charge Code	270692838
Hospital Revenue Code	272
Min. Negotiated Rate	$69.17
Max. Negotiated Rate	$1,435.00
Rate for Payer: Aetna Commercial	$1,090.60
Rate for Payer: Aetna Medicare Advantage	$861.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$731.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$731.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$731.85
Rate for Payer: Cigna Commercial	$1,435.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$861.00
Rate for Payer: Oxford Commercial	$574.00
Rate for Payer: Qualcare PPO/HMO/WC	$430.50
Rate for Payer: UnitedHealthcare Commercial	$574.00
Rate for Payer: UnitedHealthcare Community & State	$69.17
Rate for Payer: Wellpoint Medicaid Managed Care	$76.06

CANNULATED DRILL BIT 7.0MM

Facility

$2,870.00

Hospital Charge Code	270692838
Hospital Revenue Code	272
Min. Negotiated Rate	$430.50
Max. Negotiated Rate	$430.50
Rate for Payer: Qualcare PPO/HMO/WC	$430.50

CANNULATED NAIL SYSTEM 4X100M

Facility

$18,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270704014
Hospital Revenue Code	278
Min. Negotiated Rate	$2,737.50
Max. Negotiated Rate	$4,416.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,416.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,015.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,737.50

CANNULATED NAIL SYSTEM 4X100M

Facility

$18,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270704014
Hospital Revenue Code	278
Min. Negotiated Rate	$439.82
Max. Negotiated Rate	$9,125.00
Rate for Payer: Aetna Commercial	$6,935.00
Rate for Payer: Aetna Medicare Advantage	$5,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,653.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,653.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,653.75
Rate for Payer: Cigna Commercial	$9,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,416.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,015.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,737.50
Rate for Payer: UnitedHealthcare Community & State	$439.82
Rate for Payer: Wellpoint Medicaid Managed Care	$483.62

CANNULATED POLYAXIAL SCREW

Facility

$745.00

Hospital Charge Code	270664359
Hospital Revenue Code	278
Min. Negotiated Rate	$17.95
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$163.90
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$17.95
Rate for Payer: Wellpoint Medicaid Managed Care	$19.74

CANNULATED POLYAXIAL SCREW

Facility

$745.00

Hospital Charge Code	270664359
Hospital Revenue Code	278
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$163.90
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

CANNULATED SCREW 2.0MM X 14MM

Facility

$1,074.75

Service Code	HCPCS C1713
Hospital Charge Code	270679141
Hospital Revenue Code	278
Min. Negotiated Rate	$161.21
Max. Negotiated Rate	$260.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.44
Rate for Payer: Qualcare PPO/HMO/WC	$161.21

CANNULATED SCREW 2.0MM X 14MM

Facility

$1,074.75

Service Code	HCPCS C1713
Hospital Charge Code	270679141
Hospital Revenue Code	278
Min. Negotiated Rate	$25.90
Max. Negotiated Rate	$537.38
Rate for Payer: Aetna Commercial	$408.40
Rate for Payer: Aetna Medicare Advantage	$322.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.06
Rate for Payer: Cigna Commercial	$537.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.44
Rate for Payer: Qualcare PPO/HMO/WC	$161.21
Rate for Payer: UnitedHealthcare Community & State	$25.90
Rate for Payer: Wellpoint Medicaid Managed Care	$28.48

CANNULATED SCREW 75MM

Facility

$2,114.35

Service Code	HCPCS C1713
Hospital Charge Code	270704741
Hospital Revenue Code	278
Min. Negotiated Rate	$50.96
Max. Negotiated Rate	$1,057.17
Rate for Payer: Aetna Commercial	$803.45
Rate for Payer: Aetna Medicare Advantage	$634.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$539.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$539.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$422.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$539.16
Rate for Payer: Cigna Commercial	$1,057.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$511.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$465.16
Rate for Payer: Qualcare PPO/HMO/WC	$317.15
Rate for Payer: UnitedHealthcare Community & State	$50.96
Rate for Payer: Wellpoint Medicaid Managed Care	$56.03

CANNULATED SCREW 75MM

Facility

$2,114.35

Service Code	HCPCS C1713
Hospital Charge Code	270704741
Hospital Revenue Code	278
Min. Negotiated Rate	$317.15
Max. Negotiated Rate	$511.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$422.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$511.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$465.16
Rate for Payer: Qualcare PPO/HMO/WC	$317.15

CANNULATED SCREW SMALL

Facility

$910.00

Hospital Charge Code	270335014
Hospital Revenue Code	278
Min. Negotiated Rate	$21.93
Max. Negotiated Rate	$455.00
Rate for Payer: Aetna Commercial	$345.80
Rate for Payer: Aetna Medicare Advantage	$273.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.05
Rate for Payer: Cigna Commercial	$455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.20
Rate for Payer: Qualcare PPO/HMO/WC	$136.50
Rate for Payer: UnitedHealthcare Community & State	$21.93
Rate for Payer: Wellpoint Medicaid Managed Care	$24.11

CANNULATED SCREW SMALL

Facility

$910.00

Hospital Charge Code	270335014
Hospital Revenue Code	278
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$220.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.20
Rate for Payer: Qualcare PPO/HMO/WC	$136.50

CANNULATED TAP

Facility

$1,086.25

Hospital Charge Code	270701686
Hospital Revenue Code	278
Min. Negotiated Rate	$26.18
Max. Negotiated Rate	$543.12
Rate for Payer: Aetna Commercial	$412.77
Rate for Payer: Aetna Medicare Advantage	$325.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$276.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$276.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$276.99
Rate for Payer: Cigna Commercial	$543.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$238.97
Rate for Payer: Qualcare PPO/HMO/WC	$162.94
Rate for Payer: UnitedHealthcare Community & State	$26.18
Rate for Payer: Wellpoint Medicaid Managed Care	$28.79

CANNULATED TAP

Facility

$1,086.25

Hospital Charge Code	270701686
Hospital Revenue Code	278
Min. Negotiated Rate	$162.94
Max. Negotiated Rate	$262.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$238.97
Rate for Payer: Qualcare PPO/HMO/WC	$162.94

CANNULATED TAP FOR 5MM DUAL SC

Facility

$3,290.00

Hospital Charge Code	270656675
Hospital Revenue Code	272
Min. Negotiated Rate	$493.50
Max. Negotiated Rate	$493.50
Rate for Payer: Qualcare PPO/HMO/WC	$493.50

Know your out-of-pocket cost for care.

All Charges