Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

14-3-3 PROTEIN

Facility

$154.75

Service Code	HCPCS 82528
Hospital Charge Code	3038120
Hospital Revenue Code	300
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$61.25
Rate for Payer: Aetna Medicare Advantage	$72.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.29
Rate for Payer: Cigna Commercial	$77.38
Rate for Payer: Cigna Medicare Advantage	$22.52
Rate for Payer: Clover Medicare Advantage	$21.39
Rate for Payer: EmblemHealth Commercial	$67.56
Rate for Payer: Humana Medicare Advantage	$23.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.42
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.21
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$18.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.52
Rate for Payer: Wellcare Medicare Advantage	$22.52
Rate for Payer: Wellpoint Medicaid Managed Care	$4.10

14-3-3 PROTEIN

Facility

$154.75

Service Code	HCPCS 82528
Hospital Charge Code	3038120
Hospital Revenue Code	300
Min. Negotiated Rate	$23.21
Max. Negotiated Rate	$23.21
Rate for Payer: Qualcare PPO/HMO/WC	$23.21

14-3-3 PROTEIN,CSF

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	39900338
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

14-3-3 PROTEIN,CSF

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	39900338
Hospital Revenue Code	301
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 FR X 15 CM SLX SCHON CATHET

Facility

$425.00

Service Code	HCPCS C1752
Hospital Charge Code	270661315
Hospital Revenue Code	278
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

14 FR X 15 CM SLX SCHON CATHET

Facility

$425.00

Service Code	HCPCS C1752
Hospital Charge Code	270661315
Hospital Revenue Code	278
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

14 FR X 20 CM SLX SCHON CATH

Facility

$510.00

Service Code	HCPCS C1752
Hospital Charge Code	270661314
Hospital Revenue Code	278
Min. Negotiated Rate	$76.50
Max. Negotiated Rate	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$112.20
Rate for Payer: Qualcare PPO/HMO/WC	$76.50

14 FR X 20 CM SLX SCHON CATH

Facility

$510.00

Service Code	HCPCS C1752
Hospital Charge Code	270661314
Hospital Revenue Code	278
Min. Negotiated Rate	$12.29
Max. Negotiated Rate	$255.00
Rate for Payer: Aetna Commercial	$193.80
Rate for Payer: Aetna Medicare Advantage	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.05
Rate for Payer: Cigna Commercial	$255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$112.20
Rate for Payer: Qualcare PPO/HMO/WC	$76.50
Rate for Payer: UnitedHealthcare Community & State	$12.29
Rate for Payer: Wellpoint Medicaid Managed Care	$13.52

1-4MM, 30CC

Facility

$13,050.00

Service Code	HCPCS C1765
Hospital Charge Code	270704996
Hospital Revenue Code	278
Min. Negotiated Rate	$314.50
Max. Negotiated Rate	$6,525.00
Rate for Payer: Aetna Commercial	$4,959.00
Rate for Payer: Aetna Medicare Advantage	$3,915.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,327.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,327.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,610.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,327.75
Rate for Payer: Cigna Commercial	$6,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,158.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,957.50
Rate for Payer: UnitedHealthcare Community & State	$314.50
Rate for Payer: Wellpoint Medicaid Managed Care	$345.82

1-4MM, 30CC

Facility

$13,050.00

Service Code	HCPCS C1765
Hospital Charge Code	270704996
Hospital Revenue Code	278
Min. Negotiated Rate	$1,957.50
Max. Negotiated Rate	$3,158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,610.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,158.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,957.50

14MM DRILL

Facility

$825.00

Hospital Charge Code	270656331
Hospital Revenue Code	272
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$123.75
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

14MM DRILL

Facility

$825.00

Hospital Charge Code	270656331
Hospital Revenue Code	272
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.50
Rate for Payer: Oxford Commercial	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Commercial	$165.00
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

14MM SELF DRILL RESCUE SCREW

Facility

$382.50

Service Code	HCPCS C1713
Hospital Charge Code	270705021
Hospital Revenue Code	278
Min. Negotiated Rate	$57.38
Max. Negotiated Rate	$92.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$84.15
Rate for Payer: Qualcare PPO/HMO/WC	$57.38

14MM SELF DRILL RESCUE SCREW

Facility

$382.50

Service Code	HCPCS C1713
Hospital Charge Code	270705021
Hospital Revenue Code	278
Min. Negotiated Rate	$9.22
Max. Negotiated Rate	$191.25
Rate for Payer: Aetna Commercial	$145.35
Rate for Payer: Aetna Medicare Advantage	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.54
Rate for Payer: Cigna Commercial	$191.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$84.15
Rate for Payer: Qualcare PPO/HMO/WC	$57.38
Rate for Payer: UnitedHealthcare Community & State	$9.22
Rate for Payer: Wellpoint Medicaid Managed Care	$10.14

14MM VAR SCREWS

Facility

$1,560.00

Hospital Charge Code	270656333
Hospital Revenue Code	278
Min. Negotiated Rate	$37.60
Max. Negotiated Rate	$780.00
Rate for Payer: Aetna Commercial	$592.80
Rate for Payer: Aetna Medicare Advantage	$468.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$397.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$397.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$312.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$397.80
Rate for Payer: Cigna Commercial	$780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$377.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$343.20
Rate for Payer: Qualcare PPO/HMO/WC	$234.00
Rate for Payer: UnitedHealthcare Community & State	$37.60
Rate for Payer: Wellpoint Medicaid Managed Care	$41.34

14MM VAR SCREWS

Facility

$1,560.00

Hospital Charge Code	270656333
Hospital Revenue Code	278
Min. Negotiated Rate	$234.00
Max. Negotiated Rate	$377.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$312.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$377.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$343.20
Rate for Payer: Qualcare PPO/HMO/WC	$234.00

14MM X 155MM STEM EXTENSION

Facility

$5,245.85

Hospital Charge Code	270656849
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

14MM X 155MM STEM EXTENSION

Facility

$5,245.85

Hospital Charge Code	270656849
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

14X12X6 CAGE 6D TIGERSHARK

Facility

$5,500.00

Hospital Charge Code	270703449
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

14X12X6 CAGE 6D TIGERSHARK

Facility

$5,500.00

Hospital Charge Code	270703449
Hospital Revenue Code	278
Min. Negotiated Rate	$132.55
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$132.55
Rate for Payer: Wellpoint Medicaid Managed Care	$145.75

14X12X6MM STATIC CERVICAL

Facility

$17,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270706105
Hospital Revenue Code	278
Min. Negotiated Rate	$415.73
Max. Negotiated Rate	$8,625.00
Rate for Payer: Aetna Commercial	$6,555.00
Rate for Payer: Aetna Medicare Advantage	$5,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,398.75
Rate for Payer: Cigna Commercial	$8,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50
Rate for Payer: UnitedHealthcare Community & State	$415.73
Rate for Payer: Wellpoint Medicaid Managed Care	$457.12

14X12X6MM STATIC CERVICAL

Facility

$17,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270706105
Hospital Revenue Code	278
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$4,174.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

14X12X7MM,6DEGREE TIGERSHARK

Facility

$5,500.00

Hospital Charge Code	270703450
Hospital Revenue Code	278
Min. Negotiated Rate	$132.55
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$132.55
Rate for Payer: Wellpoint Medicaid Managed Care	$145.75

14X12X7MM,6DEGREE TIGERSHARK

Facility

$5,500.00

Hospital Charge Code	270703450
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

150MM CARBON ROD

Facility

$775.00

Hospital Charge Code	270339505
Hospital Revenue Code	278
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$187.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

Know your out-of-pocket cost for care.

All Charges