Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CORKSCREW ANCHOR 3.5X10MM

Facility

$1,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270660658
Hospital Revenue Code	278
Min. Negotiated Rate	$213.75
Max. Negotiated Rate	$344.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$285.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$313.50
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

CORKSCREW ANCHOR 5.0MM

Facility

$676.00

Service Code	HCPCS C1713
Hospital Charge Code	270332597
Hospital Revenue Code	278
Min. Negotiated Rate	$16.29
Max. Negotiated Rate	$338.00
Rate for Payer: Aetna Commercial	$256.88
Rate for Payer: Aetna Medicare Advantage	$202.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.38
Rate for Payer: Cigna Commercial	$338.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.72
Rate for Payer: Qualcare PPO/HMO/WC	$101.40
Rate for Payer: UnitedHealthcare Community & State	$16.29
Rate for Payer: Wellpoint Medicaid Managed Care	$17.91

CORKSCREW ANCHOR 5.0MM

Facility

$676.00

Service Code	HCPCS C1713
Hospital Charge Code	270332597
Hospital Revenue Code	278
Min. Negotiated Rate	$101.40
Max. Negotiated Rate	$163.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.72
Rate for Payer: Qualcare PPO/HMO/WC	$101.40

CORKSCREW MINI FT SUTRE ANCHOR

Facility

$2,040.00

Hospital Charge Code	270668330
Hospital Revenue Code	278
Min. Negotiated Rate	$306.00
Max. Negotiated Rate	$493.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$408.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$493.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$448.80
Rate for Payer: Qualcare PPO/HMO/WC	$306.00

CORKSCREW MINI FT SUTRE ANCHOR

Facility

$2,040.00

Hospital Charge Code	270668330
Hospital Revenue Code	278
Min. Negotiated Rate	$49.16
Max. Negotiated Rate	$1,020.00
Rate for Payer: Aetna Commercial	$775.20
Rate for Payer: Aetna Medicare Advantage	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$520.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$520.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$520.20
Rate for Payer: Cigna Commercial	$1,020.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$493.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$448.80
Rate for Payer: Qualcare PPO/HMO/WC	$306.00
Rate for Payer: UnitedHealthcare Community & State	$49.16
Rate for Payer: Wellpoint Medicaid Managed Care	$54.06

CORKSCREW NANO

Facility

$2,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270683441
Hospital Revenue Code	278
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$514.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$467.50
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

CORKSCREW NANO

Facility

$2,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270683441
Hospital Revenue Code	278
Min. Negotiated Rate	$51.21
Max. Negotiated Rate	$1,062.50
Rate for Payer: Aetna Commercial	$807.50
Rate for Payer: Aetna Medicare Advantage	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$541.88
Rate for Payer: Cigna Commercial	$1,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$467.50
Rate for Payer: Qualcare PPO/HMO/WC	$318.75
Rate for Payer: UnitedHealthcare Community & State	$51.21
Rate for Payer: Wellpoint Medicaid Managed Care	$56.31

CORKSCREW PEEK FT 4.75MM

Facility

$7,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270681457
Hospital Revenue Code	278
Min. Negotiated Rate	$1,181.25
Max. Negotiated Rate	$1,905.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,905.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,732.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25

CORKSCREW PEEK FT 4.75MM

Facility

$7,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270681457
Hospital Revenue Code	278
Min. Negotiated Rate	$189.79
Max. Negotiated Rate	$3,937.50
Rate for Payer: Aetna Commercial	$2,992.50
Rate for Payer: Aetna Medicare Advantage	$2,362.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,008.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,008.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,008.12
Rate for Payer: Cigna Commercial	$3,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,905.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,732.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25
Rate for Payer: UnitedHealthcare Community & State	$189.79
Rate for Payer: Wellpoint Medicaid Managed Care	$208.69

CORKSCREW PEEK FT 5.5x14.7MM

Facility

$1,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270674851
Hospital Revenue Code	272
Min. Negotiated Rate	$34.34
Max. Negotiated Rate	$712.50
Rate for Payer: Aetna Commercial	$541.50
Rate for Payer: Aetna Medicare Advantage	$427.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.38
Rate for Payer: Cigna Commercial	$712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$427.50
Rate for Payer: Oxford Commercial	$285.00
Rate for Payer: Qualcare PPO/HMO/WC	$213.75
Rate for Payer: UnitedHealthcare Commercial	$285.00
Rate for Payer: UnitedHealthcare Community & State	$34.34
Rate for Payer: Wellpoint Medicaid Managed Care	$37.76

CORKSCREW PEEK FT 5.5x14.7MM

Facility

$1,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270674851
Hospital Revenue Code	272
Min. Negotiated Rate	$213.75
Max. Negotiated Rate	$213.75
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

CORKSCREW PUNCH 4.5MM

Facility

$375.00

Service Code	HCPCS A4649
Hospital Charge Code	270663943
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

CORKSCREW PUNCH 4.5MM

Facility

$375.00

Service Code	HCPCS A4649
Hospital Charge Code	270663943
Hospital Revenue Code	272
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$75.00
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

CORKSCREW TIGERTAIL 4.5x14MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270674130
Hospital Revenue Code	278
Min. Negotiated Rate	$41.57
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$655.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$379.50
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Community & State	$41.57
Rate for Payer: Wellpoint Medicaid Managed Care	$45.71

CORKSCREW TIGERTAIL 4.5x14MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270674130
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$417.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$379.50
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

CORKSCREW W/SUTURE TAPE 5.5MM

Facility

$1,775.00

Hospital Charge Code	270679782
Hospital Revenue Code	272
Min. Negotiated Rate	$266.25
Max. Negotiated Rate	$266.25
Rate for Payer: Qualcare PPO/HMO/WC	$266.25

CORKSCREW W/SUTURE TAPE 5.5MM

Facility

$1,775.00

Hospital Charge Code	270679782
Hospital Revenue Code	272
Min. Negotiated Rate	$42.78
Max. Negotiated Rate	$887.50
Rate for Payer: Aetna Commercial	$674.50
Rate for Payer: Aetna Medicare Advantage	$532.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$452.62
Rate for Payer: Cigna Commercial	$887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.50
Rate for Payer: Oxford Commercial	$355.00
Rate for Payer: Qualcare PPO/HMO/WC	$266.25
Rate for Payer: UnitedHealthcare Commercial	$355.00
Rate for Payer: UnitedHealthcare Community & State	$42.78
Rate for Payer: Wellpoint Medicaid Managed Care	$47.04

CORNEA

Facility

$17,500.00

Service Code	HCPCS V2785
Hospital Charge Code	270678203
Hospital Revenue Code	810
Min. Negotiated Rate	$421.75
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$6,650.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,250.00
Rate for Payer: Oxford Commercial	$3,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00
Rate for Payer: UnitedHealthcare Commercial	$3,500.00
Rate for Payer: UnitedHealthcare Community & State	$421.75
Rate for Payer: Wellpoint Medicaid Managed Care	$463.75

CORNEA

Facility

$17,500.00

Service Code	HCPCS V2785
Hospital Charge Code	270678203
Hospital Revenue Code	810
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$2,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

CORNEA

Facility

$19,000.00

Service Code	HCPCS V2785
Hospital Charge Code	270679263
Hospital Revenue Code	810
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$2,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00

CORNEA

Facility

$19,000.00

Service Code	HCPCS V2785
Hospital Charge Code	270671147
Hospital Revenue Code	810
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$2,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00

CORNEA

Facility

$19,000.00

Service Code	HCPCS V2785
Hospital Charge Code	270679263
Hospital Revenue Code	810
Min. Negotiated Rate	$457.90
Max. Negotiated Rate	$9,500.00
Rate for Payer: Aetna Commercial	$7,220.00
Rate for Payer: Aetna Medicare Advantage	$5,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,845.00
Rate for Payer: Cigna Commercial	$9,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,700.00
Rate for Payer: Oxford Commercial	$3,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00
Rate for Payer: UnitedHealthcare Commercial	$3,800.00
Rate for Payer: UnitedHealthcare Community & State	$457.90
Rate for Payer: Wellpoint Medicaid Managed Care	$503.50

CORNEA

Facility

$19,000.00

Service Code	HCPCS V2785
Hospital Charge Code	270671147
Hospital Revenue Code	810
Min. Negotiated Rate	$457.90
Max. Negotiated Rate	$9,500.00
Rate for Payer: Aetna Commercial	$7,220.00
Rate for Payer: Aetna Medicare Advantage	$5,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,845.00
Rate for Payer: Cigna Commercial	$9,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,700.00
Rate for Payer: Oxford Commercial	$3,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00
Rate for Payer: UnitedHealthcare Commercial	$3,800.00
Rate for Payer: UnitedHealthcare Community & State	$457.90
Rate for Payer: Wellpoint Medicaid Managed Care	$503.50

CORNEA - 0509-13-01

Facility

$15,500.00

Service Code	HCPCS V2785
Hospital Charge Code	270660412
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

CORNEA - 0509-13-01

Facility

$15,500.00

Service Code	HCPCS V2785
Hospital Charge Code	270660412
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

Know your out-of-pocket cost for care.

All Charges