Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

COUNTERSINK 4MM CANN HD DRVR

Facility

$660.00

Hospital Charge Code	270700812
Hospital Revenue Code	272
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

COUNTERSINK5.0MMCANN DARTFIRE

Facility

$1,750.00

Hospital Charge Code	270700384
Hospital Revenue Code	272
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$525.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$350.00
Rate for Payer: UnitedHealthcare Community & State	$42.17
Rate for Payer: Wellpoint Medicaid Managed Care	$46.38

COUNTERSINK5.0MMCANN DARTFIRE

Facility

$1,750.00

Hospital Charge Code	270700384
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

COUNTERSINK 6MM SOLID

Facility

$650.00

Service Code	HCPCS C1713
Hospital Charge Code	270701058
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

COUNTERSINK 6MM SOLID

Facility

$650.00

Service Code	HCPCS C1713
Hospital Charge Code	270701058
Hospital Revenue Code	278
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

COUNTERSINK BX 2.7MM CS2702

Facility

$576.00

Hospital Charge Code	270620189
Hospital Revenue Code	272
Min. Negotiated Rate	$13.88
Max. Negotiated Rate	$288.00
Rate for Payer: Aetna Commercial	$218.88
Rate for Payer: Aetna Medicare Advantage	$172.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.88
Rate for Payer: Cigna Commercial	$288.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.80
Rate for Payer: Oxford Commercial	$115.20
Rate for Payer: Qualcare PPO/HMO/WC	$86.40
Rate for Payer: UnitedHealthcare Commercial	$115.20
Rate for Payer: UnitedHealthcare Community & State	$13.88
Rate for Payer: Wellpoint Medicaid Managed Care	$15.26

COUNTERSINK BX 2.7MM CS2702

Facility

$576.00

Hospital Charge Code	270620189
Hospital Revenue Code	272
Min. Negotiated Rate	$86.40
Max. Negotiated Rate	$86.40
Rate for Payer: Qualcare PPO/HMO/WC	$86.40

COUNTERSINK CANN 6.5/8MM SCREW

Facility

$1,830.00

Hospital Charge Code	270674054
Hospital Revenue Code	278
Min. Negotiated Rate	$44.10
Max. Negotiated Rate	$915.00
Rate for Payer: Aetna Commercial	$695.40
Rate for Payer: Aetna Medicare Advantage	$549.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$466.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$466.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$366.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$466.65
Rate for Payer: Cigna Commercial	$915.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$442.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$402.60
Rate for Payer: Qualcare PPO/HMO/WC	$274.50
Rate for Payer: UnitedHealthcare Community & State	$44.10
Rate for Payer: Wellpoint Medicaid Managed Care	$48.49

COUNTERSINK CANN 6.5/8MM SCREW

Facility

$1,830.00

Hospital Charge Code	270674054
Hospital Revenue Code	278
Min. Negotiated Rate	$274.50
Max. Negotiated Rate	$442.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$366.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$442.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$402.60
Rate for Payer: Qualcare PPO/HMO/WC	$274.50

COUNTERSINK CANN F/4.5MM SCREW

Facility

$1,517.20

Service Code	HCPCS C1713
Hospital Charge Code	270656226
Hospital Revenue Code	278
Min. Negotiated Rate	$36.56
Max. Negotiated Rate	$758.60
Rate for Payer: Aetna Commercial	$576.54
Rate for Payer: Aetna Medicare Advantage	$455.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$386.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$386.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$303.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$386.89
Rate for Payer: Cigna Commercial	$758.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$367.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$333.78
Rate for Payer: Qualcare PPO/HMO/WC	$227.58
Rate for Payer: UnitedHealthcare Community & State	$36.56
Rate for Payer: Wellpoint Medicaid Managed Care	$40.21

COUNTERSINK CANN F/4.5MM SCREW

Facility

$1,517.20

Service Code	HCPCS C1713
Hospital Charge Code	270656226
Hospital Revenue Code	278
Min. Negotiated Rate	$227.58
Max. Negotiated Rate	$367.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$303.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$367.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$333.78
Rate for Payer: Qualcare PPO/HMO/WC	$227.58

COUNTERSINK CANN F/6.5 & 7.3MM

Facility

$1,875.65

Hospital Charge Code	270667083
Hospital Revenue Code	278
Min. Negotiated Rate	$45.20
Max. Negotiated Rate	$937.83
Rate for Payer: Aetna Commercial	$712.75
Rate for Payer: Aetna Medicare Advantage	$562.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.29
Rate for Payer: Cigna Commercial	$937.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.64
Rate for Payer: Qualcare PPO/HMO/WC	$281.35
Rate for Payer: UnitedHealthcare Community & State	$45.20
Rate for Payer: Wellpoint Medicaid Managed Care	$49.70

COUNTERSINK CANN F/6.5 & 7.3MM

Facility

$1,875.65

Hospital Charge Code	270667083
Hospital Revenue Code	278
Min. Negotiated Rate	$281.35
Max. Negotiated Rate	$453.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.64
Rate for Payer: Qualcare PPO/HMO/WC	$281.35

COUNTERSINK CANN FOR 3.5MM/4MM

Facility

$1,416.00

Service Code	HCPCS C1713
Hospital Charge Code	270656227
Hospital Revenue Code	278
Min. Negotiated Rate	$34.13
Max. Negotiated Rate	$708.00
Rate for Payer: Aetna Commercial	$538.08
Rate for Payer: Aetna Medicare Advantage	$424.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$361.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$361.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$283.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$361.08
Rate for Payer: Cigna Commercial	$708.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$342.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$311.52
Rate for Payer: Qualcare PPO/HMO/WC	$212.40
Rate for Payer: UnitedHealthcare Community & State	$34.13
Rate for Payer: Wellpoint Medicaid Managed Care	$37.52

COUNTERSINK CANN FOR 3.5MM/4MM

Facility

$1,416.00

Service Code	HCPCS C1713
Hospital Charge Code	270656227
Hospital Revenue Code	278
Min. Negotiated Rate	$212.40
Max. Negotiated Rate	$342.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$283.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$342.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$311.52
Rate for Payer: Qualcare PPO/HMO/WC	$212.40

COUNTERSINK CANN SCREW 2/2.4MM

Facility

$1,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270662575
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$435.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

COUNTERSINK CANN SCREW 2/2.4MM

Facility

$1,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270662575
Hospital Revenue Code	278
Min. Negotiated Rate	$43.38
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$684.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Community & State	$43.38
Rate for Payer: Wellpoint Medicaid Managed Care	$47.70

COUNTERSINK CANNULATED 4.0MM

Facility

$2,553.40

Service Code	HCPCS C1713
Hospital Charge Code	270663658
Hospital Revenue Code	278
Min. Negotiated Rate	$383.01
Max. Negotiated Rate	$617.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$510.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$617.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$561.75
Rate for Payer: Qualcare PPO/HMO/WC	$383.01

COUNTERSINK CANNULATED 4.0MM

Facility

$772.50

Service Code	HCPCS C1713
Hospital Charge Code	270703752
Hospital Revenue Code	278
Min. Negotiated Rate	$115.88
Max. Negotiated Rate	$186.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$169.95
Rate for Payer: Qualcare PPO/HMO/WC	$115.88

COUNTERSINK CANNULATED 4.0MM

Facility

$2,553.40

Service Code	HCPCS C1713
Hospital Charge Code	270663658
Hospital Revenue Code	278
Min. Negotiated Rate	$61.54
Max. Negotiated Rate	$1,276.70
Rate for Payer: Aetna Commercial	$970.29
Rate for Payer: Aetna Medicare Advantage	$766.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$510.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$651.12
Rate for Payer: Cigna Commercial	$1,276.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$617.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$561.75
Rate for Payer: Qualcare PPO/HMO/WC	$383.01
Rate for Payer: UnitedHealthcare Community & State	$61.54
Rate for Payer: Wellpoint Medicaid Managed Care	$67.67

COUNTERSINK CANNULATED 4.0MM

Facility

$772.50

Service Code	HCPCS C1713
Hospital Charge Code	270703752
Hospital Revenue Code	278
Min. Negotiated Rate	$18.62
Max. Negotiated Rate	$386.25
Rate for Payer: Aetna Commercial	$293.55
Rate for Payer: Aetna Medicare Advantage	$231.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.99
Rate for Payer: Cigna Commercial	$386.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$169.95
Rate for Payer: Qualcare PPO/HMO/WC	$115.88
Rate for Payer: UnitedHealthcare Community & State	$18.62
Rate for Payer: Wellpoint Medicaid Managed Care	$20.47

COUNTERSINK F/2 & 2.4MM SCREW

Facility

$463.50

Service Code	HCPCS C1713
Hospital Charge Code	270641315
Hospital Revenue Code	278
Min. Negotiated Rate	$11.17
Max. Negotiated Rate	$231.75
Rate for Payer: Aetna Commercial	$176.13
Rate for Payer: Aetna Medicare Advantage	$139.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.19
Rate for Payer: Cigna Commercial	$231.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$101.97
Rate for Payer: Qualcare PPO/HMO/WC	$69.53
Rate for Payer: UnitedHealthcare Community & State	$11.17
Rate for Payer: Wellpoint Medicaid Managed Care	$12.28

COUNTERSINK F/2 & 2.4MM SCREW

Facility

$463.50

Service Code	HCPCS C1713
Hospital Charge Code	270641315
Hospital Revenue Code	278
Min. Negotiated Rate	$69.53
Max. Negotiated Rate	$112.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$101.97
Rate for Payer: Qualcare PPO/HMO/WC	$69.53

COUNTERSINK F/3.5 & 4.0 MM CTX

Facility

$624.20

Service Code	HCPCS C1713
Hospital Charge Code	270617326
Hospital Revenue Code	278
Min. Negotiated Rate	$15.04
Max. Negotiated Rate	$312.10
Rate for Payer: Aetna Commercial	$237.20
Rate for Payer: Aetna Medicare Advantage	$187.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.17
Rate for Payer: Cigna Commercial	$312.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.32
Rate for Payer: Qualcare PPO/HMO/WC	$93.63
Rate for Payer: UnitedHealthcare Community & State	$15.04
Rate for Payer: Wellpoint Medicaid Managed Care	$16.54

COUNTERSINK F/3.5 & 4.0 MM CTX

Facility

$624.20

Service Code	HCPCS C1713
Hospital Charge Code	270617326
Hospital Revenue Code	278
Min. Negotiated Rate	$93.63
Max. Negotiated Rate	$151.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.32
Rate for Payer: Qualcare PPO/HMO/WC	$93.63

Know your out-of-pocket cost for care.

All Charges