Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

2301 AXONICS REMOTE CONTROL

Facility

$4,400.00

Hospital Charge Code	270702023
Hospital Revenue Code	278
Min. Negotiated Rate	$106.04
Max. Negotiated Rate	$2,200.00
Rate for Payer: Aetna Commercial	$1,672.00
Rate for Payer: Aetna Medicare Advantage	$1,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$880.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,122.00
Rate for Payer: Cigna Commercial	$2,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,064.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$660.00
Rate for Payer: UnitedHealthcare Community & State	$106.04
Rate for Payer: Wellpoint Medicaid Managed Care	$116.60

2301 AXONICS REMOTE CONTROL

Facility

$4,400.00

Hospital Charge Code	270702023
Hospital Revenue Code	278
Min. Negotiated Rate	$660.00
Max. Negotiated Rate	$1,064.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$880.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,064.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$660.00

2.3MM SHORT BEVEL 35 DEG ICW

Facility

$2,455.00

Hospital Charge Code	270678531
Hospital Revenue Code	272
Min. Negotiated Rate	$59.17
Max. Negotiated Rate	$1,227.50
Rate for Payer: Aetna Commercial	$932.90
Rate for Payer: Aetna Medicare Advantage	$736.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$626.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$626.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$626.02
Rate for Payer: Cigna Commercial	$1,227.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$736.50
Rate for Payer: Oxford Commercial	$491.00
Rate for Payer: Qualcare PPO/HMO/WC	$368.25
Rate for Payer: UnitedHealthcare Commercial	$491.00
Rate for Payer: UnitedHealthcare Community & State	$59.17
Rate for Payer: Wellpoint Medicaid Managed Care	$65.06

2.3MM SHORT BEVEL 35 DEG ICW

Facility

$2,455.00

Hospital Charge Code	270678531
Hospital Revenue Code	272
Min. Negotiated Rate	$368.25
Max. Negotiated Rate	$368.25
Rate for Payer: Qualcare PPO/HMO/WC	$368.25

2.3 X 10 BONE SCREW

Facility

$555.00

Hospital Charge Code	270657983
Hospital Revenue Code	278
Min. Negotiated Rate	$13.38
Max. Negotiated Rate	$277.50
Rate for Payer: Aetna Commercial	$210.90
Rate for Payer: Aetna Medicare Advantage	$166.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$141.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$141.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$141.53
Rate for Payer: Cigna Commercial	$277.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$122.10
Rate for Payer: Qualcare PPO/HMO/WC	$83.25
Rate for Payer: UnitedHealthcare Community & State	$13.38
Rate for Payer: Wellpoint Medicaid Managed Care	$14.71

2.3 X 10 BONE SCREW

Facility

$555.00

Hospital Charge Code	270657983
Hospital Revenue Code	278
Min. Negotiated Rate	$83.25
Max. Negotiated Rate	$134.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$122.10
Rate for Payer: Qualcare PPO/HMO/WC	$83.25

2.3 X 12 BONE SCREW

Facility

$555.00

Hospital Charge Code	270657993
Hospital Revenue Code	278
Min. Negotiated Rate	$13.38
Max. Negotiated Rate	$277.50
Rate for Payer: Aetna Commercial	$210.90
Rate for Payer: Aetna Medicare Advantage	$166.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$141.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$141.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$141.53
Rate for Payer: Cigna Commercial	$277.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$122.10
Rate for Payer: Qualcare PPO/HMO/WC	$83.25
Rate for Payer: UnitedHealthcare Community & State	$13.38
Rate for Payer: Wellpoint Medicaid Managed Care	$14.71

2.3 X 12 BONE SCREW

Facility

$555.00

Hospital Charge Code	270657993
Hospital Revenue Code	278
Min. Negotiated Rate	$83.25
Max. Negotiated Rate	$134.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$122.10
Rate for Payer: Qualcare PPO/HMO/WC	$83.25

2.3 X 12 CANNULATED SCREW

Facility

$680.00

Hospital Charge Code	270656420
Hospital Revenue Code	278
Min. Negotiated Rate	$16.39
Max. Negotiated Rate	$340.00
Rate for Payer: Aetna Commercial	$258.40
Rate for Payer: Aetna Medicare Advantage	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.40
Rate for Payer: Cigna Commercial	$340.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$149.60
Rate for Payer: Qualcare PPO/HMO/WC	$102.00
Rate for Payer: UnitedHealthcare Community & State	$16.39
Rate for Payer: Wellpoint Medicaid Managed Care	$18.02

2.3 X 12 CANNULATED SCREW

Facility

$680.00

Hospital Charge Code	270656420
Hospital Revenue Code	278
Min. Negotiated Rate	$102.00
Max. Negotiated Rate	$164.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$149.60
Rate for Payer: Qualcare PPO/HMO/WC	$102.00

2.3 X 12 CORTICAL SCREW

Facility

$465.00

Hospital Charge Code	270656421
Hospital Revenue Code	278
Min. Negotiated Rate	$69.75
Max. Negotiated Rate	$112.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$102.30
Rate for Payer: Qualcare PPO/HMO/WC	$69.75

2.3 X 12 CORTICAL SCREW

Facility

$465.00

Hospital Charge Code	270656421
Hospital Revenue Code	278
Min. Negotiated Rate	$11.21
Max. Negotiated Rate	$232.50
Rate for Payer: Aetna Commercial	$176.70
Rate for Payer: Aetna Medicare Advantage	$139.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.58
Rate for Payer: Cigna Commercial	$232.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$102.30
Rate for Payer: Qualcare PPO/HMO/WC	$69.75
Rate for Payer: UnitedHealthcare Community & State	$11.21
Rate for Payer: Wellpoint Medicaid Managed Care	$12.32

2.3X12MM AO DRILL

Facility

$4,250.00

Hospital Charge Code	270705959
Hospital Revenue Code	279
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$637.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

2.3X12MM AO DRILL

Facility

$4,250.00

Hospital Charge Code	270705959
Hospital Revenue Code	279
Min. Negotiated Rate	$102.42
Max. Negotiated Rate	$2,125.00
Rate for Payer: Aetna Commercial	$1,615.00
Rate for Payer: Aetna Medicare Advantage	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,083.75
Rate for Payer: Cigna Commercial	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,275.00
Rate for Payer: Oxford Commercial	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$637.50
Rate for Payer: UnitedHealthcare Commercial	$850.00
Rate for Payer: UnitedHealthcare Community & State	$102.42
Rate for Payer: Wellpoint Medicaid Managed Care	$112.62

2.3 X 12MM LOCK SCREW

Facility

$375.00

Hospital Charge Code	270656004
Hospital Revenue Code	278
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) NJ Health	$75.00
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	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

2.3 X 12MM LOCK SCREW

Facility

$375.00

Hospital Charge Code	270656004
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

2.3X13MM BONE SCREWS,CROSS PIN

Facility

$683.70

Service Code	HCPCS C1713
Hospital Charge Code	270687944
Hospital Revenue Code	278
Min. Negotiated Rate	$16.48
Max. Negotiated Rate	$341.85
Rate for Payer: Aetna Commercial	$259.81
Rate for Payer: Aetna Medicare Advantage	$205.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.34
Rate for Payer: Cigna Commercial	$341.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$150.41
Rate for Payer: Qualcare PPO/HMO/WC	$102.56
Rate for Payer: UnitedHealthcare Community & State	$16.48
Rate for Payer: Wellpoint Medicaid Managed Care	$18.12

2.3X13MM BONE SCREWS,CROSS PIN

Facility

$683.70

Service Code	HCPCS C1713
Hospital Charge Code	270687944
Hospital Revenue Code	278
Min. Negotiated Rate	$102.56
Max. Negotiated Rate	$165.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$150.41
Rate for Payer: Qualcare PPO/HMO/WC	$102.56

2.3 X 14 CANNULATED SCREW

Facility

$680.00

Hospital Charge Code	270656422
Hospital Revenue Code	278
Min. Negotiated Rate	$102.00
Max. Negotiated Rate	$164.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$149.60
Rate for Payer: Qualcare PPO/HMO/WC	$102.00

2.3 X 14 CANNULATED SCREW

Facility

$680.00

Hospital Charge Code	270656422
Hospital Revenue Code	278
Min. Negotiated Rate	$16.39
Max. Negotiated Rate	$340.00
Rate for Payer: Aetna Commercial	$258.40
Rate for Payer: Aetna Medicare Advantage	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.40
Rate for Payer: Cigna Commercial	$340.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$149.60
Rate for Payer: Qualcare PPO/HMO/WC	$102.00
Rate for Payer: UnitedHealthcare Community & State	$16.39
Rate for Payer: Wellpoint Medicaid Managed Care	$18.02

2.3 X 14 CORTICAL SCREW

Facility

$465.00

Hospital Charge Code	270656428
Hospital Revenue Code	278
Min. Negotiated Rate	$69.75
Max. Negotiated Rate	$112.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$102.30
Rate for Payer: Qualcare PPO/HMO/WC	$69.75

2.3 X 14 CORTICAL SCREW

Facility

$465.00

Hospital Charge Code	270656428
Hospital Revenue Code	278
Min. Negotiated Rate	$11.21
Max. Negotiated Rate	$232.50
Rate for Payer: Aetna Commercial	$176.70
Rate for Payer: Aetna Medicare Advantage	$139.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.58
Rate for Payer: Cigna Commercial	$232.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$102.30
Rate for Payer: Qualcare PPO/HMO/WC	$69.75
Rate for Payer: UnitedHealthcare Community & State	$11.21
Rate for Payer: Wellpoint Medicaid Managed Care	$12.32

2.3 X 16 CANNULATED SCREW

Facility

$680.00

Hospital Charge Code	270656423
Hospital Revenue Code	278
Min. Negotiated Rate	$102.00
Max. Negotiated Rate	$164.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$149.60
Rate for Payer: Qualcare PPO/HMO/WC	$102.00

2.3 X 16 CANNULATED SCREW

Facility

$680.00

Hospital Charge Code	270656423
Hospital Revenue Code	278
Min. Negotiated Rate	$16.39
Max. Negotiated Rate	$340.00
Rate for Payer: Aetna Commercial	$258.40
Rate for Payer: Aetna Medicare Advantage	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.40
Rate for Payer: Cigna Commercial	$340.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$149.60
Rate for Payer: Qualcare PPO/HMO/WC	$102.00
Rate for Payer: UnitedHealthcare Community & State	$16.39
Rate for Payer: Wellpoint Medicaid Managed Care	$18.02

23 X 16 CORTICAL SCREW

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270656435
Hospital Revenue Code	278
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$180.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Community & State	$11.45
Rate for Payer: Wellpoint Medicaid Managed Care	$12.59

Know your out-of-pocket cost for care.

All Charges