Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

2'SUTURE ABD WALL FR EVISCRATN

Facility

$9,107.40

Service Code	HCPCS 49900
Hospital Charge Code	16000755
Hospital Revenue Code	360
Min. Negotiated Rate	$219.49
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$3,460.81
Rate for Payer: Aetna Medicare Advantage	$2,732.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,322.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,322.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,322.39
Rate for Payer: Cigna Commercial	$4,553.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,732.22
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,366.11
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$219.49
Rate for Payer: Wellpoint Medicaid Managed Care	$241.35

3-0 CT-2 VICRYL UNDYED

Facility

$7.18

Hospital Charge Code	270682048
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.59
Rate for Payer: Aetna Commercial	$2.73
Rate for Payer: Aetna Medicare Advantage	$2.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.83
Rate for Payer: Cigna Commercial	$3.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.15
Rate for Payer: Oxford Commercial	$1.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.08
Rate for Payer: UnitedHealthcare Commercial	$1.44
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

3-0 CT-2 VICRYL UNDYED

Facility

$7.18

Hospital Charge Code	270682048
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$1.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.08

3.0LOCKING SCREW 12MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270674085
Hospital Revenue Code	278
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

3.0LOCKING SCREW 12MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270674085
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

3.0 LOCKING SCREW 16MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270666082
Hospital Revenue Code	278
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

3.0 LOCKING SCREW 16MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270666082
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

3.0MM ASNIS MICRO CANN COUNTER

Facility

$1,783.15

Service Code	HCPCS C1713
Hospital Charge Code	270688749
Hospital Revenue Code	278
Min. Negotiated Rate	$267.47
Max. Negotiated Rate	$431.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$356.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$431.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$392.29
Rate for Payer: Qualcare PPO/HMO/WC	$267.47

3.0MM ASNIS MICRO CANN COUNTER

Facility

$1,783.15

Service Code	HCPCS C1713
Hospital Charge Code	270688749
Hospital Revenue Code	278
Min. Negotiated Rate	$42.97
Max. Negotiated Rate	$891.58
Rate for Payer: Aetna Commercial	$677.60
Rate for Payer: Aetna Medicare Advantage	$534.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$454.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$454.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$356.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$454.70
Rate for Payer: Cigna Commercial	$891.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$431.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$392.29
Rate for Payer: Qualcare PPO/HMO/WC	$267.47
Rate for Payer: UnitedHealthcare Community & State	$42.97
Rate for Payer: Wellpoint Medicaid Managed Care	$47.25

3.0MM CANN SCREWSHORT THREAD 3

Facility

$868.85

Service Code	HCPCS C1713
Hospital Charge Code	270682194
Hospital Revenue Code	278
Min. Negotiated Rate	$130.33
Max. Negotiated Rate	$210.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$191.15
Rate for Payer: Qualcare PPO/HMO/WC	$130.33

3.0MM CANN SCREWSHORT THREAD 3

Facility

$868.85

Service Code	HCPCS C1713
Hospital Charge Code	270682194
Hospital Revenue Code	278
Min. Negotiated Rate	$20.94
Max. Negotiated Rate	$434.43
Rate for Payer: Aetna Commercial	$330.16
Rate for Payer: Aetna Medicare Advantage	$260.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221.56
Rate for Payer: Cigna Commercial	$434.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$191.15
Rate for Payer: Qualcare PPO/HMO/WC	$130.33
Rate for Payer: UnitedHealthcare Community & State	$20.94
Rate for Payer: Wellpoint Medicaid Managed Care	$23.02

3.0MM CANN SCREWSHORT THREAD 4

Facility

$868.85

Service Code	HCPCS C1713
Hospital Charge Code	270682195
Hospital Revenue Code	278
Min. Negotiated Rate	$20.94
Max. Negotiated Rate	$434.43
Rate for Payer: Aetna Commercial	$330.16
Rate for Payer: Aetna Medicare Advantage	$260.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221.56
Rate for Payer: Cigna Commercial	$434.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$191.15
Rate for Payer: Qualcare PPO/HMO/WC	$130.33
Rate for Payer: UnitedHealthcare Community & State	$20.94
Rate for Payer: Wellpoint Medicaid Managed Care	$23.02

3.0MM CANN SCREWSHORT THREAD 4

Facility

$868.85

Service Code	HCPCS C1713
Hospital Charge Code	270682195
Hospital Revenue Code	278
Min. Negotiated Rate	$130.33
Max. Negotiated Rate	$210.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$191.15
Rate for Payer: Qualcare PPO/HMO/WC	$130.33

3.0MM CAN SCREWSHORT THREAD 16

Facility

$868.85

Service Code	HCPCS C1713
Hospital Charge Code	270682925
Hospital Revenue Code	278
Min. Negotiated Rate	$130.33
Max. Negotiated Rate	$210.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$191.15
Rate for Payer: Qualcare PPO/HMO/WC	$130.33

3.0MM CAN SCREWSHORT THREAD 16

Facility

$868.85

Service Code	HCPCS C1713
Hospital Charge Code	270682925
Hospital Revenue Code	278
Min. Negotiated Rate	$20.94
Max. Negotiated Rate	$434.43
Rate for Payer: Aetna Commercial	$330.16
Rate for Payer: Aetna Medicare Advantage	$260.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221.56
Rate for Payer: Cigna Commercial	$434.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$191.15
Rate for Payer: Qualcare PPO/HMO/WC	$130.33
Rate for Payer: UnitedHealthcare Community & State	$20.94
Rate for Payer: Wellpoint Medicaid Managed Care	$23.02

3.0MM LOCK SCREW 12MM L

Facility

$1,250.00

Hospital Charge Code	270703227
Hospital Revenue Code	276
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

3.0MM LOCK SCREW 12MM L

Facility

$1,250.00

Hospital Charge Code	270703227
Hospital Revenue Code	276
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

3.0MM LOCK SCREW 14MM L

Facility

$1,500.00

Hospital Charge Code	270703228
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

3.0MM LOCK SCREW 14MM L

Facility

$1,500.00

Hospital Charge Code	270703228
Hospital Revenue Code	278
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$36.15
Rate for Payer: Wellpoint Medicaid Managed Care	$39.75

3.0MM LOCK SCREW 16MM L

Facility

$1,250.00

Hospital Charge Code	270703229
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

3.0MM LOCK SCREW 16MM L

Facility

$1,250.00

Hospital Charge Code	270703229
Hospital Revenue Code	278
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

3.0MM LOCK SCREW 20MM L

Facility

$1,250.00

Hospital Charge Code	270703230
Hospital Revenue Code	278
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

3.0MM LOCK SCREW 20MM L

Facility

$1,250.00

Hospital Charge Code	270703230
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

30MM ROD

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270682375
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

30MM ROD

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270682375
Hospital Revenue Code	278
Min. Negotiated Rate	$48.20
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$48.20
Rate for Payer: Wellpoint Medicaid Managed Care	$53.00

Know your out-of-pocket cost for care.

All Charges