Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PEG THREADED 2.5x18mm TP18

Facility

$347.25

Hospital Charge Code	270636496
Hospital Revenue Code	272
Min. Negotiated Rate	$52.09
Max. Negotiated Rate	$52.09
Rate for Payer: Qualcare PPO/HMO/WC	$52.09

PEG THREADED 2.5x18mm TP18

Facility

$347.25

Hospital Charge Code	270636496
Hospital Revenue Code	272
Min. Negotiated Rate	$8.37
Max. Negotiated Rate	$173.62
Rate for Payer: Aetna Commercial	$131.96
Rate for Payer: Aetna Medicare Advantage	$104.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.55
Rate for Payer: Cigna Commercial	$173.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.17
Rate for Payer: Oxford Commercial	$69.45
Rate for Payer: Qualcare PPO/HMO/WC	$52.09
Rate for Payer: UnitedHealthcare Commercial	$69.45
Rate for Payer: UnitedHealthcare Community & State	$8.37
Rate for Payer: Wellpoint Medicaid Managed Care	$9.20

PEG THREADED 2.5x24mm TP24

Facility

$347.25

Hospital Charge Code	270636497
Hospital Revenue Code	272
Min. Negotiated Rate	$52.09
Max. Negotiated Rate	$52.09
Rate for Payer: Qualcare PPO/HMO/WC	$52.09

PEG THREADED 2.5x24mm TP24

Facility

$347.25

Hospital Charge Code	270636497
Hospital Revenue Code	272
Min. Negotiated Rate	$8.37
Max. Negotiated Rate	$173.62
Rate for Payer: Aetna Commercial	$131.96
Rate for Payer: Aetna Medicare Advantage	$104.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.55
Rate for Payer: Cigna Commercial	$173.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.17
Rate for Payer: Oxford Commercial	$69.45
Rate for Payer: Qualcare PPO/HMO/WC	$52.09
Rate for Payer: UnitedHealthcare Commercial	$69.45
Rate for Payer: UnitedHealthcare Community & State	$8.37
Rate for Payer: Wellpoint Medicaid Managed Care	$9.20

PEG THREADED 2.7MMX10MM NON LO

Facility

$495.00

Hospital Charge Code	270664412
Hospital Revenue Code	270
Min. Negotiated Rate	$11.93
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$188.10
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.50
Rate for Payer: Oxford Commercial	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.25
Rate for Payer: UnitedHealthcare Commercial	$99.00
Rate for Payer: UnitedHealthcare Community & State	$11.93
Rate for Payer: Wellpoint Medicaid Managed Care	$13.12

PEG THREADED 2.7MMX10MM NON LO

Facility

$495.00

Hospital Charge Code	270664412
Hospital Revenue Code	270
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$74.25
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

PEG THREADED 2.7MM X 12MM

Facility

$495.00

Hospital Charge Code	270664413
Hospital Revenue Code	278
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$119.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

PEG THREADED 2.7MM X 12MM

Facility

$495.00

Hospital Charge Code	270664413
Hospital Revenue Code	278
Min. Negotiated Rate	$11.93
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$188.10
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$74.25
Rate for Payer: UnitedHealthcare Community & State	$11.93
Rate for Payer: Wellpoint Medicaid Managed Care	$13.12

PEG THREADED 2.7MM X 14MM

Facility

$495.00

Hospital Charge Code	270664414
Hospital Revenue Code	278
Min. Negotiated Rate	$11.93
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$188.10
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$74.25
Rate for Payer: UnitedHealthcare Community & State	$11.93
Rate for Payer: Wellpoint Medicaid Managed Care	$13.12

PEG THREADED 2.7MM X 14MM

Facility

$495.00

Hospital Charge Code	270664414
Hospital Revenue Code	278
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$119.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

PEG THREADED 2.7MMX16MM

Facility

$495.00

Service Code	HCPCS C1713
Hospital Charge Code	270664415
Hospital Revenue Code	278
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$119.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

PEG THREADED 2.7MMX16MM

Facility

$495.00

Service Code	HCPCS C1713
Hospital Charge Code	270664415
Hospital Revenue Code	278
Min. Negotiated Rate	$11.93
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$188.10
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$74.25
Rate for Payer: UnitedHealthcare Community & State	$11.93
Rate for Payer: Wellpoint Medicaid Managed Care	$13.12

PEG THREADED 2.7MM X 20MM

Facility

$495.00

Service Code	HCPCS C1713
Hospital Charge Code	270664417
Hospital Revenue Code	278
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$119.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

PEG THREADED 2.7MM X 20MM

Facility

$495.00

Service Code	HCPCS C1713
Hospital Charge Code	270664417
Hospital Revenue Code	278
Min. Negotiated Rate	$11.93
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$188.10
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$74.25
Rate for Payer: UnitedHealthcare Community & State	$11.93
Rate for Payer: Wellpoint Medicaid Managed Care	$13.12

PEG THREADED 4.0x42.5 STPT425

Facility

$450.00

Hospital Charge Code	270637700
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

PEG THREADED 4.0x42.5 STPT425

Facility

$450.00

Hospital Charge Code	270637700
Hospital Revenue Code	272
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.00
Rate for Payer: Oxford Commercial	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Commercial	$90.00
Rate for Payer: UnitedHealthcare Community & State	$10.85
Rate for Payer: Wellpoint Medicaid Managed Care	$11.93

PEG THREADED CORTICAL 2.7X20MM

Facility

$975.00

Service Code	HCPCS C1713
Hospital Charge Code	270684122
Hospital Revenue Code	278
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$235.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

PEG THREADED CORTICAL 2.7X20MM

Facility

$975.00

Service Code	HCPCS C1713
Hospital Charge Code	270684122
Hospital Revenue Code	278
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

PEG THREADED CORTICAL 2.7X22MM

Facility

$975.00

Service Code	HCPCS C1713
Hospital Charge Code	270686702
Hospital Revenue Code	278
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

PEG THREADED CORTICAL 2.7X22MM

Facility

$975.00

Service Code	HCPCS C1713
Hospital Charge Code	270686702
Hospital Revenue Code	278
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$235.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

PEG THREADED LOCKING 2.3x10MM

Facility

$442.00

Service Code	HCPCS C1713
Hospital Charge Code	270664400
Hospital Revenue Code	278
Min. Negotiated Rate	$66.30
Max. Negotiated Rate	$106.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$97.24
Rate for Payer: Qualcare PPO/HMO/WC	$66.30

PEG THREADED LOCKING 2.3x10MM

Facility

$442.00

Service Code	HCPCS C1713
Hospital Charge Code	270664400
Hospital Revenue Code	278
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$221.00
Rate for Payer: Aetna Commercial	$167.96
Rate for Payer: Aetna Medicare Advantage	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.71
Rate for Payer: Cigna Commercial	$221.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$97.24
Rate for Payer: Qualcare PPO/HMO/WC	$66.30
Rate for Payer: UnitedHealthcare Community & State	$10.65
Rate for Payer: Wellpoint Medicaid Managed Care	$11.71

PEG THREADED LOCKING 2.3x16MM

Facility

$520.00

Service Code	HCPCS C1713
Hospital Charge Code	270664358
Hospital Revenue Code	278
Min. Negotiated Rate	$12.53
Max. Negotiated Rate	$260.00
Rate for Payer: Aetna Commercial	$197.60
Rate for Payer: Aetna Medicare Advantage	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.60
Rate for Payer: Cigna Commercial	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.40
Rate for Payer: Qualcare PPO/HMO/WC	$78.00
Rate for Payer: UnitedHealthcare Community & State	$12.53
Rate for Payer: Wellpoint Medicaid Managed Care	$13.78

PEG THREADED LOCKING 2.3x16MM

Facility

$520.00

Service Code	HCPCS C1713
Hospital Charge Code	270664358
Hospital Revenue Code	278
Min. Negotiated Rate	$78.00
Max. Negotiated Rate	$125.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.40
Rate for Payer: Qualcare PPO/HMO/WC	$78.00

PEG THREADED LOCKING 2.3x18MM

Facility

$442.00

Service Code	HCPCS C1713
Hospital Charge Code	270664187
Hospital Revenue Code	278
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$221.00
Rate for Payer: Aetna Commercial	$167.96
Rate for Payer: Aetna Medicare Advantage	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.71
Rate for Payer: Cigna Commercial	$221.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$97.24
Rate for Payer: Qualcare PPO/HMO/WC	$66.30
Rate for Payer: UnitedHealthcare Community & State	$10.65
Rate for Payer: Wellpoint Medicaid Managed Care	$11.71

Know your out-of-pocket cost for care.

All Charges