Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

3.5MM CORT LOCK SCR 10MM NS

Facility

$598.00

Service Code	HCPCS C1713
Hospital Charge Code	270661798
Hospital Revenue Code	278
Min. Negotiated Rate	$89.70
Max. Negotiated Rate	$144.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$131.56
Rate for Payer: Qualcare PPO/HMO/WC	$89.70

3.5MM CORT LOCK SCR 10MM NS

Facility

$598.00

Service Code	HCPCS C1713
Hospital Charge Code	270661798
Hospital Revenue Code	278
Min. Negotiated Rate	$14.41
Max. Negotiated Rate	$299.00
Rate for Payer: Aetna Commercial	$227.24
Rate for Payer: Aetna Medicare Advantage	$179.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$152.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$152.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$152.49
Rate for Payer: Cigna Commercial	$299.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$131.56
Rate for Payer: Qualcare PPO/HMO/WC	$89.70
Rate for Payer: UnitedHealthcare Community & State	$14.41
Rate for Payer: Wellpoint Medicaid Managed Care	$15.85

3.5MM CORT LOCK SCR 16MM NS

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270661805
Hospital Revenue Code	278
Min. Negotiated Rate	$94.88
Max. Negotiated Rate	$153.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$94.88

3.5MM CORT LOCK SCR 16MM NS

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270661805
Hospital Revenue Code	278
Min. Negotiated Rate	$15.24
Max. Negotiated Rate	$316.25
Rate for Payer: Aetna Commercial	$240.35
Rate for Payer: Aetna Medicare Advantage	$189.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.29
Rate for Payer: Cigna Commercial	$316.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$94.88
Rate for Payer: UnitedHealthcare Community & State	$15.24
Rate for Payer: Wellpoint Medicaid Managed Care	$16.76

3.5MM CORT LOCK SCR 20MM NS

Facility

$598.00

Service Code	HCPCS C1713
Hospital Charge Code	270661807
Hospital Revenue Code	278
Min. Negotiated Rate	$14.41
Max. Negotiated Rate	$299.00
Rate for Payer: Aetna Commercial	$227.24
Rate for Payer: Aetna Medicare Advantage	$179.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$152.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$152.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$152.49
Rate for Payer: Cigna Commercial	$299.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$131.56
Rate for Payer: Qualcare PPO/HMO/WC	$89.70
Rate for Payer: UnitedHealthcare Community & State	$14.41
Rate for Payer: Wellpoint Medicaid Managed Care	$15.85

3.5MM CORT LOCK SCR 20MM NS

Facility

$598.00

Service Code	HCPCS C1713
Hospital Charge Code	270661807
Hospital Revenue Code	278
Min. Negotiated Rate	$89.70
Max. Negotiated Rate	$144.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$131.56
Rate for Payer: Qualcare PPO/HMO/WC	$89.70

3.5MM CORT LOCK SCR 22MM NS

Facility

$572.00

Service Code	HCPCS C1713
Hospital Charge Code	270680842
Hospital Revenue Code	278
Min. Negotiated Rate	$85.80
Max. Negotiated Rate	$138.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$85.80

3.5MM CORT LOCK SCR 22MM NS

Facility

$572.00

Service Code	HCPCS C1713
Hospital Charge Code	270680842
Hospital Revenue Code	278
Min. Negotiated Rate	$13.79
Max. Negotiated Rate	$286.00
Rate for Payer: Aetna Commercial	$217.36
Rate for Payer: Aetna Medicare Advantage	$171.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.86
Rate for Payer: Cigna Commercial	$286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$85.80
Rate for Payer: UnitedHealthcare Community & State	$13.79
Rate for Payer: Wellpoint Medicaid Managed Care	$15.16

3.5MM CORT LOCK SCR 24MM NS

Facility

$595.00

Service Code	HCPCS C1713
Hospital Charge Code	270683744
Hospital Revenue Code	278
Min. Negotiated Rate	$14.34
Max. Negotiated Rate	$297.50
Rate for Payer: Aetna Commercial	$226.10
Rate for Payer: Aetna Medicare Advantage	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.72
Rate for Payer: Cigna Commercial	$297.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$130.90
Rate for Payer: Qualcare PPO/HMO/WC	$89.25
Rate for Payer: UnitedHealthcare Community & State	$14.34
Rate for Payer: Wellpoint Medicaid Managed Care	$15.77

3.5MM CORT LOCK SCR 24MM NS

Facility

$595.00

Service Code	HCPCS C1713
Hospital Charge Code	270683744
Hospital Revenue Code	278
Min. Negotiated Rate	$89.25
Max. Negotiated Rate	$143.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$130.90
Rate for Payer: Qualcare PPO/HMO/WC	$89.25

3.5MM CORT LOCK SCR 26MM NS

Facility

$905.00

Service Code	HCPCS C1713
Hospital Charge Code	270669275
Hospital Revenue Code	278
Min. Negotiated Rate	$135.75
Max. Negotiated Rate	$219.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.10
Rate for Payer: Qualcare PPO/HMO/WC	$135.75

3.5MM CORT LOCK SCR 26MM NS

Facility

$905.00

Service Code	HCPCS C1713
Hospital Charge Code	270669275
Hospital Revenue Code	278
Min. Negotiated Rate	$21.81
Max. Negotiated Rate	$452.50
Rate for Payer: Aetna Commercial	$343.90
Rate for Payer: Aetna Medicare Advantage	$271.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.78
Rate for Payer: Cigna Commercial	$452.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.10
Rate for Payer: Qualcare PPO/HMO/WC	$135.75
Rate for Payer: UnitedHealthcare Community & State	$21.81
Rate for Payer: Wellpoint Medicaid Managed Care	$23.98

3.5MM CORT LOCK SCR 28MM NS

Facility

$805.00

Service Code	HCPCS C1713
Hospital Charge Code	270658919
Hospital Revenue Code	278
Min. Negotiated Rate	$19.40
Max. Negotiated Rate	$402.50
Rate for Payer: Aetna Commercial	$305.90
Rate for Payer: Aetna Medicare Advantage	$241.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$205.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$205.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$161.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$205.28
Rate for Payer: Cigna Commercial	$402.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$177.10
Rate for Payer: Qualcare PPO/HMO/WC	$120.75
Rate for Payer: UnitedHealthcare Community & State	$19.40
Rate for Payer: Wellpoint Medicaid Managed Care	$21.33

3.5MM CORT LOCK SCR 28MM NS

Facility

$805.00

Service Code	HCPCS C1713
Hospital Charge Code	270658919
Hospital Revenue Code	278
Min. Negotiated Rate	$120.75
Max. Negotiated Rate	$194.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$161.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$177.10
Rate for Payer: Qualcare PPO/HMO/WC	$120.75

3.5MM CORT SCR S/T SM HEX 10MM

Facility

$330.00

Service Code	HCPCS C1713
Hospital Charge Code	270704662
Hospital Revenue Code	278
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$165.00
Rate for Payer: Aetna Commercial	$125.40
Rate for Payer: Aetna Medicare Advantage	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.15
Rate for Payer: Cigna Commercial	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$49.50
Rate for Payer: UnitedHealthcare Community & State	$7.95
Rate for Payer: Wellpoint Medicaid Managed Care	$8.74

3.5MM CORT SCR S/T SM HEX 10MM

Facility

$330.00

Service Code	HCPCS C1713
Hospital Charge Code	270704662
Hospital Revenue Code	278
Min. Negotiated Rate	$49.50
Max. Negotiated Rate	$79.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$49.50

3.5MM CORT SCR S/T SM HEX 12MM

Facility

$330.00

Service Code	HCPCS C1713
Hospital Charge Code	270704660
Hospital Revenue Code	278
Min. Negotiated Rate	$49.50
Max. Negotiated Rate	$79.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$49.50

3.5MM CORT SCR S/T SM HEX 12MM

Facility

$330.00

Service Code	HCPCS C1713
Hospital Charge Code	270704660
Hospital Revenue Code	278
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$165.00
Rate for Payer: Aetna Commercial	$125.40
Rate for Payer: Aetna Medicare Advantage	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.15
Rate for Payer: Cigna Commercial	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$49.50
Rate for Payer: UnitedHealthcare Community & State	$7.95
Rate for Payer: Wellpoint Medicaid Managed Care	$8.74

3.5MM CORT SCR S/T SM HEX 14MM

Facility

$330.00

Service Code	HCPCS C1713
Hospital Charge Code	270704658
Hospital Revenue Code	278
Min. Negotiated Rate	$49.50
Max. Negotiated Rate	$79.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$49.50

3.5MM CORT SCR S/T SM HEX 14MM

Facility

$330.00

Service Code	HCPCS C1713
Hospital Charge Code	270704658
Hospital Revenue Code	278
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$165.00
Rate for Payer: Aetna Commercial	$125.40
Rate for Payer: Aetna Medicare Advantage	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.15
Rate for Payer: Cigna Commercial	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$49.50
Rate for Payer: UnitedHealthcare Community & State	$7.95
Rate for Payer: Wellpoint Medicaid Managed Care	$8.74

3.5MM CRTICAL SCRW SELF-TAP SM

Facility

$122.15

Hospital Charge Code	270657761
Hospital Revenue Code	278
Min. Negotiated Rate	$18.32
Max. Negotiated Rate	$29.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.87
Rate for Payer: Qualcare PPO/HMO/WC	$18.32

3.5MM CRTICAL SCRW SELF-TAP SM

Facility

$122.15

Hospital Charge Code	270657761
Hospital Revenue Code	278
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$61.08
Rate for Payer: Aetna Commercial	$46.42
Rate for Payer: Aetna Medicare Advantage	$36.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.15
Rate for Payer: Cigna Commercial	$61.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.87
Rate for Payer: Qualcare PPO/HMO/WC	$18.32
Rate for Payer: UnitedHealthcare Community & State	$2.94
Rate for Payer: Wellpoint Medicaid Managed Care	$3.24

3.5MM CRTX SCREW/LO PROF HDSLF

Facility

$152.95

Service Code	HCPCS C1713
Hospital Charge Code	270678994
Hospital Revenue Code	278
Min. Negotiated Rate	$22.94
Max. Negotiated Rate	$37.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.65
Rate for Payer: Qualcare PPO/HMO/WC	$22.94

3.5MM CRTX SCREW/LO PROF HDSLF

Facility

$152.95

Service Code	HCPCS C1713
Hospital Charge Code	270678994
Hospital Revenue Code	278
Min. Negotiated Rate	$3.69
Max. Negotiated Rate	$76.47
Rate for Payer: Aetna Commercial	$58.12
Rate for Payer: Aetna Medicare Advantage	$45.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.00
Rate for Payer: Cigna Commercial	$76.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.65
Rate for Payer: Qualcare PPO/HMO/WC	$22.94
Rate for Payer: UnitedHealthcare Community & State	$3.69
Rate for Payer: Wellpoint Medicaid Managed Care	$4.05

3.5MM CRTX SCREW LOW PROF 36MM

Facility

$157.55

Service Code	HCPCS C1713
Hospital Charge Code	270668002
Hospital Revenue Code	278
Min. Negotiated Rate	$23.63
Max. Negotiated Rate	$38.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$34.66
Rate for Payer: Qualcare PPO/HMO/WC	$23.63

Know your out-of-pocket cost for care.

All Charges