Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW BMT CORT 4.5 34MM 235134

Facility

$153.65

Hospital Charge Code	270613967
Hospital Revenue Code	278
Min. Negotiated Rate	$23.05
Max. Negotiated Rate	$37.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.80
Rate for Payer: Qualcare PPO/HMO/WC	$23.05

SCREW BMT CORT 4.5 34MM 235134

Facility

$153.65

Hospital Charge Code	270613967
Hospital Revenue Code	278
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$76.83
Rate for Payer: Aetna Commercial	$58.39
Rate for Payer: Aetna Medicare Advantage	$46.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.18
Rate for Payer: Cigna Commercial	$76.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.80
Rate for Payer: Qualcare PPO/HMO/WC	$23.05
Rate for Payer: UnitedHealthcare Community & State	$3.70
Rate for Payer: Wellpoint Medicaid Managed Care	$4.07

SCREW BMT CORT 4.5 36MM 235136

Facility

$155.00

Service Code	HCPCS C1713
Hospital Charge Code	270613968
Hospital Revenue Code	278
Min. Negotiated Rate	$3.74
Max. Negotiated Rate	$77.50
Rate for Payer: Aetna Commercial	$58.90
Rate for Payer: Aetna Medicare Advantage	$46.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.52
Rate for Payer: Cigna Commercial	$77.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$34.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.25
Rate for Payer: UnitedHealthcare Community & State	$3.74
Rate for Payer: Wellpoint Medicaid Managed Care	$4.11

SCREW BMT CORT 4.5 36MM 235136

Facility

$155.00

Service Code	HCPCS C1713
Hospital Charge Code	270613968
Hospital Revenue Code	278
Min. Negotiated Rate	$23.25
Max. Negotiated Rate	$37.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$34.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.25

SCREW BMT CORT 4.5 36MM 345336

Facility

$870.00

Hospital Charge Code	270610872
Hospital Revenue Code	278
Min. Negotiated Rate	$20.97
Max. Negotiated Rate	$435.00
Rate for Payer: Aetna Commercial	$330.60
Rate for Payer: Aetna Medicare Advantage	$261.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$174.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221.85
Rate for Payer: Cigna Commercial	$435.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$191.40
Rate for Payer: Qualcare PPO/HMO/WC	$130.50
Rate for Payer: UnitedHealthcare Community & State	$20.97
Rate for Payer: Wellpoint Medicaid Managed Care	$23.05

SCREW BMT CORT 4.5 36MM 345336

Facility

$870.00

Hospital Charge Code	270610872
Hospital Revenue Code	278
Min. Negotiated Rate	$130.50
Max. Negotiated Rate	$210.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$174.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$191.40
Rate for Payer: Qualcare PPO/HMO/WC	$130.50

SCREW BMT CORT 4.5 38MM 235138

Facility

$153.65

Hospital Charge Code	270613969
Hospital Revenue Code	278
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$76.83
Rate for Payer: Aetna Commercial	$58.39
Rate for Payer: Aetna Medicare Advantage	$46.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.18
Rate for Payer: Cigna Commercial	$76.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.80
Rate for Payer: Qualcare PPO/HMO/WC	$23.05
Rate for Payer: UnitedHealthcare Community & State	$3.70
Rate for Payer: Wellpoint Medicaid Managed Care	$4.07

SCREW BMT CORT 4.5 38MM 235138

Facility

$153.65

Hospital Charge Code	270613969
Hospital Revenue Code	278
Min. Negotiated Rate	$23.05
Max. Negotiated Rate	$37.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.80
Rate for Payer: Qualcare PPO/HMO/WC	$23.05

SCREW BMT CORT 4.5 38MM 345338

Facility

$585.00

Hospital Charge Code	270610791
Hospital Revenue Code	278
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$222.30
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.70
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Community & State	$14.10
Rate for Payer: Wellpoint Medicaid Managed Care	$15.50

SCREW BMT CORT 4.5 38MM 345338

Facility

$585.00

Hospital Charge Code	270610791
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$141.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.70
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW BMT CORT 4.5 40MM 235140

Facility

$155.00

Service Code	HCPCS C1713
Hospital Charge Code	270612182
Hospital Revenue Code	278
Min. Negotiated Rate	$3.74
Max. Negotiated Rate	$77.50
Rate for Payer: Aetna Commercial	$58.90
Rate for Payer: Aetna Medicare Advantage	$46.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.52
Rate for Payer: Cigna Commercial	$77.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$34.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.25
Rate for Payer: UnitedHealthcare Community & State	$3.74
Rate for Payer: Wellpoint Medicaid Managed Care	$4.11

SCREW BMT CORT 4.5 40MM 235140

Facility

$155.00

Service Code	HCPCS C1713
Hospital Charge Code	270612182
Hospital Revenue Code	278
Min. Negotiated Rate	$23.25
Max. Negotiated Rate	$37.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$34.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.25

SCREW BMT CORT 4.5 42MM 235142

Facility

$153.65

Hospital Charge Code	270612181
Hospital Revenue Code	278
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$76.83
Rate for Payer: Aetna Commercial	$58.39
Rate for Payer: Aetna Medicare Advantage	$46.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.18
Rate for Payer: Cigna Commercial	$76.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.80
Rate for Payer: Qualcare PPO/HMO/WC	$23.05
Rate for Payer: UnitedHealthcare Community & State	$3.70
Rate for Payer: Wellpoint Medicaid Managed Care	$4.07

SCREW BMT CORT 4.5 42MM 235142

Facility

$153.65

Hospital Charge Code	270612181
Hospital Revenue Code	278
Min. Negotiated Rate	$23.05
Max. Negotiated Rate	$37.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.80
Rate for Payer: Qualcare PPO/HMO/WC	$23.05

SCREW BMT CORT 4.5 42MM 345342

Facility

$536.85

Hospital Charge Code	270610873
Hospital Revenue Code	278
Min. Negotiated Rate	$80.53
Max. Negotiated Rate	$129.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.11
Rate for Payer: Qualcare PPO/HMO/WC	$80.53

SCREW BMT CORT 4.5 42MM 345342

Facility

$536.85

Hospital Charge Code	270610873
Hospital Revenue Code	278
Min. Negotiated Rate	$12.94
Max. Negotiated Rate	$268.43
Rate for Payer: Aetna Commercial	$204.00
Rate for Payer: Aetna Medicare Advantage	$161.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.90
Rate for Payer: Cigna Commercial	$268.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.11
Rate for Payer: Qualcare PPO/HMO/WC	$80.53
Rate for Payer: UnitedHealthcare Community & State	$12.94
Rate for Payer: Wellpoint Medicaid Managed Care	$14.23

SCREW BMT CORT 4.5 44MM 235144

Facility

$100.00

Hospital Charge Code	270612180
Hospital Revenue Code	278
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$38.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Community & State	$2.41
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

SCREW BMT CORT 4.5 44MM 235144

Facility

$100.00

Hospital Charge Code	270612180
Hospital Revenue Code	278
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$24.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

SCREW BMT CORT 4.5 46MM 235146

Facility

$155.00

Service Code	HCPCS C1713
Hospital Charge Code	270612877
Hospital Revenue Code	278
Min. Negotiated Rate	$3.74
Max. Negotiated Rate	$77.50
Rate for Payer: Aetna Commercial	$58.90
Rate for Payer: Aetna Medicare Advantage	$46.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.52
Rate for Payer: Cigna Commercial	$77.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$34.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.25
Rate for Payer: UnitedHealthcare Community & State	$3.74
Rate for Payer: Wellpoint Medicaid Managed Care	$4.11

SCREW BMT CORT 4.5 46MM 235146

Facility

$155.00

Service Code	HCPCS C1713
Hospital Charge Code	270612877
Hospital Revenue Code	278
Min. Negotiated Rate	$23.25
Max. Negotiated Rate	$37.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$34.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.25

SCREW BMT CORT 4.5 48MM 235148

Facility

$153.65

Hospital Charge Code	270612303
Hospital Revenue Code	278
Min. Negotiated Rate	$23.05
Max. Negotiated Rate	$37.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.80
Rate for Payer: Qualcare PPO/HMO/WC	$23.05

SCREW BMT CORT 4.5 48MM 235148

Facility

$153.65

Hospital Charge Code	270612303
Hospital Revenue Code	278
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$76.83
Rate for Payer: Aetna Commercial	$58.39
Rate for Payer: Aetna Medicare Advantage	$46.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.18
Rate for Payer: Cigna Commercial	$76.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.80
Rate for Payer: Qualcare PPO/HMO/WC	$23.05
Rate for Payer: UnitedHealthcare Community & State	$3.70
Rate for Payer: Wellpoint Medicaid Managed Care	$4.07

SCREW BMT CORT 4.5 50MM 235150

Facility

$94.25

Hospital Charge Code	270627429
Hospital Revenue Code	278
Min. Negotiated Rate	$14.14
Max. Negotiated Rate	$22.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$20.73
Rate for Payer: Qualcare PPO/HMO/WC	$14.14

SCREW BMT CORT 4.5 50MM 235150

Facility

$94.25

Hospital Charge Code	270627429
Hospital Revenue Code	278
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$47.12
Rate for Payer: Aetna Commercial	$35.81
Rate for Payer: Aetna Medicare Advantage	$28.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.03
Rate for Payer: Cigna Commercial	$47.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$20.73
Rate for Payer: Qualcare PPO/HMO/WC	$14.14
Rate for Payer: UnitedHealthcare Community & State	$2.27
Rate for Payer: Wellpoint Medicaid Managed Care	$2.50

SCREW BMT CORT 5.0 25 345420

Facility

$708.00

Hospital Charge Code	270622768
Hospital Revenue Code	278
Min. Negotiated Rate	$17.06
Max. Negotiated Rate	$354.00
Rate for Payer: Aetna Commercial	$269.04
Rate for Payer: Aetna Medicare Advantage	$212.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$180.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$180.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$180.54
Rate for Payer: Cigna Commercial	$354.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$155.76
Rate for Payer: Qualcare PPO/HMO/WC	$106.20
Rate for Payer: UnitedHealthcare Community & State	$17.06
Rate for Payer: Wellpoint Medicaid Managed Care	$18.76

Know your out-of-pocket cost for care.

All Charges