Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW BMT TRNV 5.0 40 156940

Facility

$1,056.50

Hospital Charge Code	270628484
Hospital Revenue Code	278
Min. Negotiated Rate	$158.47
Max. Negotiated Rate	$255.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$232.43
Rate for Payer: Qualcare PPO/HMO/WC	$158.47

SCREW BMT TRNV 5.0 40 345426

Facility

$813.65

Hospital Charge Code	270612304
Hospital Revenue Code	278
Min. Negotiated Rate	$19.61
Max. Negotiated Rate	$406.82
Rate for Payer: Aetna Commercial	$309.19
Rate for Payer: Aetna Medicare Advantage	$244.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.48
Rate for Payer: Cigna Commercial	$406.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$179.00
Rate for Payer: Qualcare PPO/HMO/WC	$122.05
Rate for Payer: UnitedHealthcare Community & State	$19.61
Rate for Payer: Wellpoint Medicaid Managed Care	$21.56

SCREW BMT TRNV 5.0 40 345426

Facility

$813.65

Hospital Charge Code	270612304
Hospital Revenue Code	278
Min. Negotiated Rate	$122.05
Max. Negotiated Rate	$196.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$179.00
Rate for Payer: Qualcare PPO/HMO/WC	$122.05

SCREW BMT TRNV 5.0 55 345432

Facility

$813.65

Hospital Charge Code	270612310
Hospital Revenue Code	278
Min. Negotiated Rate	$19.61
Max. Negotiated Rate	$406.82
Rate for Payer: Aetna Commercial	$309.19
Rate for Payer: Aetna Medicare Advantage	$244.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.48
Rate for Payer: Cigna Commercial	$406.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$179.00
Rate for Payer: Qualcare PPO/HMO/WC	$122.05
Rate for Payer: UnitedHealthcare Community & State	$19.61
Rate for Payer: Wellpoint Medicaid Managed Care	$21.56

SCREW BMT TRNV 5.0 55 345432

Facility

$813.65

Hospital Charge Code	270612310
Hospital Revenue Code	278
Min. Negotiated Rate	$122.05
Max. Negotiated Rate	$196.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$179.00
Rate for Payer: Qualcare PPO/HMO/WC	$122.05

SCREW BMT TRNV 5.0 60 345434

Facility

$698.45

Hospital Charge Code	270607862
Hospital Revenue Code	278
Min. Negotiated Rate	$104.77
Max. Negotiated Rate	$169.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$153.66
Rate for Payer: Qualcare PPO/HMO/WC	$104.77

SCREW BMT TRNV 5.0 60 345434

Facility

$698.45

Hospital Charge Code	270607862
Hospital Revenue Code	278
Min. Negotiated Rate	$16.83
Max. Negotiated Rate	$349.23
Rate for Payer: Aetna Commercial	$265.41
Rate for Payer: Aetna Medicare Advantage	$209.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.10
Rate for Payer: Cigna Commercial	$349.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$153.66
Rate for Payer: Qualcare PPO/HMO/WC	$104.77
Rate for Payer: UnitedHealthcare Community & State	$16.83
Rate for Payer: Wellpoint Medicaid Managed Care	$18.51

SCREW BMT TRNV 5.0 70 345438

Facility

$698.45

Hospital Charge Code	270606464
Hospital Revenue Code	278
Min. Negotiated Rate	$104.77
Max. Negotiated Rate	$169.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$153.66
Rate for Payer: Qualcare PPO/HMO/WC	$104.77

SCREW BMT TRNV 5.0 70 345438

Facility

$698.45

Hospital Charge Code	270606464
Hospital Revenue Code	278
Min. Negotiated Rate	$16.83
Max. Negotiated Rate	$349.23
Rate for Payer: Aetna Commercial	$265.41
Rate for Payer: Aetna Medicare Advantage	$209.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.10
Rate for Payer: Cigna Commercial	$349.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$153.66
Rate for Payer: Qualcare PPO/HMO/WC	$104.77
Rate for Payer: UnitedHealthcare Community & State	$16.83
Rate for Payer: Wellpoint Medicaid Managed Care	$18.51

SCREW BMT TRNV 5.0 75 345440

Facility

$698.45

Hospital Charge Code	270606463
Hospital Revenue Code	278
Min. Negotiated Rate	$16.83
Max. Negotiated Rate	$349.23
Rate for Payer: Aetna Commercial	$265.41
Rate for Payer: Aetna Medicare Advantage	$209.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.10
Rate for Payer: Cigna Commercial	$349.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$153.66
Rate for Payer: Qualcare PPO/HMO/WC	$104.77
Rate for Payer: UnitedHealthcare Community & State	$16.83
Rate for Payer: Wellpoint Medicaid Managed Care	$18.51

SCREW BMT TRNV 5.0 75 345440

Facility

$698.45

Hospital Charge Code	270606463
Hospital Revenue Code	278
Min. Negotiated Rate	$104.77
Max. Negotiated Rate	$169.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$153.66
Rate for Payer: Qualcare PPO/HMO/WC	$104.77

SCREW BMT TRNV 6.5 15 103530

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270615803
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW BMT TRNV 6.5 15 103530

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270615803
Hospital Revenue Code	278
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

SCREW BMT TRNV 6.5 25 103532

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270615802
Hospital Revenue Code	278
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

SCREW BMT TRNV 6.5 25 103532

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270615802
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW BMT TRNV 6.5 45 103536

Facility

$584.00

Hospital Charge Code	270617805
Hospital Revenue Code	278
Min. Negotiated Rate	$87.60
Max. Negotiated Rate	$141.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.48
Rate for Payer: Qualcare PPO/HMO/WC	$87.60

SCREW BMT TRNV 6.5 45 103536

Facility

$584.00

Hospital Charge Code	270617805
Hospital Revenue Code	278
Min. Negotiated Rate	$14.07
Max. Negotiated Rate	$292.00
Rate for Payer: Aetna Commercial	$221.92
Rate for Payer: Aetna Medicare Advantage	$175.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.92
Rate for Payer: Cigna Commercial	$292.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.48
Rate for Payer: Qualcare PPO/HMO/WC	$87.60
Rate for Payer: UnitedHealthcare Community & State	$14.07
Rate for Payer: Wellpoint Medicaid Managed Care	$15.48

SCREW BMT TRNV 6.5 50 103537

Facility

$584.00

Hospital Charge Code	270619771
Hospital Revenue Code	278
Min. Negotiated Rate	$87.60
Max. Negotiated Rate	$141.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.48
Rate for Payer: Qualcare PPO/HMO/WC	$87.60

SCREW BMT TRNV 6.5 50 103537

Facility

$584.00

Hospital Charge Code	270619771
Hospital Revenue Code	278
Min. Negotiated Rate	$14.07
Max. Negotiated Rate	$292.00
Rate for Payer: Aetna Commercial	$221.92
Rate for Payer: Aetna Medicare Advantage	$175.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.92
Rate for Payer: Cigna Commercial	$292.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.48
Rate for Payer: Qualcare PPO/HMO/WC	$87.60
Rate for Payer: UnitedHealthcare Community & State	$14.07
Rate for Payer: Wellpoint Medicaid Managed Care	$15.48

SCREW BMT VHS LAG 65 200165

Facility

$997.00

Hospital Charge Code	270627425
Hospital Revenue Code	278
Min. Negotiated Rate	$149.55
Max. Negotiated Rate	$241.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$241.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$219.34
Rate for Payer: Qualcare PPO/HMO/WC	$149.55

SCREW BMT VHS LAG 65 200165

Facility

$997.00

Hospital Charge Code	270627425
Hospital Revenue Code	278
Min. Negotiated Rate	$24.03
Max. Negotiated Rate	$498.50
Rate for Payer: Aetna Commercial	$378.86
Rate for Payer: Aetna Medicare Advantage	$299.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.24
Rate for Payer: Cigna Commercial	$498.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$241.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$219.34
Rate for Payer: Qualcare PPO/HMO/WC	$149.55
Rate for Payer: UnitedHealthcare Community & State	$24.03
Rate for Payer: Wellpoint Medicaid Managed Care	$26.42

SCREW BN CORT 150x40 HAA601540

Facility

$565.00

Hospital Charge Code	270643266
Hospital Revenue Code	278
Min. Negotiated Rate	$84.75
Max. Negotiated Rate	$136.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$124.30
Rate for Payer: Qualcare PPO/HMO/WC	$84.75

SCREW BN CORT 150x40 HAA601540

Facility

$565.00

Hospital Charge Code	270643266
Hospital Revenue Code	278
Min. Negotiated Rate	$13.62
Max. Negotiated Rate	$282.50
Rate for Payer: Aetna Commercial	$214.70
Rate for Payer: Aetna Medicare Advantage	$169.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.07
Rate for Payer: Cigna Commercial	$282.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$124.30
Rate for Payer: Qualcare PPO/HMO/WC	$84.75
Rate for Payer: UnitedHealthcare Community & State	$13.62
Rate for Payer: Wellpoint Medicaid Managed Care	$14.97

SCREW BNE 1.7MMx10MM 58-17010E

Facility

$550.00

Hospital Charge Code	270655374
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

SCREW BNE 1.7MMx10MM 58-17010E

Facility

$550.00

Hospital Charge Code	270655374
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

Know your out-of-pocket cost for care.

All Charges