Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW DHS LAG 14.0 60 280.460

Facility

$1,342.45

Hospital Charge Code	270603783
Hospital Revenue Code	278
Min. Negotiated Rate	$32.35
Max. Negotiated Rate	$671.23
Rate for Payer: Aetna Commercial	$510.13
Rate for Payer: Aetna Medicare Advantage	$402.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$342.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$342.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$342.32
Rate for Payer: Cigna Commercial	$671.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$295.34
Rate for Payer: Qualcare PPO/HMO/WC	$201.37
Rate for Payer: UnitedHealthcare Community & State	$32.35
Rate for Payer: Wellpoint Medicaid Managed Care	$35.57

SCREW DHS LAG 14.0 65 280.465

Facility

$1,342.45

Hospital Charge Code	270603784
Hospital Revenue Code	278
Min. Negotiated Rate	$201.37
Max. Negotiated Rate	$324.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$295.34
Rate for Payer: Qualcare PPO/HMO/WC	$201.37

SCREW DHS LAG 14.0 65 280.465

Facility

$1,342.45

Hospital Charge Code	270603784
Hospital Revenue Code	278
Min. Negotiated Rate	$32.35
Max. Negotiated Rate	$671.23
Rate for Payer: Aetna Commercial	$510.13
Rate for Payer: Aetna Medicare Advantage	$402.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$342.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$342.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$342.32
Rate for Payer: Cigna Commercial	$671.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$295.34
Rate for Payer: Qualcare PPO/HMO/WC	$201.37
Rate for Payer: UnitedHealthcare Community & State	$32.35
Rate for Payer: Wellpoint Medicaid Managed Care	$35.57

SCREW DHS LAG 14.0 70 280.470

Facility

$1,342.45

Hospital Charge Code	270603785
Hospital Revenue Code	278
Min. Negotiated Rate	$201.37
Max. Negotiated Rate	$324.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$295.34
Rate for Payer: Qualcare PPO/HMO/WC	$201.37

SCREW DHS LAG 14.0 70 280.470

Facility

$1,342.45

Hospital Charge Code	270603785
Hospital Revenue Code	278
Min. Negotiated Rate	$32.35
Max. Negotiated Rate	$671.23
Rate for Payer: Aetna Commercial	$510.13
Rate for Payer: Aetna Medicare Advantage	$402.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$342.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$342.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$342.32
Rate for Payer: Cigna Commercial	$671.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$295.34
Rate for Payer: Qualcare PPO/HMO/WC	$201.37
Rate for Payer: UnitedHealthcare Community & State	$32.35
Rate for Payer: Wellpoint Medicaid Managed Care	$35.57

SCREW DHS LAG 14.0 75 280.475

Facility

$1,342.45

Hospital Charge Code	270603786
Hospital Revenue Code	278
Min. Negotiated Rate	$201.37
Max. Negotiated Rate	$324.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$295.34
Rate for Payer: Qualcare PPO/HMO/WC	$201.37

SCREW DHS LAG 14.0 75 280.475

Facility

$1,342.45

Hospital Charge Code	270603786
Hospital Revenue Code	278
Min. Negotiated Rate	$32.35
Max. Negotiated Rate	$671.23
Rate for Payer: Aetna Commercial	$510.13
Rate for Payer: Aetna Medicare Advantage	$402.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$342.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$342.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$342.32
Rate for Payer: Cigna Commercial	$671.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$295.34
Rate for Payer: Qualcare PPO/HMO/WC	$201.37
Rate for Payer: UnitedHealthcare Community & State	$32.35
Rate for Payer: Wellpoint Medicaid Managed Care	$35.57

SCREW DHS LAG 14.0 80 280.480

Facility

$1,342.45

Hospital Charge Code	270603787
Hospital Revenue Code	278
Min. Negotiated Rate	$32.35
Max. Negotiated Rate	$671.23
Rate for Payer: Aetna Commercial	$510.13
Rate for Payer: Aetna Medicare Advantage	$402.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$342.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$342.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$342.32
Rate for Payer: Cigna Commercial	$671.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$295.34
Rate for Payer: Qualcare PPO/HMO/WC	$201.37
Rate for Payer: UnitedHealthcare Community & State	$32.35
Rate for Payer: Wellpoint Medicaid Managed Care	$35.57

SCREW DHS LAG 14.0 80 280.480

Facility

$1,342.45

Hospital Charge Code	270603787
Hospital Revenue Code	278
Min. Negotiated Rate	$201.37
Max. Negotiated Rate	$324.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$295.34
Rate for Payer: Qualcare PPO/HMO/WC	$201.37

SCREW DHS LAG 14.0 85 280.485

Facility

$1,342.45

Hospital Charge Code	270603788
Hospital Revenue Code	278
Min. Negotiated Rate	$201.37
Max. Negotiated Rate	$324.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$295.34
Rate for Payer: Qualcare PPO/HMO/WC	$201.37

SCREW DHS LAG 14.0 85 280.485

Facility

$1,342.45

Hospital Charge Code	270603788
Hospital Revenue Code	278
Min. Negotiated Rate	$32.35
Max. Negotiated Rate	$671.23
Rate for Payer: Aetna Commercial	$510.13
Rate for Payer: Aetna Medicare Advantage	$402.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$342.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$342.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$342.32
Rate for Payer: Cigna Commercial	$671.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$295.34
Rate for Payer: Qualcare PPO/HMO/WC	$201.37
Rate for Payer: UnitedHealthcare Community & State	$32.35
Rate for Payer: Wellpoint Medicaid Managed Care	$35.57

SCREW DHS LAG 14.0 90 280.490

Facility

$1,320.00

Hospital Charge Code	270603789
Hospital Revenue Code	278
Min. Negotiated Rate	$198.00
Max. Negotiated Rate	$319.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$290.40
Rate for Payer: Qualcare PPO/HMO/WC	$198.00

SCREW DHS LAG 14.0 90 280.490

Facility

$1,320.00

Hospital Charge Code	270603789
Hospital Revenue Code	278
Min. Negotiated Rate	$31.81
Max. Negotiated Rate	$660.00
Rate for Payer: Aetna Commercial	$501.60
Rate for Payer: Aetna Medicare Advantage	$396.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$336.60
Rate for Payer: Cigna Commercial	$660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$290.40
Rate for Payer: Qualcare PPO/HMO/WC	$198.00
Rate for Payer: UnitedHealthcare Community & State	$31.81
Rate for Payer: Wellpoint Medicaid Managed Care	$34.98

SCREW DHS LAG 14.0 95 280.495

Facility

$1,342.45

Hospital Charge Code	270603790
Hospital Revenue Code	278
Min. Negotiated Rate	$201.37
Max. Negotiated Rate	$324.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$295.34
Rate for Payer: Qualcare PPO/HMO/WC	$201.37

SCREW DHS LAG 14.0 95 280.495

Facility

$1,342.45

Hospital Charge Code	270603790
Hospital Revenue Code	278
Min. Negotiated Rate	$32.35
Max. Negotiated Rate	$671.23
Rate for Payer: Aetna Commercial	$510.13
Rate for Payer: Aetna Medicare Advantage	$402.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$342.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$342.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$342.32
Rate for Payer: Cigna Commercial	$671.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$295.34
Rate for Payer: Qualcare PPO/HMO/WC	$201.37
Rate for Payer: UnitedHealthcare Community & State	$32.35
Rate for Payer: Wellpoint Medicaid Managed Care	$35.57

SCREW DOME MPACT 15MM

Facility

$16,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270684245
Hospital Revenue Code	278
Min. Negotiated Rate	$2,452.50
Max. Negotiated Rate	$3,956.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,956.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,597.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,452.50

SCREW DOME MPACT 15MM

Facility

$16,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270684245
Hospital Revenue Code	278
Min. Negotiated Rate	$394.04
Max. Negotiated Rate	$8,175.00
Rate for Payer: Aetna Commercial	$6,213.00
Rate for Payer: Aetna Medicare Advantage	$4,905.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,169.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,169.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,169.25
Rate for Payer: Cigna Commercial	$8,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,956.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,597.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,452.50
Rate for Payer: UnitedHealthcare Community & State	$394.04
Rate for Payer: Wellpoint Medicaid Managed Care	$433.27

SCREW DPY CANC 4.0 26 14369226

Facility

$136.85

Hospital Charge Code	270622982
Hospital Revenue Code	278
Min. Negotiated Rate	$20.53
Max. Negotiated Rate	$33.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.11
Rate for Payer: Qualcare PPO/HMO/WC	$20.53

SCREW DPY CANC 4.0 26 14369226

Facility

$136.85

Hospital Charge Code	270622982
Hospital Revenue Code	278
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$68.42
Rate for Payer: Aetna Commercial	$52.00
Rate for Payer: Aetna Medicare Advantage	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.90
Rate for Payer: Cigna Commercial	$68.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.11
Rate for Payer: Qualcare PPO/HMO/WC	$20.53
Rate for Payer: UnitedHealthcare Community & State	$3.30
Rate for Payer: Wellpoint Medicaid Managed Care	$3.63

SCREW DPY CANC 4.0 28 1436928

Facility

$136.85

Service Code	HCPCS C1713
Hospital Charge Code	270622981
Hospital Revenue Code	278
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$68.42
Rate for Payer: Aetna Commercial	$52.00
Rate for Payer: Aetna Medicare Advantage	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.90
Rate for Payer: Cigna Commercial	$68.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.11
Rate for Payer: Qualcare PPO/HMO/WC	$20.53
Rate for Payer: UnitedHealthcare Community & State	$3.30
Rate for Payer: Wellpoint Medicaid Managed Care	$3.63

SCREW DPY CANC 4.0 28 1436928

Facility

$136.85

Service Code	HCPCS C1713
Hospital Charge Code	270622981
Hospital Revenue Code	278
Min. Negotiated Rate	$20.53
Max. Negotiated Rate	$33.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.11
Rate for Payer: Qualcare PPO/HMO/WC	$20.53

SCREW DPY CANC 4.0 36 14369236

Facility

$164.00

Hospital Charge Code	270622988
Hospital Revenue Code	278
Min. Negotiated Rate	$3.95
Max. Negotiated Rate	$82.00
Rate for Payer: Aetna Commercial	$62.32
Rate for Payer: Aetna Medicare Advantage	$49.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.82
Rate for Payer: Cigna Commercial	$82.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$36.08
Rate for Payer: Qualcare PPO/HMO/WC	$24.60
Rate for Payer: UnitedHealthcare Community & State	$3.95
Rate for Payer: Wellpoint Medicaid Managed Care	$4.35

SCREW DPY CANC 4.0 36 14369236

Facility

$164.00

Hospital Charge Code	270622988
Hospital Revenue Code	278
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$39.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$36.08
Rate for Payer: Qualcare PPO/HMO/WC	$24.60

SCREW DPY CANC 4.0 42 1437642

Facility

$551.25

Hospital Charge Code	270622987
Hospital Revenue Code	278
Min. Negotiated Rate	$13.29
Max. Negotiated Rate	$275.62
Rate for Payer: Aetna Commercial	$209.47
Rate for Payer: Aetna Medicare Advantage	$165.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.57
Rate for Payer: Cigna Commercial	$275.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.28
Rate for Payer: Qualcare PPO/HMO/WC	$82.69
Rate for Payer: UnitedHealthcare Community & State	$13.29
Rate for Payer: Wellpoint Medicaid Managed Care	$14.61

SCREW DPY CANC 4.0 42 1437642

Facility

$551.25

Hospital Charge Code	270622987
Hospital Revenue Code	278
Min. Negotiated Rate	$82.69
Max. Negotiated Rate	$133.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.28
Rate for Payer: Qualcare PPO/HMO/WC	$82.69

Know your out-of-pocket cost for care.

All Charges