Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW ECT 4.5 SLF TP 16-64MM**

Facility

$51.00

Hospital Charge Code	1605674
Hospital Revenue Code	274
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$25.50
Rate for Payer: Aetna Commercial	$19.38
Rate for Payer: Aetna Medicare Advantage	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.01
Rate for Payer: Cigna Commercial	$25.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.22
Rate for Payer: Qualcare PPO/HMO/WC	$7.65
Rate for Payer: UnitedHealthcare Community & State	$1.23
Rate for Payer: Wellpoint Medicaid Managed Care	$1.35

SCREW ECT CANC FL THD 10-20MM

Facility

$40.00

Hospital Charge Code	1603695
Hospital Revenue Code	274
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$9.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

SCREW ECT CANC FL THD 10-20MM

Facility

$40.00

Hospital Charge Code	1603695
Hospital Revenue Code	274
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

SCREW ECT CANC FL THD 22-32MM

Facility

$44.00

Hospital Charge Code	1603703
Hospital Revenue Code	274
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$10.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.68
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

SCREW ECT CANC FL THD 22-32MM

Facility

$44.00

Hospital Charge Code	1603703
Hospital Revenue Code	274
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.68
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Community & State	$1.06
Rate for Payer: Wellpoint Medicaid Managed Care	$1.17

SCREW ECT CANC FL THD 34-60MM

Facility

$47.00

Hospital Charge Code	1603711
Hospital Revenue Code	274
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$11.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$10.34
Rate for Payer: Qualcare PPO/HMO/WC	$7.05

SCREW ECT CANC FL THD 34-60MM

Facility

$47.00

Hospital Charge Code	1603711
Hospital Revenue Code	274
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$23.50
Rate for Payer: Aetna Commercial	$17.86
Rate for Payer: Aetna Medicare Advantage	$14.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.98
Rate for Payer: Cigna Commercial	$23.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$10.34
Rate for Payer: Qualcare PPO/HMO/WC	$7.05
Rate for Payer: UnitedHealthcare Community & State	$1.13
Rate for Payer: Wellpoint Medicaid Managed Care	$1.25

SCREW ECT CANC PT THD 22-30MM

Facility

$45.00

Hospital Charge Code	1603737
Hospital Revenue Code	274
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

SCREW ECT CANC PT THD 22-30MM

Facility

$45.00

Hospital Charge Code	1603737
Hospital Revenue Code	274
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$10.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

SCREW ECT CANC PT THD 35-50MM

Facility

$49.00

Hospital Charge Code	1603745
Hospital Revenue Code	274
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$24.50
Rate for Payer: Aetna Commercial	$18.62
Rate for Payer: Aetna Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.49
Rate for Payer: Cigna Commercial	$24.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$10.78
Rate for Payer: Qualcare PPO/HMO/WC	$7.35
Rate for Payer: UnitedHealthcare Community & State	$1.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1.30

SCREW ECT CANC PT THD 35-50MM

Facility

$49.00

Hospital Charge Code	1603745
Hospital Revenue Code	274
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$11.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$10.78
Rate for Payer: Qualcare PPO/HMO/WC	$7.35

SCREW ECT CORT 1.5/16MM

Facility

$27.73

Hospital Charge Code	2706012001
Hospital Revenue Code	274
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$6.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6.10
Rate for Payer: Qualcare PPO/HMO/WC	$4.16

SCREW ECT CORT 1.5/16MM

Facility

$27.73

Hospital Charge Code	2706012001
Hospital Revenue Code	274
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$13.87
Rate for Payer: Aetna Commercial	$10.54
Rate for Payer: Aetna Medicare Advantage	$8.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.07
Rate for Payer: Cigna Commercial	$13.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6.10
Rate for Payer: Qualcare PPO/HMO/WC	$4.16
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.73

SCREW ECT CORT SF TP 4.5/42MM

Facility

$32.64

Hospital Charge Code	270605550
Hospital Revenue Code	279
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$16.32
Rate for Payer: Aetna Commercial	$12.40
Rate for Payer: Aetna Medicare Advantage	$9.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.32
Rate for Payer: Cigna Commercial	$16.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.79
Rate for Payer: Oxford Commercial	$6.53
Rate for Payer: Qualcare PPO/HMO/WC	$4.90
Rate for Payer: UnitedHealthcare Commercial	$6.53
Rate for Payer: UnitedHealthcare Community & State	$0.79
Rate for Payer: Wellpoint Medicaid Managed Care	$0.86

SCREW ECT CORT SF TP 4.5/42MM

Facility

$32.64

Hospital Charge Code	270605550
Hospital Revenue Code	279
Min. Negotiated Rate	$4.90
Max. Negotiated Rate	$4.90
Rate for Payer: Qualcare PPO/HMO/WC	$4.90

SCREW ECT MALLEOLAR 4.5MM***

Facility

$54.00

Hospital Charge Code	1602325
Hospital Revenue Code	274
Min. Negotiated Rate	$8.10
Max. Negotiated Rate	$13.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.88
Rate for Payer: Qualcare PPO/HMO/WC	$8.10

SCREW ECT MALLEOLAR 4.5MM***

Facility

$54.00

Hospital Charge Code	1602325
Hospital Revenue Code	274
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$27.00
Rate for Payer: Aetna Commercial	$20.52
Rate for Payer: Aetna Medicare Advantage	$16.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.77
Rate for Payer: Cigna Commercial	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.88
Rate for Payer: Qualcare PPO/HMO/WC	$8.10
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.43

SCREW ECT PT THD 4.0/10-20MM

Facility

$41.00

Hospital Charge Code	1603729
Hospital Revenue Code	274
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$9.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.02
Rate for Payer: Qualcare PPO/HMO/WC	$6.15

SCREW ECT PT THD 4.0/10-20MM

Facility

$41.00

Hospital Charge Code	1603729
Hospital Revenue Code	274
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$20.50
Rate for Payer: Aetna Commercial	$15.58
Rate for Payer: Aetna Medicare Advantage	$12.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.46
Rate for Payer: Cigna Commercial	$20.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.02
Rate for Payer: Qualcare PPO/HMO/WC	$6.15
Rate for Payer: UnitedHealthcare Community & State	$0.99
Rate for Payer: Wellpoint Medicaid Managed Care	$1.09

SCREW EDS AXIAL 6.5 55 7006555

Facility

$5,391.25

Hospital Charge Code	270628750
Hospital Revenue Code	278
Min. Negotiated Rate	$129.93
Max. Negotiated Rate	$2,695.62
Rate for Payer: Aetna Commercial	$2,048.68
Rate for Payer: Aetna Medicare Advantage	$1,617.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,374.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,374.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,078.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,374.77
Rate for Payer: Cigna Commercial	$2,695.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,304.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,186.08
Rate for Payer: Qualcare PPO/HMO/WC	$808.69
Rate for Payer: UnitedHealthcare Community & State	$129.93
Rate for Payer: Wellpoint Medicaid Managed Care	$142.87

SCREW EDS AXIAL 6.5 55 7006555

Facility

$5,391.25

Hospital Charge Code	270628750
Hospital Revenue Code	278
Min. Negotiated Rate	$808.69
Max. Negotiated Rate	$1,304.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,078.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,304.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,186.08
Rate for Payer: Qualcare PPO/HMO/WC	$808.69

SCREW ES2 5.5 X 40 MM

Facility

$7,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270701778
Hospital Revenue Code	278
Min. Negotiated Rate	$168.70
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,660.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,540.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00
Rate for Payer: UnitedHealthcare Community & State	$168.70
Rate for Payer: Wellpoint Medicaid Managed Care	$185.50

SCREW ES2 5.5 X 40 MM

Facility

$7,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270701778
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,540.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

SCREW ES2 6.5 X 40 MM

Facility

$7,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270701779
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,540.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

SCREW ES2 6.5 X 40 MM

Facility

$7,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270701779
Hospital Revenue Code	278
Min. Negotiated Rate	$168.70
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,660.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,540.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00
Rate for Payer: UnitedHealthcare Community & State	$168.70
Rate for Payer: Wellpoint Medicaid Managed Care	$185.50

Know your out-of-pocket cost for care.

All Charges