Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW HMD CORT 5 50 5210-1050

Facility

$315.25

Hospital Charge Code	270620194
Hospital Revenue Code	278
Min. Negotiated Rate	$7.60
Max. Negotiated Rate	$157.62
Rate for Payer: Aetna Commercial	$119.80
Rate for Payer: Aetna Medicare Advantage	$94.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.39
Rate for Payer: Cigna Commercial	$157.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$69.36
Rate for Payer: Qualcare PPO/HMO/WC	$47.29
Rate for Payer: UnitedHealthcare Community & State	$7.60
Rate for Payer: Wellpoint Medicaid Managed Care	$8.35

SCREW HMD DISTAL 30 3370-5030

Facility

$721.65

Hospital Charge Code	270613078
Hospital Revenue Code	278
Min. Negotiated Rate	$17.39
Max. Negotiated Rate	$360.82
Rate for Payer: Aetna Commercial	$274.23
Rate for Payer: Aetna Medicare Advantage	$216.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.02
Rate for Payer: Cigna Commercial	$360.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.76
Rate for Payer: Qualcare PPO/HMO/WC	$108.25
Rate for Payer: UnitedHealthcare Community & State	$17.39
Rate for Payer: Wellpoint Medicaid Managed Care	$19.12

SCREW HMD DISTAL 30 3370-5030

Facility

$721.65

Hospital Charge Code	270613078
Hospital Revenue Code	278
Min. Negotiated Rate	$108.25
Max. Negotiated Rate	$174.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.76
Rate for Payer: Qualcare PPO/HMO/WC	$108.25

SCREW HMD DISTAL 35 3370-5035

Facility

$760.00

Hospital Charge Code	270617159
Hospital Revenue Code	278
Min. Negotiated Rate	$114.00
Max. Negotiated Rate	$183.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$152.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$167.20
Rate for Payer: Qualcare PPO/HMO/WC	$114.00

SCREW HMD DISTAL 35 3370-5035

Facility

$760.00

Hospital Charge Code	270617159
Hospital Revenue Code	278
Min. Negotiated Rate	$18.32
Max. Negotiated Rate	$380.00
Rate for Payer: Aetna Commercial	$288.80
Rate for Payer: Aetna Medicare Advantage	$228.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$193.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$193.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$152.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$193.80
Rate for Payer: Cigna Commercial	$380.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$167.20
Rate for Payer: Qualcare PPO/HMO/WC	$114.00
Rate for Payer: UnitedHealthcare Community & State	$18.32
Rate for Payer: Wellpoint Medicaid Managed Care	$20.14

SCREW HMD DISTAL 45 33705045

Facility

$797.65

Hospital Charge Code	270615323
Hospital Revenue Code	278
Min. Negotiated Rate	$19.22
Max. Negotiated Rate	$398.82
Rate for Payer: Aetna Commercial	$303.11
Rate for Payer: Aetna Medicare Advantage	$239.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$203.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$203.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$203.40
Rate for Payer: Cigna Commercial	$398.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$175.48
Rate for Payer: Qualcare PPO/HMO/WC	$119.65
Rate for Payer: UnitedHealthcare Community & State	$19.22
Rate for Payer: Wellpoint Medicaid Managed Care	$21.14

SCREW HMD DISTAL 45 33705045

Facility

$797.65

Hospital Charge Code	270615323
Hospital Revenue Code	278
Min. Negotiated Rate	$119.65
Max. Negotiated Rate	$193.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$175.48
Rate for Payer: Qualcare PPO/HMO/WC	$119.65

SCREW HMD DISTAL 453370-5045**

Facility

$312.00

Hospital Charge Code	270615353
Hospital Revenue Code	279
Min. Negotiated Rate	$7.52
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$118.56
Rate for Payer: Aetna Medicare Advantage	$93.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.56
Rate for Payer: Cigna Commercial	$156.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.60
Rate for Payer: Oxford Commercial	$62.40
Rate for Payer: Qualcare PPO/HMO/WC	$46.80
Rate for Payer: UnitedHealthcare Commercial	$62.40
Rate for Payer: UnitedHealthcare Community & State	$7.52
Rate for Payer: Wellpoint Medicaid Managed Care	$8.27

SCREW HMD DISTAL 453370-5045**

Facility

$312.00

Hospital Charge Code	270615353
Hospital Revenue Code	279
Min. Negotiated Rate	$46.80
Max. Negotiated Rate	$46.80
Rate for Payer: Qualcare PPO/HMO/WC	$46.80

SCREW HMD DISTAL 50 3370-5050

Facility

$760.00

Hospital Charge Code	270617160
Hospital Revenue Code	278
Min. Negotiated Rate	$114.00
Max. Negotiated Rate	$183.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$152.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$167.20
Rate for Payer: Qualcare PPO/HMO/WC	$114.00

SCREW HMD DISTAL 50 3370-5050

Facility

$760.00

Hospital Charge Code	270617160
Hospital Revenue Code	278
Min. Negotiated Rate	$18.32
Max. Negotiated Rate	$380.00
Rate for Payer: Aetna Commercial	$288.80
Rate for Payer: Aetna Medicare Advantage	$228.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$193.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$193.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$152.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$193.80
Rate for Payer: Cigna Commercial	$380.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$167.20
Rate for Payer: Qualcare PPO/HMO/WC	$114.00
Rate for Payer: UnitedHealthcare Community & State	$18.32
Rate for Payer: Wellpoint Medicaid Managed Care	$20.14

SCREW HMD FT 6.28 40 33705040

Facility

$797.65

Hospital Charge Code	270620984
Hospital Revenue Code	278
Min. Negotiated Rate	$19.22
Max. Negotiated Rate	$398.82
Rate for Payer: Aetna Commercial	$303.11
Rate for Payer: Aetna Medicare Advantage	$239.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$203.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$203.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$203.40
Rate for Payer: Cigna Commercial	$398.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$175.48
Rate for Payer: Qualcare PPO/HMO/WC	$119.65
Rate for Payer: UnitedHealthcare Community & State	$19.22
Rate for Payer: Wellpoint Medicaid Managed Care	$21.14

SCREW HMD FT 6.28 40 33705040

Facility

$797.65

Hospital Charge Code	270620984
Hospital Revenue Code	278
Min. Negotiated Rate	$119.65
Max. Negotiated Rate	$193.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$175.48
Rate for Payer: Qualcare PPO/HMO/WC	$119.65

SCREW HMD LAG 80MM 3370-2080

Facility

$1,786.45

Hospital Charge Code	270620983
Hospital Revenue Code	278
Min. Negotiated Rate	$267.97
Max. Negotiated Rate	$432.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$357.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$432.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$393.02
Rate for Payer: Qualcare PPO/HMO/WC	$267.97

SCREW HMD LAG 80MM 3370-2080

Facility

$1,786.45

Hospital Charge Code	270620983
Hospital Revenue Code	278
Min. Negotiated Rate	$43.05
Max. Negotiated Rate	$893.23
Rate for Payer: Aetna Commercial	$678.85
Rate for Payer: Aetna Medicare Advantage	$535.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$455.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$455.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$357.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$455.54
Rate for Payer: Cigna Commercial	$893.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$432.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$393.02
Rate for Payer: Qualcare PPO/HMO/WC	$267.97
Rate for Payer: UnitedHealthcare Community & State	$43.05
Rate for Payer: Wellpoint Medicaid Managed Care	$47.34

SCREW HMD LAG 85MM 3370-2085

Facility

$1,609.65

Hospital Charge Code	270611709
Hospital Revenue Code	278
Min. Negotiated Rate	$241.45
Max. Negotiated Rate	$389.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$321.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$354.12
Rate for Payer: Qualcare PPO/HMO/WC	$241.45

SCREW HMD LAG 85MM 3370-2085

Facility

$1,609.65

Hospital Charge Code	270611709
Hospital Revenue Code	278
Min. Negotiated Rate	$38.79
Max. Negotiated Rate	$804.83
Rate for Payer: Aetna Commercial	$611.67
Rate for Payer: Aetna Medicare Advantage	$482.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$321.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.46
Rate for Payer: Cigna Commercial	$804.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$354.12
Rate for Payer: Qualcare PPO/HMO/WC	$241.45
Rate for Payer: UnitedHealthcare Community & State	$38.79
Rate for Payer: Wellpoint Medicaid Managed Care	$42.66

SCREW HMD SET 3370

Facility

$607.25

Hospital Charge Code	270611708
Hospital Revenue Code	278
Min. Negotiated Rate	$91.09
Max. Negotiated Rate	$146.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$133.59
Rate for Payer: Qualcare PPO/HMO/WC	$91.09

SCREW HMD SET 3370

Facility

$607.25

Hospital Charge Code	270611708
Hospital Revenue Code	278
Min. Negotiated Rate	$14.63
Max. Negotiated Rate	$303.62
Rate for Payer: Aetna Commercial	$230.75
Rate for Payer: Aetna Medicare Advantage	$182.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.85
Rate for Payer: Cigna Commercial	$303.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$133.59
Rate for Payer: Qualcare PPO/HMO/WC	$91.09
Rate for Payer: UnitedHealthcare Community & State	$14.63
Rate for Payer: Wellpoint Medicaid Managed Care	$16.09

SCREW HOLDING/DRIVER ASSY

Facility

$10,920.00

Hospital Charge Code	270686085
Hospital Revenue Code	272
Min. Negotiated Rate	$263.17
Max. Negotiated Rate	$5,460.00
Rate for Payer: Aetna Commercial	$4,149.60
Rate for Payer: Aetna Medicare Advantage	$3,276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,784.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,784.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,784.60
Rate for Payer: Cigna Commercial	$5,460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,276.00
Rate for Payer: Oxford Commercial	$2,184.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,638.00
Rate for Payer: UnitedHealthcare Commercial	$2,184.00
Rate for Payer: UnitedHealthcare Community & State	$263.17
Rate for Payer: Wellpoint Medicaid Managed Care	$289.38

SCREW HOLDING/DRIVER ASSY

Facility

$10,920.00

Hospital Charge Code	270686085
Hospital Revenue Code	272
Min. Negotiated Rate	$1,638.00
Max. Negotiated Rate	$1,638.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,638.00

SCREW HUMERAL TAPER SIZE 25 OR

Facility

$2,675.00

Service Code	HCPCS C1713
Hospital Charge Code	270679727
Hospital Revenue Code	278
Min. Negotiated Rate	$401.25
Max. Negotiated Rate	$647.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$647.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$588.50
Rate for Payer: Qualcare PPO/HMO/WC	$401.25

SCREW HUMERAL TAPER SIZE 25 OR

Facility

$2,675.00

Service Code	HCPCS C1713
Hospital Charge Code	270679727
Hospital Revenue Code	278
Min. Negotiated Rate	$64.47
Max. Negotiated Rate	$1,337.50
Rate for Payer: Aetna Commercial	$1,016.50
Rate for Payer: Aetna Medicare Advantage	$802.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$682.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$682.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$682.12
Rate for Payer: Cigna Commercial	$1,337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$647.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$588.50
Rate for Payer: Qualcare PPO/HMO/WC	$401.25
Rate for Payer: UnitedHealthcare Community & State	$64.47
Rate for Payer: Wellpoint Medicaid Managed Care	$70.89

SCREW, IDTI ALIF SA,LAT 5.0X25

Facility

$2,845.00

Hospital Charge Code	270703003
Hospital Revenue Code	278
Min. Negotiated Rate	$68.56
Max. Negotiated Rate	$1,422.50
Rate for Payer: Aetna Commercial	$1,081.10
Rate for Payer: Aetna Medicare Advantage	$853.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$725.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$725.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$725.48
Rate for Payer: Cigna Commercial	$1,422.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$625.90
Rate for Payer: Qualcare PPO/HMO/WC	$426.75
Rate for Payer: UnitedHealthcare Community & State	$68.56
Rate for Payer: Wellpoint Medicaid Managed Care	$75.39

SCREW, IDTI ALIF SA,LAT 5.0X25

Facility

$2,845.00

Hospital Charge Code	270703003
Hospital Revenue Code	278
Min. Negotiated Rate	$426.75
Max. Negotiated Rate	$688.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$625.90
Rate for Payer: Qualcare PPO/HMO/WC	$426.75

Know your out-of-pocket cost for care.

All Charges