Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW MVX CANN 28 P23528

Facility

$500.00

Hospital Charge Code	270609876
Hospital Revenue Code	278
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

SCREW MVX CANN 28 P23528

Facility

$500.00

Hospital Charge Code	270609876
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW MVX CANN 30 P23530

Facility

$500.00

Hospital Charge Code	270609877
Hospital Revenue Code	278
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

SCREW MVX CANN 30 P23530

Facility

$500.00

Hospital Charge Code	270609877
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW MVX CANN 32 P23532

Facility

$500.00

Hospital Charge Code	270609878
Hospital Revenue Code	278
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

SCREW MVX CANN 32 P23532

Facility

$500.00

Hospital Charge Code	270609878
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW MVX CANN 34 P23534

Facility

$500.00

Hospital Charge Code	270609879
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW MVX CANN 34 P23534

Facility

$500.00

Hospital Charge Code	270609879
Hospital Revenue Code	278
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

SCREW MVX CANN 36 P23536

Facility

$500.00

Hospital Charge Code	270609880
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW MVX CANN 36 P23536

Facility

$500.00

Hospital Charge Code	270609880
Hospital Revenue Code	278
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

SCREW MVX CANN 38 P23538

Facility

$500.00

Hospital Charge Code	270609881
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW MVX CANN 38 P23538

Facility

$500.00

Hospital Charge Code	270609881
Hospital Revenue Code	278
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

SCREW NAUTILUS POLYAX 8.5X80MM

Facility

$6,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270699335
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,687.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,534.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

SCREW NAUTILUS POLYAX 8.5X80MM

Facility

$6,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270699335
Hospital Revenue Code	278
Min. Negotiated Rate	$168.10
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,650.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,534.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25
Rate for Payer: UnitedHealthcare Community & State	$168.10
Rate for Payer: Wellpoint Medicaid Managed Care	$184.84

SCREW NAUTILUS POLYAX 8.5X80MM

Facility

$6,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270699341
Hospital Revenue Code	278
Min. Negotiated Rate	$168.10
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,650.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,534.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25
Rate for Payer: UnitedHealthcare Community & State	$168.10
Rate for Payer: Wellpoint Medicaid Managed Care	$184.84

SCREW NAUTILUS POLYAX 8.5X80MM

Facility

$6,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270699341
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,687.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,534.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

SCREW NAUTILUS POLYAX 8.5X90MM

Facility

$6,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270699334
Hospital Revenue Code	278
Min. Negotiated Rate	$168.10
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,650.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,534.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25
Rate for Payer: UnitedHealthcare Community & State	$168.10
Rate for Payer: Wellpoint Medicaid Managed Care	$184.84

SCREW NAUTILUS POLYAX 8.5X90MM

Facility

$6,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270699334
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,687.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,534.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

SCREW NCB 5X60MM SELF TAP

Facility

$1,223.40

Hospital Charge Code	270702812
Hospital Revenue Code	278
Min. Negotiated Rate	$29.48
Max. Negotiated Rate	$611.70
Rate for Payer: Aetna Commercial	$464.89
Rate for Payer: Aetna Medicare Advantage	$367.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.97
Rate for Payer: Cigna Commercial	$611.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51
Rate for Payer: UnitedHealthcare Community & State	$29.48
Rate for Payer: Wellpoint Medicaid Managed Care	$32.42

SCREW NCB 5X60MM SELF TAP

Facility

$1,223.40

Hospital Charge Code	270702812
Hospital Revenue Code	278
Min. Negotiated Rate	$183.51
Max. Negotiated Rate	$296.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51

SCREW NCB 5X70MM SELF TAP

Facility

$1,223.40

Hospital Charge Code	270702813
Hospital Revenue Code	278
Min. Negotiated Rate	$183.51
Max. Negotiated Rate	$296.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51

SCREW NCB 5X70MM SELF TAP

Facility

$1,223.40

Hospital Charge Code	270702813
Hospital Revenue Code	278
Min. Negotiated Rate	$29.48
Max. Negotiated Rate	$611.70
Rate for Payer: Aetna Commercial	$464.89
Rate for Payer: Aetna Medicare Advantage	$367.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.97
Rate for Payer: Cigna Commercial	$611.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51
Rate for Payer: UnitedHealthcare Community & State	$29.48
Rate for Payer: Wellpoint Medicaid Managed Care	$32.42

SCREW NCB 5X80MM SELF TAP

Facility

$1,223.40

Hospital Charge Code	270702814
Hospital Revenue Code	278
Min. Negotiated Rate	$29.48
Max. Negotiated Rate	$611.70
Rate for Payer: Aetna Commercial	$464.89
Rate for Payer: Aetna Medicare Advantage	$367.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.97
Rate for Payer: Cigna Commercial	$611.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51
Rate for Payer: UnitedHealthcare Community & State	$29.48
Rate for Payer: Wellpoint Medicaid Managed Care	$32.42

SCREW NCB 5X80MM SELF TAP

Facility

$1,223.40

Hospital Charge Code	270702814
Hospital Revenue Code	278
Min. Negotiated Rate	$183.51
Max. Negotiated Rate	$296.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51

SCREW NCB 5X85MM SELF TAP

Facility

$1,045.00

Hospital Charge Code	270702815
Hospital Revenue Code	278
Min. Negotiated Rate	$156.75
Max. Negotiated Rate	$252.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$209.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$156.75

Know your out-of-pocket cost for care.

All Charges