Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW OTPD CANN 2.2/16MM

Facility

$436.85

Hospital Charge Code	270606267
Hospital Revenue Code	278
Min. Negotiated Rate	$10.53
Max. Negotiated Rate	$218.43
Rate for Payer: Aetna Commercial	$166.00
Rate for Payer: Aetna Medicare Advantage	$131.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.40
Rate for Payer: Cigna Commercial	$218.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.11
Rate for Payer: Qualcare PPO/HMO/WC	$65.53
Rate for Payer: UnitedHealthcare Community & State	$10.53
Rate for Payer: Wellpoint Medicaid Managed Care	$11.58

SCREW OTPD CANN 2.2/16MM

Facility

$420.00

Hospital Charge Code	270606259
Hospital Revenue Code	278
Min. Negotiated Rate	$10.12
Max. Negotiated Rate	$210.00
Rate for Payer: Aetna Commercial	$159.60
Rate for Payer: Aetna Medicare Advantage	$126.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.10
Rate for Payer: Cigna Commercial	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$92.40
Rate for Payer: Qualcare PPO/HMO/WC	$63.00
Rate for Payer: UnitedHealthcare Community & State	$10.12
Rate for Payer: Wellpoint Medicaid Managed Care	$11.13

SCREW OTPD CANN 2.2/18MM

Facility

$420.00

Hospital Charge Code	270606260
Hospital Revenue Code	278
Min. Negotiated Rate	$10.12
Max. Negotiated Rate	$210.00
Rate for Payer: Aetna Commercial	$159.60
Rate for Payer: Aetna Medicare Advantage	$126.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.10
Rate for Payer: Cigna Commercial	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$92.40
Rate for Payer: Qualcare PPO/HMO/WC	$63.00
Rate for Payer: UnitedHealthcare Community & State	$10.12
Rate for Payer: Wellpoint Medicaid Managed Care	$11.13

SCREW OTPD CANN 2.2/18MM

Facility

$420.00

Hospital Charge Code	270606260
Hospital Revenue Code	278
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$101.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$92.40
Rate for Payer: Qualcare PPO/HMO/WC	$63.00

SCREW OTPD CANN 2.2/18MM

Facility

$436.85

Hospital Charge Code	270606268
Hospital Revenue Code	278
Min. Negotiated Rate	$65.53
Max. Negotiated Rate	$105.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.11
Rate for Payer: Qualcare PPO/HMO/WC	$65.53

SCREW OTPD CANN 2.2/18MM

Facility

$436.85

Hospital Charge Code	270606268
Hospital Revenue Code	278
Min. Negotiated Rate	$10.53
Max. Negotiated Rate	$218.43
Rate for Payer: Aetna Commercial	$166.00
Rate for Payer: Aetna Medicare Advantage	$131.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.40
Rate for Payer: Cigna Commercial	$218.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.11
Rate for Payer: Qualcare PPO/HMO/WC	$65.53
Rate for Payer: UnitedHealthcare Community & State	$10.53
Rate for Payer: Wellpoint Medicaid Managed Care	$11.58

SCREW OTPD CANN 2.2/20MM

Facility

$436.85

Hospital Charge Code	270606269
Hospital Revenue Code	278
Min. Negotiated Rate	$10.53
Max. Negotiated Rate	$218.43
Rate for Payer: Aetna Commercial	$166.00
Rate for Payer: Aetna Medicare Advantage	$131.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.40
Rate for Payer: Cigna Commercial	$218.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.11
Rate for Payer: Qualcare PPO/HMO/WC	$65.53
Rate for Payer: UnitedHealthcare Community & State	$10.53
Rate for Payer: Wellpoint Medicaid Managed Care	$11.58

SCREW OTPD CANN 2.2/20MM

Facility

$436.85

Hospital Charge Code	270606269
Hospital Revenue Code	278
Min. Negotiated Rate	$65.53
Max. Negotiated Rate	$105.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.11
Rate for Payer: Qualcare PPO/HMO/WC	$65.53

SCREW OTPD CANN 2.2/22MM

Facility

$420.00

Hospital Charge Code	270606262
Hospital Revenue Code	278
Min. Negotiated Rate	$10.12
Max. Negotiated Rate	$210.00
Rate for Payer: Aetna Commercial	$159.60
Rate for Payer: Aetna Medicare Advantage	$126.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.10
Rate for Payer: Cigna Commercial	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$92.40
Rate for Payer: Qualcare PPO/HMO/WC	$63.00
Rate for Payer: UnitedHealthcare Community & State	$10.12
Rate for Payer: Wellpoint Medicaid Managed Care	$11.13

SCREW OTPD CANN 2.2/22MM

Facility

$382.45

Hospital Charge Code	270606270
Hospital Revenue Code	278
Min. Negotiated Rate	$57.37
Max. Negotiated Rate	$92.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$84.14
Rate for Payer: Qualcare PPO/HMO/WC	$57.37

SCREW OTPD CANN 2.2/22MM

Facility

$420.00

Hospital Charge Code	270606262
Hospital Revenue Code	278
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$101.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$92.40
Rate for Payer: Qualcare PPO/HMO/WC	$63.00

SCREW OTPD CANN 2.2/22MM

Facility

$382.45

Hospital Charge Code	270606270
Hospital Revenue Code	278
Min. Negotiated Rate	$9.22
Max. Negotiated Rate	$191.22
Rate for Payer: Aetna Commercial	$145.33
Rate for Payer: Aetna Medicare Advantage	$114.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.52
Rate for Payer: Cigna Commercial	$191.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$84.14
Rate for Payer: Qualcare PPO/HMO/WC	$57.37
Rate for Payer: UnitedHealthcare Community & State	$9.22
Rate for Payer: Wellpoint Medicaid Managed Care	$10.13

SCREW OTPD CANN 2.2/24MM

Facility

$420.00

Hospital Charge Code	270606263
Hospital Revenue Code	278
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$101.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$92.40
Rate for Payer: Qualcare PPO/HMO/WC	$63.00

SCREW OTPD CANN 2.2/24MM

Facility

$382.45

Hospital Charge Code	270606272
Hospital Revenue Code	278
Min. Negotiated Rate	$9.22
Max. Negotiated Rate	$191.22
Rate for Payer: Aetna Commercial	$145.33
Rate for Payer: Aetna Medicare Advantage	$114.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.52
Rate for Payer: Cigna Commercial	$191.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$84.14
Rate for Payer: Qualcare PPO/HMO/WC	$57.37
Rate for Payer: UnitedHealthcare Community & State	$9.22
Rate for Payer: Wellpoint Medicaid Managed Care	$10.13

SCREW OTPD CANN 2.2/24MM

Facility

$420.00

Hospital Charge Code	270606263
Hospital Revenue Code	278
Min. Negotiated Rate	$10.12
Max. Negotiated Rate	$210.00
Rate for Payer: Aetna Commercial	$159.60
Rate for Payer: Aetna Medicare Advantage	$126.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.10
Rate for Payer: Cigna Commercial	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$92.40
Rate for Payer: Qualcare PPO/HMO/WC	$63.00
Rate for Payer: UnitedHealthcare Community & State	$10.12
Rate for Payer: Wellpoint Medicaid Managed Care	$11.13

SCREW OTPD CANN 2.2/24MM

Facility

$382.45

Hospital Charge Code	270606272
Hospital Revenue Code	278
Min. Negotiated Rate	$57.37
Max. Negotiated Rate	$92.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$84.14
Rate for Payer: Qualcare PPO/HMO/WC	$57.37

SCREW OTPD CANN 2.2/26MM

Facility

$436.85

Hospital Charge Code	270606274
Hospital Revenue Code	278
Min. Negotiated Rate	$10.53
Max. Negotiated Rate	$218.43
Rate for Payer: Aetna Commercial	$166.00
Rate for Payer: Aetna Medicare Advantage	$131.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.40
Rate for Payer: Cigna Commercial	$218.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.11
Rate for Payer: Qualcare PPO/HMO/WC	$65.53
Rate for Payer: UnitedHealthcare Community & State	$10.53
Rate for Payer: Wellpoint Medicaid Managed Care	$11.58

SCREW OTPD CANN 2.2/26MM

Facility

$436.85

Hospital Charge Code	270606274
Hospital Revenue Code	278
Min. Negotiated Rate	$65.53
Max. Negotiated Rate	$105.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.11
Rate for Payer: Qualcare PPO/HMO/WC	$65.53

SCREW OTPD CANN 2.7/28MM

Facility

$436.85

Hospital Charge Code	270606275
Hospital Revenue Code	278
Min. Negotiated Rate	$65.53
Max. Negotiated Rate	$105.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.11
Rate for Payer: Qualcare PPO/HMO/WC	$65.53

SCREW OTPD CANN 2.7/28MM

Facility

$436.85

Hospital Charge Code	270606275
Hospital Revenue Code	278
Min. Negotiated Rate	$10.53
Max. Negotiated Rate	$218.43
Rate for Payer: Aetna Commercial	$166.00
Rate for Payer: Aetna Medicare Advantage	$131.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.40
Rate for Payer: Cigna Commercial	$218.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.11
Rate for Payer: Qualcare PPO/HMO/WC	$65.53
Rate for Payer: UnitedHealthcare Community & State	$10.53
Rate for Payer: Wellpoint Medicaid Managed Care	$11.58

SCREW OUT RESTORE REVISION SM

Facility

$2,130.00

Hospital Charge Code	270637163
Hospital Revenue Code	278
Min. Negotiated Rate	$51.33
Max. Negotiated Rate	$1,065.00
Rate for Payer: Aetna Commercial	$809.40
Rate for Payer: Aetna Medicare Advantage	$639.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$543.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$543.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$543.15
Rate for Payer: Cigna Commercial	$1,065.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$468.60
Rate for Payer: Qualcare PPO/HMO/WC	$319.50
Rate for Payer: UnitedHealthcare Community & State	$51.33
Rate for Payer: Wellpoint Medicaid Managed Care	$56.45

SCREW OUT RESTORE REVISION SM

Facility

$2,130.00

Hospital Charge Code	270637163
Hospital Revenue Code	278
Min. Negotiated Rate	$319.50
Max. Negotiated Rate	$515.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$468.60
Rate for Payer: Qualcare PPO/HMO/WC	$319.50

SCREW OUT REST REV LG 219382

Facility

$2,130.00

Hospital Charge Code	270637164
Hospital Revenue Code	278
Min. Negotiated Rate	$319.50
Max. Negotiated Rate	$515.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$468.60
Rate for Payer: Qualcare PPO/HMO/WC	$319.50

SCREW OUT REST REV LG 219382

Facility

$2,130.00

Hospital Charge Code	270637164
Hospital Revenue Code	278
Min. Negotiated Rate	$51.33
Max. Negotiated Rate	$1,065.00
Rate for Payer: Aetna Commercial	$809.40
Rate for Payer: Aetna Medicare Advantage	$639.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$543.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$543.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$543.15
Rate for Payer: Cigna Commercial	$1,065.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$468.60
Rate for Payer: Qualcare PPO/HMO/WC	$319.50
Rate for Payer: UnitedHealthcare Community & State	$51.33
Rate for Payer: Wellpoint Medicaid Managed Care	$56.45

SCREW OVERWATCH 7.5MMX50 MM

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692997
Hospital Revenue Code	278
Min. Negotiated Rate	$126.53
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,995.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,155.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Community & State	$126.53
Rate for Payer: Wellpoint Medicaid Managed Care	$139.12

Know your out-of-pocket cost for care.

All Charges