Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW PERI 3.5x26 234802635

Facility

$128.15

Hospital Charge Code	270632807
Hospital Revenue Code	278
Min. Negotiated Rate	$3.09
Max. Negotiated Rate	$64.08
Rate for Payer: Aetna Commercial	$48.70
Rate for Payer: Aetna Medicare Advantage	$38.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.68
Rate for Payer: Cigna Commercial	$64.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$28.19
Rate for Payer: Qualcare PPO/HMO/WC	$19.22
Rate for Payer: UnitedHealthcare Community & State	$3.09
Rate for Payer: Wellpoint Medicaid Managed Care	$3.40

SCREW PERI 3.5x26 234802635

Facility

$128.15

Hospital Charge Code	270632807
Hospital Revenue Code	278
Min. Negotiated Rate	$19.22
Max. Negotiated Rate	$31.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$28.19
Rate for Payer: Qualcare PPO/HMO/WC	$19.22

SCREW PERI 3.5X26 2348-028-35

Facility

$134.60

Hospital Charge Code	270638711
Hospital Revenue Code	278
Min. Negotiated Rate	$20.19
Max. Negotiated Rate	$32.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.61
Rate for Payer: Qualcare PPO/HMO/WC	$20.19

SCREW PERI 3.5X26 2348-028-35

Facility

$134.60

Hospital Charge Code	270638711
Hospital Revenue Code	278
Min. Negotiated Rate	$3.24
Max. Negotiated Rate	$67.30
Rate for Payer: Aetna Commercial	$51.15
Rate for Payer: Aetna Medicare Advantage	$40.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.32
Rate for Payer: Cigna Commercial	$67.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.61
Rate for Payer: Qualcare PPO/HMO/WC	$20.19
Rate for Payer: UnitedHealthcare Community & State	$3.24
Rate for Payer: Wellpoint Medicaid Managed Care	$3.57

SCREW PERI 3.5x32 234803235

Facility

$117.50

Hospital Charge Code	270632808
Hospital Revenue Code	278
Min. Negotiated Rate	$2.83
Max. Negotiated Rate	$58.75
Rate for Payer: Aetna Commercial	$44.65
Rate for Payer: Aetna Medicare Advantage	$35.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.96
Rate for Payer: Cigna Commercial	$58.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.85
Rate for Payer: Qualcare PPO/HMO/WC	$17.62
Rate for Payer: UnitedHealthcare Community & State	$2.83
Rate for Payer: Wellpoint Medicaid Managed Care	$3.11

SCREW PERI 3.5x32 234803235

Facility

$117.50

Hospital Charge Code	270632808
Hospital Revenue Code	278
Min. Negotiated Rate	$17.62
Max. Negotiated Rate	$28.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.85
Rate for Payer: Qualcare PPO/HMO/WC	$17.62

SCREW PERI 3.5X36 2348-036-35

Facility

$134.60

Hospital Charge Code	270638712
Hospital Revenue Code	278
Min. Negotiated Rate	$20.19
Max. Negotiated Rate	$32.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.61
Rate for Payer: Qualcare PPO/HMO/WC	$20.19

SCREW PERI 3.5X36 2348-036-35

Facility

$134.60

Hospital Charge Code	270638712
Hospital Revenue Code	278
Min. Negotiated Rate	$3.24
Max. Negotiated Rate	$67.30
Rate for Payer: Aetna Commercial	$51.15
Rate for Payer: Aetna Medicare Advantage	$40.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.32
Rate for Payer: Cigna Commercial	$67.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.61
Rate for Payer: Qualcare PPO/HMO/WC	$20.19
Rate for Payer: UnitedHealthcare Community & State	$3.24
Rate for Payer: Wellpoint Medicaid Managed Care	$3.57

SCREW PERI 3.5X50 2348-050-35

Facility

$134.60

Hospital Charge Code	270638713
Hospital Revenue Code	278
Min. Negotiated Rate	$3.24
Max. Negotiated Rate	$67.30
Rate for Payer: Aetna Commercial	$51.15
Rate for Payer: Aetna Medicare Advantage	$40.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.32
Rate for Payer: Cigna Commercial	$67.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.61
Rate for Payer: Qualcare PPO/HMO/WC	$20.19
Rate for Payer: UnitedHealthcare Community & State	$3.24
Rate for Payer: Wellpoint Medicaid Managed Care	$3.57

SCREW PERI 3.5X50 2348-050-35

Facility

$134.60

Hospital Charge Code	270638713
Hospital Revenue Code	278
Min. Negotiated Rate	$20.19
Max. Negotiated Rate	$32.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.61
Rate for Payer: Qualcare PPO/HMO/WC	$20.19

SCREW PERIA LOCK/CANN 4.5X28MM

Facility

$610.00

Hospital Charge Code	270639623
Hospital Revenue Code	278
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$305.00
Rate for Payer: Aetna Commercial	$231.80
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.20
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Community & State	$14.70
Rate for Payer: Wellpoint Medicaid Managed Care	$16.16

SCREW PERIA LOCK/CANN 4.5X28MM

Facility

$610.00

Hospital Charge Code	270639623
Hospital Revenue Code	278
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$147.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.20
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

SCREW PERIA LOCK/CANN 4.5X32MM

Facility

$940.00

Service Code	HCPCS C1713
Hospital Charge Code	270639624
Hospital Revenue Code	278
Min. Negotiated Rate	$22.65
Max. Negotiated Rate	$470.00
Rate for Payer: Aetna Commercial	$357.20
Rate for Payer: Aetna Medicare Advantage	$282.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$239.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$239.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$188.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$239.70
Rate for Payer: Cigna Commercial	$470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$206.80
Rate for Payer: Qualcare PPO/HMO/WC	$141.00
Rate for Payer: UnitedHealthcare Community & State	$22.65
Rate for Payer: Wellpoint Medicaid Managed Care	$24.91

SCREW PERIA LOCK/CANN 4.5X32MM

Facility

$940.00

Service Code	HCPCS C1713
Hospital Charge Code	270639624
Hospital Revenue Code	278
Min. Negotiated Rate	$141.00
Max. Negotiated Rate	$227.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$188.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$206.80
Rate for Payer: Qualcare PPO/HMO/WC	$141.00

SCREW PERIA LOCK/CANN 4.5X40MM

Facility

$610.00

Service Code	HCPCS C1713
Hospital Charge Code	270639201
Hospital Revenue Code	278
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$305.00
Rate for Payer: Aetna Commercial	$231.80
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.20
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Community & State	$14.70
Rate for Payer: Wellpoint Medicaid Managed Care	$16.16

SCREW PERIA LOCK/CANN 4.5X40MM

Facility

$610.00

Service Code	HCPCS C1713
Hospital Charge Code	270639201
Hospital Revenue Code	278
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$147.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.20
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

SCREW PERIA LOCK/CANN 5.5X25MM

Facility

$910.00

Hospital Charge Code	270670427
Hospital Revenue Code	278
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$220.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.20
Rate for Payer: Qualcare PPO/HMO/WC	$136.50

SCREW PERIA LOCK/CANN 5.5X25MM

Facility

$910.00

Hospital Charge Code	270670427
Hospital Revenue Code	278
Min. Negotiated Rate	$21.93
Max. Negotiated Rate	$455.00
Rate for Payer: Aetna Commercial	$345.80
Rate for Payer: Aetna Medicare Advantage	$273.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.05
Rate for Payer: Cigna Commercial	$455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.20
Rate for Payer: Qualcare PPO/HMO/WC	$136.50
Rate for Payer: UnitedHealthcare Community & State	$21.93
Rate for Payer: Wellpoint Medicaid Managed Care	$24.11

SCREW PERIA LOCK/CANN 5.5X45MM

Facility

$910.00

Hospital Charge Code	270648674
Hospital Revenue Code	278
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$220.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.20
Rate for Payer: Qualcare PPO/HMO/WC	$136.50

SCREW PERIA LOCK/CANN 5.5X45MM

Facility

$910.00

Hospital Charge Code	270648674
Hospital Revenue Code	278
Min. Negotiated Rate	$21.93
Max. Negotiated Rate	$455.00
Rate for Payer: Aetna Commercial	$345.80
Rate for Payer: Aetna Medicare Advantage	$273.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.05
Rate for Payer: Cigna Commercial	$455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.20
Rate for Payer: Qualcare PPO/HMO/WC	$136.50
Rate for Payer: UnitedHealthcare Community & State	$21.93
Rate for Payer: Wellpoint Medicaid Managed Care	$24.11

SCREW PERIA LOCK/CANN 5.5X60MM

Facility

$910.00

Hospital Charge Code	270639678
Hospital Revenue Code	278
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$220.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.20
Rate for Payer: Qualcare PPO/HMO/WC	$136.50

SCREW PERIA LOCK/CANN 5.5X60MM

Facility

$910.00

Hospital Charge Code	270639678
Hospital Revenue Code	278
Min. Negotiated Rate	$21.93
Max. Negotiated Rate	$455.00
Rate for Payer: Aetna Commercial	$345.80
Rate for Payer: Aetna Medicare Advantage	$273.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.05
Rate for Payer: Cigna Commercial	$455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.20
Rate for Payer: Qualcare PPO/HMO/WC	$136.50
Rate for Payer: UnitedHealthcare Community & State	$21.93
Rate for Payer: Wellpoint Medicaid Managed Care	$24.11

SCREW PERIA LOCK/CANN 5.5X70MM

Facility

$910.00

Hospital Charge Code	270639197
Hospital Revenue Code	278
Min. Negotiated Rate	$21.93
Max. Negotiated Rate	$455.00
Rate for Payer: Aetna Commercial	$345.80
Rate for Payer: Aetna Medicare Advantage	$273.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.05
Rate for Payer: Cigna Commercial	$455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.20
Rate for Payer: Qualcare PPO/HMO/WC	$136.50
Rate for Payer: UnitedHealthcare Community & State	$21.93
Rate for Payer: Wellpoint Medicaid Managed Care	$24.11

SCREW PERIA LOCK/CANN 5.5X70MM

Facility

$910.00

Hospital Charge Code	270639197
Hospital Revenue Code	278
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$220.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.20
Rate for Payer: Qualcare PPO/HMO/WC	$136.50

SCREW PERIA LOCK/CANN 5.5X80MM

Facility

$910.00

Hospital Charge Code	270639677
Hospital Revenue Code	278
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$220.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.20
Rate for Payer: Qualcare PPO/HMO/WC	$136.50

Know your out-of-pocket cost for care.

All Charges