Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

4.0MM/4.0MM CLAMP

Facility

$1,435.40

Hospital Charge Code	270601807
Hospital Revenue Code	272
Min. Negotiated Rate	$215.31
Max. Negotiated Rate	$215.31
Rate for Payer: Qualcare PPO/HMO/WC	$215.31

4.0MM/4.0MM OPEN CLAMP

Facility

$1,537.20

Hospital Charge Code	270601816
Hospital Revenue Code	272
Min. Negotiated Rate	$37.05
Max. Negotiated Rate	$768.60
Rate for Payer: Aetna Commercial	$584.14
Rate for Payer: Aetna Medicare Advantage	$461.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$391.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$391.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$391.99
Rate for Payer: Cigna Commercial	$768.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$461.16
Rate for Payer: Oxford Commercial	$307.44
Rate for Payer: Qualcare PPO/HMO/WC	$230.58
Rate for Payer: UnitedHealthcare Commercial	$307.44
Rate for Payer: UnitedHealthcare Community & State	$37.05
Rate for Payer: Wellpoint Medicaid Managed Care	$40.74

4.0MM/4.0MM OPEN CLAMP

Facility

$1,537.20

Hospital Charge Code	270601816
Hospital Revenue Code	272
Min. Negotiated Rate	$230.58
Max. Negotiated Rate	$230.58
Rate for Payer: Qualcare PPO/HMO/WC	$230.58

4.0MM CANC LOCK SCREW 22MM

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270685142
Hospital Revenue Code	278
Min. Negotiated Rate	$94.88
Max. Negotiated Rate	$153.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$94.88

4.0MM CANC LOCK SCREW 22MM

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270685142
Hospital Revenue Code	278
Min. Negotiated Rate	$15.24
Max. Negotiated Rate	$316.25
Rate for Payer: Aetna Commercial	$240.35
Rate for Payer: Aetna Medicare Advantage	$189.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.29
Rate for Payer: Cigna Commercial	$316.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$94.88
Rate for Payer: UnitedHealthcare Community & State	$15.24
Rate for Payer: Wellpoint Medicaid Managed Care	$16.76

4.0MM CANC LOCK SCREW 34MM

Facility

$572.00

Service Code	HCPCS C1713
Hospital Charge Code	270680687
Hospital Revenue Code	278
Min. Negotiated Rate	$13.79
Max. Negotiated Rate	$286.00
Rate for Payer: Aetna Commercial	$217.36
Rate for Payer: Aetna Medicare Advantage	$171.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.86
Rate for Payer: Cigna Commercial	$286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$85.80
Rate for Payer: UnitedHealthcare Community & State	$13.79
Rate for Payer: Wellpoint Medicaid Managed Care	$15.16

4.0MM CANC LOCK SCREW 34MM

Facility

$572.00

Service Code	HCPCS C1713
Hospital Charge Code	270680687
Hospital Revenue Code	278
Min. Negotiated Rate	$85.80
Max. Negotiated Rate	$138.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$85.80

4.0MM CANC LOCK SCREW 36MM

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270680686
Hospital Revenue Code	278
Min. Negotiated Rate	$15.24
Max. Negotiated Rate	$316.25
Rate for Payer: Aetna Commercial	$240.35
Rate for Payer: Aetna Medicare Advantage	$189.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.29
Rate for Payer: Cigna Commercial	$316.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$94.88
Rate for Payer: UnitedHealthcare Community & State	$15.24
Rate for Payer: Wellpoint Medicaid Managed Care	$16.76

4.0MM CANC LOCK SCREW 36MM

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270680686
Hospital Revenue Code	278
Min. Negotiated Rate	$94.88
Max. Negotiated Rate	$153.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$94.88

4.0MM CANC LOCK SCREW 38MM

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270680840
Hospital Revenue Code	278
Min. Negotiated Rate	$94.88
Max. Negotiated Rate	$153.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$94.88

4.0MM CANC LOCK SCREW 38MM

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270680840
Hospital Revenue Code	278
Min. Negotiated Rate	$15.24
Max. Negotiated Rate	$316.25
Rate for Payer: Aetna Commercial	$240.35
Rate for Payer: Aetna Medicare Advantage	$189.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.29
Rate for Payer: Cigna Commercial	$316.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$94.88
Rate for Payer: UnitedHealthcare Community & State	$15.24
Rate for Payer: Wellpoint Medicaid Managed Care	$16.76

4.0MM CANC LOCK SCREW 46MM

Facility

$572.00

Service Code	HCPCS C1713
Hospital Charge Code	270680685
Hospital Revenue Code	278
Min. Negotiated Rate	$13.79
Max. Negotiated Rate	$286.00
Rate for Payer: Aetna Commercial	$217.36
Rate for Payer: Aetna Medicare Advantage	$171.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.86
Rate for Payer: Cigna Commercial	$286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$85.80
Rate for Payer: UnitedHealthcare Community & State	$13.79
Rate for Payer: Wellpoint Medicaid Managed Care	$15.16

4.0MM CANC LOCK SCREW 46MM

Facility

$572.00

Service Code	HCPCS C1713
Hospital Charge Code	270680685
Hospital Revenue Code	278
Min. Negotiated Rate	$85.80
Max. Negotiated Rate	$138.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$85.80

4.0MM CANC LOCK SCREW 50MM

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270680841
Hospital Revenue Code	278
Min. Negotiated Rate	$15.24
Max. Negotiated Rate	$316.25
Rate for Payer: Aetna Commercial	$240.35
Rate for Payer: Aetna Medicare Advantage	$189.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.29
Rate for Payer: Cigna Commercial	$316.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$94.88
Rate for Payer: UnitedHealthcare Community & State	$15.24
Rate for Payer: Wellpoint Medicaid Managed Care	$16.76

4.0MM CANC LOCK SCREW 50MM

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270680841
Hospital Revenue Code	278
Min. Negotiated Rate	$94.88
Max. Negotiated Rate	$153.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$94.88

4.0MM CANC LOCK SCREW 55MM

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270680684
Hospital Revenue Code	278
Min. Negotiated Rate	$94.88
Max. Negotiated Rate	$153.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$94.88

4.0MM CANC LOCK SCREW 55MM

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270680684
Hospital Revenue Code	278
Min. Negotiated Rate	$15.24
Max. Negotiated Rate	$316.25
Rate for Payer: Aetna Commercial	$240.35
Rate for Payer: Aetna Medicare Advantage	$189.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.29
Rate for Payer: Cigna Commercial	$316.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$94.88
Rate for Payer: UnitedHealthcare Community & State	$15.24
Rate for Payer: Wellpoint Medicaid Managed Care	$16.76

4.0MM CANC LOCK SCREW 60MM

Facility

$552.00

Service Code	HCPCS C1713
Hospital Charge Code	270680683
Hospital Revenue Code	278
Min. Negotiated Rate	$13.30
Max. Negotiated Rate	$276.00
Rate for Payer: Aetna Commercial	$209.76
Rate for Payer: Aetna Medicare Advantage	$165.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.76
Rate for Payer: Cigna Commercial	$276.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.44
Rate for Payer: Qualcare PPO/HMO/WC	$82.80
Rate for Payer: UnitedHealthcare Community & State	$13.30
Rate for Payer: Wellpoint Medicaid Managed Care	$14.63

4.0MM CANC LOCK SCREW 60MM

Facility

$552.00

Service Code	HCPCS C1713
Hospital Charge Code	270680683
Hospital Revenue Code	278
Min. Negotiated Rate	$82.80
Max. Negotiated Rate	$133.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.44
Rate for Payer: Qualcare PPO/HMO/WC	$82.80

4.0MM CANC LOCK SCRW 40MM

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270686585
Hospital Revenue Code	278
Min. Negotiated Rate	$15.24
Max. Negotiated Rate	$316.25
Rate for Payer: Aetna Commercial	$240.35
Rate for Payer: Aetna Medicare Advantage	$189.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.29
Rate for Payer: Cigna Commercial	$316.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$94.88
Rate for Payer: UnitedHealthcare Community & State	$15.24
Rate for Payer: Wellpoint Medicaid Managed Care	$16.76

4.0MM CANC LOCK SCRW 40MM

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270686585
Hospital Revenue Code	278
Min. Negotiated Rate	$94.88
Max. Negotiated Rate	$153.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$94.88

4.0MM CANC SCR FT 26MM NS

Facility

$247.50

Service Code	HCPCS C1713
Hospital Charge Code	270686155
Hospital Revenue Code	278
Min. Negotiated Rate	$5.96
Max. Negotiated Rate	$123.75
Rate for Payer: Aetna Commercial	$94.05
Rate for Payer: Aetna Medicare Advantage	$74.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.11
Rate for Payer: Cigna Commercial	$123.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$37.12
Rate for Payer: UnitedHealthcare Community & State	$5.96
Rate for Payer: Wellpoint Medicaid Managed Care	$6.56

4.0MM CANC SCR FT 26MM NS

Facility

$247.50

Service Code	HCPCS C1713
Hospital Charge Code	270686155
Hospital Revenue Code	278
Min. Negotiated Rate	$37.12
Max. Negotiated Rate	$59.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$37.12

4.0MM CANC SCR FT 30MM NS

Facility

$247.50

Service Code	HCPCS C1713
Hospital Charge Code	270686154
Hospital Revenue Code	278
Min. Negotiated Rate	$5.96
Max. Negotiated Rate	$123.75
Rate for Payer: Aetna Commercial	$94.05
Rate for Payer: Aetna Medicare Advantage	$74.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.11
Rate for Payer: Cigna Commercial	$123.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$37.12
Rate for Payer: UnitedHealthcare Community & State	$5.96
Rate for Payer: Wellpoint Medicaid Managed Care	$6.56

4.0MM CANC SCR FT 30MM NS

Facility

$247.50

Service Code	HCPCS C1713
Hospital Charge Code	270686154
Hospital Revenue Code	278
Min. Negotiated Rate	$37.12
Max. Negotiated Rate	$59.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$37.12

Know your out-of-pocket cost for care.

All Charges