Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW PERIPR VAL OPTILINK 5.0

Facility

$1,569.50

Service Code	HCPCS C1713
Hospital Charge Code	270693770
Hospital Revenue Code	278
Min. Negotiated Rate	$37.82
Max. Negotiated Rate	$784.75
Rate for Payer: Aetna Commercial	$596.41
Rate for Payer: Aetna Medicare Advantage	$470.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$400.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$400.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$400.22
Rate for Payer: Cigna Commercial	$784.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$379.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$345.29
Rate for Payer: Qualcare PPO/HMO/WC	$235.43
Rate for Payer: UnitedHealthcare Community & State	$37.82
Rate for Payer: Wellpoint Medicaid Managed Care	$41.59

SCREW PERI SELF-TAP 234801235

Facility

$114.15

Hospital Charge Code	270630833
Hospital Revenue Code	278
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$57.08
Rate for Payer: Aetna Commercial	$43.38
Rate for Payer: Aetna Medicare Advantage	$34.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.11
Rate for Payer: Cigna Commercial	$57.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.11
Rate for Payer: Qualcare PPO/HMO/WC	$17.12
Rate for Payer: UnitedHealthcare Community & State	$2.75
Rate for Payer: Wellpoint Medicaid Managed Care	$3.02

SCREW PERI SELF-TAP 234801235

Facility

$114.15

Hospital Charge Code	270630833
Hospital Revenue Code	278
Min. Negotiated Rate	$17.12
Max. Negotiated Rate	$27.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.11
Rate for Payer: Qualcare PPO/HMO/WC	$17.12

SCREW PERI SELF-TAP 234801435

Facility

$122.25

Hospital Charge Code	270630834
Hospital Revenue Code	278
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$61.12
Rate for Payer: Aetna Commercial	$46.45
Rate for Payer: Aetna Medicare Advantage	$36.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.17
Rate for Payer: Cigna Commercial	$61.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$18.34
Rate for Payer: UnitedHealthcare Community & State	$2.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.24

SCREW PERI SELF-TAP 234801435

Facility

$122.25

Hospital Charge Code	270630834
Hospital Revenue Code	278
Min. Negotiated Rate	$18.34
Max. Negotiated Rate	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$18.34

SCREW PERI SELF-TAP 234801635

Facility

$122.25

Hospital Charge Code	270630835
Hospital Revenue Code	278
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$61.12
Rate for Payer: Aetna Commercial	$46.45
Rate for Payer: Aetna Medicare Advantage	$36.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.17
Rate for Payer: Cigna Commercial	$61.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$18.34
Rate for Payer: UnitedHealthcare Community & State	$2.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.24

SCREW PERI SELF-TAP 234801635

Facility

$122.25

Hospital Charge Code	270630835
Hospital Revenue Code	278
Min. Negotiated Rate	$18.34
Max. Negotiated Rate	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$18.34

SCREW PERI SELF-TAP 234802035

Facility

$128.15

Hospital Charge Code	270630836
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 SELF-TAP 234802035

Facility

$128.15

Hospital Charge Code	270630836
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 SELF-TAP 234802235

Facility

$128.15

Hospital Charge Code	270630837
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 SELF-TAP 234802235

Facility

$128.15

Hospital Charge Code	270630837
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 SELF TAP 3.5X12MM

Facility

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	270661351
Hospital Revenue Code	278
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$42.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

SCREW PERI SELF TAP 3.5X12MM

Facility

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	270661351
Hospital Revenue Code	278
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.64

SCREW PERITICULAR 60m 23472660

Facility

$117.00

Hospital Charge Code	270632308
Hospital Revenue Code	278
Min. Negotiated Rate	$2.82
Max. Negotiated Rate	$58.50
Rate for Payer: Aetna Commercial	$44.46
Rate for Payer: Aetna Medicare Advantage	$35.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.84
Rate for Payer: Cigna Commercial	$58.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.74
Rate for Payer: Qualcare PPO/HMO/WC	$17.55
Rate for Payer: UnitedHealthcare Community & State	$2.82
Rate for Payer: Wellpoint Medicaid Managed Care	$3.10

SCREW PERITICULAR 60m 23472660

Facility

$117.00

Hospital Charge Code	270632308
Hospital Revenue Code	278
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$28.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.74
Rate for Payer: Qualcare PPO/HMO/WC	$17.55

SCREW PERITICULAR 70m 23472370

Facility

$116.95

Hospital Charge Code	270632309
Hospital Revenue Code	278
Min. Negotiated Rate	$2.82
Max. Negotiated Rate	$58.48
Rate for Payer: Aetna Commercial	$44.44
Rate for Payer: Aetna Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.82
Rate for Payer: Cigna Commercial	$58.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.73
Rate for Payer: Qualcare PPO/HMO/WC	$17.54
Rate for Payer: UnitedHealthcare Community & State	$2.82
Rate for Payer: Wellpoint Medicaid Managed Care	$3.10

SCREW PERITICULAR 70m 23472370

Facility

$116.95

Hospital Charge Code	270632309
Hospital Revenue Code	278
Min. Negotiated Rate	$17.54
Max. Negotiated Rate	$28.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.73
Rate for Payer: Qualcare PPO/HMO/WC	$17.54

SCREW PERITICULAR 75m 23472675

Facility

$109.20

Hospital Charge Code	270632310
Hospital Revenue Code	278
Min. Negotiated Rate	$16.38
Max. Negotiated Rate	$26.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$24.02
Rate for Payer: Qualcare PPO/HMO/WC	$16.38

SCREW PERITICULAR 75m 23472675

Facility

$109.20

Hospital Charge Code	270632310
Hospital Revenue Code	278
Min. Negotiated Rate	$2.63
Max. Negotiated Rate	$54.60
Rate for Payer: Aetna Commercial	$41.50
Rate for Payer: Aetna Medicare Advantage	$32.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.85
Rate for Payer: Cigna Commercial	$54.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$24.02
Rate for Payer: Qualcare PPO/HMO/WC	$16.38
Rate for Payer: UnitedHealthcare Community & State	$2.63
Rate for Payer: Wellpoint Medicaid Managed Care	$2.89

SCREW PERP AEQ PERF REV 5X14MM

Facility

$1,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270700527
Hospital Revenue Code	278
Min. Negotiated Rate	$43.38
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$684.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Community & State	$43.38
Rate for Payer: Wellpoint Medicaid Managed Care	$47.70

SCREW PERP AEQ PERF REV 5X14MM

Facility

$1,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270700527
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$435.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

SCREW PERP AEQ PERF REV 5X18MM

Facility

$1,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270700526
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$435.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

SCREW PERP AEQ PERF REV 5X18MM

Facility

$1,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270700526
Hospital Revenue Code	278
Min. Negotiated Rate	$43.38
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$684.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Community & State	$43.38
Rate for Payer: Wellpoint Medicaid Managed Care	$47.70

SCREW PERP AEQ PERF REV 5X30MM

Facility

$1,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270700529
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$435.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

SCREW PERP AEQ PERF REV 5X30MM

Facility

$1,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270700529
Hospital Revenue Code	278
Min. Negotiated Rate	$43.38
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$684.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Community & State	$43.38
Rate for Payer: Wellpoint Medicaid Managed Care	$47.70

Know your out-of-pocket cost for care.

All Charges