Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW SD 3.5X12MM

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270699101
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SCREW SD DAKOTA 3.5X12MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270696091
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

SCREW SD DAKOTA 3.5X12MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270696091
Hospital Revenue Code	278
Min. Negotiated Rate	$162.68
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$162.68
Rate for Payer: Wellpoint Medicaid Managed Care	$178.88

SCREW SD DAKOTA 3.5X14MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697665
Hospital Revenue Code	278
Min. Negotiated Rate	$162.68
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$162.68
Rate for Payer: Wellpoint Medicaid Managed Care	$178.88

SCREW SD DAKOTA 3.5X14MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697665
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

SCREW SD DAKOTA ACDF 4X12MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697751
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

SCREW SD DAKOTA ACDF 4X12MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697751
Hospital Revenue Code	278
Min. Negotiated Rate	$162.68
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$162.68
Rate for Payer: Wellpoint Medicaid Managed Care	$178.88

SCREW SD FIXED 4.0X14MM

Facility

$2,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270695867
Hospital Revenue Code	278
Min. Negotiated Rate	$50.61
Max. Negotiated Rate	$1,050.00
Rate for Payer: Aetna Commercial	$798.00
Rate for Payer: Aetna Medicare Advantage	$630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$535.50
Rate for Payer: Cigna Commercial	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$462.00
Rate for Payer: Qualcare PPO/HMO/WC	$315.00
Rate for Payer: UnitedHealthcare Community & State	$50.61
Rate for Payer: Wellpoint Medicaid Managed Care	$55.65

SCREW SD FIXED 4.0X14MM

Facility

$2,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270695867
Hospital Revenue Code	278
Min. Negotiated Rate	$315.00
Max. Negotiated Rate	$508.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$462.00
Rate for Payer: Qualcare PPO/HMO/WC	$315.00

SCREW SDK CANC 3.5 14MM 870214

Facility

$1,288.00

Hospital Charge Code	270614968
Hospital Revenue Code	278
Min. Negotiated Rate	$31.04
Max. Negotiated Rate	$644.00
Rate for Payer: Aetna Commercial	$489.44
Rate for Payer: Aetna Medicare Advantage	$386.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.44
Rate for Payer: Cigna Commercial	$644.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$283.36
Rate for Payer: Qualcare PPO/HMO/WC	$193.20
Rate for Payer: UnitedHealthcare Community & State	$31.04
Rate for Payer: Wellpoint Medicaid Managed Care	$34.13

SCREW SDK CANC 3.5 14MM 870214

Facility

$1,288.00

Hospital Charge Code	270614968
Hospital Revenue Code	278
Min. Negotiated Rate	$193.20
Max. Negotiated Rate	$311.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$283.36
Rate for Payer: Qualcare PPO/HMO/WC	$193.20

SCREW SDK CANC 4.0 13MM 871013

Facility

$1,256.85

Hospital Charge Code	270607298
Hospital Revenue Code	278
Min. Negotiated Rate	$188.53
Max. Negotiated Rate	$304.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$276.51
Rate for Payer: Qualcare PPO/HMO/WC	$188.53

SCREW SDK CANC 4.0 13MM 871013

Facility

$1,256.85

Hospital Charge Code	270607298
Hospital Revenue Code	278
Min. Negotiated Rate	$30.29
Max. Negotiated Rate	$628.42
Rate for Payer: Aetna Commercial	$477.60
Rate for Payer: Aetna Medicare Advantage	$377.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$320.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$320.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$320.50
Rate for Payer: Cigna Commercial	$628.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$276.51
Rate for Payer: Qualcare PPO/HMO/WC	$188.53
Rate for Payer: UnitedHealthcare Community & State	$30.29
Rate for Payer: Wellpoint Medicaid Managed Care	$33.31

SCREW SDK CANC 4.0 13MM 876013

Facility

$1,456.00

Hospital Charge Code	270616041
Hospital Revenue Code	278
Min. Negotiated Rate	$218.40
Max. Negotiated Rate	$352.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$291.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$352.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$320.32
Rate for Payer: Qualcare PPO/HMO/WC	$218.40

SCREW SDK CANC 4.0 13MM 876013

Facility

$1,456.00

Hospital Charge Code	270616041
Hospital Revenue Code	278
Min. Negotiated Rate	$35.09
Max. Negotiated Rate	$728.00
Rate for Payer: Aetna Commercial	$553.28
Rate for Payer: Aetna Medicare Advantage	$436.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$371.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$371.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$291.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$371.28
Rate for Payer: Cigna Commercial	$728.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$352.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$320.32
Rate for Payer: Qualcare PPO/HMO/WC	$218.40
Rate for Payer: UnitedHealthcare Community & State	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$38.58

SCREW SDK CANC 4.0 13MM 876313

Facility

$1,456.00

Hospital Charge Code	270614734
Hospital Revenue Code	278
Min. Negotiated Rate	$35.09
Max. Negotiated Rate	$728.00
Rate for Payer: Aetna Commercial	$553.28
Rate for Payer: Aetna Medicare Advantage	$436.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$371.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$371.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$291.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$371.28
Rate for Payer: Cigna Commercial	$728.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$352.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$320.32
Rate for Payer: Qualcare PPO/HMO/WC	$218.40
Rate for Payer: UnitedHealthcare Community & State	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$38.58

SCREW SDK CANC 4.0 13MM 876313

Facility

$1,456.00

Hospital Charge Code	270614734
Hospital Revenue Code	278
Min. Negotiated Rate	$218.40
Max. Negotiated Rate	$352.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$291.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$352.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$320.32
Rate for Payer: Qualcare PPO/HMO/WC	$218.40

SCREW SDK CANC 4.0 16MM 876316

Facility

$1,603.25

Hospital Charge Code	270618015
Hospital Revenue Code	278
Min. Negotiated Rate	$240.49
Max. Negotiated Rate	$387.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$352.71
Rate for Payer: Qualcare PPO/HMO/WC	$240.49

SCREW SDK CANC 4.0 16MM 876316

Facility

$1,603.25

Hospital Charge Code	270618015
Hospital Revenue Code	278
Min. Negotiated Rate	$38.64
Max. Negotiated Rate	$801.62
Rate for Payer: Aetna Commercial	$609.24
Rate for Payer: Aetna Medicare Advantage	$480.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$408.83
Rate for Payer: Cigna Commercial	$801.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$352.71
Rate for Payer: Qualcare PPO/HMO/WC	$240.49
Rate for Payer: UnitedHealthcare Community & State	$38.64
Rate for Payer: Wellpoint Medicaid Managed Care	$42.49

SCREW SDK CANC 4.0 18MM 876318

Facility

$1,603.25

Hospital Charge Code	270618017
Hospital Revenue Code	278
Min. Negotiated Rate	$38.64
Max. Negotiated Rate	$801.62
Rate for Payer: Aetna Commercial	$609.24
Rate for Payer: Aetna Medicare Advantage	$480.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$408.83
Rate for Payer: Cigna Commercial	$801.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$352.71
Rate for Payer: Qualcare PPO/HMO/WC	$240.49
Rate for Payer: UnitedHealthcare Community & State	$38.64
Rate for Payer: Wellpoint Medicaid Managed Care	$42.49

SCREW SDK CANC 4.0 18MM 876318

Facility

$1,603.25

Hospital Charge Code	270618017
Hospital Revenue Code	278
Min. Negotiated Rate	$240.49
Max. Negotiated Rate	$387.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$352.71
Rate for Payer: Qualcare PPO/HMO/WC	$240.49

SCREW SDK CANC 4.3 15MM 871055

Facility

$1,342.45

Hospital Charge Code	270613167
Hospital Revenue Code	278
Min. Negotiated Rate	$32.35
Max. Negotiated Rate	$671.23
Rate for Payer: Aetna Commercial	$510.13
Rate for Payer: Aetna Medicare Advantage	$402.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$342.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$342.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$342.32
Rate for Payer: Cigna Commercial	$671.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$295.34
Rate for Payer: Qualcare PPO/HMO/WC	$201.37
Rate for Payer: UnitedHealthcare Community & State	$32.35
Rate for Payer: Wellpoint Medicaid Managed Care	$35.57

SCREW SDK CANC 4.3 15MM 871055

Facility

$1,342.45

Hospital Charge Code	270613167
Hospital Revenue Code	278
Min. Negotiated Rate	$201.37
Max. Negotiated Rate	$324.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$295.34
Rate for Payer: Qualcare PPO/HMO/WC	$201.37

SCREW SDK CANC 4.5 13MM 871053

Facility

$1,595.25

Hospital Charge Code	270608798
Hospital Revenue Code	278
Min. Negotiated Rate	$239.29
Max. Negotiated Rate	$386.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$319.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$386.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$350.95
Rate for Payer: Qualcare PPO/HMO/WC	$239.29

SCREW SDK CANC 4.5 13MM 871053

Facility

$1,595.25

Hospital Charge Code	270608798
Hospital Revenue Code	278
Min. Negotiated Rate	$38.45
Max. Negotiated Rate	$797.62
Rate for Payer: Aetna Commercial	$606.20
Rate for Payer: Aetna Medicare Advantage	$478.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$406.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$406.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$319.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$406.79
Rate for Payer: Cigna Commercial	$797.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$386.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$350.95
Rate for Payer: Qualcare PPO/HMO/WC	$239.29
Rate for Payer: UnitedHealthcare Community & State	$38.45
Rate for Payer: Wellpoint Medicaid Managed Care	$42.27

Know your out-of-pocket cost for care.

All Charges