Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW TAP 2.7MM

Facility

$395.00

Hospital Charge Code	270656750
Hospital Revenue Code	278
Min. Negotiated Rate	$59.25
Max. Negotiated Rate	$95.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$86.90
Rate for Payer: Qualcare PPO/HMO/WC	$59.25

SCREW TAP 2.7MM

Facility

$395.00

Hospital Charge Code	270656750
Hospital Revenue Code	278
Min. Negotiated Rate	$9.52
Max. Negotiated Rate	$197.50
Rate for Payer: Aetna Commercial	$150.10
Rate for Payer: Aetna Medicare Advantage	$118.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.72
Rate for Payer: Cigna Commercial	$197.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$86.90
Rate for Payer: Qualcare PPO/HMO/WC	$59.25
Rate for Payer: UnitedHealthcare Community & State	$9.52
Rate for Payer: Wellpoint Medicaid Managed Care	$10.47

SCREW TAP 3.0MM

Facility

$2,450.00

Service Code	HCPCS A4649
Hospital Charge Code	270699637
Hospital Revenue Code	272
Min. Negotiated Rate	$367.50
Max. Negotiated Rate	$367.50
Rate for Payer: Qualcare PPO/HMO/WC	$367.50

SCREW TAP 3.0MM

Facility

$2,450.00

Service Code	HCPCS A4649
Hospital Charge Code	270699637
Hospital Revenue Code	272
Min. Negotiated Rate	$59.05
Max. Negotiated Rate	$1,225.00
Rate for Payer: Aetna Commercial	$931.00
Rate for Payer: Aetna Medicare Advantage	$735.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$624.75
Rate for Payer: Cigna Commercial	$1,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$735.00
Rate for Payer: Oxford Commercial	$490.00
Rate for Payer: Qualcare PPO/HMO/WC	$367.50
Rate for Payer: UnitedHealthcare Commercial	$490.00
Rate for Payer: UnitedHealthcare Community & State	$59.05
Rate for Payer: Wellpoint Medicaid Managed Care	$64.92

SCREW TAP 3.5MM

Facility

$2,450.00

Service Code	HCPCS A4649
Hospital Charge Code	270699636
Hospital Revenue Code	272
Min. Negotiated Rate	$367.50
Max. Negotiated Rate	$367.50
Rate for Payer: Qualcare PPO/HMO/WC	$367.50

SCREW TAP 3.5MM

Facility

$2,450.00

Service Code	HCPCS A4649
Hospital Charge Code	270699636
Hospital Revenue Code	272
Min. Negotiated Rate	$59.05
Max. Negotiated Rate	$1,225.00
Rate for Payer: Aetna Commercial	$931.00
Rate for Payer: Aetna Medicare Advantage	$735.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$624.75
Rate for Payer: Cigna Commercial	$1,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$735.00
Rate for Payer: Oxford Commercial	$490.00
Rate for Payer: Qualcare PPO/HMO/WC	$367.50
Rate for Payer: UnitedHealthcare Commercial	$490.00
Rate for Payer: UnitedHealthcare Community & State	$59.05
Rate for Payer: Wellpoint Medicaid Managed Care	$64.92

SCREW TAP 4.0MM

Facility

$2,450.00

Service Code	HCPCS A4649
Hospital Charge Code	270699635
Hospital Revenue Code	272
Min. Negotiated Rate	$367.50
Max. Negotiated Rate	$367.50
Rate for Payer: Qualcare PPO/HMO/WC	$367.50

SCREW TAP 4.0MM

Facility

$2,450.00

Service Code	HCPCS A4649
Hospital Charge Code	270699635
Hospital Revenue Code	272
Min. Negotiated Rate	$59.05
Max. Negotiated Rate	$1,225.00
Rate for Payer: Aetna Commercial	$931.00
Rate for Payer: Aetna Medicare Advantage	$735.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$624.75
Rate for Payer: Cigna Commercial	$1,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$735.00
Rate for Payer: Oxford Commercial	$490.00
Rate for Payer: Qualcare PPO/HMO/WC	$367.50
Rate for Payer: UnitedHealthcare Commercial	$490.00
Rate for Payer: UnitedHealthcare Community & State	$59.05
Rate for Payer: Wellpoint Medicaid Managed Care	$64.92

SCREW TAP. 4.5MM

Facility

$16,980.00

Service Code	HCPCS C1713
Hospital Charge Code	270683896
Hospital Revenue Code	278
Min. Negotiated Rate	$409.22
Max. Negotiated Rate	$8,490.00
Rate for Payer: Aetna Commercial	$6,452.40
Rate for Payer: Aetna Medicare Advantage	$5,094.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,329.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,329.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,396.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,329.90
Rate for Payer: Cigna Commercial	$8,490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,109.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,735.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,547.00
Rate for Payer: UnitedHealthcare Community & State	$409.22
Rate for Payer: Wellpoint Medicaid Managed Care	$449.97

SCREW TAP. 4.5MM

Facility

$16,980.00

Service Code	HCPCS C1713
Hospital Charge Code	270683896
Hospital Revenue Code	278
Min. Negotiated Rate	$2,547.00
Max. Negotiated Rate	$4,109.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,396.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,109.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,735.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,547.00

SCREW TAP 4 X 16 MM

Facility

$1,000.00

Hospital Charge Code	270695121
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW TAP 4 X 16 MM

Facility

$1,000.00

Hospital Charge Code	270695121
Hospital Revenue Code	278
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

SCREW TAPER 6-8mmx30mm 254602

Facility

$900.00

Hospital Charge Code	270638807
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

SCREW TAPER 6-8mmx30mm 254602

Facility

$900.00

Hospital Charge Code	270638807
Hospital Revenue Code	278
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

SCREW TAPERED 8-10X30mm 254603

Facility

$900.00

Hospital Charge Code	270636751
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

SCREW TAPERED 8-10X30mm 254603

Facility

$900.00

Hospital Charge Code	270636751
Hospital Revenue Code	278
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

SCREW TAPERED CANNULATED DELTA

Facility

$1,680.00

Hospital Charge Code	270666963
Hospital Revenue Code	278
Min. Negotiated Rate	$40.49
Max. Negotiated Rate	$840.00
Rate for Payer: Aetna Commercial	$638.40
Rate for Payer: Aetna Medicare Advantage	$504.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$428.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$428.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$428.40
Rate for Payer: Cigna Commercial	$840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$406.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$369.60
Rate for Payer: Qualcare PPO/HMO/WC	$252.00
Rate for Payer: UnitedHealthcare Community & State	$40.49
Rate for Payer: Wellpoint Medicaid Managed Care	$44.52

SCREW TAPERED CANNULATED DELTA

Facility

$1,680.00

Hospital Charge Code	270666963
Hospital Revenue Code	278
Min. Negotiated Rate	$252.00
Max. Negotiated Rate	$406.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$336.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$406.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$369.60
Rate for Payer: Qualcare PPO/HMO/WC	$252.00

SCREW TAPERED IN 7X9X30 254609

Facility

$820.00

Hospital Charge Code	270637734
Hospital Revenue Code	278
Min. Negotiated Rate	$123.00
Max. Negotiated Rate	$198.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$164.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$180.40
Rate for Payer: Qualcare PPO/HMO/WC	$123.00

SCREW TAPERED IN 7X9X30 254609

Facility

$820.00

Hospital Charge Code	270637734
Hospital Revenue Code	278
Min. Negotiated Rate	$19.76
Max. Negotiated Rate	$410.00
Rate for Payer: Aetna Commercial	$311.60
Rate for Payer: Aetna Medicare Advantage	$246.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$164.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.10
Rate for Payer: Cigna Commercial	$410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$180.40
Rate for Payer: Qualcare PPO/HMO/WC	$123.00
Rate for Payer: UnitedHealthcare Community & State	$19.76
Rate for Payer: Wellpoint Medicaid Managed Care	$21.73

SCREW TAP SELF 16MM

Facility

$1,258.75

Service Code	HCPCS C1713
Hospital Charge Code	270689204
Hospital Revenue Code	278
Min. Negotiated Rate	$30.34
Max. Negotiated Rate	$629.38
Rate for Payer: Aetna Commercial	$478.32
Rate for Payer: Aetna Medicare Advantage	$377.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$320.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$320.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$320.98
Rate for Payer: Cigna Commercial	$629.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$276.93
Rate for Payer: Qualcare PPO/HMO/WC	$188.81
Rate for Payer: UnitedHealthcare Community & State	$30.34
Rate for Payer: Wellpoint Medicaid Managed Care	$33.36

SCREW TAP SELF 16MM

Facility

$1,258.75

Service Code	HCPCS C1713
Hospital Charge Code	270689204
Hospital Revenue Code	278
Min. Negotiated Rate	$188.81
Max. Negotiated Rate	$304.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$276.93
Rate for Payer: Qualcare PPO/HMO/WC	$188.81

SCREW TAP VARIABLE 4.5X12MM

Facility

$875.00

Hospital Charge Code	270703044
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SCREW TAP VARIABLE 4.5X12MM

Facility

$875.00

Hospital Charge Code	270703044
Hospital Revenue Code	278
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

SCREW TBOLT POLY 5.5X40MM

Facility

$4,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696794
Hospital Revenue Code	278
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

Know your out-of-pocket cost for care.

All Charges