Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW VA LCKG S/TPNG 3.5x34MM

Facility

$662.00

Service Code	HCPCS C1713
Hospital Charge Code	270676495
Hospital Revenue Code	278
Min. Negotiated Rate	$15.95
Max. Negotiated Rate	$331.00
Rate for Payer: Aetna Commercial	$251.56
Rate for Payer: Aetna Medicare Advantage	$198.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.81
Rate for Payer: Cigna Commercial	$331.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.64
Rate for Payer: Qualcare PPO/HMO/WC	$99.30
Rate for Payer: UnitedHealthcare Community & State	$15.95
Rate for Payer: Wellpoint Medicaid Managed Care	$17.54

SCREW VA LCKG S/TPNG 3.5x34MM

Facility

$662.00

Service Code	HCPCS C1713
Hospital Charge Code	270676495
Hospital Revenue Code	278
Min. Negotiated Rate	$99.30
Max. Negotiated Rate	$160.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.64
Rate for Payer: Qualcare PPO/HMO/WC	$99.30

SCREW VA LCKG S/TPNG 3.5x42MM

Facility

$624.00

Service Code	HCPCS C1713
Hospital Charge Code	270676494
Hospital Revenue Code	278
Min. Negotiated Rate	$15.04
Max. Negotiated Rate	$312.00
Rate for Payer: Aetna Commercial	$237.12
Rate for Payer: Aetna Medicare Advantage	$187.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.12
Rate for Payer: Cigna Commercial	$312.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.28
Rate for Payer: Qualcare PPO/HMO/WC	$93.60
Rate for Payer: UnitedHealthcare Community & State	$15.04
Rate for Payer: Wellpoint Medicaid Managed Care	$16.54

SCREW VA LCKG S/TPNG 3.5x42MM

Facility

$624.00

Service Code	HCPCS C1713
Hospital Charge Code	270676494
Hospital Revenue Code	278
Min. Negotiated Rate	$93.60
Max. Negotiated Rate	$151.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.28
Rate for Payer: Qualcare PPO/HMO/WC	$93.60

SCREW VA LCKG S/TPNG 3.5x48MM

Facility

$642.70

Service Code	HCPCS C1713
Hospital Charge Code	270686778
Hospital Revenue Code	278
Min. Negotiated Rate	$96.41
Max. Negotiated Rate	$155.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.39
Rate for Payer: Qualcare PPO/HMO/WC	$96.41

SCREW VA LCKG S/TPNG 3.5x48MM

Facility

$642.70

Service Code	HCPCS C1713
Hospital Charge Code	270686778
Hospital Revenue Code	278
Min. Negotiated Rate	$15.49
Max. Negotiated Rate	$321.35
Rate for Payer: Aetna Commercial	$244.23
Rate for Payer: Aetna Medicare Advantage	$192.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.89
Rate for Payer: Cigna Commercial	$321.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.39
Rate for Payer: Qualcare PPO/HMO/WC	$96.41
Rate for Payer: UnitedHealthcare Community & State	$15.49
Rate for Payer: Wellpoint Medicaid Managed Care	$17.03

SCREW VA LCKG S/TPNG 3.5x58MM

Facility

$662.00

Service Code	HCPCS C1713
Hospital Charge Code	270665812
Hospital Revenue Code	278
Min. Negotiated Rate	$15.95
Max. Negotiated Rate	$331.00
Rate for Payer: Aetna Commercial	$251.56
Rate for Payer: Aetna Medicare Advantage	$198.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.81
Rate for Payer: Cigna Commercial	$331.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.64
Rate for Payer: Qualcare PPO/HMO/WC	$99.30
Rate for Payer: UnitedHealthcare Community & State	$15.95
Rate for Payer: Wellpoint Medicaid Managed Care	$17.54

SCREW VA LCKG S/TPNG 3.5x58MM

Facility

$662.00

Service Code	HCPCS C1713
Hospital Charge Code	270665812
Hospital Revenue Code	278
Min. Negotiated Rate	$99.30
Max. Negotiated Rate	$160.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.64
Rate for Payer: Qualcare PPO/HMO/WC	$99.30

SCREW VA LCKG S/TPNG 3.5x85MM

Facility

$662.00

Service Code	HCPCS C1713
Hospital Charge Code	270664457
Hospital Revenue Code	278
Min. Negotiated Rate	$15.95
Max. Negotiated Rate	$331.00
Rate for Payer: Aetna Commercial	$251.56
Rate for Payer: Aetna Medicare Advantage	$198.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.81
Rate for Payer: Cigna Commercial	$331.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.64
Rate for Payer: Qualcare PPO/HMO/WC	$99.30
Rate for Payer: UnitedHealthcare Community & State	$15.95
Rate for Payer: Wellpoint Medicaid Managed Care	$17.54

SCREW VA LCKG S/TPNG 3.5x85MM

Facility

$662.00

Service Code	HCPCS C1713
Hospital Charge Code	270664457
Hospital Revenue Code	278
Min. Negotiated Rate	$99.30
Max. Negotiated Rate	$160.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.64
Rate for Payer: Qualcare PPO/HMO/WC	$99.30

SCREW VA LCKG S/TPPNG 5.0x24MM

Facility

$798.85

Service Code	HCPCS C1713
Hospital Charge Code	270685403
Hospital Revenue Code	278
Min. Negotiated Rate	$19.25
Max. Negotiated Rate	$399.43
Rate for Payer: Aetna Commercial	$303.56
Rate for Payer: Aetna Medicare Advantage	$239.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$203.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$203.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$203.71
Rate for Payer: Cigna Commercial	$399.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$175.75
Rate for Payer: Qualcare PPO/HMO/WC	$119.83
Rate for Payer: UnitedHealthcare Community & State	$19.25
Rate for Payer: Wellpoint Medicaid Managed Care	$21.17

SCREW VA LCKG S/TPPNG 5.0x24MM

Facility

$798.85

Service Code	HCPCS C1713
Hospital Charge Code	270685403
Hospital Revenue Code	278
Min. Negotiated Rate	$119.83
Max. Negotiated Rate	$193.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$175.75
Rate for Payer: Qualcare PPO/HMO/WC	$119.83

SCREW VA LCKG S/TPPNG 5.0x32MM

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270675714
Hospital Revenue Code	278
Min. Negotiated Rate	$112.95
Max. Negotiated Rate	$182.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.66
Rate for Payer: Qualcare PPO/HMO/WC	$112.95

SCREW VA LCKG S/TPPNG 5.0x32MM

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270675714
Hospital Revenue Code	278
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$376.50
Rate for Payer: Aetna Commercial	$286.14
Rate for Payer: Aetna Medicare Advantage	$225.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.01
Rate for Payer: Cigna Commercial	$376.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.66
Rate for Payer: Qualcare PPO/HMO/WC	$112.95
Rate for Payer: UnitedHealthcare Community & State	$18.15
Rate for Payer: Wellpoint Medicaid Managed Care	$19.95

SCREW VA LCKG S/TPPNG 5.0x34MM

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270675715
Hospital Revenue Code	278
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$376.50
Rate for Payer: Aetna Commercial	$286.14
Rate for Payer: Aetna Medicare Advantage	$225.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.01
Rate for Payer: Cigna Commercial	$376.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.66
Rate for Payer: Qualcare PPO/HMO/WC	$112.95
Rate for Payer: UnitedHealthcare Community & State	$18.15
Rate for Payer: Wellpoint Medicaid Managed Care	$19.95

SCREW VA LCKG S/TPPNG 5.0x34MM

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270675715
Hospital Revenue Code	278
Min. Negotiated Rate	$112.95
Max. Negotiated Rate	$182.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.66
Rate for Payer: Qualcare PPO/HMO/WC	$112.95

SCREW VA LCKG S/TPPNG 5.0x36MM

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270677142
Hospital Revenue Code	278
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$376.50
Rate for Payer: Aetna Commercial	$286.14
Rate for Payer: Aetna Medicare Advantage	$225.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.01
Rate for Payer: Cigna Commercial	$376.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.66
Rate for Payer: Qualcare PPO/HMO/WC	$112.95
Rate for Payer: UnitedHealthcare Community & State	$18.15
Rate for Payer: Wellpoint Medicaid Managed Care	$19.95

SCREW VA LCKG S/TPPNG 5.0x36MM

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270677142
Hospital Revenue Code	278
Min. Negotiated Rate	$112.95
Max. Negotiated Rate	$182.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.66
Rate for Payer: Qualcare PPO/HMO/WC	$112.95

SCREW VA LCKG S/TPPNG 5.0x38MM

Facility

$775.60

Service Code	HCPCS C1713
Hospital Charge Code	270649687
Hospital Revenue Code	278
Min. Negotiated Rate	$116.34
Max. Negotiated Rate	$187.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.63
Rate for Payer: Qualcare PPO/HMO/WC	$116.34

SCREW VA LCKG S/TPPNG 5.0x38MM

Facility

$775.60

Service Code	HCPCS C1713
Hospital Charge Code	270649687
Hospital Revenue Code	278
Min. Negotiated Rate	$18.69
Max. Negotiated Rate	$387.80
Rate for Payer: Aetna Commercial	$294.73
Rate for Payer: Aetna Medicare Advantage	$232.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.78
Rate for Payer: Cigna Commercial	$387.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.63
Rate for Payer: Qualcare PPO/HMO/WC	$116.34
Rate for Payer: UnitedHealthcare Community & State	$18.69
Rate for Payer: Wellpoint Medicaid Managed Care	$20.55

SCREW VA LCKG S/TPPNG 5.0x40MM

Facility

$775.60

Service Code	HCPCS C1713
Hospital Charge Code	270649688
Hospital Revenue Code	278
Min. Negotiated Rate	$116.34
Max. Negotiated Rate	$187.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.63
Rate for Payer: Qualcare PPO/HMO/WC	$116.34

SCREW VA LCKG S/TPPNG 5.0x40MM

Facility

$775.60

Service Code	HCPCS C1713
Hospital Charge Code	270649688
Hospital Revenue Code	278
Min. Negotiated Rate	$18.69
Max. Negotiated Rate	$387.80
Rate for Payer: Aetna Commercial	$294.73
Rate for Payer: Aetna Medicare Advantage	$232.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.78
Rate for Payer: Cigna Commercial	$387.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.63
Rate for Payer: Qualcare PPO/HMO/WC	$116.34
Rate for Payer: UnitedHealthcare Community & State	$18.69
Rate for Payer: Wellpoint Medicaid Managed Care	$20.55

SCREW VA LCKG S/TPPNG 5.0x42MM

Facility

$775.60

Service Code	HCPCS C1713
Hospital Charge Code	270649690
Hospital Revenue Code	278
Min. Negotiated Rate	$116.34
Max. Negotiated Rate	$187.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.63
Rate for Payer: Qualcare PPO/HMO/WC	$116.34

SCREW VA LCKG S/TPPNG 5.0x42MM

Facility

$775.60

Service Code	HCPCS C1713
Hospital Charge Code	270649690
Hospital Revenue Code	278
Min. Negotiated Rate	$18.69
Max. Negotiated Rate	$387.80
Rate for Payer: Aetna Commercial	$294.73
Rate for Payer: Aetna Medicare Advantage	$232.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.78
Rate for Payer: Cigna Commercial	$387.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.63
Rate for Payer: Qualcare PPO/HMO/WC	$116.34
Rate for Payer: UnitedHealthcare Community & State	$18.69
Rate for Payer: Wellpoint Medicaid Managed Care	$20.55

SCREW VA LCKG S/TPPNG 5.0x46MM

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270677143
Hospital Revenue Code	278
Min. Negotiated Rate	$112.95
Max. Negotiated Rate	$182.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.66
Rate for Payer: Qualcare PPO/HMO/WC	$112.95

Know your out-of-pocket cost for care.

All Charges