Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 5.0x48MM

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270676132
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 5.0x48MM

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270676132
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 5.0x55MM

Facility

$7,514.35

Service Code	HCPCS C1713
Hospital Charge Code	270682055
Hospital Revenue Code	278
Min. Negotiated Rate	$1,127.15
Max. Negotiated Rate	$1,818.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,502.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,818.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,653.16
Rate for Payer: Qualcare PPO/HMO/WC	$1,127.15

SCREW VA LCKG S/TPPNG 5.0x55MM

Facility

$7,514.35

Service Code	HCPCS C1713
Hospital Charge Code	270682055
Hospital Revenue Code	278
Min. Negotiated Rate	$181.10
Max. Negotiated Rate	$3,757.18
Rate for Payer: Aetna Commercial	$2,855.45
Rate for Payer: Aetna Medicare Advantage	$2,254.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,916.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,916.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,502.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,916.16
Rate for Payer: Cigna Commercial	$3,757.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,818.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,653.16
Rate for Payer: Qualcare PPO/HMO/WC	$1,127.15
Rate for Payer: UnitedHealthcare Community & State	$181.10
Rate for Payer: Wellpoint Medicaid Managed Care	$199.13

SCREW VA LCKG S/TPPNG 5.0x60MM

Facility

$753.00

Hospital Charge Code	270677414
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 5.0x60MM

Facility

$753.00

Hospital Charge Code	270677414
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 5.0x70MM

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270677479
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 5.0x70MM

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270677479
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 5.0x75MM

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270675716
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 5.0x75MM

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270675716
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 LCKNG 3.5MM 28MM

Facility

$670.80

Service Code	HCPCS C1713
Hospital Charge Code	270689596
Hospital Revenue Code	278
Min. Negotiated Rate	$16.17
Max. Negotiated Rate	$335.40
Rate for Payer: Aetna Commercial	$254.90
Rate for Payer: Aetna Medicare Advantage	$201.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.05
Rate for Payer: Cigna Commercial	$335.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.58
Rate for Payer: Qualcare PPO/HMO/WC	$100.62
Rate for Payer: UnitedHealthcare Community & State	$16.17
Rate for Payer: Wellpoint Medicaid Managed Care	$17.78

SCREW VA LCKNG 3.5MM 28MM

Facility

$670.80

Service Code	HCPCS C1713
Hospital Charge Code	270689596
Hospital Revenue Code	278
Min. Negotiated Rate	$100.62
Max. Negotiated Rate	$162.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.58
Rate for Payer: Qualcare PPO/HMO/WC	$100.62

SCREW VA LCKNG 3.5MM 32MM

Facility

$670.80

Service Code	HCPCS C1713
Hospital Charge Code	270689598
Hospital Revenue Code	278
Min. Negotiated Rate	$100.62
Max. Negotiated Rate	$162.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.58
Rate for Payer: Qualcare PPO/HMO/WC	$100.62

SCREW VA LCKNG 3.5MM 32MM

Facility

$670.80

Service Code	HCPCS C1713
Hospital Charge Code	270689598
Hospital Revenue Code	278
Min. Negotiated Rate	$16.17
Max. Negotiated Rate	$335.40
Rate for Payer: Aetna Commercial	$254.90
Rate for Payer: Aetna Medicare Advantage	$201.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.05
Rate for Payer: Cigna Commercial	$335.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.58
Rate for Payer: Qualcare PPO/HMO/WC	$100.62
Rate for Payer: UnitedHealthcare Community & State	$16.17
Rate for Payer: Wellpoint Medicaid Managed Care	$17.78

SCREW VA LCKNG 3.5MM 34MM

Facility

$670.80

Service Code	HCPCS C1713
Hospital Charge Code	270689599
Hospital Revenue Code	278
Min. Negotiated Rate	$16.17
Max. Negotiated Rate	$335.40
Rate for Payer: Aetna Commercial	$254.90
Rate for Payer: Aetna Medicare Advantage	$201.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.05
Rate for Payer: Cigna Commercial	$335.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.58
Rate for Payer: Qualcare PPO/HMO/WC	$100.62
Rate for Payer: UnitedHealthcare Community & State	$16.17
Rate for Payer: Wellpoint Medicaid Managed Care	$17.78

SCREW VA LCKNG 3.5MM 34MM

Facility

$670.80

Service Code	HCPCS C1713
Hospital Charge Code	270689599
Hospital Revenue Code	278
Min. Negotiated Rate	$100.62
Max. Negotiated Rate	$162.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.58
Rate for Payer: Qualcare PPO/HMO/WC	$100.62

SCREW VA LCKNG 3.5 VA 30MM

Facility

$670.80

Service Code	HCPCS C1713
Hospital Charge Code	270689597
Hospital Revenue Code	278
Min. Negotiated Rate	$100.62
Max. Negotiated Rate	$162.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.58
Rate for Payer: Qualcare PPO/HMO/WC	$100.62

SCREW VA LCKNG 3.5 VA 30MM

Facility

$670.80

Service Code	HCPCS C1713
Hospital Charge Code	270689597
Hospital Revenue Code	278
Min. Negotiated Rate	$16.17
Max. Negotiated Rate	$335.40
Rate for Payer: Aetna Commercial	$254.90
Rate for Payer: Aetna Medicare Advantage	$201.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.05
Rate for Payer: Cigna Commercial	$335.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.58
Rate for Payer: Qualcare PPO/HMO/WC	$100.62
Rate for Payer: UnitedHealthcare Community & State	$16.17
Rate for Payer: Wellpoint Medicaid Managed Care	$17.78

SCREW VA LCKNG 3.5 x 26MM

Facility

$670.80

Service Code	HCPCS C1713
Hospital Charge Code	270689595
Hospital Revenue Code	278
Min. Negotiated Rate	$100.62
Max. Negotiated Rate	$162.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.58
Rate for Payer: Qualcare PPO/HMO/WC	$100.62

SCREW VA LCKNG 3.5 x 26MM

Facility

$670.80

Service Code	HCPCS C1713
Hospital Charge Code	270689595
Hospital Revenue Code	278
Min. Negotiated Rate	$16.17
Max. Negotiated Rate	$335.40
Rate for Payer: Aetna Commercial	$254.90
Rate for Payer: Aetna Medicare Advantage	$201.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.05
Rate for Payer: Cigna Commercial	$335.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.58
Rate for Payer: Qualcare PPO/HMO/WC	$100.62
Rate for Payer: UnitedHealthcare Community & State	$16.17
Rate for Payer: Wellpoint Medicaid Managed Care	$17.78

SCREW VA LCKNG S/TAP 2.7x18MM

Facility

$623.80

Service Code	HCPCS C1713
Hospital Charge Code	270648931
Hospital Revenue Code	278
Min. Negotiated Rate	$93.57
Max. Negotiated Rate	$150.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.24
Rate for Payer: Qualcare PPO/HMO/WC	$93.57

SCREW VA LCKNG S/TAP 2.7x18MM

Facility

$623.80

Service Code	HCPCS C1713
Hospital Charge Code	270648931
Hospital Revenue Code	278
Min. Negotiated Rate	$15.03
Max. Negotiated Rate	$311.90
Rate for Payer: Aetna Commercial	$237.04
Rate for Payer: Aetna Medicare Advantage	$187.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.07
Rate for Payer: Cigna Commercial	$311.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.24
Rate for Payer: Qualcare PPO/HMO/WC	$93.57
Rate for Payer: UnitedHealthcare Community & State	$15.03
Rate for Payer: Wellpoint Medicaid Managed Care	$16.53

SCREW VA LCKNG S/TAP 2.7x20MM

Facility

$623.80

Service Code	HCPCS C1713
Hospital Charge Code	270648928
Hospital Revenue Code	278
Min. Negotiated Rate	$93.57
Max. Negotiated Rate	$150.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.24
Rate for Payer: Qualcare PPO/HMO/WC	$93.57

SCREW VA LCKNG S/TAP 2.7x20MM

Facility

$623.80

Service Code	HCPCS C1713
Hospital Charge Code	270648928
Hospital Revenue Code	278
Min. Negotiated Rate	$15.03
Max. Negotiated Rate	$311.90
Rate for Payer: Aetna Commercial	$237.04
Rate for Payer: Aetna Medicare Advantage	$187.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.07
Rate for Payer: Cigna Commercial	$311.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.24
Rate for Payer: Qualcare PPO/HMO/WC	$93.57
Rate for Payer: UnitedHealthcare Community & State	$15.03
Rate for Payer: Wellpoint Medicaid Managed Care	$16.53

Know your out-of-pocket cost for care.

All Charges