Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW VLX CANN 3.0 34 P227-34

Facility

$484.00

Hospital Charge Code	270614808
Hospital Revenue Code	278
Min. Negotiated Rate	$72.60
Max. Negotiated Rate	$117.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$106.48
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

SCREW VLX CANN 3.0 34 P227-34

Facility

$484.00

Hospital Charge Code	270614808
Hospital Revenue Code	278
Min. Negotiated Rate	$11.66
Max. Negotiated Rate	$242.00
Rate for Payer: Aetna Commercial	$183.92
Rate for Payer: Aetna Medicare Advantage	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.42
Rate for Payer: Cigna Commercial	$242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$106.48
Rate for Payer: Qualcare PPO/HMO/WC	$72.60
Rate for Payer: UnitedHealthcare Community & State	$11.66
Rate for Payer: Wellpoint Medicaid Managed Care	$12.83

SCREW VLX CANN 3.0 36 P227-36

Facility

$484.00

Hospital Charge Code	270614809
Hospital Revenue Code	278
Min. Negotiated Rate	$72.60
Max. Negotiated Rate	$117.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$106.48
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

SCREW VLX CANN 3.0 36 P227-36

Facility

$484.00

Hospital Charge Code	270614809
Hospital Revenue Code	278
Min. Negotiated Rate	$11.66
Max. Negotiated Rate	$242.00
Rate for Payer: Aetna Commercial	$183.92
Rate for Payer: Aetna Medicare Advantage	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.42
Rate for Payer: Cigna Commercial	$242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$106.48
Rate for Payer: Qualcare PPO/HMO/WC	$72.60
Rate for Payer: UnitedHealthcare Community & State	$11.66
Rate for Payer: Wellpoint Medicaid Managed Care	$12.83

SCREW VOYAGER 5.5 MAS 5.5X50MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270699435
Hospital Revenue Code	278
Min. Negotiated Rate	$160.75
Max. Negotiated Rate	$3,335.00
Rate for Payer: Aetna Commercial	$2,534.60
Rate for Payer: Aetna Medicare Advantage	$2,001.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,700.85
Rate for Payer: Cigna Commercial	$3,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,467.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50
Rate for Payer: UnitedHealthcare Community & State	$160.75
Rate for Payer: Wellpoint Medicaid Managed Care	$176.75

SCREW VOYAGER 5.5 MAS 5.5X50MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270699435
Hospital Revenue Code	278
Min. Negotiated Rate	$1,000.50
Max. Negotiated Rate	$1,614.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,467.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50

SCREW VOYAGER 5.5 MAS 6.5X50MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270699432
Hospital Revenue Code	278
Min. Negotiated Rate	$160.75
Max. Negotiated Rate	$3,335.00
Rate for Payer: Aetna Commercial	$2,534.60
Rate for Payer: Aetna Medicare Advantage	$2,001.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,700.85
Rate for Payer: Cigna Commercial	$3,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,467.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50
Rate for Payer: UnitedHealthcare Community & State	$160.75
Rate for Payer: Wellpoint Medicaid Managed Care	$176.75

SCREW VOYAGER 5.5 MAS 6.5X50MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270699432
Hospital Revenue Code	278
Min. Negotiated Rate	$1,000.50
Max. Negotiated Rate	$1,614.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,467.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50

SCREW VOYAGER 5.5X40MM

Facility

$14,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270697029
Hospital Revenue Code	278
Min. Negotiated Rate	$2,175.00
Max. Negotiated Rate	$3,509.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,190.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00

SCREW VOYAGER 5.5X40MM

Facility

$14,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270697029
Hospital Revenue Code	278
Min. Negotiated Rate	$349.45
Max. Negotiated Rate	$7,250.00
Rate for Payer: Aetna Commercial	$5,510.00
Rate for Payer: Aetna Medicare Advantage	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,697.50
Rate for Payer: Cigna Commercial	$7,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,190.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00
Rate for Payer: UnitedHealthcare Community & State	$349.45
Rate for Payer: Wellpoint Medicaid Managed Care	$384.25

SCREW VOYAGER MAS 6.5X45MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270699078
Hospital Revenue Code	278
Min. Negotiated Rate	$1,000.50
Max. Negotiated Rate	$1,614.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,467.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50

SCREW VOYAGER MAS 6.5X45MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270699078
Hospital Revenue Code	278
Min. Negotiated Rate	$160.75
Max. Negotiated Rate	$3,335.00
Rate for Payer: Aetna Commercial	$2,534.60
Rate for Payer: Aetna Medicare Advantage	$2,001.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,700.85
Rate for Payer: Cigna Commercial	$3,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,467.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50
Rate for Payer: UnitedHealthcare Community & State	$160.75
Rate for Payer: Wellpoint Medicaid Managed Care	$176.75

SCREW VPC 3.4 X 28 MM

Facility

$1,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270689421
Hospital Revenue Code	278
Min. Negotiated Rate	$46.99
Max. Negotiated Rate	$975.00
Rate for Payer: Aetna Commercial	$741.00
Rate for Payer: Aetna Medicare Advantage	$585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$497.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$497.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$497.25
Rate for Payer: Cigna Commercial	$975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$429.00
Rate for Payer: Qualcare PPO/HMO/WC	$292.50
Rate for Payer: UnitedHealthcare Community & State	$46.99
Rate for Payer: Wellpoint Medicaid Managed Care	$51.67

SCREW VPC 3.4 X 28 MM

Facility

$1,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270689422
Hospital Revenue Code	278
Min. Negotiated Rate	$292.50
Max. Negotiated Rate	$471.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$429.00
Rate for Payer: Qualcare PPO/HMO/WC	$292.50

SCREW VPC 3.4 X 28 MM

Facility

$1,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270689422
Hospital Revenue Code	278
Min. Negotiated Rate	$46.99
Max. Negotiated Rate	$975.00
Rate for Payer: Aetna Commercial	$741.00
Rate for Payer: Aetna Medicare Advantage	$585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$497.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$497.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$497.25
Rate for Payer: Cigna Commercial	$975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$429.00
Rate for Payer: Qualcare PPO/HMO/WC	$292.50
Rate for Payer: UnitedHealthcare Community & State	$46.99
Rate for Payer: Wellpoint Medicaid Managed Care	$51.67

SCREW VPC 3.4 X 28 MM

Facility

$1,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270689421
Hospital Revenue Code	278
Min. Negotiated Rate	$292.50
Max. Negotiated Rate	$471.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$429.00
Rate for Payer: Qualcare PPO/HMO/WC	$292.50

SCREW VSD 32MM 14MM

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270696323
Hospital Revenue Code	278
Min. Negotiated Rate	$463.93
Max. Negotiated Rate	$9,625.00
Rate for Payer: Aetna Commercial	$7,315.00
Rate for Payer: Aetna Medicare Advantage	$5,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,908.75
Rate for Payer: Cigna Commercial	$9,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50
Rate for Payer: UnitedHealthcare Community & State	$463.93
Rate for Payer: Wellpoint Medicaid Managed Care	$510.12

SCREW VSD 32MM 14MM

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270696323
Hospital Revenue Code	278
Min. Negotiated Rate	$2,887.50
Max. Negotiated Rate	$4,658.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50

SCREW VSD 4.0X10MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695489
Hospital Revenue Code	278
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

SCREW VSD 4.0X10MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695489
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW VSD 4X16 MM

Facility

$875.00

Hospital Charge Code	270703097
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 VSD 4X16 MM

Facility

$875.00

Hospital Charge Code	270703097
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 VSD 5X20MM

Facility

$950.00

Service Code	HCPCS C1713
Hospital Charge Code	270703637
Hospital Revenue Code	278
Min. Negotiated Rate	$22.89
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$361.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.00
Rate for Payer: Qualcare PPO/HMO/WC	$142.50
Rate for Payer: UnitedHealthcare Community & State	$22.89
Rate for Payer: Wellpoint Medicaid Managed Care	$25.18

SCREW VSD 5X20MM

Facility

$950.00

Service Code	HCPCS C1713
Hospital Charge Code	270703637
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$229.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.00
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

SCREW WEDGE 8x25MM

Facility

$955.00

Hospital Charge Code	270676063
Hospital Revenue Code	278
Min. Negotiated Rate	$143.25
Max. Negotiated Rate	$231.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$210.10
Rate for Payer: Qualcare PPO/HMO/WC	$143.25

Know your out-of-pocket cost for care.

All Charges