Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW WLZ LP SLT 2.0 7 018042

Facility

$729.65

Hospital Charge Code	270607817
Hospital Revenue Code	278
Min. Negotiated Rate	$109.45
Max. Negotiated Rate	$176.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$160.52
Rate for Payer: Qualcare PPO/HMO/WC	$109.45

SCREW WLZ SLOT 2.0 15 999415

Facility

$175.25

Hospital Charge Code	270612075
Hospital Revenue Code	278
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$87.62
Rate for Payer: Aetna Commercial	$66.59
Rate for Payer: Aetna Medicare Advantage	$52.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.69
Rate for Payer: Cigna Commercial	$87.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.55
Rate for Payer: Qualcare PPO/HMO/WC	$26.29
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.64

SCREW WLZ SLOT 2.0 15 999415

Facility

$175.25

Hospital Charge Code	270612075
Hospital Revenue Code	278
Min. Negotiated Rate	$26.29
Max. Negotiated Rate	$42.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.55
Rate for Payer: Qualcare PPO/HMO/WC	$26.29

SCREW WLZ SLOT 2.0 17 999417

Facility

$172.85

Hospital Charge Code	270612076
Hospital Revenue Code	278
Min. Negotiated Rate	$4.17
Max. Negotiated Rate	$86.42
Rate for Payer: Aetna Commercial	$65.68
Rate for Payer: Aetna Medicare Advantage	$51.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.08
Rate for Payer: Cigna Commercial	$86.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.03
Rate for Payer: Qualcare PPO/HMO/WC	$25.93
Rate for Payer: UnitedHealthcare Community & State	$4.17
Rate for Payer: Wellpoint Medicaid Managed Care	$4.58

SCREW WLZ SLOT 2.0 17 999417

Facility

$172.85

Hospital Charge Code	270612076
Hospital Revenue Code	278
Min. Negotiated Rate	$25.93
Max. Negotiated Rate	$41.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.03
Rate for Payer: Qualcare PPO/HMO/WC	$25.93

SCREW X-CORE MINI TI LOCK,E

Facility

$2,475.00

Hospital Charge Code	270666086
Hospital Revenue Code	278
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

SCREW X-CORE MINI TI LOCK,E

Facility

$2,475.00

Hospital Charge Code	270666086
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

SCREW XTAB CANN FEN POLYAX 7.5

Facility

$9,250.00

Hospital Charge Code	270701735
Hospital Revenue Code	278
Min. Negotiated Rate	$1,387.50
Max. Negotiated Rate	$2,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,035.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50

SCREW XTAB CANN FEN POLYAX 7.5

Facility

$9,250.00

Hospital Charge Code	270701735
Hospital Revenue Code	278
Min. Negotiated Rate	$222.93
Max. Negotiated Rate	$4,625.00
Rate for Payer: Aetna Commercial	$3,515.00
Rate for Payer: Aetna Medicare Advantage	$2,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,358.75
Rate for Payer: Cigna Commercial	$4,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,035.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50
Rate for Payer: UnitedHealthcare Community & State	$222.93
Rate for Payer: Wellpoint Medicaid Managed Care	$245.12

SCREW ZAVATION SDVA 4.0X12MM

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270699099
Hospital Revenue Code	278
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

SCREW ZAVATION SDVA 4.0X12MM

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270699099
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

SCREW ZEVO VAR SD 3.5X13MM

Facility

$2,486.25

Service Code	HCPCS C1713
Hospital Charge Code	270697820
Hospital Revenue Code	278
Min. Negotiated Rate	$372.94
Max. Negotiated Rate	$601.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$497.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$601.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$546.98
Rate for Payer: Qualcare PPO/HMO/WC	$372.94

SCREW ZEVO VAR SD 3.5X13MM

Facility

$2,486.25

Service Code	HCPCS C1713
Hospital Charge Code	270697820
Hospital Revenue Code	278
Min. Negotiated Rate	$59.92
Max. Negotiated Rate	$1,243.12
Rate for Payer: Aetna Commercial	$944.77
Rate for Payer: Aetna Medicare Advantage	$745.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$633.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$633.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$497.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$633.99
Rate for Payer: Cigna Commercial	$1,243.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$601.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$546.98
Rate for Payer: Qualcare PPO/HMO/WC	$372.94
Rate for Payer: UnitedHealthcare Community & State	$59.92
Rate for Payer: Wellpoint Medicaid Managed Care	$65.89

SCREW ZEVO VAR SD 3.5X15MM

Facility

$2,920.00

Service Code	HCPCS C1713
Hospital Charge Code	270695968
Hospital Revenue Code	278
Min. Negotiated Rate	$70.37
Max. Negotiated Rate	$1,460.00
Rate for Payer: Aetna Commercial	$1,109.60
Rate for Payer: Aetna Medicare Advantage	$876.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$744.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$744.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$584.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$744.60
Rate for Payer: Cigna Commercial	$1,460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$706.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$642.40
Rate for Payer: Qualcare PPO/HMO/WC	$438.00
Rate for Payer: UnitedHealthcare Community & State	$70.37
Rate for Payer: Wellpoint Medicaid Managed Care	$77.38

SCREW ZEVO VAR SD 3.5X15MM

Facility

$2,920.00

Service Code	HCPCS C1713
Hospital Charge Code	270695968
Hospital Revenue Code	278
Min. Negotiated Rate	$438.00
Max. Negotiated Rate	$706.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$584.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$706.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$642.40
Rate for Payer: Qualcare PPO/HMO/WC	$438.00

SCREW ZIM CANC 4.0 10 234011

Facility

$40.00

Hospital Charge Code	270610176
Hospital Revenue Code	278
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

SCREW ZIM CANC 4.0 10 234011

Facility

$40.00

Hospital Charge Code	270610176
Hospital Revenue Code	278
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$9.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

SCREW ZIM CANC 4.0 12 234013

Facility

$69.65

Hospital Charge Code	270610177
Hospital Revenue Code	278
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$34.83
Rate for Payer: Aetna Commercial	$26.47
Rate for Payer: Aetna Medicare Advantage	$20.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.76
Rate for Payer: Cigna Commercial	$34.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.32
Rate for Payer: Qualcare PPO/HMO/WC	$10.45
Rate for Payer: UnitedHealthcare Community & State	$1.68
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

SCREW ZIM CANC 4.0 12 234013

Facility

$69.65

Hospital Charge Code	270610177
Hospital Revenue Code	278
Min. Negotiated Rate	$10.45
Max. Negotiated Rate	$16.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.32
Rate for Payer: Qualcare PPO/HMO/WC	$10.45

SCREW ZIM CANC 4.0 14 234015

Facility

$57.65

Hospital Charge Code	270608441
Hospital Revenue Code	278
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$28.82
Rate for Payer: Aetna Commercial	$21.91
Rate for Payer: Aetna Medicare Advantage	$17.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.70
Rate for Payer: Cigna Commercial	$28.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.68
Rate for Payer: Qualcare PPO/HMO/WC	$8.65
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.53

SCREW ZIM CANC 4.0 14 234015

Facility

$57.65

Hospital Charge Code	270608441
Hospital Revenue Code	278
Min. Negotiated Rate	$8.65
Max. Negotiated Rate	$13.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.68
Rate for Payer: Qualcare PPO/HMO/WC	$8.65

SCREW ZIM CANC 4.0 16 234017

Facility

$43.25

Hospital Charge Code	270607159
Hospital Revenue Code	278
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.62
Rate for Payer: Aetna Commercial	$16.43
Rate for Payer: Aetna Medicare Advantage	$12.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.03
Rate for Payer: Cigna Commercial	$21.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.52
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.15

SCREW ZIM CANC 4.0 16 234017

Facility

$43.25

Hospital Charge Code	270607159
Hospital Revenue Code	278
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$10.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.52
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

SCREW ZIM CANC 4.0 18 232219

Facility

$43.25

Hospital Charge Code	270610234
Hospital Revenue Code	278
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.62
Rate for Payer: Aetna Commercial	$16.43
Rate for Payer: Aetna Medicare Advantage	$12.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.03
Rate for Payer: Cigna Commercial	$21.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.52
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.15

SCREW ZIM CANC 4.0 18 232219

Facility

$43.25

Hospital Charge Code	270610234
Hospital Revenue Code	278
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$10.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.52
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

Know your out-of-pocket cost for care.

All Charges