Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCRW 3.5x34 LP NLCK1312-18-034

Facility

$350.00

Service Code	HCPCS C1713
Hospital Charge Code	270658895
Hospital Revenue Code	278
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$133.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$77.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Community & State	$8.44
Rate for Payer: Wellpoint Medicaid Managed Care	$9.28

SCRW 3.5x34 LP NLCK1312-18-034

Facility

$350.00

Service Code	HCPCS C1713
Hospital Charge Code	270658895
Hospital Revenue Code	278
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$84.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$77.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

SCRW 3.5x36 LPNLCK 1312-18-036

Facility

$350.00

Hospital Charge Code	270658892
Hospital Revenue Code	278
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$133.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$77.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Community & State	$8.44
Rate for Payer: Wellpoint Medicaid Managed Care	$9.28

SCRW 3.5x36 LPNLCK 1312-18-036

Facility

$350.00

Hospital Charge Code	270658892
Hospital Revenue Code	278
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$84.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$77.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

SCRW 3.5x65 LP NLCK1312-18-065

Facility

$350.00

Hospital Charge Code	270658894
Hospital Revenue Code	278
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$84.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$77.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

SCRW 3.5x65 LP NLCK1312-18-065

Facility

$350.00

Hospital Charge Code	270658894
Hospital Revenue Code	278
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$133.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$77.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Community & State	$8.44
Rate for Payer: Wellpoint Medicaid Managed Care	$9.28

SCRW 4.0X12 CNCLCK 8161-40-012

Facility

$850.00

Service Code	HCPCS C1713
Hospital Charge Code	270661580
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

SCRW 4.0X12 CNCLCK 8161-40-012

Facility

$850.00

Service Code	HCPCS C1713
Hospital Charge Code	270661580
Hospital Revenue Code	278
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Community & State	$20.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.52

SCRW 4.0X14 CNCLCK 8161-40-014

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270661577
Hospital Revenue Code	278
Min. Negotiated Rate	$15.24
Max. Negotiated Rate	$316.25
Rate for Payer: Aetna Commercial	$240.35
Rate for Payer: Aetna Medicare Advantage	$189.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.29
Rate for Payer: Cigna Commercial	$316.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$94.88
Rate for Payer: UnitedHealthcare Community & State	$15.24
Rate for Payer: Wellpoint Medicaid Managed Care	$16.76

SCRW 4.0X14 CNCLCK 8161-40-014

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270661577
Hospital Revenue Code	278
Min. Negotiated Rate	$94.88
Max. Negotiated Rate	$153.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$94.88

SCRW 4.0X16 CNCLCK 8161-40-016

Facility

$850.00

Service Code	HCPCS C1713
Hospital Charge Code	270661578
Hospital Revenue Code	278
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Community & State	$20.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.52

SCRW 4.0X16 CNCLCK 8161-40-016

Facility

$850.00

Service Code	HCPCS C1713
Hospital Charge Code	270661578
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

SCRW 4.0X18 CNCLCK 8161-40-018

Facility

$850.00

Service Code	HCPCS C1713
Hospital Charge Code	270661579
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

SCRW 4.0X18 CNCLCK 8161-40-018

Facility

$850.00

Service Code	HCPCS C1713
Hospital Charge Code	270661579
Hospital Revenue Code	278
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Community & State	$20.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.52

SCRW 4.0X20 CNCLCK 8161-40-020

Facility

$850.00

Hospital Charge Code	270661581
Hospital Revenue Code	278
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Community & State	$20.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.52

SCRW 4.0X20 CNCLCK 8161-40-020

Facility

$850.00

Hospital Charge Code	270661581
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

SCRW 4.5m MALLEOLAR 50m2334051

Facility

$85.00

Hospital Charge Code	270610356
Hospital Revenue Code	278
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$20.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.70
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

SCRW 4.5m MALLEOLAR 50m2334051

Facility

$85.00

Hospital Charge Code	270610356
Hospital Revenue Code	278
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$42.50
Rate for Payer: Aetna Commercial	$32.30
Rate for Payer: Aetna Medicare Advantage	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.68
Rate for Payer: Cigna Commercial	$42.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.70
Rate for Payer: Qualcare PPO/HMO/WC	$12.75
Rate for Payer: UnitedHealthcare Community & State	$2.05
Rate for Payer: Wellpoint Medicaid Managed Care	$2.25

SCRW AFFIXS CORT BONE 5.0X38MM

Facility

$722.30

Service Code	HCPCS C1713
Hospital Charge Code	270679372
Hospital Revenue Code	278
Min. Negotiated Rate	$17.41
Max. Negotiated Rate	$361.15
Rate for Payer: Aetna Commercial	$274.47
Rate for Payer: Aetna Medicare Advantage	$216.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.19
Rate for Payer: Cigna Commercial	$361.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.91
Rate for Payer: Qualcare PPO/HMO/WC	$108.34
Rate for Payer: UnitedHealthcare Community & State	$17.41
Rate for Payer: Wellpoint Medicaid Managed Care	$19.14

SCRW AFFIXS CORT BONE 5.0X38MM

Facility

$722.30

Service Code	HCPCS C1713
Hospital Charge Code	270679372
Hospital Revenue Code	278
Min. Negotiated Rate	$108.34
Max. Negotiated Rate	$174.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.91
Rate for Payer: Qualcare PPO/HMO/WC	$108.34

SCRW BNE 1.7MMx11MM 58-17011E

Facility

$550.00

Hospital Charge Code	270655366
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

SCRW BNE 1.7MMx11MM 58-17011E

Facility

$550.00

Hospital Charge Code	270655366
Hospital Revenue Code	278
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

SCRW BNE1.7MMx9MM LCK53-17009E

Facility

$705.00

Hospital Charge Code	270655373
Hospital Revenue Code	278
Min. Negotiated Rate	$16.99
Max. Negotiated Rate	$352.50
Rate for Payer: Aetna Commercial	$267.90
Rate for Payer: Aetna Medicare Advantage	$211.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.78
Rate for Payer: Cigna Commercial	$352.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$155.10
Rate for Payer: Qualcare PPO/HMO/WC	$105.75
Rate for Payer: UnitedHealthcare Community & State	$16.99
Rate for Payer: Wellpoint Medicaid Managed Care	$18.68

SCRW BNE1.7MMx9MM LCK53-17009E

Facility

$705.00

Hospital Charge Code	270655373
Hospital Revenue Code	278
Min. Negotiated Rate	$105.75
Max. Negotiated Rate	$170.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$155.10
Rate for Payer: Qualcare PPO/HMO/WC	$105.75

SCRW BNE LOCK 14Mx2.7M 5227014

Facility

$450.00

Hospital Charge Code	270640884
Hospital Revenue Code	278
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Community & State	$10.85
Rate for Payer: Wellpoint Medicaid Managed Care	$11.93

Know your out-of-pocket cost for care.

All Charges