Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCRW CAN PRT THD 5X32 11425132

Facility

$568.60

Hospital Charge Code	270635958
Hospital Revenue Code	272
Min. Negotiated Rate	$85.29
Max. Negotiated Rate	$85.29
Rate for Payer: Qualcare PPO/HMO/WC	$85.29

SCRW CAN PRT THD 5X32 11425132

Facility

$568.60

Hospital Charge Code	270635958
Hospital Revenue Code	272
Min. Negotiated Rate	$13.70
Max. Negotiated Rate	$284.30
Rate for Payer: Aetna Commercial	$216.07
Rate for Payer: Aetna Medicare Advantage	$170.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.99
Rate for Payer: Cigna Commercial	$284.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.58
Rate for Payer: Oxford Commercial	$113.72
Rate for Payer: Qualcare PPO/HMO/WC	$85.29
Rate for Payer: UnitedHealthcare Commercial	$113.72
Rate for Payer: UnitedHealthcare Community & State	$13.70
Rate for Payer: Wellpoint Medicaid Managed Care	$15.07

SCRW COMP HEADLES 2.4x18MM LNG

Facility

$1,709.15

Service Code	HCPCS C1713
Hospital Charge Code	270681290
Hospital Revenue Code	278
Min. Negotiated Rate	$256.37
Max. Negotiated Rate	$413.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$341.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$376.01
Rate for Payer: Qualcare PPO/HMO/WC	$256.37

SCRW COMP HEADLES 2.4x18MM LNG

Facility

$1,709.15

Service Code	HCPCS C1713
Hospital Charge Code	270681290
Hospital Revenue Code	278
Min. Negotiated Rate	$41.19
Max. Negotiated Rate	$854.58
Rate for Payer: Aetna Commercial	$649.48
Rate for Payer: Aetna Medicare Advantage	$512.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$435.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$435.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$341.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$435.83
Rate for Payer: Cigna Commercial	$854.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$376.01
Rate for Payer: Qualcare PPO/HMO/WC	$256.37
Rate for Payer: UnitedHealthcare Community & State	$41.19
Rate for Payer: Wellpoint Medicaid Managed Care	$45.29

SCRW COMP HEADLES 2.4x20MM LG

Facility

$1,709.15

Service Code	HCPCS C1713
Hospital Charge Code	270681289
Hospital Revenue Code	278
Min. Negotiated Rate	$256.37
Max. Negotiated Rate	$413.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$341.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$376.01
Rate for Payer: Qualcare PPO/HMO/WC	$256.37

SCRW COMP HEADLES 2.4x20MM LG

Facility

$1,709.15

Service Code	HCPCS C1713
Hospital Charge Code	270681289
Hospital Revenue Code	278
Min. Negotiated Rate	$41.19
Max. Negotiated Rate	$854.58
Rate for Payer: Aetna Commercial	$649.48
Rate for Payer: Aetna Medicare Advantage	$512.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$435.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$435.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$341.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$435.83
Rate for Payer: Cigna Commercial	$854.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$376.01
Rate for Payer: Qualcare PPO/HMO/WC	$256.37
Rate for Payer: UnitedHealthcare Community & State	$41.19
Rate for Payer: Wellpoint Medicaid Managed Care	$45.29

SCRW COMP HEADLES 2.4x20MM SRT

Facility

$1,410.00

Service Code	HCPCS C1713
Hospital Charge Code	270663957
Hospital Revenue Code	278
Min. Negotiated Rate	$211.50
Max. Negotiated Rate	$341.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$310.20
Rate for Payer: Qualcare PPO/HMO/WC	$211.50

SCRW COMP HEADLES 2.4x20MM SRT

Facility

$1,410.00

Service Code	HCPCS C1713
Hospital Charge Code	270663957
Hospital Revenue Code	278
Min. Negotiated Rate	$33.98
Max. Negotiated Rate	$705.00
Rate for Payer: Aetna Commercial	$535.80
Rate for Payer: Aetna Medicare Advantage	$423.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$359.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$359.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$359.55
Rate for Payer: Cigna Commercial	$705.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$310.20
Rate for Payer: Qualcare PPO/HMO/WC	$211.50
Rate for Payer: UnitedHealthcare Community & State	$33.98
Rate for Payer: Wellpoint Medicaid Managed Care	$37.37

SCRW COMP HEADLES 2.4x22MM LNG

Facility

$1,709.15

Service Code	HCPCS C1713
Hospital Charge Code	270681288
Hospital Revenue Code	278
Min. Negotiated Rate	$41.19
Max. Negotiated Rate	$854.58
Rate for Payer: Aetna Commercial	$649.48
Rate for Payer: Aetna Medicare Advantage	$512.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$435.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$435.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$341.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$435.83
Rate for Payer: Cigna Commercial	$854.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$376.01
Rate for Payer: Qualcare PPO/HMO/WC	$256.37
Rate for Payer: UnitedHealthcare Community & State	$41.19
Rate for Payer: Wellpoint Medicaid Managed Care	$45.29

SCRW COMP HEADLES 2.4x22MM LNG

Facility

$1,709.15

Service Code	HCPCS C1713
Hospital Charge Code	270681288
Hospital Revenue Code	278
Min. Negotiated Rate	$256.37
Max. Negotiated Rate	$413.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$341.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$376.01
Rate for Payer: Qualcare PPO/HMO/WC	$256.37

SCRW COMP HEDLES SHRT 3.0X36MM

Facility

$1,452.30

Service Code	HCPCS C1713
Hospital Charge Code	270680184
Hospital Revenue Code	278
Min. Negotiated Rate	$35.00
Max. Negotiated Rate	$726.15
Rate for Payer: Aetna Commercial	$551.87
Rate for Payer: Aetna Medicare Advantage	$435.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$370.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$370.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$370.34
Rate for Payer: Cigna Commercial	$726.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$351.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$319.51
Rate for Payer: Qualcare PPO/HMO/WC	$217.84
Rate for Payer: UnitedHealthcare Community & State	$35.00
Rate for Payer: Wellpoint Medicaid Managed Care	$38.49

SCRW COMP HEDLES SHRT 3.0X36MM

Facility

$1,452.30

Service Code	HCPCS C1713
Hospital Charge Code	270680184
Hospital Revenue Code	278
Min. Negotiated Rate	$217.84
Max. Negotiated Rate	$351.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$351.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$319.51
Rate for Payer: Qualcare PPO/HMO/WC	$217.84

SCRW COMP KREULOK 2.7X22MM

Facility

$1,500.00

Hospital Charge Code	270703178
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

SCRW COMP KREULOK 2.7X22MM

Facility

$1,500.00

Hospital Charge Code	270703178
Hospital Revenue Code	278
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$36.15
Rate for Payer: Wellpoint Medicaid Managed Care	$39.75

SCRW COMPRSSN 3.0x30mm NCS3030

Facility

$1,325.00

Hospital Charge Code	270647214
Hospital Revenue Code	278
Min. Negotiated Rate	$31.93
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$31.93
Rate for Payer: Wellpoint Medicaid Managed Care	$35.11

SCRW COMPRSSN 3.0x30mm NCS3030

Facility

$1,325.00

Hospital Charge Code	270647214
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

SCRW COMP VAL KRELCK TI 3.5X10

Facility

$1,625.00

Hospital Charge Code	270703730
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

SCRW COMP VAL KRELCK TI 3.5X10

Facility

$1,625.00

Hospital Charge Code	270703730
Hospital Revenue Code	278
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

SCRW COMP VAL KRELCK TI 3.5X12

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270703732
Hospital Revenue Code	278
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

SCRW COMP VAL KRELCK TI 3.5X12

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270703732
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

SCRW COMP VAL KRELCK TI 3.5X14

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270703731
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

SCRW COMP VAL KRELCK TI 3.5X14

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270703731
Hospital Revenue Code	278
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

SCRW CORTCAL 150X50mm A6015050

Facility

$718.75

Hospital Charge Code	270637344
Hospital Revenue Code	278
Min. Negotiated Rate	$17.32
Max. Negotiated Rate	$359.38
Rate for Payer: Aetna Commercial	$273.12
Rate for Payer: Aetna Medicare Advantage	$215.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.28
Rate for Payer: Cigna Commercial	$359.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.12
Rate for Payer: Qualcare PPO/HMO/WC	$107.81
Rate for Payer: UnitedHealthcare Community & State	$17.32
Rate for Payer: Wellpoint Medicaid Managed Care	$19.05

SCRW CORTCAL 150X50mm A6015050

Facility

$718.75

Hospital Charge Code	270637344
Hospital Revenue Code	278
Min. Negotiated Rate	$107.81
Max. Negotiated Rate	$173.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.12
Rate for Payer: Qualcare PPO/HMO/WC	$107.81

SCRW CORTCL 4.5mX65m 23472365

Facility

$111.65

Hospital Charge Code	270635860
Hospital Revenue Code	278
Min. Negotiated Rate	$16.75
Max. Negotiated Rate	$27.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$24.56
Rate for Payer: Qualcare PPO/HMO/WC	$16.75

Know your out-of-pocket cost for care.

All Charges