Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCRW CORTCL 4.5mX65m 23472365

Facility

$111.65

Hospital Charge Code	270635860
Hospital Revenue Code	278
Min. Negotiated Rate	$2.69
Max. Negotiated Rate	$55.83
Rate for Payer: Aetna Commercial	$42.43
Rate for Payer: Aetna Medicare Advantage	$33.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.47
Rate for Payer: Cigna Commercial	$55.83
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
Rate for Payer: UnitedHealthcare Community & State	$2.69
Rate for Payer: Wellpoint Medicaid Managed Care	$2.96

SCRW CORTEX 4.5mmx60mm 217.860

Facility

$85.65

Hospital Charge Code	270635647
Hospital Revenue Code	278
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$42.83
Rate for Payer: Aetna Commercial	$32.55
Rate for Payer: Aetna Medicare Advantage	$25.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.84
Rate for Payer: Cigna Commercial	$42.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.85
Rate for Payer: UnitedHealthcare Community & State	$2.06
Rate for Payer: Wellpoint Medicaid Managed Care	$2.27

SCRW CORTEX 4.5mmx60mm 217.860

Facility

$85.65

Hospital Charge Code	270635647
Hospital Revenue Code	278
Min. Negotiated Rate	$12.85
Max. Negotiated Rate	$20.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.85

SCRW CORTICAL BONE 5.0MM X32MM

Facility

$722.30

Service Code	HCPCS C1713
Hospital Charge Code	270678401
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 CORTICAL BONE 5.0MM X32MM

Facility

$722.30

Service Code	HCPCS C1713
Hospital Charge Code	270678401
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 CORT LOPRF SLFTPN3.5x26MM

Facility

$148.50

Service Code	HCPCS C1713
Hospital Charge Code	270668001
Hospital Revenue Code	278
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$35.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$22.27

SCRW CORT LOPRF SLFTPN3.5x26MM

Facility

$148.50

Service Code	HCPCS C1713
Hospital Charge Code	270668001
Hospital Revenue Code	278
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$74.25
Rate for Payer: Aetna Commercial	$56.43
Rate for Payer: Aetna Medicare Advantage	$44.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.87
Rate for Payer: Cigna Commercial	$74.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$22.27
Rate for Payer: UnitedHealthcare Community & State	$3.58
Rate for Payer: Wellpoint Medicaid Managed Care	$3.94

SCRW CRT 2.4x12 SELFTAP401.512

Facility

$297.65

Hospital Charge Code	270635603
Hospital Revenue Code	278
Min. Negotiated Rate	$44.65
Max. Negotiated Rate	$72.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.48
Rate for Payer: Qualcare PPO/HMO/WC	$44.65

SCRW CRT 2.4x12 SELFTAP401.512

Facility

$297.65

Hospital Charge Code	270635603
Hospital Revenue Code	278
Min. Negotiated Rate	$7.17
Max. Negotiated Rate	$148.82
Rate for Payer: Aetna Commercial	$113.11
Rate for Payer: Aetna Medicare Advantage	$89.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.90
Rate for Payer: Cigna Commercial	$148.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.48
Rate for Payer: Qualcare PPO/HMO/WC	$44.65
Rate for Payer: UnitedHealthcare Community & State	$7.17
Rate for Payer: Wellpoint Medicaid Managed Care	$7.89

SCRW CRTCL 130mmX40mm A6013040

Facility

$718.75

Hospital Charge Code	270637341
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 CRTCL 130mmX40mm A6013040

Facility

$718.75

Hospital Charge Code	270637341
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 CRTICL 4.5mX44m 23472344

Facility

$111.65

Hospital Charge Code	270635859
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

SCRW CRTICL 4.5mX44m 23472344

Facility

$111.65

Hospital Charge Code	270635859
Hospital Revenue Code	278
Min. Negotiated Rate	$2.69
Max. Negotiated Rate	$55.83
Rate for Payer: Aetna Commercial	$42.43
Rate for Payer: Aetna Medicare Advantage	$33.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.47
Rate for Payer: Cigna Commercial	$55.83
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
Rate for Payer: UnitedHealthcare Community & State	$2.69
Rate for Payer: Wellpoint Medicaid Managed Care	$2.96

SCRW CRTIL 6.5mX65m 23472665

Facility

$116.95

Hospital Charge Code	270635861
Hospital Revenue Code	278
Min. Negotiated Rate	$17.54
Max. Negotiated Rate	$28.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.73
Rate for Payer: Qualcare PPO/HMO/WC	$17.54

SCRW CRTIL 6.5mX65m 23472665

Facility

$116.95

Hospital Charge Code	270635861
Hospital Revenue Code	278
Min. Negotiated Rate	$2.82
Max. Negotiated Rate	$58.48
Rate for Payer: Aetna Commercial	$44.44
Rate for Payer: Aetna Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.82
Rate for Payer: Cigna Commercial	$58.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.73
Rate for Payer: Qualcare PPO/HMO/WC	$17.54
Rate for Payer: UnitedHealthcare Community & State	$2.82
Rate for Payer: Wellpoint Medicaid Managed Care	$3.10

SCRW CRT LO PRF SLFTPN3.5x18MM

Facility

$150.65

Service Code	HCPCS C1713
Hospital Charge Code	270680261
Hospital Revenue Code	278
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$75.33
Rate for Payer: Aetna Commercial	$57.25
Rate for Payer: Aetna Medicare Advantage	$45.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.42
Rate for Payer: Cigna Commercial	$75.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.14
Rate for Payer: Qualcare PPO/HMO/WC	$22.60
Rate for Payer: UnitedHealthcare Community & State	$3.63
Rate for Payer: Wellpoint Medicaid Managed Care	$3.99

SCRW CRT LO PRF SLFTPN3.5x18MM

Facility

$150.65

Service Code	HCPCS C1713
Hospital Charge Code	270680261
Hospital Revenue Code	278
Min. Negotiated Rate	$22.60
Max. Negotiated Rate	$36.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.14
Rate for Payer: Qualcare PPO/HMO/WC	$22.60

SCRW LAG ONE-PC 11m85m22590135

Facility

$1,036.10

Hospital Charge Code	270636139
Hospital Revenue Code	278
Min. Negotiated Rate	$24.97
Max. Negotiated Rate	$518.05
Rate for Payer: Aetna Commercial	$393.72
Rate for Payer: Aetna Medicare Advantage	$310.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$264.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$264.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$207.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$264.21
Rate for Payer: Cigna Commercial	$518.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$227.94
Rate for Payer: Qualcare PPO/HMO/WC	$155.41
Rate for Payer: UnitedHealthcare Community & State	$24.97
Rate for Payer: Wellpoint Medicaid Managed Care	$27.46

SCRW LAG ONE-PC 11m85m22590135

Facility

$1,036.10

Hospital Charge Code	270636139
Hospital Revenue Code	278
Min. Negotiated Rate	$155.41
Max. Negotiated Rate	$250.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$207.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$227.94
Rate for Payer: Qualcare PPO/HMO/WC	$155.41

SCRW LCK 4.5x24mm 27824

Facility

$610.00

Hospital Charge Code	270648675
Hospital Revenue Code	278
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$147.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.20
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

SCRW LCK 4.5x24mm 27824

Facility

$610.00

Hospital Charge Code	270648675
Hospital Revenue Code	278
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$305.00
Rate for Payer: Aetna Commercial	$231.80
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.20
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Community & State	$14.70
Rate for Payer: Wellpoint Medicaid Managed Care	$16.16

SCRW LG CAN 5.5x85 N/LCK 26485

Facility

$405.00

Hospital Charge Code	270648673
Hospital Revenue Code	278
Min. Negotiated Rate	$9.76
Max. Negotiated Rate	$202.50
Rate for Payer: Aetna Commercial	$153.90
Rate for Payer: Aetna Medicare Advantage	$121.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$103.28
Rate for Payer: Cigna Commercial	$202.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$89.10
Rate for Payer: Qualcare PPO/HMO/WC	$60.75
Rate for Payer: UnitedHealthcare Community & State	$9.76
Rate for Payer: Wellpoint Medicaid Managed Care	$10.73

SCRW LG CAN 5.5x85 N/LCK 26485

Facility

$405.00

Hospital Charge Code	270648673
Hospital Revenue Code	278
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$98.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$89.10
Rate for Payer: Qualcare PPO/HMO/WC	$60.75

SCRW LG CN 5.5x80 NNLCKG 26480

Facility

$375.00

Hospital Charge Code	270639195
Hospital Revenue Code	278
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

SCRW LG CN 5.5x80 NNLCKG 26480

Facility

$375.00

Hospital Charge Code	270639195
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

Know your out-of-pocket cost for care.

All Charges