Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCRW LOCK FULL 5x35 189650538

Facility

$910.00

Hospital Charge Code	270639019
Hospital Revenue Code	278
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$220.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.20
Rate for Payer: Qualcare PPO/HMO/WC	$136.50

SCRW LOCK FULL 5x35 189650538

Facility

$910.00

Hospital Charge Code	270639019
Hospital Revenue Code	278
Min. Negotiated Rate	$21.93
Max. Negotiated Rate	$455.00
Rate for Payer: Aetna Commercial	$345.80
Rate for Payer: Aetna Medicare Advantage	$273.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.05
Rate for Payer: Cigna Commercial	$455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.20
Rate for Payer: Qualcare PPO/HMO/WC	$136.50
Rate for Payer: UnitedHealthcare Community & State	$21.93
Rate for Payer: Wellpoint Medicaid Managed Care	$24.11

SCRW LOW PROF 3mmX.75mm400.833

Facility

$282.45

Hospital Charge Code	270635020
Hospital Revenue Code	278
Min. Negotiated Rate	$6.81
Max. Negotiated Rate	$141.22
Rate for Payer: Aetna Commercial	$107.33
Rate for Payer: Aetna Medicare Advantage	$84.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.02
Rate for Payer: Cigna Commercial	$141.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$62.14
Rate for Payer: Qualcare PPO/HMO/WC	$42.37
Rate for Payer: UnitedHealthcare Community & State	$6.81
Rate for Payer: Wellpoint Medicaid Managed Care	$7.48

SCRW LOW PROF 3mmX.75mm400.833

Facility

$282.45

Hospital Charge Code	270635020
Hospital Revenue Code	278
Min. Negotiated Rate	$42.37
Max. Negotiated Rate	$68.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$62.14
Rate for Payer: Qualcare PPO/HMO/WC	$42.37

SCRW MATR MIDFA 4MM04503224015

Facility

$365.00

Hospital Charge Code	270640740
Hospital Revenue Code	278
Min. Negotiated Rate	$54.75
Max. Negotiated Rate	$88.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$80.30
Rate for Payer: Qualcare PPO/HMO/WC	$54.75

SCRW MATR MIDFA 4MM04503224015

Facility

$365.00

Hospital Charge Code	270640740
Hospital Revenue Code	278
Min. Negotiated Rate	$8.80
Max. Negotiated Rate	$182.50
Rate for Payer: Aetna Commercial	$138.70
Rate for Payer: Aetna Medicare Advantage	$109.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.08
Rate for Payer: Cigna Commercial	$182.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$80.30
Rate for Payer: Qualcare PPO/HMO/WC	$54.75
Rate for Payer: UnitedHealthcare Community & State	$8.80
Rate for Payer: Wellpoint Medicaid Managed Care	$9.67

SCRW MD 3.5MMx18MM 8163-35-018

Facility

$1,245.00

Hospital Charge Code	270661593
Hospital Revenue Code	278
Min. Negotiated Rate	$186.75
Max. Negotiated Rate	$301.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.90
Rate for Payer: Qualcare PPO/HMO/WC	$186.75

SCRW MD 3.5MMx18MM 8163-35-018

Facility

$1,245.00

Hospital Charge Code	270661593
Hospital Revenue Code	278
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$622.50
Rate for Payer: Aetna Commercial	$473.10
Rate for Payer: Aetna Medicare Advantage	$373.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$317.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$317.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$317.48
Rate for Payer: Cigna Commercial	$622.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.90
Rate for Payer: Qualcare PPO/HMO/WC	$186.75
Rate for Payer: UnitedHealthcare Community & State	$30.00
Rate for Payer: Wellpoint Medicaid Managed Care	$32.99

SCRW METPHYS SLFTP T8 2.7x10MM

Facility

$200.50

Service Code	HCPCS C1713
Hospital Charge Code	270677642
Hospital Revenue Code	278
Min. Negotiated Rate	$4.83
Max. Negotiated Rate	$100.25
Rate for Payer: Aetna Commercial	$76.19
Rate for Payer: Aetna Medicare Advantage	$60.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.13
Rate for Payer: Cigna Commercial	$100.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.11
Rate for Payer: Qualcare PPO/HMO/WC	$30.07
Rate for Payer: UnitedHealthcare Community & State	$4.83
Rate for Payer: Wellpoint Medicaid Managed Care	$5.31

SCRW METPHYS SLFTP T8 2.7x10MM

Facility

$200.50

Service Code	HCPCS C1713
Hospital Charge Code	270677642
Hospital Revenue Code	278
Min. Negotiated Rate	$30.07
Max. Negotiated Rate	$48.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.11
Rate for Payer: Qualcare PPO/HMO/WC	$30.07

SCRW METPHYS SLFTP T8 2.7x30MM

Facility

$194.65

Service Code	HCPCS C1713
Hospital Charge Code	270677645
Hospital Revenue Code	278
Min. Negotiated Rate	$4.69
Max. Negotiated Rate	$97.33
Rate for Payer: Aetna Commercial	$73.97
Rate for Payer: Aetna Medicare Advantage	$58.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.64
Rate for Payer: Cigna Commercial	$97.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$42.82
Rate for Payer: Qualcare PPO/HMO/WC	$29.20
Rate for Payer: UnitedHealthcare Community & State	$4.69
Rate for Payer: Wellpoint Medicaid Managed Care	$5.16

SCRW METPHYS SLFTP T8 2.7x30MM

Facility

$194.65

Service Code	HCPCS C1713
Hospital Charge Code	270677645
Hospital Revenue Code	278
Min. Negotiated Rate	$29.20
Max. Negotiated Rate	$47.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$42.82
Rate for Payer: Qualcare PPO/HMO/WC	$29.20

SCRW N-LCK PIT R3CON 3.5X26MM

Facility

$612.00

Service Code	HCPCS C1713
Hospital Charge Code	270702048
Hospital Revenue Code	278
Min. Negotiated Rate	$14.75
Max. Negotiated Rate	$306.00
Rate for Payer: Aetna Commercial	$232.56
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.64
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Community & State	$14.75
Rate for Payer: Wellpoint Medicaid Managed Care	$16.22

SCRW N-LCK PIT R3CON 3.5X26MM

Facility

$612.00

Service Code	HCPCS C1713
Hospital Charge Code	270702048
Hospital Revenue Code	278
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$148.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.64
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

SCRW RELN MAS 8.5X45MM 2CPLYAX

Facility

$9,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270686470
Hospital Revenue Code	278
Min. Negotiated Rate	$216.90
Max. Negotiated Rate	$4,500.00
Rate for Payer: Aetna Commercial	$3,420.00
Rate for Payer: Aetna Medicare Advantage	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,295.00
Rate for Payer: Cigna Commercial	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,980.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00
Rate for Payer: UnitedHealthcare Community & State	$216.90
Rate for Payer: Wellpoint Medicaid Managed Care	$238.50

SCRW RELN MAS 8.5X45MM 2CPLYAX

Facility

$9,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270686470
Hospital Revenue Code	278
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$2,178.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,980.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00

SCRW SLF TAP VAR ANGL 3.5X44MM

Facility

$662.00

Service Code	HCPCS C1713
Hospital Charge Code	270678175
Hospital Revenue Code	278
Min. Negotiated Rate	$15.95
Max. Negotiated Rate	$331.00
Rate for Payer: Aetna Commercial	$251.56
Rate for Payer: Aetna Medicare Advantage	$198.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.81
Rate for Payer: Cigna Commercial	$331.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.64
Rate for Payer: Qualcare PPO/HMO/WC	$99.30
Rate for Payer: UnitedHealthcare Community & State	$15.95
Rate for Payer: Wellpoint Medicaid Managed Care	$17.54

SCRW SLF TAP VAR ANGL 3.5X44MM

Facility

$662.00

Service Code	HCPCS C1713
Hospital Charge Code	270678175
Hospital Revenue Code	278
Min. Negotiated Rate	$99.30
Max. Negotiated Rate	$160.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.64
Rate for Payer: Qualcare PPO/HMO/WC	$99.30

SCRW ST 4.5 X 14 MM

Facility

$2,700.00

Hospital Charge Code	270648863
Hospital Revenue Code	278
Min. Negotiated Rate	$65.07
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$1,026.00
Rate for Payer: Aetna Medicare Advantage	$810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$688.50
Rate for Payer: Cigna Commercial	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$594.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00
Rate for Payer: UnitedHealthcare Community & State	$65.07
Rate for Payer: Wellpoint Medicaid Managed Care	$71.55

SCRW ST 4.5 X 14 MM

Facility

$2,700.00

Hospital Charge Code	270648863
Hospital Revenue Code	278
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$653.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$594.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00

SCRW V-LOCK 90-DEG 3.8x26mNL26

Facility

$421.65

Hospital Charge Code	270636724
Hospital Revenue Code	278
Min. Negotiated Rate	$63.25
Max. Negotiated Rate	$102.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$92.76
Rate for Payer: Qualcare PPO/HMO/WC	$63.25

SCRW V-LOCK 90-DEG 3.8x26mNL26

Facility

$421.65

Hospital Charge Code	270636724
Hospital Revenue Code	278
Min. Negotiated Rate	$10.16
Max. Negotiated Rate	$210.82
Rate for Payer: Aetna Commercial	$160.23
Rate for Payer: Aetna Medicare Advantage	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.52
Rate for Payer: Cigna Commercial	$210.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$92.76
Rate for Payer: Qualcare PPO/HMO/WC	$63.25
Rate for Payer: UnitedHealthcare Community & State	$10.16
Rate for Payer: Wellpoint Medicaid Managed Care	$11.17

SCRW V-LOCK 90-DEG 3.8x36mNL36

Facility

$421.65

Hospital Charge Code	270636726
Hospital Revenue Code	278
Min. Negotiated Rate	$10.16
Max. Negotiated Rate	$210.82
Rate for Payer: Aetna Commercial	$160.23
Rate for Payer: Aetna Medicare Advantage	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.52
Rate for Payer: Cigna Commercial	$210.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$92.76
Rate for Payer: Qualcare PPO/HMO/WC	$63.25
Rate for Payer: UnitedHealthcare Community & State	$10.16
Rate for Payer: Wellpoint Medicaid Managed Care	$11.17

SCRW V-LOCK 90-DEG 3.8x36mNL36

Facility

$421.65

Hospital Charge Code	270636726
Hospital Revenue Code	278
Min. Negotiated Rate	$63.25
Max. Negotiated Rate	$102.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$92.76
Rate for Payer: Qualcare PPO/HMO/WC	$63.25

SCRW ZIM COMP HX 1 47-1162-21

Facility

$183.80

Hospital Charge Code	270602003
Hospital Revenue Code	278
Min. Negotiated Rate	$4.43
Max. Negotiated Rate	$91.90
Rate for Payer: Aetna Commercial	$69.84
Rate for Payer: Aetna Medicare Advantage	$55.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.87
Rate for Payer: Cigna Commercial	$91.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$40.44
Rate for Payer: Qualcare PPO/HMO/WC	$27.57
Rate for Payer: UnitedHealthcare Community & State	$4.43
Rate for Payer: Wellpoint Medicaid Managed Care	$4.87

Know your out-of-pocket cost for care.

All Charges