Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SET SCREW

Facility

$2,900.00

Hospital Charge Code	270662645
Hospital Revenue Code	278
Min. Negotiated Rate	$69.89
Max. Negotiated Rate	$1,450.00
Rate for Payer: Aetna Commercial	$1,102.00
Rate for Payer: Aetna Medicare Advantage	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$739.50
Rate for Payer: Cigna Commercial	$1,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$638.00
Rate for Payer: Qualcare PPO/HMO/WC	$435.00
Rate for Payer: UnitedHealthcare Community & State	$69.89
Rate for Payer: Wellpoint Medicaid Managed Care	$76.85

SET SCREW #11-4001

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705470
Hospital Revenue Code	278
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

SET SCREW #11-4001

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705470
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SET SCREW EVEREST POLYAXIAL

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	270670411
Hospital Revenue Code	278
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

SET SCREW EVEREST POLYAXIAL

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	270670411
Hospital Revenue Code	278
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

SET SCREW LATERAL PLATE NEXXT

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270693626
Hospital Revenue Code	278
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

SET SCREW LATERAL PLATE NEXXT

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270693626
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SET SCREW M8 BREAK OFF 8590855

Facility

$674.65

Hospital Charge Code	270630622
Hospital Revenue Code	278
Min. Negotiated Rate	$101.20
Max. Negotiated Rate	$163.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.42
Rate for Payer: Qualcare PPO/HMO/WC	$101.20

SET SCREW M8 BREAK OFF 8590855

Facility

$674.65

Hospital Charge Code	270630622
Hospital Revenue Code	278
Min. Negotiated Rate	$16.26
Max. Negotiated Rate	$337.32
Rate for Payer: Aetna Commercial	$256.37
Rate for Payer: Aetna Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.04
Rate for Payer: Cigna Commercial	$337.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.42
Rate for Payer: Qualcare PPO/HMO/WC	$101.20
Rate for Payer: UnitedHealthcare Community & State	$16.26
Rate for Payer: Wellpoint Medicaid Managed Care	$17.88

SET SCREW PEDICLE 4.15X9MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693617
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SET SCREW PEDICLE 4.15X9MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693617
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

SET SCREWS

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270705515
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

SET SCREWS

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270705515
Hospital Revenue Code	278
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$180.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Community & State	$11.45
Rate for Payer: Wellpoint Medicaid Managed Care	$12.59

SET SCREWS

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270703859
Hospital Revenue Code	278
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

SET SCREWS

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270703859
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SET SMN SCREW IM HIP HN1202

Facility

$668.85

Hospital Charge Code	270621506
Hospital Revenue Code	278
Min. Negotiated Rate	$16.12
Max. Negotiated Rate	$334.43
Rate for Payer: Aetna Commercial	$254.16
Rate for Payer: Aetna Medicare Advantage	$200.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.56
Rate for Payer: Cigna Commercial	$334.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.15
Rate for Payer: Qualcare PPO/HMO/WC	$100.33
Rate for Payer: UnitedHealthcare Community & State	$16.12
Rate for Payer: Wellpoint Medicaid Managed Care	$17.72

SET SMN SCREW IM HIP HN1202

Facility

$668.85

Hospital Charge Code	270621506
Hospital Revenue Code	278
Min. Negotiated Rate	$100.33
Max. Negotiated Rate	$161.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.15
Rate for Payer: Qualcare PPO/HMO/WC	$100.33

SET SPRAY FOR TISSO DEV 921031

Facility

$198.45

Hospital Charge Code	270635063
Hospital Revenue Code	272
Min. Negotiated Rate	$4.78
Max. Negotiated Rate	$99.22
Rate for Payer: Aetna Commercial	$75.41
Rate for Payer: Aetna Medicare Advantage	$59.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.60
Rate for Payer: Cigna Commercial	$99.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.53
Rate for Payer: Oxford Commercial	$39.69
Rate for Payer: Qualcare PPO/HMO/WC	$29.77
Rate for Payer: UnitedHealthcare Commercial	$39.69
Rate for Payer: UnitedHealthcare Community & State	$4.78
Rate for Payer: Wellpoint Medicaid Managed Care	$5.26

SET SPRAY FOR TISSO DEV 921031

Facility

$198.45

Hospital Charge Code	270635063
Hospital Revenue Code	272
Min. Negotiated Rate	$29.77
Max. Negotiated Rate	$29.77
Rate for Payer: Qualcare PPO/HMO/WC	$29.77

SET STRY ARTHRSC PUMP 0350202

Facility

$248.00

Hospital Charge Code	270620476
Hospital Revenue Code	272
Min. Negotiated Rate	$5.98
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$94.24
Rate for Payer: Aetna Medicare Advantage	$74.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.24
Rate for Payer: Cigna Commercial	$124.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.40
Rate for Payer: Oxford Commercial	$49.60
Rate for Payer: Qualcare PPO/HMO/WC	$37.20
Rate for Payer: UnitedHealthcare Commercial	$49.60
Rate for Payer: UnitedHealthcare Community & State	$5.98
Rate for Payer: Wellpoint Medicaid Managed Care	$6.57

SET STRY ARTHRSC PUMP 0350202

Facility

$248.00

Hospital Charge Code	270620476
Hospital Revenue Code	272
Min. Negotiated Rate	$37.20
Max. Negotiated Rate	$37.20
Rate for Payer: Qualcare PPO/HMO/WC	$37.20

SET SUTURE DISP

Facility

$28.17

Hospital Charge Code	270600744
Hospital Revenue Code	272
Min. Negotiated Rate	$4.23
Max. Negotiated Rate	$4.23
Rate for Payer: Qualcare PPO/HMO/WC	$4.23

SET SUTURE DISP

Facility

$28.17

Hospital Charge Code	270600744
Hospital Revenue Code	272
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$14.09
Rate for Payer: Aetna Commercial	$10.70
Rate for Payer: Aetna Medicare Advantage	$8.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.18
Rate for Payer: Cigna Commercial	$14.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.45
Rate for Payer: Oxford Commercial	$5.63
Rate for Payer: Qualcare PPO/HMO/WC	$4.23
Rate for Payer: UnitedHealthcare Commercial	$5.63
Rate for Payer: UnitedHealthcare Community & State	$0.68
Rate for Payer: Wellpoint Medicaid Managed Care	$0.75

SET SUTURE REMOVAL

Facility

$5.28

Hospital Charge Code	270302266
Hospital Revenue Code	272
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.64
Rate for Payer: Aetna Commercial	$2.01
Rate for Payer: Aetna Medicare Advantage	$1.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.35
Rate for Payer: Cigna Commercial	$2.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.58
Rate for Payer: Oxford Commercial	$1.06
Rate for Payer: Qualcare PPO/HMO/WC	$0.79
Rate for Payer: UnitedHealthcare Commercial	$1.06
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

SET SUTURE REMOVAL

Facility

$5.28

Hospital Charge Code	270302266W
Hospital Revenue Code	272
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.64
Rate for Payer: Aetna Commercial	$2.01
Rate for Payer: Aetna Medicare Advantage	$1.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.35
Rate for Payer: Cigna Commercial	$2.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.58
Rate for Payer: Oxford Commercial	$1.06
Rate for Payer: Qualcare PPO/HMO/WC	$0.79
Rate for Payer: UnitedHealthcare Commercial	$1.06
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

Know your out-of-pocket cost for care.

All Charges