Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SHAFT SCREWDRIVER 165MM STARD

Facility

$1,460.85

Hospital Charge Code	270686030
Hospital Revenue Code	272
Min. Negotiated Rate	$35.21
Max. Negotiated Rate	$730.42
Rate for Payer: Aetna Commercial	$555.12
Rate for Payer: Aetna Medicare Advantage	$438.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$372.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$372.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$372.52
Rate for Payer: Cigna Commercial	$730.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$438.25
Rate for Payer: Oxford Commercial	$292.17
Rate for Payer: Qualcare PPO/HMO/WC	$219.13
Rate for Payer: UnitedHealthcare Commercial	$292.17
Rate for Payer: UnitedHealthcare Community & State	$35.21
Rate for Payer: Wellpoint Medicaid Managed Care	$38.71

SHAFT T25 3.5 MM 280 MM

Facility

$2,355.15

Hospital Charge Code	270691506
Hospital Revenue Code	272
Min. Negotiated Rate	$56.76
Max. Negotiated Rate	$1,177.58
Rate for Payer: Aetna Commercial	$894.96
Rate for Payer: Aetna Medicare Advantage	$706.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$600.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$600.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$600.56
Rate for Payer: Cigna Commercial	$1,177.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$706.54
Rate for Payer: Oxford Commercial	$471.03
Rate for Payer: Qualcare PPO/HMO/WC	$353.27
Rate for Payer: UnitedHealthcare Commercial	$471.03
Rate for Payer: UnitedHealthcare Community & State	$56.76
Rate for Payer: Wellpoint Medicaid Managed Care	$62.41

SHAFT T25 3.5 MM 280 MM

Facility

$2,355.15

Hospital Charge Code	270691506
Hospital Revenue Code	272
Min. Negotiated Rate	$353.27
Max. Negotiated Rate	$353.27
Rate for Payer: Qualcare PPO/HMO/WC	$353.27

SHAMPOO 2OZ

Facility

$34.60

Hospital Charge Code	6004873
Hospital Revenue Code	251
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$5.19
Rate for Payer: Qualcare PPO/HMO/WC	$5.19

SHAMPOO 2OZ

Facility

$34.60

Hospital Charge Code	6004873
Hospital Revenue Code	251
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$17.30
Rate for Payer: Aetna Commercial	$13.15
Rate for Payer: Aetna Medicare Advantage	$10.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.82
Rate for Payer: Cigna Commercial	$17.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.38
Rate for Payer: Oxford Commercial	$6.92
Rate for Payer: Qualcare PPO/HMO/WC	$5.19
Rate for Payer: UnitedHealthcare Commercial	$6.92
Rate for Payer: UnitedHealthcare Community & State	$0.83
Rate for Payer: Wellpoint Medicaid Managed Care	$0.92

SHAMPOO/CONDITIONER RINSE

Facility

$9.59

Hospital Charge Code	270649503
Hospital Revenue Code	272
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$1.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.44

SHAMPOO/CONDITIONER RINSE

Facility

$9.59

Hospital Charge Code	270649503
Hospital Revenue Code	272
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.79
Rate for Payer: Aetna Commercial	$3.64
Rate for Payer: Aetna Medicare Advantage	$2.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.45
Rate for Payer: Cigna Commercial	$4.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.88
Rate for Payer: Oxford Commercial	$1.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.44
Rate for Payer: UnitedHealthcare Commercial	$1.92
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.25

SHAMPOO NO RINSE 8OZ

Facility

$19.25

Hospital Charge Code	270301955
Hospital Revenue Code	270
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.62
Rate for Payer: Aetna Commercial	$7.32
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.91
Rate for Payer: Cigna Commercial	$9.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.78
Rate for Payer: Oxford Commercial	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.89
Rate for Payer: UnitedHealthcare Commercial	$3.85
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

SHAMPOO NO RINSE 8OZ

Facility

$19.25

Hospital Charge Code	270301955
Hospital Revenue Code	270
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$2.89
Rate for Payer: Qualcare PPO/HMO/WC	$2.89

SHANK 5.5 X 25MM

Facility

$5,060.00

Hospital Charge Code	270667321
Hospital Revenue Code	278
Min. Negotiated Rate	$759.00
Max. Negotiated Rate	$1,224.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,012.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,224.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,113.20
Rate for Payer: Qualcare PPO/HMO/WC	$759.00

SHANK 5.5 X 25MM

Facility

$5,060.00

Hospital Charge Code	270667321
Hospital Revenue Code	278
Min. Negotiated Rate	$121.95
Max. Negotiated Rate	$2,530.00
Rate for Payer: Aetna Commercial	$1,922.80
Rate for Payer: Aetna Medicare Advantage	$1,518.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,290.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,290.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,012.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,290.30
Rate for Payer: Cigna Commercial	$2,530.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,224.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,113.20
Rate for Payer: Qualcare PPO/HMO/WC	$759.00
Rate for Payer: UnitedHealthcare Community & State	$121.95
Rate for Payer: Wellpoint Medicaid Managed Care	$134.09

SHANK 6.5 X 30MM

Facility

$5,060.00

Hospital Charge Code	270667322
Hospital Revenue Code	278
Min. Negotiated Rate	$759.00
Max. Negotiated Rate	$1,224.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,012.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,224.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,113.20
Rate for Payer: Qualcare PPO/HMO/WC	$759.00

SHANK 6.5 X 30MM

Facility

$5,060.00

Hospital Charge Code	270667322
Hospital Revenue Code	278
Min. Negotiated Rate	$121.95
Max. Negotiated Rate	$2,530.00
Rate for Payer: Aetna Commercial	$1,922.80
Rate for Payer: Aetna Medicare Advantage	$1,518.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,290.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,290.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,012.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,290.30
Rate for Payer: Cigna Commercial	$2,530.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,224.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,113.20
Rate for Payer: Qualcare PPO/HMO/WC	$759.00
Rate for Payer: UnitedHealthcare Community & State	$121.95
Rate for Payer: Wellpoint Medicaid Managed Care	$134.09

SHANK 6.5X40MM

Facility

$500.00

Hospital Charge Code	270702999
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

SHANK 6.5X40MM

Facility

$500.00

Hospital Charge Code	270702999
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

SHANK 6.5X45MM

Facility

$3,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270705425
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

SHANK 6.5X45MM

Facility

$3,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270705425
Hospital Revenue Code	278
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$99.38

SHANK 7.5X40MM

Facility

$3,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270705426
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

SHANK 7.5X40MM

Facility

$3,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270705426
Hospital Revenue Code	278
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$99.38

SHANK MAS PLIF 5.5X30MM EZ

Facility

$5,060.00

Hospital Charge Code	270663764
Hospital Revenue Code	270
Min. Negotiated Rate	$759.00
Max. Negotiated Rate	$759.00
Rate for Payer: Qualcare PPO/HMO/WC	$759.00

SHANK MAS PLIF 5.5X30MM EZ

Facility

$5,060.00

Hospital Charge Code	270663764
Hospital Revenue Code	270
Min. Negotiated Rate	$121.95
Max. Negotiated Rate	$2,530.00
Rate for Payer: Aetna Commercial	$1,922.80
Rate for Payer: Aetna Medicare Advantage	$1,518.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,290.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,290.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,290.30
Rate for Payer: Cigna Commercial	$2,530.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,518.00
Rate for Payer: Oxford Commercial	$1,012.00
Rate for Payer: Qualcare PPO/HMO/WC	$759.00
Rate for Payer: UnitedHealthcare Commercial	$1,012.00
Rate for Payer: UnitedHealthcare Community & State	$121.95
Rate for Payer: Wellpoint Medicaid Managed Care	$134.09

SHANK MAS PLIF 5.5X35MM EZ

Facility

$2,375.00

Hospital Charge Code	270663765
Hospital Revenue Code	270
Min. Negotiated Rate	$356.25
Max. Negotiated Rate	$356.25
Rate for Payer: Qualcare PPO/HMO/WC	$356.25

SHANK MAS PLIF 5.5X35MM EZ

Facility

$2,375.00

Hospital Charge Code	270663765
Hospital Revenue Code	270
Min. Negotiated Rate	$57.24
Max. Negotiated Rate	$1,187.50
Rate for Payer: Aetna Commercial	$902.50
Rate for Payer: Aetna Medicare Advantage	$712.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$605.62
Rate for Payer: Cigna Commercial	$1,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$712.50
Rate for Payer: Oxford Commercial	$475.00
Rate for Payer: Qualcare PPO/HMO/WC	$356.25
Rate for Payer: UnitedHealthcare Commercial	$475.00
Rate for Payer: UnitedHealthcare Community & State	$57.24
Rate for Payer: Wellpoint Medicaid Managed Care	$62.94

SHANK MODULEX 7.5X50 ATS

Facility

$25,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270698930
Hospital Revenue Code	278
Min. Negotiated Rate	$614.55
Max. Negotiated Rate	$12,750.00
Rate for Payer: Aetna Commercial	$9,690.00
Rate for Payer: Aetna Medicare Advantage	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,502.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,502.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,502.50
Rate for Payer: Cigna Commercial	$12,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,171.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,610.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,825.00
Rate for Payer: UnitedHealthcare Community & State	$614.55
Rate for Payer: Wellpoint Medicaid Managed Care	$675.75

SHANK MODULEX 7.5X50 ATS

Facility

$25,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270698930
Hospital Revenue Code	278
Min. Negotiated Rate	$3,825.00
Max. Negotiated Rate	$6,171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,171.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,610.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,825.00

Know your out-of-pocket cost for care.

All Charges