Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

6.5X 45MM SHANKS

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270697218
Hospital Revenue Code	278
Min. Negotiated Rate	$162.43
Max. Negotiated Rate	$3,370.00
Rate for Payer: Aetna Commercial	$2,561.20
Rate for Payer: Aetna Medicare Advantage	$2,022.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,718.70
Rate for Payer: Cigna Commercial	$3,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,482.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00
Rate for Payer: UnitedHealthcare Community & State	$162.43
Rate for Payer: Wellpoint Medicaid Managed Care	$178.61

6.5 X 50MM POLY SCREW

Facility

$8,900.00

Hospital Charge Code	270665485
Hospital Revenue Code	278
Min. Negotiated Rate	$1,335.00
Max. Negotiated Rate	$2,153.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,153.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,958.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,335.00

6.5 X 50MM POLY SCREW

Facility

$8,900.00

Hospital Charge Code	270665485
Hospital Revenue Code	278
Min. Negotiated Rate	$214.49
Max. Negotiated Rate	$4,450.00
Rate for Payer: Aetna Commercial	$3,382.00
Rate for Payer: Aetna Medicare Advantage	$2,670.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,269.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,269.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,780.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,269.50
Rate for Payer: Cigna Commercial	$4,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,153.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,958.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,335.00
Rate for Payer: UnitedHealthcare Community & State	$214.49
Rate for Payer: Wellpoint Medicaid Managed Care	$235.85

6.5X50MM SCREW

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270703946
Hospital Revenue Code	278
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$877.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$797.50
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

6.5X50MM SCREW

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270703946
Hospital Revenue Code	278
Min. Negotiated Rate	$87.36
Max. Negotiated Rate	$1,812.50
Rate for Payer: Aetna Commercial	$1,377.50
Rate for Payer: Aetna Medicare Advantage	$1,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$924.38
Rate for Payer: Cigna Commercial	$1,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$797.50
Rate for Payer: Qualcare PPO/HMO/WC	$543.75
Rate for Payer: UnitedHealthcare Community & State	$87.36
Rate for Payer: Wellpoint Medicaid Managed Care	$96.06

6.5X55MM SCREW

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270698586
Hospital Revenue Code	278
Min. Negotiated Rate	$114.47
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,805.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,045.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Community & State	$114.47
Rate for Payer: Wellpoint Medicaid Managed Care	$125.88

6.5X55MM SCREW

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270698586
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,045.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

6.5 X 95 X 20TL SCREW

Facility

$1,235.50

Hospital Charge Code	270656461
Hospital Revenue Code	278
Min. Negotiated Rate	$185.32
Max. Negotiated Rate	$298.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$247.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$298.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$271.81
Rate for Payer: Qualcare PPO/HMO/WC	$185.32

6.5 X 95 X 20TL SCREW

Facility

$1,235.50

Hospital Charge Code	270656461
Hospital Revenue Code	278
Min. Negotiated Rate	$29.78
Max. Negotiated Rate	$617.75
Rate for Payer: Aetna Commercial	$469.49
Rate for Payer: Aetna Medicare Advantage	$370.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$315.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$315.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$247.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$315.05
Rate for Payer: Cigna Commercial	$617.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$298.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$271.81
Rate for Payer: Qualcare PPO/HMO/WC	$185.32
Rate for Payer: UnitedHealthcare Community & State	$29.78
Rate for Payer: Wellpoint Medicaid Managed Care	$32.74

6.7X80 CANN. SCREW

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270679508
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

6.7X80 CANN. SCREW

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270679508
Hospital Revenue Code	278
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

6.9-16 MM THREAD SCREW 75

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270680283
Hospital Revenue Code	278
Min. Negotiated Rate	$53.02
Max. Negotiated Rate	$1,100.00
Rate for Payer: Aetna Commercial	$836.00
Rate for Payer: Aetna Medicare Advantage	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$561.00
Rate for Payer: Cigna Commercial	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$330.00
Rate for Payer: UnitedHealthcare Community & State	$53.02
Rate for Payer: Wellpoint Medicaid Managed Care	$58.30

6.9-16 MM THREAD SCREW 75

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270680283
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$532.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$330.00

#6 CROSSLINK

Facility

$8,010.00

Service Code	HCPCS C1713
Hospital Charge Code	270683988
Hospital Revenue Code	278
Min. Negotiated Rate	$1,201.50
Max. Negotiated Rate	$1,938.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,602.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,938.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,762.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,201.50

#6 CROSSLINK

Facility

$8,010.00

Service Code	HCPCS C1713
Hospital Charge Code	270683988
Hospital Revenue Code	278
Min. Negotiated Rate	$193.04
Max. Negotiated Rate	$4,005.00
Rate for Payer: Aetna Commercial	$3,043.80
Rate for Payer: Aetna Medicare Advantage	$2,403.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,042.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,042.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,602.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,042.55
Rate for Payer: Cigna Commercial	$4,005.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,938.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,762.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,201.50
Rate for Payer: UnitedHealthcare Community & State	$193.04
Rate for Payer: Wellpoint Medicaid Managed Care	$212.26

6Fr Neuron Max sheath 80 MP

Facility

$2,475.00

Hospital Charge Code	270684222S
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

6Fr Neuron Max sheath 80 MP

Facility

$2,475.00

Hospital Charge Code	270684222S
Hospital Revenue Code	272
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$742.50
Rate for Payer: Oxford Commercial	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$495.00
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

6FR NEURON MAX SHEATH 80 MP

Facility

$2,475.00

Hospital Charge Code	270684222N
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

6FR NEURON MAX SHEATH 80 MP

Facility

$2,475.00

Hospital Charge Code	270684222N
Hospital Revenue Code	272
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$742.50
Rate for Payer: Oxford Commercial	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$495.00
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

6Fr Neuron Max sheath 80 Str

Facility

$2,475.00

Hospital Charge Code	270685061S
Hospital Revenue Code	272
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$742.50
Rate for Payer: Oxford Commercial	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$495.00
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

6Fr Neuron Max sheath 80 Str

Facility

$2,475.00

Hospital Charge Code	270685061N
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

6Fr Neuron Max sheath 80 Str

Facility

$2,475.00

Hospital Charge Code	270685061S
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

6Fr Neuron Max sheath 80 Str

Facility

$2,475.00

Hospital Charge Code	270685061N
Hospital Revenue Code	272
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$742.50
Rate for Payer: Oxford Commercial	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$495.00
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

6Fr Neuron Max sheath 90 MP

Facility

$2,475.00

Hospital Charge Code	270685063N
Hospital Revenue Code	272
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$742.50
Rate for Payer: Oxford Commercial	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$495.00
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

6Fr Neuron Max sheath 90 MP

Facility

$2,475.00

Hospital Charge Code	270685063N
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

Know your out-of-pocket cost for care.

All Charges