Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

6MM SMALL SPIRA C

Facility

$8,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270703918
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

6V30W HALOGEN BULB FOR BX40, I

Facility

$6.20

Hospital Charge Code	270665599
Hospital Revenue Code	270
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$3.10
Rate for Payer: Aetna Commercial	$2.36
Rate for Payer: Aetna Medicare Advantage	$1.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.58
Rate for Payer: Cigna Commercial	$3.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.86
Rate for Payer: Oxford Commercial	$1.24
Rate for Payer: Qualcare PPO/HMO/WC	$0.93
Rate for Payer: UnitedHealthcare Commercial	$1.24
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

6V30W HALOGEN BULB FOR BX40, I

Facility

$6.20

Hospital Charge Code	270665599
Hospital Revenue Code	270
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$0.93
Rate for Payer: Qualcare PPO/HMO/WC	$0.93

6 X 200 SHANTZ PIN

Facility

$887.95

Service Code	HCPCS C1713
Hospital Charge Code	270686263
Hospital Revenue Code	278
Min. Negotiated Rate	$133.19
Max. Negotiated Rate	$214.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$195.35
Rate for Payer: Qualcare PPO/HMO/WC	$133.19

6 X 200 SHANTZ PIN

Facility

$887.95

Service Code	HCPCS C1713
Hospital Charge Code	270686263
Hospital Revenue Code	278
Min. Negotiated Rate	$21.40
Max. Negotiated Rate	$443.98
Rate for Payer: Aetna Commercial	$337.42
Rate for Payer: Aetna Medicare Advantage	$266.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.43
Rate for Payer: Cigna Commercial	$443.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$195.35
Rate for Payer: Qualcare PPO/HMO/WC	$133.19
Rate for Payer: UnitedHealthcare Community & State	$21.40
Rate for Payer: Wellpoint Medicaid Managed Care	$23.53

6X25MM SDF SCREW

Facility

$950.00

Service Code	HCPCS C1713
Hospital Charge Code	270704184
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$229.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.00
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

6X25MM SDF SCREW

Facility

$950.00

Service Code	HCPCS C1713
Hospital Charge Code	270704184
Hospital Revenue Code	278
Min. Negotiated Rate	$22.89
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$361.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.00
Rate for Payer: Qualcare PPO/HMO/WC	$142.50
Rate for Payer: UnitedHealthcare Community & State	$22.89
Rate for Payer: Wellpoint Medicaid Managed Care	$25.18

6 X 40 SCREW

Facility

$7,254.30

Service Code	HCPCS C1713
Hospital Charge Code	270680777
Hospital Revenue Code	278
Min. Negotiated Rate	$174.83
Max. Negotiated Rate	$3,627.15
Rate for Payer: Aetna Commercial	$2,756.63
Rate for Payer: Aetna Medicare Advantage	$2,176.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,849.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,849.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,450.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,849.85
Rate for Payer: Cigna Commercial	$3,627.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,755.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,595.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,088.14
Rate for Payer: UnitedHealthcare Community & State	$174.83
Rate for Payer: Wellpoint Medicaid Managed Care	$192.24

6 X 40 SCREW

Facility

$7,254.30

Service Code	HCPCS C1713
Hospital Charge Code	270680777
Hospital Revenue Code	278
Min. Negotiated Rate	$1,088.14
Max. Negotiated Rate	$1,755.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,450.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,755.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,595.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,088.14

6X42X30MM SPACER 15DEGREES

Facility

$33,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270705941
Hospital Revenue Code	278
Min. Negotiated Rate	$798.31
Max. Negotiated Rate	$16,562.50
Rate for Payer: Aetna Commercial	$12,587.50
Rate for Payer: Aetna Medicare Advantage	$9,937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,446.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,446.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,446.88
Rate for Payer: Cigna Commercial	$16,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,016.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,287.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,968.75
Rate for Payer: UnitedHealthcare Community & State	$798.31
Rate for Payer: Wellpoint Medicaid Managed Care	$877.81

6X42X30MM SPACER 15DEGREES

Facility

$33,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270705941
Hospital Revenue Code	278
Min. Negotiated Rate	$4,968.75
Max. Negotiated Rate	$8,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,016.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,287.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,968.75

6 X45 SCREW

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270673341
Hospital Revenue Code	278
Min. Negotiated Rate	$210.88
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$210.88
Rate for Payer: Wellpoint Medicaid Managed Care	$231.88

6 X45 SCREW

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270673341
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

6 X 50 SCREW

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270673342
Hospital Revenue Code	278
Min. Negotiated Rate	$210.88
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$210.88
Rate for Payer: Wellpoint Medicaid Managed Care	$231.88

6 X 50 SCREW

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270673342
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

6 X 55 SCREW

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270679974
Hospital Revenue Code	278
Min. Negotiated Rate	$210.88
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$210.88
Rate for Payer: Wellpoint Medicaid Managed Care	$231.88

6 X 55 SCREW

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270679974
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

6 X 60 SCREW

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270679975
Hospital Revenue Code	278
Min. Negotiated Rate	$210.88
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$210.88
Rate for Payer: Wellpoint Medicaid Managed Care	$231.88

6 X 60 SCREW

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270679975
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

70MM ROD

Facility

$875.00

Hospital Charge Code	270702888
Hospital Revenue Code	278
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

70MM ROD

Facility

$875.00

Hospital Charge Code	270702888
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

7.3CANNULATED LOCKING SCREW 35

Facility

$1,239.10

Service Code	HCPCS C1713
Hospital Charge Code	270679065
Hospital Revenue Code	278
Min. Negotiated Rate	$185.87
Max. Negotiated Rate	$299.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$247.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$299.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$272.60
Rate for Payer: Qualcare PPO/HMO/WC	$185.87

7.3CANNULATED LOCKING SCREW 35

Facility

$1,239.10

Service Code	HCPCS C1713
Hospital Charge Code	270679065
Hospital Revenue Code	278
Min. Negotiated Rate	$29.86
Max. Negotiated Rate	$619.55
Rate for Payer: Aetna Commercial	$470.86
Rate for Payer: Aetna Medicare Advantage	$371.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$315.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$315.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$247.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$315.97
Rate for Payer: Cigna Commercial	$619.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$299.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$272.60
Rate for Payer: Qualcare PPO/HMO/WC	$185.87
Rate for Payer: UnitedHealthcare Community & State	$29.86
Rate for Payer: Wellpoint Medicaid Managed Care	$32.84

7.3 CANNULATED LOCKING SCREW 7

Facility

$1,239.10

Service Code	HCPCS C1713
Hospital Charge Code	270679066
Hospital Revenue Code	278
Min. Negotiated Rate	$185.87
Max. Negotiated Rate	$299.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$247.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$299.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$272.60
Rate for Payer: Qualcare PPO/HMO/WC	$185.87

7.3 CANNULATED LOCKING SCREW 7

Facility

$1,239.10

Service Code	HCPCS C1713
Hospital Charge Code	270679066
Hospital Revenue Code	278
Min. Negotiated Rate	$29.86
Max. Negotiated Rate	$619.55
Rate for Payer: Aetna Commercial	$470.86
Rate for Payer: Aetna Medicare Advantage	$371.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$315.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$315.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$247.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$315.97
Rate for Payer: Cigna Commercial	$619.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$299.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$272.60
Rate for Payer: Qualcare PPO/HMO/WC	$185.87
Rate for Payer: UnitedHealthcare Community & State	$29.86
Rate for Payer: Wellpoint Medicaid Managed Care	$32.84

Know your out-of-pocket cost for care.

All Charges