Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CORTEX SCREW SELF TAP 30

Facility

$333.00

Service Code	HCPCS C1713
Hospital Charge Code	270656616
Hospital Revenue Code	278
Min. Negotiated Rate	$49.95
Max. Negotiated Rate	$80.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$73.26
Rate for Payer: Qualcare PPO/HMO/WC	$49.95

CORTEX SCREW SELF TAP 30

Facility

$333.00

Service Code	HCPCS C1713
Hospital Charge Code	270656616
Hospital Revenue Code	278
Min. Negotiated Rate	$8.03
Max. Negotiated Rate	$166.50
Rate for Payer: Aetna Commercial	$126.54
Rate for Payer: Aetna Medicare Advantage	$99.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.92
Rate for Payer: Cigna Commercial	$166.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$73.26
Rate for Payer: Qualcare PPO/HMO/WC	$49.95
Rate for Payer: UnitedHealthcare Community & State	$8.03
Rate for Payer: Wellpoint Medicaid Managed Care	$8.82

CORT FIX POLYAX SCR 5.5 5X45MM

Facility

$7,254.30

Service Code	HCPCS C1713
Hospital Charge Code	270691061
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

CORT FIX POLYAX SCR 5.5 5X45MM

Facility

$7,254.30

Service Code	HCPCS C1713
Hospital Charge Code	270691061
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

CORTICAINE CREAM/30GM

Facility

$23.00

Hospital Charge Code	60634298
Hospital Revenue Code	250
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

CORTICAINE CREAM/30GM

Facility

$23.00

Hospital Charge Code	60634298
Hospital Revenue Code	250
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$8.74
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.90
Rate for Payer: Oxford Commercial	$4.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$4.60
Rate for Payer: UnitedHealthcare Community & State	$0.55
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

CORTICAL 3.5MMX18MM

Facility

$200.00

Hospital Charge Code	270656486
Hospital Revenue Code	278
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$48.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

CORTICAL 3.5MMX18MM

Facility

$200.00

Hospital Charge Code	270656486
Hospital Revenue Code	278
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Community & State	$4.82
Rate for Payer: Wellpoint Medicaid Managed Care	$5.30

CORTICAL 3.5MMX20MM

Facility

$200.00

Hospital Charge Code	270656489
Hospital Revenue Code	278
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Community & State	$4.82
Rate for Payer: Wellpoint Medicaid Managed Care	$5.30

CORTICAL 3.5MMX20MM

Facility

$200.00

Hospital Charge Code	270656489
Hospital Revenue Code	278
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$48.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

CORTICAL 3.5X14MM

Facility

$200.00

Hospital Charge Code	270656490
Hospital Revenue Code	278
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$48.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

CORTICAL 3.5X14MM

Facility

$200.00

Hospital Charge Code	270656490
Hospital Revenue Code	278
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Community & State	$4.82
Rate for Payer: Wellpoint Medicaid Managed Care	$5.30

CORTICAL BONE SCR 5.0MM X 36MM

Facility

$744.00

Service Code	HCPCS C1713
Hospital Charge Code	270681530
Hospital Revenue Code	278
Min. Negotiated Rate	$17.93
Max. Negotiated Rate	$372.00
Rate for Payer: Aetna Commercial	$282.72
Rate for Payer: Aetna Medicare Advantage	$223.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.72
Rate for Payer: Cigna Commercial	$372.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$163.68
Rate for Payer: Qualcare PPO/HMO/WC	$111.60
Rate for Payer: UnitedHealthcare Community & State	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$19.72

CORTICAL BONE SCR 5.0MM X 36MM

Facility

$744.00

Service Code	HCPCS C1713
Hospital Charge Code	270681530
Hospital Revenue Code	278
Min. Negotiated Rate	$111.60
Max. Negotiated Rate	$180.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$163.68
Rate for Payer: Qualcare PPO/HMO/WC	$111.60

CORTICAL BONE SCR 5.0MM X 44MM

Facility

$744.00

Service Code	HCPCS C1713
Hospital Charge Code	270680795
Hospital Revenue Code	278
Min. Negotiated Rate	$111.60
Max. Negotiated Rate	$180.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$163.68
Rate for Payer: Qualcare PPO/HMO/WC	$111.60

CORTICAL BONE SCR 5.0MM X 44MM

Facility

$744.00

Service Code	HCPCS C1713
Hospital Charge Code	270680795
Hospital Revenue Code	278
Min. Negotiated Rate	$17.93
Max. Negotiated Rate	$372.00
Rate for Payer: Aetna Commercial	$282.72
Rate for Payer: Aetna Medicare Advantage	$223.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.72
Rate for Payer: Cigna Commercial	$372.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$163.68
Rate for Payer: Qualcare PPO/HMO/WC	$111.60
Rate for Payer: UnitedHealthcare Community & State	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$19.72

CORTICAL BONE SCR 5.0MM X 50MM

Facility

$744.00

Service Code	HCPCS C1713
Hospital Charge Code	270680794
Hospital Revenue Code	278
Min. Negotiated Rate	$17.93
Max. Negotiated Rate	$372.00
Rate for Payer: Aetna Commercial	$282.72
Rate for Payer: Aetna Medicare Advantage	$223.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.72
Rate for Payer: Cigna Commercial	$372.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$163.68
Rate for Payer: Qualcare PPO/HMO/WC	$111.60
Rate for Payer: UnitedHealthcare Community & State	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$19.72

CORTICAL BONE SCR 5.0MM X 50MM

Facility

$744.00

Service Code	HCPCS C1713
Hospital Charge Code	270680794
Hospital Revenue Code	278
Min. Negotiated Rate	$111.60
Max. Negotiated Rate	$180.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$163.68
Rate for Payer: Qualcare PPO/HMO/WC	$111.60

CORTICAL BONE SCR 5.0MM X 60 M

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270688656
Hospital Revenue Code	278
Min. Negotiated Rate	$19.28
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$21.20

CORTICAL BONE SCR 5.0MM X 60 M

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270688656
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

CORTICAL BONE SCREW 2.0MM X 40

Facility

$768.00

Service Code	HCPCS C1713
Hospital Charge Code	270681749
Hospital Revenue Code	278
Min. Negotiated Rate	$115.20
Max. Negotiated Rate	$185.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$168.96
Rate for Payer: Qualcare PPO/HMO/WC	$115.20

CORTICAL BONE SCREW 2.0MM X 40

Facility

$768.00

Service Code	HCPCS C1713
Hospital Charge Code	270681749
Hospital Revenue Code	278
Min. Negotiated Rate	$18.51
Max. Negotiated Rate	$384.00
Rate for Payer: Aetna Commercial	$291.84
Rate for Payer: Aetna Medicare Advantage	$230.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.84
Rate for Payer: Cigna Commercial	$384.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$168.96
Rate for Payer: Qualcare PPO/HMO/WC	$115.20
Rate for Payer: UnitedHealthcare Community & State	$18.51
Rate for Payer: Wellpoint Medicaid Managed Care	$20.35

CORTICAL BONE SCREW 5.0MMX42M

Facility

$722.40

Service Code	HCPCS C1713
Hospital Charge Code	270679177
Hospital Revenue Code	278
Min. Negotiated Rate	$108.36
Max. Negotiated Rate	$174.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.93
Rate for Payer: Qualcare PPO/HMO/WC	$108.36

CORTICAL BONE SCREW 5.0MMX42M

Facility

$722.40

Service Code	HCPCS C1713
Hospital Charge Code	270679177
Hospital Revenue Code	278
Min. Negotiated Rate	$17.41
Max. Negotiated Rate	$361.20
Rate for Payer: Aetna Commercial	$274.51
Rate for Payer: Aetna Medicare Advantage	$216.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.21
Rate for Payer: Cigna Commercial	$361.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.93
Rate for Payer: Qualcare PPO/HMO/WC	$108.36
Rate for Payer: UnitedHealthcare Community & State	$17.41
Rate for Payer: Wellpoint Medicaid Managed Care	$19.14

CORTICAL BONE SCREW 5.0MM X 46

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270684664
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

Know your out-of-pocket cost for care.

All Charges