Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 SCREW 5.0MMX48MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270684396
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 SCREW 5.0MMX48MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270684396
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 5.0MMX48MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270684349
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 SCREW 5.0MMX48MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270684349
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 6.5X50MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270704526
Hospital Revenue Code	278
Min. Negotiated Rate	$75.31
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$75.31
Rate for Payer: Wellpoint Medicaid Managed Care	$82.81

CORTICAL BONE SCREW 6.5X50MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270704526
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

CORTICAL CREW 5.0MM X 40MM

Facility

$1,107.95

Hospital Charge Code	270657839
Hospital Revenue Code	278
Min. Negotiated Rate	$166.19
Max. Negotiated Rate	$268.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$221.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$243.75
Rate for Payer: Qualcare PPO/HMO/WC	$166.19

CORTICAL CREW 5.0MM X 40MM

Facility

$1,107.95

Hospital Charge Code	270657839
Hospital Revenue Code	278
Min. Negotiated Rate	$26.70
Max. Negotiated Rate	$553.98
Rate for Payer: Aetna Commercial	$421.02
Rate for Payer: Aetna Medicare Advantage	$332.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$282.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$282.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$221.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$282.53
Rate for Payer: Cigna Commercial	$553.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$243.75
Rate for Payer: Qualcare PPO/HMO/WC	$166.19
Rate for Payer: UnitedHealthcare Community & State	$26.70
Rate for Payer: Wellpoint Medicaid Managed Care	$29.36

CORTICAL SCREW 2.7 X 14 MM

Facility

$225.00

Service Code	HCPCS C1713
Hospital Charge Code	270667345
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

CORTICAL SCREW 2.7 X 14 MM

Facility

$225.00

Service Code	HCPCS C1713
Hospital Charge Code	270667345
Hospital Revenue Code	278
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

CORTICAL SCREW 3.5MM X 10MM

Facility

$176.95

Hospital Charge Code	270657736
Hospital Revenue Code	278
Min. Negotiated Rate	$26.54
Max. Negotiated Rate	$42.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.93
Rate for Payer: Qualcare PPO/HMO/WC	$26.54

CORTICAL SCREW 3.5MM X 10MM

Facility

$176.95

Hospital Charge Code	270657736
Hospital Revenue Code	278
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$88.47
Rate for Payer: Aetna Commercial	$67.24
Rate for Payer: Aetna Medicare Advantage	$53.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.12
Rate for Payer: Cigna Commercial	$88.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.93
Rate for Payer: Qualcare PPO/HMO/WC	$26.54
Rate for Payer: UnitedHealthcare Community & State	$4.26
Rate for Payer: Wellpoint Medicaid Managed Care	$4.69

CORTICAL SCREW 3.5MM X 13MM

Facility

$495.00

Service Code	HCPCS C1713
Hospital Charge Code	270661776
Hospital Revenue Code	278
Min. Negotiated Rate	$11.93
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$188.10
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$74.25
Rate for Payer: UnitedHealthcare Community & State	$11.93
Rate for Payer: Wellpoint Medicaid Managed Care	$13.12

CORTICAL SCREW 3.5MM X 13MM

Facility

$495.00

Service Code	HCPCS C1713
Hospital Charge Code	270661776
Hospital Revenue Code	278
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$119.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

CORTICAL SCREW 3.5MM X 14MM

Facility

$176.95

Hospital Charge Code	270657737
Hospital Revenue Code	278
Min. Negotiated Rate	$26.54
Max. Negotiated Rate	$42.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.93
Rate for Payer: Qualcare PPO/HMO/WC	$26.54

CORTICAL SCREW 3.5MM X 14MM

Facility

$176.95

Hospital Charge Code	270657737
Hospital Revenue Code	278
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$88.47
Rate for Payer: Aetna Commercial	$67.24
Rate for Payer: Aetna Medicare Advantage	$53.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.12
Rate for Payer: Cigna Commercial	$88.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.93
Rate for Payer: Qualcare PPO/HMO/WC	$26.54
Rate for Payer: UnitedHealthcare Community & State	$4.26
Rate for Payer: Wellpoint Medicaid Managed Care	$4.69

CORTICAL SCREW 3.5MM X 14MM

Facility

$176.95

Hospital Charge Code	270657741
Hospital Revenue Code	278
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$88.47
Rate for Payer: Aetna Commercial	$67.24
Rate for Payer: Aetna Medicare Advantage	$53.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.12
Rate for Payer: Cigna Commercial	$88.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.93
Rate for Payer: Qualcare PPO/HMO/WC	$26.54
Rate for Payer: UnitedHealthcare Community & State	$4.26
Rate for Payer: Wellpoint Medicaid Managed Care	$4.69

CORTICAL SCREW 3.5MM X 14MM

Facility

$176.95

Hospital Charge Code	270657741
Hospital Revenue Code	278
Min. Negotiated Rate	$26.54
Max. Negotiated Rate	$42.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.93
Rate for Payer: Qualcare PPO/HMO/WC	$26.54

CORTICAL SCREW 3.5MM X 16MM

Facility

$176.95

Hospital Charge Code	270657743
Hospital Revenue Code	278
Min. Negotiated Rate	$26.54
Max. Negotiated Rate	$42.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.93
Rate for Payer: Qualcare PPO/HMO/WC	$26.54

CORTICAL SCREW 3.5MM X 16MM

Facility

$122.15

Hospital Charge Code	270657760
Hospital Revenue Code	278
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$61.08
Rate for Payer: Aetna Commercial	$46.42
Rate for Payer: Aetna Medicare Advantage	$36.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.15
Rate for Payer: Cigna Commercial	$61.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.87
Rate for Payer: Qualcare PPO/HMO/WC	$18.32
Rate for Payer: UnitedHealthcare Community & State	$2.94
Rate for Payer: Wellpoint Medicaid Managed Care	$3.24

CORTICAL SCREW 3.5MM X 16MM

Facility

$122.15

Hospital Charge Code	270657760
Hospital Revenue Code	278
Min. Negotiated Rate	$18.32
Max. Negotiated Rate	$29.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.87
Rate for Payer: Qualcare PPO/HMO/WC	$18.32

CORTICAL SCREW 3.5MM X 16MM

Facility

$176.95

Hospital Charge Code	270657743
Hospital Revenue Code	278
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$88.47
Rate for Payer: Aetna Commercial	$67.24
Rate for Payer: Aetna Medicare Advantage	$53.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.12
Rate for Payer: Cigna Commercial	$88.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.93
Rate for Payer: Qualcare PPO/HMO/WC	$26.54
Rate for Payer: UnitedHealthcare Community & State	$4.26
Rate for Payer: Wellpoint Medicaid Managed Care	$4.69

CORTICAL SCREW 3.5 X 14MM

Facility

$247.50

Service Code	HCPCS C1713
Hospital Charge Code	270688913
Hospital Revenue Code	278
Min. Negotiated Rate	$37.12
Max. Negotiated Rate	$59.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$37.12

CORTICAL SCREW 3.5 X 14MM

Facility

$247.50

Service Code	HCPCS C1713
Hospital Charge Code	270688913
Hospital Revenue Code	278
Min. Negotiated Rate	$5.96
Max. Negotiated Rate	$123.75
Rate for Payer: Aetna Commercial	$94.05
Rate for Payer: Aetna Medicare Advantage	$74.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.11
Rate for Payer: Cigna Commercial	$123.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$37.12
Rate for Payer: UnitedHealthcare Community & State	$5.96
Rate for Payer: Wellpoint Medicaid Managed Care	$6.56

Know your out-of-pocket cost for care.

All Charges