Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

3.5 X 14 F.A. SCREW

Facility

$5,815.00

Service Code	HCPCS C1713
Hospital Charge Code	270688889
Hospital Revenue Code	278
Min. Negotiated Rate	$140.14
Max. Negotiated Rate	$2,907.50
Rate for Payer: Aetna Commercial	$2,209.70
Rate for Payer: Aetna Medicare Advantage	$1,744.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,482.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,482.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,163.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,482.83
Rate for Payer: Cigna Commercial	$2,907.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,407.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,279.30
Rate for Payer: Qualcare PPO/HMO/WC	$872.25
Rate for Payer: UnitedHealthcare Community & State	$140.14
Rate for Payer: Wellpoint Medicaid Managed Care	$154.10

3.5X14 LOCK SCREW

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270668409
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

3.5X14 LOCK SCREW

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270668409
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

3.5 X 14MM LOCKING SCREW

Facility

$841.50

Service Code	HCPCS C1713
Hospital Charge Code	270687469
Hospital Revenue Code	278
Min. Negotiated Rate	$20.28
Max. Negotiated Rate	$420.75
Rate for Payer: Aetna Commercial	$319.77
Rate for Payer: Aetna Medicare Advantage	$252.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.58
Rate for Payer: Cigna Commercial	$420.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$185.13
Rate for Payer: Qualcare PPO/HMO/WC	$126.22
Rate for Payer: UnitedHealthcare Community & State	$20.28
Rate for Payer: Wellpoint Medicaid Managed Care	$22.30

3.5 X 14MM LOCKING SCREW

Facility

$841.50

Service Code	HCPCS C1713
Hospital Charge Code	270687469
Hospital Revenue Code	278
Min. Negotiated Rate	$126.22
Max. Negotiated Rate	$203.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$168.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$185.13
Rate for Payer: Qualcare PPO/HMO/WC	$126.22

3.5X14MM SCREW

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	270705461
Hospital Revenue Code	278
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

3.5X14MM SCREW

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	270705461
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

3.5X16MM LOCKING SCREW

Facility

$1,520.03

Service Code	HCPCS C1713
Hospital Charge Code	270704803
Hospital Revenue Code	278
Min. Negotiated Rate	$228.00
Max. Negotiated Rate	$367.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$304.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$367.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$334.41
Rate for Payer: Qualcare PPO/HMO/WC	$228.00

3.5X16MM LOCKING SCREW

Facility

$1,520.03

Service Code	HCPCS C1713
Hospital Charge Code	270704803
Hospital Revenue Code	278
Min. Negotiated Rate	$36.63
Max. Negotiated Rate	$760.01
Rate for Payer: Aetna Commercial	$577.61
Rate for Payer: Aetna Medicare Advantage	$456.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$387.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$387.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$304.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$387.61
Rate for Payer: Cigna Commercial	$760.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$367.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$334.41
Rate for Payer: Qualcare PPO/HMO/WC	$228.00
Rate for Payer: UnitedHealthcare Community & State	$36.63
Rate for Payer: Wellpoint Medicaid Managed Care	$40.28

3.5 X 16MM NON-LOCKING SCREW

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270687471
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

3.5 X 16MM NON-LOCKING SCREW

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270687471
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

3.5 X 18MM LOCKING SCREW

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270687470
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

3.5 X 18MM LOCKING SCREW

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270687470
Hospital Revenue Code	278
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

3.5 X 20MM NON-LOCKING SCREW

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270687472
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

3.5 X 20MM NON-LOCKING SCREW

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270687472
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

3.5X26 LOCK SCREW

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270681354
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

3.5X26 LOCK SCREW

Facility

$425.00

Service Code	HCPCS C1713
Hospital Charge Code	270681321
Hospital Revenue Code	278
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

3.5X26 LOCK SCREW

Facility

$425.00

Service Code	HCPCS C1713
Hospital Charge Code	270681321
Hospital Revenue Code	278
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

3.5X26 LOCK SCREW

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270681354
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

3.5 X 26MM BONE SCREW

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	270665476
Hospital Revenue Code	278
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

3.5 X 26MM BONE SCREW

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	270665476
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

3.5X28 CORTICAL SCREW

Facility

$145.00

Hospital Charge Code	270656405
Hospital Revenue Code	278
Min. Negotiated Rate	$3.49
Max. Negotiated Rate	$72.50
Rate for Payer: Aetna Commercial	$55.10
Rate for Payer: Aetna Medicare Advantage	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.98
Rate for Payer: Cigna Commercial	$72.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$31.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.75
Rate for Payer: UnitedHealthcare Community & State	$3.49
Rate for Payer: Wellpoint Medicaid Managed Care	$3.84

3.5X28 CORTICAL SCREW

Facility

$145.00

Hospital Charge Code	270656405
Hospital Revenue Code	278
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$31.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

3.5X36 PT SCREW

Facility

$885.00

Service Code	HCPCS C1713
Hospital Charge Code	270703143
Hospital Revenue Code	278
Min. Negotiated Rate	$21.33
Max. Negotiated Rate	$442.50
Rate for Payer: Aetna Commercial	$336.30
Rate for Payer: Aetna Medicare Advantage	$265.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$225.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$225.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$225.68
Rate for Payer: Cigna Commercial	$442.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$194.70
Rate for Payer: Qualcare PPO/HMO/WC	$132.75
Rate for Payer: UnitedHealthcare Community & State	$21.33
Rate for Payer: Wellpoint Medicaid Managed Care	$23.45

3.5X36 PT SCREW

Facility

$885.00

Service Code	HCPCS C1713
Hospital Charge Code	270703143
Hospital Revenue Code	278
Min. Negotiated Rate	$132.75
Max. Negotiated Rate	$214.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$194.70
Rate for Payer: Qualcare PPO/HMO/WC	$132.75

Know your out-of-pocket cost for care.

All Charges