Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW2.5TIHDLSCANNCOMPLT22MM

Facility

$2,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270698218
Hospital Revenue Code	278
Min. Negotiated Rate	$54.35
Max. Negotiated Rate	$1,127.50
Rate for Payer: Aetna Commercial	$856.90
Rate for Payer: Aetna Medicare Advantage	$676.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$575.02
Rate for Payer: Cigna Commercial	$1,127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$338.25
Rate for Payer: UnitedHealthcare Community & State	$54.35
Rate for Payer: Wellpoint Medicaid Managed Care	$59.76

SCREW2.5TIHDLSCANNCOMPLT22MM

Facility

$2,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270698218
Hospital Revenue Code	278
Min. Negotiated Rate	$338.25
Max. Negotiated Rate	$545.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$338.25

SCREW2.5TIHDLSCANNCOMPLT26MM

Facility

$2,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270698217
Hospital Revenue Code	278
Min. Negotiated Rate	$338.25
Max. Negotiated Rate	$545.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$338.25

SCREW2.5TIHDLSCANNCOMPLT26MM

Facility

$2,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270698217
Hospital Revenue Code	278
Min. Negotiated Rate	$54.35
Max. Negotiated Rate	$1,127.50
Rate for Payer: Aetna Commercial	$856.90
Rate for Payer: Aetna Medicare Advantage	$676.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$575.02
Rate for Payer: Cigna Commercial	$1,127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$338.25
Rate for Payer: UnitedHealthcare Community & State	$54.35
Rate for Payer: Wellpoint Medicaid Managed Care	$59.76

SCREW 2.5 X 11 MM

Facility

$925.50

Service Code	HCPCS C1713
Hospital Charge Code	270701815
Hospital Revenue Code	278
Min. Negotiated Rate	$22.30
Max. Negotiated Rate	$462.75
Rate for Payer: Aetna Commercial	$351.69
Rate for Payer: Aetna Medicare Advantage	$277.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$236.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$236.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$236.00
Rate for Payer: Cigna Commercial	$462.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$203.61
Rate for Payer: Qualcare PPO/HMO/WC	$138.82
Rate for Payer: UnitedHealthcare Community & State	$22.30
Rate for Payer: Wellpoint Medicaid Managed Care	$24.53

SCREW 2.5 X 11 MM

Facility

$925.50

Service Code	HCPCS C1713
Hospital Charge Code	270701815
Hospital Revenue Code	278
Min. Negotiated Rate	$138.82
Max. Negotiated Rate	$223.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$203.61
Rate for Payer: Qualcare PPO/HMO/WC	$138.82

SCREW 2.5 X 14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270690539
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW 2.5 X 14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270690539
Hospital Revenue Code	278
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

SCREW 2.5x16MM PEG PRT TP16000

Facility

$540.00

Service Code	HCPCS C1713
Hospital Charge Code	270648149
Hospital Revenue Code	278
Min. Negotiated Rate	$81.00
Max. Negotiated Rate	$130.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.80
Rate for Payer: Qualcare PPO/HMO/WC	$81.00

SCREW 2.5x16MM PEG PRT TP16000

Facility

$540.00

Service Code	HCPCS C1713
Hospital Charge Code	270648149
Hospital Revenue Code	278
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$270.00
Rate for Payer: Aetna Commercial	$205.20
Rate for Payer: Aetna Medicare Advantage	$162.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.70
Rate for Payer: Cigna Commercial	$270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.80
Rate for Payer: Qualcare PPO/HMO/WC	$81.00
Rate for Payer: UnitedHealthcare Community & State	$13.01
Rate for Payer: Wellpoint Medicaid Managed Care	$14.31

SCREW 2.5x18MM PEG PRT TP18000

Facility

$540.00

Hospital Charge Code	270648151
Hospital Revenue Code	278
Min. Negotiated Rate	$81.00
Max. Negotiated Rate	$130.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.80
Rate for Payer: Qualcare PPO/HMO/WC	$81.00

SCREW 2.5x18MM PEG PRT TP18000

Facility

$540.00

Hospital Charge Code	270648151
Hospital Revenue Code	278
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$270.00
Rate for Payer: Aetna Commercial	$205.20
Rate for Payer: Aetna Medicare Advantage	$162.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.70
Rate for Payer: Cigna Commercial	$270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.80
Rate for Payer: Qualcare PPO/HMO/WC	$81.00
Rate for Payer: UnitedHealthcare Community & State	$13.01
Rate for Payer: Wellpoint Medicaid Managed Care	$14.31

SCREW 2.5 X 19 MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270701810
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

SCREW 2.5 X 19 MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270701810
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

SCREW 2.5x24MM PEG PRT TP24000

Facility

$540.00

Hospital Charge Code	270648154
Hospital Revenue Code	278
Min. Negotiated Rate	$81.00
Max. Negotiated Rate	$130.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.80
Rate for Payer: Qualcare PPO/HMO/WC	$81.00

SCREW 2.5x24MM PEG PRT TP24000

Facility

$540.00

Hospital Charge Code	270648154
Hospital Revenue Code	278
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$270.00
Rate for Payer: Aetna Commercial	$205.20
Rate for Payer: Aetna Medicare Advantage	$162.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.70
Rate for Payer: Cigna Commercial	$270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.80
Rate for Payer: Qualcare PPO/HMO/WC	$81.00
Rate for Payer: UnitedHealthcare Community & State	$13.01
Rate for Payer: Wellpoint Medicaid Managed Care	$14.31

SCREW 2.5 X 8 MM HEADLESS

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270690629
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW 2.5 X 8 MM HEADLESS

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270690629
Hospital Revenue Code	278
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

SCREW 2.7 CORTEX SELF TAPPING

Facility

$135.75

Hospital Charge Code	270656723
Hospital Revenue Code	278
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$67.88
Rate for Payer: Aetna Commercial	$51.59
Rate for Payer: Aetna Medicare Advantage	$40.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.62
Rate for Payer: Cigna Commercial	$67.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.86
Rate for Payer: Qualcare PPO/HMO/WC	$20.36
Rate for Payer: UnitedHealthcare Community & State	$3.27
Rate for Payer: Wellpoint Medicaid Managed Care	$3.60

SCREW 2.7 CORTEX SELF TAPPING

Facility

$135.75

Hospital Charge Code	270657221
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$32.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.86
Rate for Payer: Qualcare PPO/HMO/WC	$20.36

SCREW 2.7 CORTEX SELF TAPPING

Facility

$135.75

Hospital Charge Code	270656724
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$32.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.86
Rate for Payer: Qualcare PPO/HMO/WC	$20.36

SCREW 2.7 CORTEX SELF TAPPING

Facility

$135.75

Hospital Charge Code	270656722
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$32.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.86
Rate for Payer: Qualcare PPO/HMO/WC	$20.36

SCREW 2.7 CORTEX SELF TAPPING

Facility

$135.75

Hospital Charge Code	270656724
Hospital Revenue Code	278
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$67.88
Rate for Payer: Aetna Commercial	$51.59
Rate for Payer: Aetna Medicare Advantage	$40.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.62
Rate for Payer: Cigna Commercial	$67.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.86
Rate for Payer: Qualcare PPO/HMO/WC	$20.36
Rate for Payer: UnitedHealthcare Community & State	$3.27
Rate for Payer: Wellpoint Medicaid Managed Care	$3.60

SCREW 2.7 CORTEX SELF TAPPING

Facility

$135.75

Hospital Charge Code	270656725
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$32.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.86
Rate for Payer: Qualcare PPO/HMO/WC	$20.36

SCREW 2.7 CORTEX SELF TAPPING

Facility

$135.75

Hospital Charge Code	270656719
Hospital Revenue Code	278
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$67.88
Rate for Payer: Aetna Commercial	$51.59
Rate for Payer: Aetna Medicare Advantage	$40.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.62
Rate for Payer: Cigna Commercial	$67.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.86
Rate for Payer: Qualcare PPO/HMO/WC	$20.36
Rate for Payer: UnitedHealthcare Community & State	$3.27
Rate for Payer: Wellpoint Medicaid Managed Care	$3.60

Know your out-of-pocket cost for care.

All Charges