Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW 3.5 MM 50 CC

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270684027
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SCREW 3.5 MM 50 CC

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270684027
Hospital Revenue Code	278
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

SCREW3.5MM CANN PART

Facility

$765.00

Hospital Charge Code	27655860
Hospital Revenue Code	278
Min. Negotiated Rate	$18.44
Max. Negotiated Rate	$382.50
Rate for Payer: Aetna Commercial	$290.70
Rate for Payer: Aetna Medicare Advantage	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.07
Rate for Payer: Cigna Commercial	$382.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$168.30
Rate for Payer: Qualcare PPO/HMO/WC	$114.75
Rate for Payer: UnitedHealthcare Community & State	$18.44
Rate for Payer: Wellpoint Medicaid Managed Care	$20.27

SCREW3.5MM CANN PART

Facility

$765.00

Hospital Charge Code	27655860
Hospital Revenue Code	278
Min. Negotiated Rate	$114.75
Max. Negotiated Rate	$185.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$168.30
Rate for Payer: Qualcare PPO/HMO/WC	$114.75

SCREW3.5MM CANN PART THREAD

Facility

$765.00

Hospital Charge Code	270655869
Hospital Revenue Code	278
Min. Negotiated Rate	$18.44
Max. Negotiated Rate	$382.50
Rate for Payer: Aetna Commercial	$290.70
Rate for Payer: Aetna Medicare Advantage	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.07
Rate for Payer: Cigna Commercial	$382.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$168.30
Rate for Payer: Qualcare PPO/HMO/WC	$114.75
Rate for Payer: UnitedHealthcare Community & State	$18.44
Rate for Payer: Wellpoint Medicaid Managed Care	$20.27

SCREW3.5MM CANN PART THREAD

Facility

$765.00

Hospital Charge Code	270655869
Hospital Revenue Code	278
Min. Negotiated Rate	$114.75
Max. Negotiated Rate	$185.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$168.30
Rate for Payer: Qualcare PPO/HMO/WC	$114.75

SCREW 3.5MM CORT 15MM CS15000

Facility

$540.00

Service Code	HCPCS C1713
Hospital Charge Code	270651368
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 3.5MM CORT 15MM CS15000

Facility

$540.00

Service Code	HCPCS C1713
Hospital Charge Code	270651368
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 3.5MM CORTEX 38MM

Facility

$200.00

Service Code	HCPCS C1713
Hospital Charge Code	270651357
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

SCREW 3.5MM CORTEX 38MM

Facility

$200.00

Service Code	HCPCS C1713
Hospital Charge Code	270651357
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

SCREW 3.5MM CORTEX 80MM

Facility

$200.00

Hospital Charge Code	270651358
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

SCREW 3.5MM CORTEX 80MM

Facility

$200.00

Hospital Charge Code	270651358
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

SCREW 3.5MM CORTEX SELF TAP

Facility

$87.75

Hospital Charge Code	270656834
Hospital Revenue Code	278
Min. Negotiated Rate	$13.16
Max. Negotiated Rate	$21.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19.30
Rate for Payer: Qualcare PPO/HMO/WC	$13.16

SCREW 3.5MM CORTEX SELF TAP

Facility

$87.75

Hospital Charge Code	270656925
Hospital Revenue Code	278
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$43.88
Rate for Payer: Aetna Commercial	$33.34
Rate for Payer: Aetna Medicare Advantage	$26.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.38
Rate for Payer: Cigna Commercial	$43.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19.30
Rate for Payer: Qualcare PPO/HMO/WC	$13.16
Rate for Payer: UnitedHealthcare Community & State	$2.11
Rate for Payer: Wellpoint Medicaid Managed Care	$2.33

SCREW 3.5MM CORTEX SELF TAP

Facility

$87.75

Hospital Charge Code	270656831
Hospital Revenue Code	278
Min. Negotiated Rate	$13.16
Max. Negotiated Rate	$21.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19.30
Rate for Payer: Qualcare PPO/HMO/WC	$13.16

SCREW 3.5MM CORTEX SELF TAP

Facility

$87.75

Hospital Charge Code	270656838
Hospital Revenue Code	278
Min. Negotiated Rate	$13.16
Max. Negotiated Rate	$21.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19.30
Rate for Payer: Qualcare PPO/HMO/WC	$13.16

SCREW 3.5MM CORTEX SELF TAP

Facility

$87.75

Hospital Charge Code	270656839
Hospital Revenue Code	278
Min. Negotiated Rate	$13.16
Max. Negotiated Rate	$21.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19.30
Rate for Payer: Qualcare PPO/HMO/WC	$13.16

SCREW 3.5MM CORTEX SELF TAP

Facility

$87.75

Hospital Charge Code	270656921
Hospital Revenue Code	278
Min. Negotiated Rate	$13.16
Max. Negotiated Rate	$21.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19.30
Rate for Payer: Qualcare PPO/HMO/WC	$13.16

SCREW 3.5MM CORTEX SELF TAP

Facility

$87.75

Hospital Charge Code	270656832
Hospital Revenue Code	278
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$43.88
Rate for Payer: Aetna Commercial	$33.34
Rate for Payer: Aetna Medicare Advantage	$26.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.38
Rate for Payer: Cigna Commercial	$43.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19.30
Rate for Payer: Qualcare PPO/HMO/WC	$13.16
Rate for Payer: UnitedHealthcare Community & State	$2.11
Rate for Payer: Wellpoint Medicaid Managed Care	$2.33

SCREW 3.5MM CORTEX SELF TAP

Facility

$87.75

Hospital Charge Code	270656921
Hospital Revenue Code	278
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$43.88
Rate for Payer: Aetna Commercial	$33.34
Rate for Payer: Aetna Medicare Advantage	$26.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.38
Rate for Payer: Cigna Commercial	$43.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19.30
Rate for Payer: Qualcare PPO/HMO/WC	$13.16
Rate for Payer: UnitedHealthcare Community & State	$2.11
Rate for Payer: Wellpoint Medicaid Managed Care	$2.33

SCREW 3.5MM CORTEX SELF TAP

Facility

$87.75

Hospital Charge Code	270656920
Hospital Revenue Code	278
Min. Negotiated Rate	$13.16
Max. Negotiated Rate	$21.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19.30
Rate for Payer: Qualcare PPO/HMO/WC	$13.16

SCREW 3.5MM CORTEX SELF TAP

Facility

$87.75

Hospital Charge Code	270656925
Hospital Revenue Code	278
Min. Negotiated Rate	$13.16
Max. Negotiated Rate	$21.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19.30
Rate for Payer: Qualcare PPO/HMO/WC	$13.16

SCREW 3.5MM CORTEX SELF TAP

Facility

$87.75

Hospital Charge Code	270656920
Hospital Revenue Code	278
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$43.88
Rate for Payer: Aetna Commercial	$33.34
Rate for Payer: Aetna Medicare Advantage	$26.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.38
Rate for Payer: Cigna Commercial	$43.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19.30
Rate for Payer: Qualcare PPO/HMO/WC	$13.16
Rate for Payer: UnitedHealthcare Community & State	$2.11
Rate for Payer: Wellpoint Medicaid Managed Care	$2.33

SCREW 3.5MM CORTEX SELF TAP

Facility

$87.75

Hospital Charge Code	270656838
Hospital Revenue Code	278
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$43.88
Rate for Payer: Aetna Commercial	$33.34
Rate for Payer: Aetna Medicare Advantage	$26.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.38
Rate for Payer: Cigna Commercial	$43.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19.30
Rate for Payer: Qualcare PPO/HMO/WC	$13.16
Rate for Payer: UnitedHealthcare Community & State	$2.11
Rate for Payer: Wellpoint Medicaid Managed Care	$2.33

SCREW 3.5MM CORTEX SELF TAP

Facility

$87.75

Hospital Charge Code	270656829
Hospital Revenue Code	278
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$43.88
Rate for Payer: Aetna Commercial	$33.34
Rate for Payer: Aetna Medicare Advantage	$26.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.38
Rate for Payer: Cigna Commercial	$43.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19.30
Rate for Payer: Qualcare PPO/HMO/WC	$13.16
Rate for Payer: UnitedHealthcare Community & State	$2.11
Rate for Payer: Wellpoint Medicaid Managed Care	$2.33

Know your out-of-pocket cost for care.

All Charges