Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW 3.5MM LOCKING SELF TAP

Facility

$534.55

Service Code	HCPCS C1713
Hospital Charge Code	270656221
Hospital Revenue Code	278
Min. Negotiated Rate	$80.18
Max. Negotiated Rate	$129.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.60
Rate for Payer: Qualcare PPO/HMO/WC	$80.18

SCREW 3.5MM LOCKING SELF TAP

Facility

$519.00

Hospital Charge Code	270656811
Hospital Revenue Code	278
Min. Negotiated Rate	$12.51
Max. Negotiated Rate	$259.50
Rate for Payer: Aetna Commercial	$197.22
Rate for Payer: Aetna Medicare Advantage	$155.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.34
Rate for Payer: Cigna Commercial	$259.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.18
Rate for Payer: Qualcare PPO/HMO/WC	$77.85
Rate for Payer: UnitedHealthcare Community & State	$12.51
Rate for Payer: Wellpoint Medicaid Managed Care	$13.75

SCREW 3.5MM LOCKING SELF TAP

Facility

$534.55

Service Code	HCPCS C1713
Hospital Charge Code	270656220
Hospital Revenue Code	278
Min. Negotiated Rate	$12.88
Max. Negotiated Rate	$267.27
Rate for Payer: Aetna Commercial	$203.13
Rate for Payer: Aetna Medicare Advantage	$160.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.31
Rate for Payer: Cigna Commercial	$267.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.60
Rate for Payer: Qualcare PPO/HMO/WC	$80.18
Rate for Payer: UnitedHealthcare Community & State	$12.88
Rate for Payer: Wellpoint Medicaid Managed Care	$14.17

SCREW 3.5MM LOCKING SELF TAP

Facility

$519.00

Hospital Charge Code	270656811
Hospital Revenue Code	278
Min. Negotiated Rate	$77.85
Max. Negotiated Rate	$125.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.18
Rate for Payer: Qualcare PPO/HMO/WC	$77.85

SCREW 3.5MM LOCKING SELF TAP

Facility

$534.55

Service Code	HCPCS C1713
Hospital Charge Code	270656222
Hospital Revenue Code	278
Min. Negotiated Rate	$80.18
Max. Negotiated Rate	$129.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.60
Rate for Payer: Qualcare PPO/HMO/WC	$80.18

SCREW 3.5MM LOCKING SELF TAP

Facility

$519.00

Hospital Charge Code	270656814
Hospital Revenue Code	278
Min. Negotiated Rate	$12.51
Max. Negotiated Rate	$259.50
Rate for Payer: Aetna Commercial	$197.22
Rate for Payer: Aetna Medicare Advantage	$155.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.34
Rate for Payer: Cigna Commercial	$259.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.18
Rate for Payer: Qualcare PPO/HMO/WC	$77.85
Rate for Payer: UnitedHealthcare Community & State	$12.51
Rate for Payer: Wellpoint Medicaid Managed Care	$13.75

SCREW 3.5MM LOCKING SELF TAP

Facility

$519.00

Hospital Charge Code	270656814
Hospital Revenue Code	278
Min. Negotiated Rate	$77.85
Max. Negotiated Rate	$125.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.18
Rate for Payer: Qualcare PPO/HMO/WC	$77.85

SCREW 3.5MM LOCKING SELF TAP

Facility

$534.55

Service Code	HCPCS C1713
Hospital Charge Code	270656221
Hospital Revenue Code	278
Min. Negotiated Rate	$12.88
Max. Negotiated Rate	$267.27
Rate for Payer: Aetna Commercial	$203.13
Rate for Payer: Aetna Medicare Advantage	$160.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.31
Rate for Payer: Cigna Commercial	$267.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.60
Rate for Payer: Qualcare PPO/HMO/WC	$80.18
Rate for Payer: UnitedHealthcare Community & State	$12.88
Rate for Payer: Wellpoint Medicaid Managed Care	$14.17

SCREW 3.5MM LOCKING SELF TAP

Facility

$534.55

Service Code	HCPCS C1713
Hospital Charge Code	270656211
Hospital Revenue Code	278
Min. Negotiated Rate	$80.18
Max. Negotiated Rate	$129.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.60
Rate for Payer: Qualcare PPO/HMO/WC	$80.18

SCREW 3.5MM LOCKING SELFTAP

Facility

$519.00

Hospital Charge Code	270656225
Hospital Revenue Code	278
Min. Negotiated Rate	$12.51
Max. Negotiated Rate	$259.50
Rate for Payer: Aetna Commercial	$197.22
Rate for Payer: Aetna Medicare Advantage	$155.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.34
Rate for Payer: Cigna Commercial	$259.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.18
Rate for Payer: Qualcare PPO/HMO/WC	$77.85
Rate for Payer: UnitedHealthcare Community & State	$12.51
Rate for Payer: Wellpoint Medicaid Managed Care	$13.75

SCREW 3.5MM LOCKING SELFTAP

Facility

$519.00

Hospital Charge Code	270656216
Hospital Revenue Code	278
Min. Negotiated Rate	$77.85
Max. Negotiated Rate	$125.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.18
Rate for Payer: Qualcare PPO/HMO/WC	$77.85

SCREW 3.5MM LOCKING SELFTAP

Facility

$519.00

Hospital Charge Code	270656213
Hospital Revenue Code	278
Min. Negotiated Rate	$77.85
Max. Negotiated Rate	$125.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.18
Rate for Payer: Qualcare PPO/HMO/WC	$77.85

SCREW 3.5MM LOCKING SELFTAP

Facility

$519.00

Hospital Charge Code	270656216
Hospital Revenue Code	278
Min. Negotiated Rate	$12.51
Max. Negotiated Rate	$259.50
Rate for Payer: Aetna Commercial	$197.22
Rate for Payer: Aetna Medicare Advantage	$155.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.34
Rate for Payer: Cigna Commercial	$259.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.18
Rate for Payer: Qualcare PPO/HMO/WC	$77.85
Rate for Payer: UnitedHealthcare Community & State	$12.51
Rate for Payer: Wellpoint Medicaid Managed Care	$13.75

SCREW 3.5MM LOCKING SELFTAP

Facility

$519.00

Hospital Charge Code	270656214
Hospital Revenue Code	278
Min. Negotiated Rate	$77.85
Max. Negotiated Rate	$125.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.18
Rate for Payer: Qualcare PPO/HMO/WC	$77.85

SCREW 3.5MM LOCKING SELFTAP

Facility

$519.00

Hospital Charge Code	270656213
Hospital Revenue Code	278
Min. Negotiated Rate	$12.51
Max. Negotiated Rate	$259.50
Rate for Payer: Aetna Commercial	$197.22
Rate for Payer: Aetna Medicare Advantage	$155.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.34
Rate for Payer: Cigna Commercial	$259.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.18
Rate for Payer: Qualcare PPO/HMO/WC	$77.85
Rate for Payer: UnitedHealthcare Community & State	$12.51
Rate for Payer: Wellpoint Medicaid Managed Care	$13.75

SCREW 3.5MM LOCKING SELFTAP

Facility

$519.00

Hospital Charge Code	270656218
Hospital Revenue Code	278
Min. Negotiated Rate	$12.51
Max. Negotiated Rate	$259.50
Rate for Payer: Aetna Commercial	$197.22
Rate for Payer: Aetna Medicare Advantage	$155.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.34
Rate for Payer: Cigna Commercial	$259.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.18
Rate for Payer: Qualcare PPO/HMO/WC	$77.85
Rate for Payer: UnitedHealthcare Community & State	$12.51
Rate for Payer: Wellpoint Medicaid Managed Care	$13.75

SCREW 3.5MM LOCKING SELFTAP

Facility

$519.00

Hospital Charge Code	270656225
Hospital Revenue Code	278
Min. Negotiated Rate	$77.85
Max. Negotiated Rate	$125.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.18
Rate for Payer: Qualcare PPO/HMO/WC	$77.85

SCREW 3.5MM LOCKING SELFTAP

Facility

$519.00

Hospital Charge Code	270656218
Hospital Revenue Code	278
Min. Negotiated Rate	$77.85
Max. Negotiated Rate	$125.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.18
Rate for Payer: Qualcare PPO/HMO/WC	$77.85

SCREW 3.5MM LOCKING SELFTAP

Facility

$519.00

Hospital Charge Code	270656214
Hospital Revenue Code	278
Min. Negotiated Rate	$12.51
Max. Negotiated Rate	$259.50
Rate for Payer: Aetna Commercial	$197.22
Rate for Payer: Aetna Medicare Advantage	$155.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.34
Rate for Payer: Cigna Commercial	$259.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.18
Rate for Payer: Qualcare PPO/HMO/WC	$77.85
Rate for Payer: UnitedHealthcare Community & State	$12.51
Rate for Payer: Wellpoint Medicaid Managed Care	$13.75

SCREW 3.5MM TI 34MM

Facility

$87.75

Hospital Charge Code	270656817
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 TI 34MM

Facility

$87.75

Hospital Charge Code	270656817
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 TI SHAFT 36MM

Facility

$74.25

Hospital Charge Code	270656845
Hospital Revenue Code	278
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$37.12
Rate for Payer: Aetna Commercial	$28.21
Rate for Payer: Aetna Medicare Advantage	$22.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.93
Rate for Payer: Cigna Commercial	$37.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.34
Rate for Payer: Qualcare PPO/HMO/WC	$11.14
Rate for Payer: UnitedHealthcare Community & State	$1.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1.97

SCREW 3.5MM TI SHAFT 36MM

Facility

$74.25

Hospital Charge Code	270656845
Hospital Revenue Code	278
Min. Negotiated Rate	$11.14
Max. Negotiated Rate	$17.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.34
Rate for Payer: Qualcare PPO/HMO/WC	$11.14

SCREW 3.5MM TI SHAFT 38MM

Facility

$74.25

Hospital Charge Code	270656850
Hospital Revenue Code	278
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$37.12
Rate for Payer: Aetna Commercial	$28.21
Rate for Payer: Aetna Medicare Advantage	$22.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.93
Rate for Payer: Cigna Commercial	$37.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.34
Rate for Payer: Qualcare PPO/HMO/WC	$11.14
Rate for Payer: UnitedHealthcare Community & State	$1.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1.97

SCREW 3.5MM TI SHAFT 38MM

Facility

$74.25

Hospital Charge Code	270656850
Hospital Revenue Code	278
Min. Negotiated Rate	$11.14
Max. Negotiated Rate	$17.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.34
Rate for Payer: Qualcare PPO/HMO/WC	$11.14

Know your out-of-pocket cost for care.

All Charges