Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW 3.5X12MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270694820
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$1,631.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,482.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

SCREW 3.5X12MM IRIXC SELFDRILL

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693291
Hospital Revenue Code	278
Min. Negotiated Rate	$162.68
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$162.68
Rate for Payer: Wellpoint Medicaid Managed Care	$178.88

SCREW 3.5X12MM IRIXC SELFDRILL

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693291
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

SCREW 3.5x12MM LOCK col-3120

Facility

$590.00

Hospital Charge Code	270648049
Hospital Revenue Code	278
Min. Negotiated Rate	$88.50
Max. Negotiated Rate	$142.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$129.80
Rate for Payer: Qualcare PPO/HMO/WC	$88.50

SCREW 3.5x12MM LOCK col-3120

Facility

$590.00

Hospital Charge Code	270648049
Hospital Revenue Code	278
Min. Negotiated Rate	$14.22
Max. Negotiated Rate	$295.00
Rate for Payer: Aetna Commercial	$224.20
Rate for Payer: Aetna Medicare Advantage	$177.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.45
Rate for Payer: Cigna Commercial	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$129.80
Rate for Payer: Qualcare PPO/HMO/WC	$88.50
Rate for Payer: UnitedHealthcare Community & State	$14.22
Rate for Payer: Wellpoint Medicaid Managed Care	$15.63

SCREW 3.5x12MM POLY

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270679254
Hospital Revenue Code	278
Min. Negotiated Rate	$114.47
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,805.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,045.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Community & State	$114.47
Rate for Payer: Wellpoint Medicaid Managed Care	$125.88

SCREW 3.5x12MM POLY

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270679254
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,045.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

SCREW 3.5X14

Facility

$200.00

Hospital Charge Code	270661846
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 3.5X14

Facility

$200.00

Hospital Charge Code	270661846
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 3.5x14 LP LCK8161-35-014

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270658901
Hospital Revenue Code	278
Min. Negotiated Rate	$15.24
Max. Negotiated Rate	$316.25
Rate for Payer: Aetna Commercial	$240.35
Rate for Payer: Aetna Medicare Advantage	$189.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.29
Rate for Payer: Cigna Commercial	$316.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$94.88
Rate for Payer: UnitedHealthcare Community & State	$15.24
Rate for Payer: Wellpoint Medicaid Managed Care	$16.76

SCREW 3.5x14 LP LCK8161-35-014

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270658901
Hospital Revenue Code	278
Min. Negotiated Rate	$94.88
Max. Negotiated Rate	$153.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$94.88

SCREW 3.5 X 14 MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693201
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 3.5 X 14 MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693201
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 3.5 X 14MM

Facility

$354.90

Service Code	HCPCS C1713
Hospital Charge Code	270664089
Hospital Revenue Code	278
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$177.45
Rate for Payer: Aetna Commercial	$134.86
Rate for Payer: Aetna Medicare Advantage	$106.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.50
Rate for Payer: Cigna Commercial	$177.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$78.08
Rate for Payer: Qualcare PPO/HMO/WC	$53.23
Rate for Payer: UnitedHealthcare Community & State	$8.55
Rate for Payer: Wellpoint Medicaid Managed Care	$9.40

SCREW 3.5 X 14MM

Facility

$354.90

Service Code	HCPCS C1713
Hospital Charge Code	270664089
Hospital Revenue Code	278
Min. Negotiated Rate	$53.23
Max. Negotiated Rate	$85.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$78.08
Rate for Payer: Qualcare PPO/HMO/WC	$53.23

SCREW 3.5X14MM

Facility

$2,505.00

Service Code	HCPCS C1713
Hospital Charge Code	270693297
Hospital Revenue Code	278
Min. Negotiated Rate	$60.37
Max. Negotiated Rate	$1,252.50
Rate for Payer: Aetna Commercial	$951.90
Rate for Payer: Aetna Medicare Advantage	$751.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$638.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$638.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$638.77
Rate for Payer: Cigna Commercial	$1,252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$606.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$551.10
Rate for Payer: Qualcare PPO/HMO/WC	$375.75
Rate for Payer: UnitedHealthcare Community & State	$60.37
Rate for Payer: Wellpoint Medicaid Managed Care	$66.38

SCREW 3.5X14MM

Facility

$3,900.00

Hospital Charge Code	270669222
Hospital Revenue Code	278
Min. Negotiated Rate	$585.00
Max. Negotiated Rate	$943.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$943.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$858.00
Rate for Payer: Qualcare PPO/HMO/WC	$585.00

SCREW 3.5X14MM

Facility

$3,900.00

Hospital Charge Code	270669222
Hospital Revenue Code	278
Min. Negotiated Rate	$93.99
Max. Negotiated Rate	$1,950.00
Rate for Payer: Aetna Commercial	$1,482.00
Rate for Payer: Aetna Medicare Advantage	$1,170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$994.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$994.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$780.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$994.50
Rate for Payer: Cigna Commercial	$1,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$943.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$858.00
Rate for Payer: Qualcare PPO/HMO/WC	$585.00
Rate for Payer: UnitedHealthcare Community & State	$93.99
Rate for Payer: Wellpoint Medicaid Managed Care	$103.35

SCREW 3.5X14MM

Facility

$2,505.00

Service Code	HCPCS C1713
Hospital Charge Code	270693297
Hospital Revenue Code	278
Min. Negotiated Rate	$375.75
Max. Negotiated Rate	$606.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$606.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$551.10
Rate for Payer: Qualcare PPO/HMO/WC	$375.75

SCREW 3.5X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704844
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 3.5X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704844
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 3.5X14MM LOCKING

Facility

$2,889.15

Service Code	HCPCS C1713
Hospital Charge Code	270705392
Hospital Revenue Code	278
Min. Negotiated Rate	$433.37
Max. Negotiated Rate	$699.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$577.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$699.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$635.61
Rate for Payer: Qualcare PPO/HMO/WC	$433.37

SCREW 3.5X14MM LOCKING

Facility

$2,889.15

Service Code	HCPCS C1713
Hospital Charge Code	270705392
Hospital Revenue Code	278
Min. Negotiated Rate	$69.63
Max. Negotiated Rate	$1,444.58
Rate for Payer: Aetna Commercial	$1,097.88
Rate for Payer: Aetna Medicare Advantage	$866.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$736.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$736.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$577.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$736.73
Rate for Payer: Cigna Commercial	$1,444.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$699.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$635.61
Rate for Payer: Qualcare PPO/HMO/WC	$433.37
Rate for Payer: UnitedHealthcare Community & State	$69.63
Rate for Payer: Wellpoint Medicaid Managed Care	$76.56

SCREW 3.5X14MM NL

Facility

$267.65

Service Code	HCPCS C1713
Hospital Charge Code	270703461
Hospital Revenue Code	278
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$133.82
Rate for Payer: Aetna Commercial	$101.71
Rate for Payer: Aetna Medicare Advantage	$80.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.25
Rate for Payer: Cigna Commercial	$133.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$58.88
Rate for Payer: Qualcare PPO/HMO/WC	$40.15
Rate for Payer: UnitedHealthcare Community & State	$6.45
Rate for Payer: Wellpoint Medicaid Managed Care	$7.09

SCREW 3.5X14MM NL

Facility

$267.65

Service Code	HCPCS C1713
Hospital Charge Code	270703461
Hospital Revenue Code	278
Min. Negotiated Rate	$40.15
Max. Negotiated Rate	$64.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$58.88
Rate for Payer: Qualcare PPO/HMO/WC	$40.15

Know your out-of-pocket cost for care.

All Charges