Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW 4.0 POLY SYMPH 3.5X14MM

Facility

$7,836.15

Service Code	HCPCS C1713
Hospital Charge Code	270693353
Hospital Revenue Code	278
Min. Negotiated Rate	$188.85
Max. Negotiated Rate	$3,918.07
Rate for Payer: Aetna Commercial	$2,977.74
Rate for Payer: Aetna Medicare Advantage	$2,350.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,998.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,998.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,567.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,998.22
Rate for Payer: Cigna Commercial	$3,918.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,896.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,723.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,175.42
Rate for Payer: UnitedHealthcare Community & State	$188.85
Rate for Payer: Wellpoint Medicaid Managed Care	$207.66

SCREW 4.0 POLY SYMPH 3.5X16MM

Facility

$7,836.15

Service Code	HCPCS C1713
Hospital Charge Code	270693346
Hospital Revenue Code	278
Min. Negotiated Rate	$1,175.42
Max. Negotiated Rate	$1,896.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,567.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,896.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,723.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,175.42

SCREW 4.0 POLY SYMPH 3.5X16MM

Facility

$7,836.15

Service Code	HCPCS C1713
Hospital Charge Code	270693346
Hospital Revenue Code	278
Min. Negotiated Rate	$188.85
Max. Negotiated Rate	$3,918.07
Rate for Payer: Aetna Commercial	$2,977.74
Rate for Payer: Aetna Medicare Advantage	$2,350.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,998.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,998.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,567.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,998.22
Rate for Payer: Cigna Commercial	$3,918.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,896.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,723.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,175.42
Rate for Payer: UnitedHealthcare Community & State	$188.85
Rate for Payer: Wellpoint Medicaid Managed Care	$207.66

SCREW 4.0 TI CANN HDLESS 38MM

Facility

$2,007.50

Service Code	HCPCS C1713
Hospital Charge Code	270696215
Hospital Revenue Code	278
Min. Negotiated Rate	$48.38
Max. Negotiated Rate	$1,003.75
Rate for Payer: Aetna Commercial	$762.85
Rate for Payer: Aetna Medicare Advantage	$602.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$511.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$511.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$401.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$511.91
Rate for Payer: Cigna Commercial	$1,003.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$485.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$441.65
Rate for Payer: Qualcare PPO/HMO/WC	$301.12
Rate for Payer: UnitedHealthcare Community & State	$48.38
Rate for Payer: Wellpoint Medicaid Managed Care	$53.20

SCREW 4.0 TI CANN HDLESS 38MM

Facility

$2,007.50

Service Code	HCPCS C1713
Hospital Charge Code	270696215
Hospital Revenue Code	278
Min. Negotiated Rate	$301.12
Max. Negotiated Rate	$485.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$401.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$485.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$441.65
Rate for Payer: Qualcare PPO/HMO/WC	$301.12

SCREW 4.0 TI CANN HDLESS 40MM

Facility

$2,007.50

Service Code	HCPCS C1713
Hospital Charge Code	270696216
Hospital Revenue Code	278
Min. Negotiated Rate	$48.38
Max. Negotiated Rate	$1,003.75
Rate for Payer: Aetna Commercial	$762.85
Rate for Payer: Aetna Medicare Advantage	$602.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$511.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$511.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$401.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$511.91
Rate for Payer: Cigna Commercial	$1,003.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$485.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$441.65
Rate for Payer: Qualcare PPO/HMO/WC	$301.12
Rate for Payer: UnitedHealthcare Community & State	$48.38
Rate for Payer: Wellpoint Medicaid Managed Care	$53.20

SCREW 4.0 TI CANN HDLESS 40MM

Facility

$2,007.50

Service Code	HCPCS C1713
Hospital Charge Code	270696216
Hospital Revenue Code	278
Min. Negotiated Rate	$301.12
Max. Negotiated Rate	$485.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$401.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$485.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$441.65
Rate for Payer: Qualcare PPO/HMO/WC	$301.12

SCREW 4.0x10mm CANC LOCKING

Facility

$850.00

Hospital Charge Code	270665685
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

SCREW 4.0x10mm CANC LOCKING

Facility

$850.00

Hospital Charge Code	270665685
Hospital Revenue Code	278
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Community & State	$20.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.52

SCREW 40X12M

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270685320
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW 40X12M

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270685320
Hospital Revenue Code	278
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

SCREW 4.0 X 12MM

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270657250
Hospital Revenue Code	278
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

SCREW 4.0 X 12MM

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270657250
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

SCREW 4.0X 12MM

Facility

$11,735.00

Service Code	HCPCS C1713
Hospital Charge Code	270694870
Hospital Revenue Code	278
Min. Negotiated Rate	$1,760.25
Max. Negotiated Rate	$2,839.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,347.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,839.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,581.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,760.25

SCREW 4.0X 12MM

Facility

$11,735.00

Service Code	HCPCS C1713
Hospital Charge Code	270694870
Hospital Revenue Code	278
Min. Negotiated Rate	$282.81
Max. Negotiated Rate	$5,867.50
Rate for Payer: Aetna Commercial	$4,459.30
Rate for Payer: Aetna Medicare Advantage	$3,520.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,992.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,992.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,347.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,992.43
Rate for Payer: Cigna Commercial	$5,867.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,839.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,581.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,760.25
Rate for Payer: UnitedHealthcare Community & State	$282.81
Rate for Payer: Wellpoint Medicaid Managed Care	$310.98

SCREW 4.0 X 12MM SELF TAPPING

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270686428
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 4.0 X 12MM SELF TAPPING

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270686428
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 40 X 14 MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270687500
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW 40 X 14 MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270687500
Hospital Revenue Code	278
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

SCREW 4.0X14MM CERES-C SELFTAP

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692584
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 4.0X14MM CERES-C SELFTAP

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692584
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 4.0 X 14MM SELF TAPPING

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270686429
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 4.0 X 14MM SELF TAPPING

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270686429
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 4.0X15mm 876.815

Facility

$1,428.50

Hospital Charge Code	270631183
Hospital Revenue Code	278
Min. Negotiated Rate	$214.28
Max. Negotiated Rate	$345.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$285.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$345.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$314.27
Rate for Payer: Qualcare PPO/HMO/WC	$214.28

SCREW 4.0X15mm 876.815

Facility

$1,428.50

Hospital Charge Code	270631183
Hospital Revenue Code	278
Min. Negotiated Rate	$34.43
Max. Negotiated Rate	$714.25
Rate for Payer: Aetna Commercial	$542.83
Rate for Payer: Aetna Medicare Advantage	$428.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$285.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.27
Rate for Payer: Cigna Commercial	$714.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$345.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$314.27
Rate for Payer: Qualcare PPO/HMO/WC	$214.28
Rate for Payer: UnitedHealthcare Community & State	$34.43
Rate for Payer: Wellpoint Medicaid Managed Care	$37.86

Know your out-of-pocket cost for care.

All Charges