Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW 4.0 X 50 MM

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270691651
Hospital Revenue Code	278
Min. Negotiated Rate	$45.74
Max. Negotiated Rate	$949.00
Rate for Payer: Aetna Commercial	$721.24
Rate for Payer: Aetna Medicare Advantage	$569.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$483.99
Rate for Payer: Cigna Commercial	$949.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$417.56
Rate for Payer: Qualcare PPO/HMO/WC	$284.70
Rate for Payer: UnitedHealthcare Community & State	$45.74
Rate for Payer: Wellpoint Medicaid Managed Care	$50.30

SCREW 4.0 X 50 MM

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270691651
Hospital Revenue Code	278
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$459.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$417.56
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

SCREW 4.0 X 50 mm CANNULATED

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270682951
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW 4.0 X 50 mm CANNULATED

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270682951
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW 4.0 X 55 mm CANNULATED

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270682952
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW 4.0 X 55 mm CANNULATED

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270682952
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW 4.0 X 60 mm CANNULATED

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270682953
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW 4.0 X 60 mm CANNULATED

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270682953
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW 4.25X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270706109
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 4.25X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270706109
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 4.25X16MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270706124
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 4.25X16MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270706124
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 42 MM LGTH

Facility

$2,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270691767
Hospital Revenue Code	278
Min. Negotiated Rate	$356.25
Max. Negotiated Rate	$574.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$574.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$522.50
Rate for Payer: Qualcare PPO/HMO/WC	$356.25

SCREW 42 MM LGTH

Facility

$2,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270691767
Hospital Revenue Code	278
Min. Negotiated Rate	$57.24
Max. Negotiated Rate	$1,187.50
Rate for Payer: Aetna Commercial	$902.50
Rate for Payer: Aetna Medicare Advantage	$712.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$605.62
Rate for Payer: Cigna Commercial	$1,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$574.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$522.50
Rate for Payer: Qualcare PPO/HMO/WC	$356.25
Rate for Payer: UnitedHealthcare Community & State	$57.24
Rate for Payer: Wellpoint Medicaid Managed Care	$62.94

SCREW 4.3

Facility

$589.00

Hospital Charge Code	270335967
Hospital Revenue Code	278
Min. Negotiated Rate	$88.35
Max. Negotiated Rate	$142.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$129.58
Rate for Payer: Qualcare PPO/HMO/WC	$88.35

SCREW 4.3

Facility

$589.00

Hospital Charge Code	270335967
Hospital Revenue Code	278
Min. Negotiated Rate	$14.19
Max. Negotiated Rate	$294.50
Rate for Payer: Aetna Commercial	$223.82
Rate for Payer: Aetna Medicare Advantage	$176.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.19
Rate for Payer: Cigna Commercial	$294.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$129.58
Rate for Payer: Qualcare PPO/HMO/WC	$88.35
Rate for Payer: UnitedHealthcare Community & State	$14.19
Rate for Payer: Wellpoint Medicaid Managed Care	$15.61

SCREW 4.35MM X 45 MM

Facility

$7,678.35

Service Code	HCPCS C1713
Hospital Charge Code	270691005
Hospital Revenue Code	278
Min. Negotiated Rate	$185.05
Max. Negotiated Rate	$3,839.18
Rate for Payer: Aetna Commercial	$2,917.77
Rate for Payer: Aetna Medicare Advantage	$2,303.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,957.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,957.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,535.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,957.98
Rate for Payer: Cigna Commercial	$3,839.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,858.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,689.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,151.75
Rate for Payer: UnitedHealthcare Community & State	$185.05
Rate for Payer: Wellpoint Medicaid Managed Care	$203.48

SCREW 4.35MM X 45 MM

Facility

$7,678.35

Service Code	HCPCS C1713
Hospital Charge Code	270691005
Hospital Revenue Code	278
Min. Negotiated Rate	$1,151.75
Max. Negotiated Rate	$1,858.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,535.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,858.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,689.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,151.75

SCREW 4.35 X 40 MM

Facility

$7,693.35

Service Code	HCPCS C1713
Hospital Charge Code	270691004
Hospital Revenue Code	278
Min. Negotiated Rate	$1,154.00
Max. Negotiated Rate	$1,861.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,538.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,861.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,692.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,154.00

SCREW 4.35 X 40 MM

Facility

$7,693.35

Service Code	HCPCS C1713
Hospital Charge Code	270691004
Hospital Revenue Code	278
Min. Negotiated Rate	$185.41
Max. Negotiated Rate	$3,846.68
Rate for Payer: Aetna Commercial	$2,923.47
Rate for Payer: Aetna Medicare Advantage	$2,308.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,961.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,961.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,538.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,961.80
Rate for Payer: Cigna Commercial	$3,846.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,861.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,692.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,154.00
Rate for Payer: UnitedHealthcare Community & State	$185.41
Rate for Payer: Wellpoint Medicaid Managed Care	$203.87

SCREW 4.5MM CORTEX SEFLTAP24MM

Facility

$91.15

Service Code	HCPCS C1713
Hospital Charge Code	270655724
Hospital Revenue Code	278
Min. Negotiated Rate	$2.20
Max. Negotiated Rate	$45.58
Rate for Payer: Aetna Commercial	$34.64
Rate for Payer: Aetna Medicare Advantage	$27.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.24
Rate for Payer: Cigna Commercial	$45.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$20.05
Rate for Payer: Qualcare PPO/HMO/WC	$13.67
Rate for Payer: UnitedHealthcare Community & State	$2.20
Rate for Payer: Wellpoint Medicaid Managed Care	$2.42

SCREW 4.5MM CORTEX SEFLTAP24MM

Facility

$91.15

Service Code	HCPCS C1713
Hospital Charge Code	270655724
Hospital Revenue Code	278
Min. Negotiated Rate	$13.67
Max. Negotiated Rate	$22.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$20.05
Rate for Payer: Qualcare PPO/HMO/WC	$13.67

SCREW 4.5MMCORTEX SELFTAP100MM

Facility

$145.25

Service Code	HCPCS C1713
Hospital Charge Code	270655801
Hospital Revenue Code	278
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$72.62
Rate for Payer: Aetna Commercial	$55.20
Rate for Payer: Aetna Medicare Advantage	$43.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.04
Rate for Payer: Cigna Commercial	$72.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$31.95
Rate for Payer: Qualcare PPO/HMO/WC	$21.79
Rate for Payer: UnitedHealthcare Community & State	$3.50
Rate for Payer: Wellpoint Medicaid Managed Care	$3.85

SCREW 4.5MMCORTEX SELFTAP100MM

Facility

$145.25

Service Code	HCPCS C1713
Hospital Charge Code	270655801
Hospital Revenue Code	278
Min. Negotiated Rate	$21.79
Max. Negotiated Rate	$35.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$31.95
Rate for Payer: Qualcare PPO/HMO/WC	$21.79

SCREW 4.5MMCORTEX SELFTAP105MM

Facility

$145.25

Service Code	HCPCS C1713
Hospital Charge Code	270655805
Hospital Revenue Code	278
Min. Negotiated Rate	$21.79
Max. Negotiated Rate	$35.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$31.95
Rate for Payer: Qualcare PPO/HMO/WC	$21.79

Know your out-of-pocket cost for care.

All Charges