Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW 4.5mm CORTICAL 54 230655

Facility

$36.25

Hospital Charge Code	270610345
Hospital Revenue Code	278
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$18.12
Rate for Payer: Aetna Commercial	$13.78
Rate for Payer: Aetna Medicare Advantage	$10.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.24
Rate for Payer: Cigna Commercial	$18.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7.97
Rate for Payer: Qualcare PPO/HMO/WC	$5.44
Rate for Payer: UnitedHealthcare Community & State	$0.87
Rate for Payer: Wellpoint Medicaid Managed Care	$0.96

SCREW 4.5 MM X 20 MM

Facility

$984.75

Service Code	HCPCS C1713
Hospital Charge Code	270688817
Hospital Revenue Code	278
Min. Negotiated Rate	$147.71
Max. Negotiated Rate	$238.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$216.65
Rate for Payer: Qualcare PPO/HMO/WC	$147.71

SCREW 4.5 MM X 20 MM

Facility

$984.75

Service Code	HCPCS C1713
Hospital Charge Code	270688817
Hospital Revenue Code	278
Min. Negotiated Rate	$23.73
Max. Negotiated Rate	$492.38
Rate for Payer: Aetna Commercial	$374.20
Rate for Payer: Aetna Medicare Advantage	$295.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.11
Rate for Payer: Cigna Commercial	$492.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$216.65
Rate for Payer: Qualcare PPO/HMO/WC	$147.71
Rate for Payer: UnitedHealthcare Community & State	$23.73
Rate for Payer: Wellpoint Medicaid Managed Care	$26.10

SCREW 4.5MM X 50 CANNULATED

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270702092
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 4.5MM X 50 CANNULATED

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270702092
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 4.5 TI CAN HDLSS ST 55MM

Facility

$2,007.50

Service Code	HCPCS C1713
Hospital Charge Code	270696488
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 4.5 TI CAN HDLSS ST 55MM

Facility

$2,007.50

Service Code	HCPCS C1713
Hospital Charge Code	270696488
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 4.5 TI CANN COMP 28

Facility

$2,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270695650
Hospital Revenue Code	278
Min. Negotiated Rate	$338.25
Max. Negotiated Rate	$545.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$338.25

SCREW 4.5 TI CANN COMP 28

Facility

$2,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270695650
Hospital Revenue Code	278
Min. Negotiated Rate	$54.35
Max. Negotiated Rate	$1,127.50
Rate for Payer: Aetna Commercial	$856.90
Rate for Payer: Aetna Medicare Advantage	$676.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$575.02
Rate for Payer: Cigna Commercial	$1,127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$338.25
Rate for Payer: UnitedHealthcare Community & State	$54.35
Rate for Payer: Wellpoint Medicaid Managed Care	$59.76

SCREW 4.5 TI CANN COMP 30

Facility

$2,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270695649
Hospital Revenue Code	278
Min. Negotiated Rate	$54.35
Max. Negotiated Rate	$1,127.50
Rate for Payer: Aetna Commercial	$856.90
Rate for Payer: Aetna Medicare Advantage	$676.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$575.02
Rate for Payer: Cigna Commercial	$1,127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$338.25
Rate for Payer: UnitedHealthcare Community & State	$54.35
Rate for Payer: Wellpoint Medicaid Managed Care	$59.76

SCREW 4.5 TI CANN COMP 30

Facility

$2,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270695649
Hospital Revenue Code	278
Min. Negotiated Rate	$338.25
Max. Negotiated Rate	$545.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$338.25

SCREW 4.5 TI CANN COMP 38

Facility

$2,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270695648
Hospital Revenue Code	278
Min. Negotiated Rate	$54.35
Max. Negotiated Rate	$1,127.50
Rate for Payer: Aetna Commercial	$856.90
Rate for Payer: Aetna Medicare Advantage	$676.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$575.02
Rate for Payer: Cigna Commercial	$1,127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$338.25
Rate for Payer: UnitedHealthcare Community & State	$54.35
Rate for Payer: Wellpoint Medicaid Managed Care	$59.76

SCREW 4.5 TI CANN COMP 38

Facility

$2,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270695648
Hospital Revenue Code	278
Min. Negotiated Rate	$338.25
Max. Negotiated Rate	$545.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$338.25

SCREW 4.5 TI CANN COMP 42

Facility

$2,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270695647
Hospital Revenue Code	278
Min. Negotiated Rate	$338.25
Max. Negotiated Rate	$545.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$338.25

SCREW 4.5 TI CANN COMP 42

Facility

$2,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270695647
Hospital Revenue Code	278
Min. Negotiated Rate	$54.35
Max. Negotiated Rate	$1,127.50
Rate for Payer: Aetna Commercial	$856.90
Rate for Payer: Aetna Medicare Advantage	$676.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$575.02
Rate for Payer: Cigna Commercial	$1,127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$338.25
Rate for Payer: UnitedHealthcare Community & State	$54.35
Rate for Payer: Wellpoint Medicaid Managed Care	$59.76

SCREW 4.5 TI MULTILOK 32MM

Facility

$1,633.50

Service Code	HCPCS C1713
Hospital Charge Code	270694986
Hospital Revenue Code	278
Min. Negotiated Rate	$39.37
Max. Negotiated Rate	$816.75
Rate for Payer: Aetna Commercial	$620.73
Rate for Payer: Aetna Medicare Advantage	$490.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$416.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$416.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$326.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$416.54
Rate for Payer: Cigna Commercial	$816.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$395.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$359.37
Rate for Payer: Qualcare PPO/HMO/WC	$245.03
Rate for Payer: UnitedHealthcare Community & State	$39.37
Rate for Payer: Wellpoint Medicaid Managed Care	$43.29

SCREW 4.5 TI MULTILOK 32MM

Facility

$1,633.50

Service Code	HCPCS C1713
Hospital Charge Code	270694986
Hospital Revenue Code	278
Min. Negotiated Rate	$245.03
Max. Negotiated Rate	$395.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$326.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$395.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$359.37
Rate for Payer: Qualcare PPO/HMO/WC	$245.03

SCREW 4.5 X 14MM

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270701786
Hospital Revenue Code	278
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

SCREW 4.5 X 14MM

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270701786
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SCREW 4.5X14MM CERES-C SLF TAP

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692579
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 4.5X14MM CERES-C SLF TAP

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692579
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 4.5X16MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705158
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 4.5X16MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705158
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 4.5X16MM CERES-C SLF TAP

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692580
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 4.5X16MM CERES-C SLF TAP

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692580
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

Know your out-of-pocket cost for care.

All Charges