Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW 4.5X18MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705132
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 4.5X18MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705132
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 4.5X 25MM

Facility

$533.35

Service Code	HCPCS C1713
Hospital Charge Code	270704982
Hospital Revenue Code	278
Min. Negotiated Rate	$80.00
Max. Negotiated Rate	$129.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.34
Rate for Payer: Qualcare PPO/HMO/WC	$80.00

SCREW 4.5X 25MM

Facility

$533.35

Service Code	HCPCS C1713
Hospital Charge Code	270704982
Hospital Revenue Code	278
Min. Negotiated Rate	$12.85
Max. Negotiated Rate	$266.68
Rate for Payer: Aetna Commercial	$202.67
Rate for Payer: Aetna Medicare Advantage	$160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.00
Rate for Payer: Cigna Commercial	$266.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.34
Rate for Payer: Qualcare PPO/HMO/WC	$80.00
Rate for Payer: UnitedHealthcare Community & State	$12.85
Rate for Payer: Wellpoint Medicaid Managed Care	$14.13

SCREW 4.5X26MM

Facility

$3,675.00

Service Code	HCPCS C1713
Hospital Charge Code	270704442
Hospital Revenue Code	278
Min. Negotiated Rate	$88.57
Max. Negotiated Rate	$1,837.50
Rate for Payer: Aetna Commercial	$1,396.50
Rate for Payer: Aetna Medicare Advantage	$1,102.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$937.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$937.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$735.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$937.12
Rate for Payer: Cigna Commercial	$1,837.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$889.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$808.50
Rate for Payer: Qualcare PPO/HMO/WC	$551.25
Rate for Payer: UnitedHealthcare Community & State	$88.57
Rate for Payer: Wellpoint Medicaid Managed Care	$97.39

SCREW 4.5X26MM

Facility

$3,675.00

Service Code	HCPCS C1713
Hospital Charge Code	270704442
Hospital Revenue Code	278
Min. Negotiated Rate	$551.25
Max. Negotiated Rate	$889.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$735.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$889.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$808.50
Rate for Payer: Qualcare PPO/HMO/WC	$551.25

SCREW 4.5X30MM

Facility

$3,675.00

Service Code	HCPCS C1713
Hospital Charge Code	270704441
Hospital Revenue Code	278
Min. Negotiated Rate	$88.57
Max. Negotiated Rate	$1,837.50
Rate for Payer: Aetna Commercial	$1,396.50
Rate for Payer: Aetna Medicare Advantage	$1,102.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$937.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$937.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$735.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$937.12
Rate for Payer: Cigna Commercial	$1,837.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$889.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$808.50
Rate for Payer: Qualcare PPO/HMO/WC	$551.25
Rate for Payer: UnitedHealthcare Community & State	$88.57
Rate for Payer: Wellpoint Medicaid Managed Care	$97.39

SCREW 4.5X30MM

Facility

$3,675.00

Service Code	HCPCS C1713
Hospital Charge Code	270704441
Hospital Revenue Code	278
Min. Negotiated Rate	$551.25
Max. Negotiated Rate	$889.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$735.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$889.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$808.50
Rate for Payer: Qualcare PPO/HMO/WC	$551.25

SCREW 4.5x32mm 1402232

Facility

$84.40

Hospital Charge Code	270633170
Hospital Revenue Code	278
Min. Negotiated Rate	$2.03
Max. Negotiated Rate	$42.20
Rate for Payer: Aetna Commercial	$32.07
Rate for Payer: Aetna Medicare Advantage	$25.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.52
Rate for Payer: Cigna Commercial	$42.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.57
Rate for Payer: Qualcare PPO/HMO/WC	$12.66
Rate for Payer: UnitedHealthcare Community & State	$2.03
Rate for Payer: Wellpoint Medicaid Managed Care	$2.24

SCREW 4.5x32mm 1402232

Facility

$84.40

Hospital Charge Code	270633170
Hospital Revenue Code	278
Min. Negotiated Rate	$12.66
Max. Negotiated Rate	$20.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.57
Rate for Payer: Qualcare PPO/HMO/WC	$12.66

SCREW 4.5x34mm 1402234

Facility

$84.40

Hospital Charge Code	270633171
Hospital Revenue Code	278
Min. Negotiated Rate	$2.03
Max. Negotiated Rate	$42.20
Rate for Payer: Aetna Commercial	$32.07
Rate for Payer: Aetna Medicare Advantage	$25.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.52
Rate for Payer: Cigna Commercial	$42.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.57
Rate for Payer: Qualcare PPO/HMO/WC	$12.66
Rate for Payer: UnitedHealthcare Community & State	$2.03
Rate for Payer: Wellpoint Medicaid Managed Care	$2.24

SCREW 4.5x34mm 1402234

Facility

$84.40

Hospital Charge Code	270633171
Hospital Revenue Code	278
Min. Negotiated Rate	$12.66
Max. Negotiated Rate	$20.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.57
Rate for Payer: Qualcare PPO/HMO/WC	$12.66

SCREW 4.5X38MM

Facility

$5,460.00

Service Code	HCPCS C1713
Hospital Charge Code	270684552
Hospital Revenue Code	278
Min. Negotiated Rate	$131.59
Max. Negotiated Rate	$2,730.00
Rate for Payer: Aetna Commercial	$2,074.80
Rate for Payer: Aetna Medicare Advantage	$1,638.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,392.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,392.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,092.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,392.30
Rate for Payer: Cigna Commercial	$2,730.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,321.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,201.20
Rate for Payer: Qualcare PPO/HMO/WC	$819.00
Rate for Payer: UnitedHealthcare Community & State	$131.59
Rate for Payer: Wellpoint Medicaid Managed Care	$144.69

SCREW 4.5X38MM

Facility

$5,460.00

Service Code	HCPCS C1713
Hospital Charge Code	270684552
Hospital Revenue Code	278
Min. Negotiated Rate	$819.00
Max. Negotiated Rate	$1,321.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,092.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,321.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,201.20
Rate for Payer: Qualcare PPO/HMO/WC	$819.00

SCREW 4.5x38mm 1402238

Facility

$84.40

Hospital Charge Code	270633173
Hospital Revenue Code	278
Min. Negotiated Rate	$2.03
Max. Negotiated Rate	$42.20
Rate for Payer: Aetna Commercial	$32.07
Rate for Payer: Aetna Medicare Advantage	$25.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.52
Rate for Payer: Cigna Commercial	$42.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.57
Rate for Payer: Qualcare PPO/HMO/WC	$12.66
Rate for Payer: UnitedHealthcare Community & State	$2.03
Rate for Payer: Wellpoint Medicaid Managed Care	$2.24

SCREW 4.5x38mm 1402238

Facility

$84.40

Hospital Charge Code	270633173
Hospital Revenue Code	278
Min. Negotiated Rate	$12.66
Max. Negotiated Rate	$20.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.57
Rate for Payer: Qualcare PPO/HMO/WC	$12.66

SCREW 4.5x44mm 1402244

Facility

$94.25

Hospital Charge Code	270633172
Hospital Revenue Code	278
Min. Negotiated Rate	$14.14
Max. Negotiated Rate	$22.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$20.73
Rate for Payer: Qualcare PPO/HMO/WC	$14.14

SCREW 4.5x44mm 1402244

Facility

$94.25

Hospital Charge Code	270633172
Hospital Revenue Code	278
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$47.12
Rate for Payer: Aetna Commercial	$35.81
Rate for Payer: Aetna Medicare Advantage	$28.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.03
Rate for Payer: Cigna Commercial	$47.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$20.73
Rate for Payer: Qualcare PPO/HMO/WC	$14.14
Rate for Payer: UnitedHealthcare Community & State	$2.27
Rate for Payer: Wellpoint Medicaid Managed Care	$2.50

SCREW 4.5x46mm 1402246

Facility

$94.25

Hospital Charge Code	270633174
Hospital Revenue Code	278
Min. Negotiated Rate	$14.14
Max. Negotiated Rate	$22.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$20.73
Rate for Payer: Qualcare PPO/HMO/WC	$14.14

SCREW 4.5x46mm 1402246

Facility

$94.25

Hospital Charge Code	270633174
Hospital Revenue Code	278
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$47.12
Rate for Payer: Aetna Commercial	$35.81
Rate for Payer: Aetna Medicare Advantage	$28.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.03
Rate for Payer: Cigna Commercial	$47.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$20.73
Rate for Payer: Qualcare PPO/HMO/WC	$14.14
Rate for Payer: UnitedHealthcare Community & State	$2.27
Rate for Payer: Wellpoint Medicaid Managed Care	$2.50

SCREW 4.75 EXTTAB CAN 6.5X40MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270699276
Hospital Revenue Code	278
Min. Negotiated Rate	$160.75
Max. Negotiated Rate	$3,335.00
Rate for Payer: Aetna Commercial	$2,534.60
Rate for Payer: Aetna Medicare Advantage	$2,001.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,700.85
Rate for Payer: Cigna Commercial	$3,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,467.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50
Rate for Payer: UnitedHealthcare Community & State	$160.75
Rate for Payer: Wellpoint Medicaid Managed Care	$176.75

SCREW 4.75 EXTTAB CAN 6.5X40MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270699276
Hospital Revenue Code	278
Min. Negotiated Rate	$1,000.50
Max. Negotiated Rate	$1,614.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,467.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50

SCREW 4.75 EXTTAB CAN 6.5X45MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270699280
Hospital Revenue Code	278
Min. Negotiated Rate	$160.75
Max. Negotiated Rate	$3,335.00
Rate for Payer: Aetna Commercial	$2,534.60
Rate for Payer: Aetna Medicare Advantage	$2,001.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,700.85
Rate for Payer: Cigna Commercial	$3,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,467.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50
Rate for Payer: UnitedHealthcare Community & State	$160.75
Rate for Payer: Wellpoint Medicaid Managed Care	$176.75

SCREW 4.75 EXTTAB CAN 6.5X45MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270699280
Hospital Revenue Code	278
Min. Negotiated Rate	$1,000.50
Max. Negotiated Rate	$1,614.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,467.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50

SCREW 4 CANC P/THD 45 2322046

Facility

$26.25

Hospital Charge Code	270610243
Hospital Revenue Code	278
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$13.12
Rate for Payer: Aetna Commercial	$9.97
Rate for Payer: Aetna Medicare Advantage	$7.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.69
Rate for Payer: Cigna Commercial	$13.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5.78
Rate for Payer: Qualcare PPO/HMO/WC	$3.94
Rate for Payer: UnitedHealthcare Community & State	$0.63
Rate for Payer: Wellpoint Medicaid Managed Care	$0.70

Know your out-of-pocket cost for care.

All Charges