Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW 4 CANC P/THD 45 2322046

Facility

$26.25

Hospital Charge Code	270610243
Hospital Revenue Code	278
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$6.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.25
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

SCREW 4MM

Facility

$415.00

Service Code	HCPCS C1713
Hospital Charge Code	270680774
Hospital Revenue Code	278
Min. Negotiated Rate	$10.00
Max. Negotiated Rate	$207.50
Rate for Payer: Aetna Commercial	$157.70
Rate for Payer: Aetna Medicare Advantage	$124.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$83.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.83
Rate for Payer: Cigna Commercial	$207.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$91.30
Rate for Payer: Qualcare PPO/HMO/WC	$62.25
Rate for Payer: UnitedHealthcare Community & State	$10.00
Rate for Payer: Wellpoint Medicaid Managed Care	$11.00

SCREW 4MM

Facility

$415.00

Service Code	HCPCS C1713
Hospital Charge Code	270680774
Hospital Revenue Code	278
Min. Negotiated Rate	$62.25
Max. Negotiated Rate	$100.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$83.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$91.30
Rate for Payer: Qualcare PPO/HMO/WC	$62.25

SCREW 4mm CANC P/THRE 40mm

Facility

$26.40

Hospital Charge Code	270610242
Hospital Revenue Code	278
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$13.20
Rate for Payer: Aetna Commercial	$10.03
Rate for Payer: Aetna Medicare Advantage	$7.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.73
Rate for Payer: Cigna Commercial	$13.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5.81
Rate for Payer: Qualcare PPO/HMO/WC	$3.96
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.70

SCREW 4mm CANC P/THRE 40mm

Facility

$26.40

Hospital Charge Code	270610242
Hospital Revenue Code	278
Min. Negotiated Rate	$3.96
Max. Negotiated Rate	$6.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5.81
Rate for Payer: Qualcare PPO/HMO/WC	$3.96

SCREW 4mm MTRX 04.503.224.01

Facility

$383.25

Hospital Charge Code	270640446
Hospital Revenue Code	278
Min. Negotiated Rate	$57.49
Max. Negotiated Rate	$92.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$84.31
Rate for Payer: Qualcare PPO/HMO/WC	$57.49

SCREW 4mm MTRX 04.503.224.01

Facility

$383.25

Hospital Charge Code	270640446
Hospital Revenue Code	278
Min. Negotiated Rate	$9.24
Max. Negotiated Rate	$191.62
Rate for Payer: Aetna Commercial	$145.63
Rate for Payer: Aetna Medicare Advantage	$114.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.73
Rate for Payer: Cigna Commercial	$191.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$84.31
Rate for Payer: Qualcare PPO/HMO/WC	$57.49
Rate for Payer: UnitedHealthcare Community & State	$9.24
Rate for Payer: Wellpoint Medicaid Managed Care	$10.16

SCREW 4 X 14 MM

Facility

$875.00

Hospital Charge Code	270702969
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 X 14 MM

Facility

$875.00

Hospital Charge Code	270702969
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 4X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270703038
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 4X14MM

Facility

$13,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270704158
Hospital Revenue Code	278
Min. Negotiated Rate	$1,987.50
Max. Negotiated Rate	$3,206.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,206.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,915.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,987.50

SCREW 4X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270703038
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 4X14MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692582
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 4X14MM

Facility

$1,495.00

Service Code	HCPCS 1495
Hospital Charge Code	270705763
Hospital Revenue Code	278
Min. Negotiated Rate	$224.25
Max. Negotiated Rate	$361.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$299.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$328.90
Rate for Payer: Qualcare PPO/HMO/WC	$224.25

SCREW 4X14MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692582
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 4X14MM

Facility

$1,495.00

Service Code	HCPCS 1495
Hospital Charge Code	270705763
Hospital Revenue Code	278
Min. Negotiated Rate	$36.03
Max. Negotiated Rate	$747.50
Rate for Payer: Aetna Commercial	$568.10
Rate for Payer: Aetna Medicare Advantage	$448.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$381.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$381.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$299.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$381.23
Rate for Payer: Cigna Commercial	$747.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$328.90
Rate for Payer: Qualcare PPO/HMO/WC	$224.25
Rate for Payer: UnitedHealthcare Community & State	$36.03
Rate for Payer: Wellpoint Medicaid Managed Care	$39.62

SCREW 4X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705705
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 4X14MM

Facility

$13,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270704158
Hospital Revenue Code	278
Min. Negotiated Rate	$319.32
Max. Negotiated Rate	$6,625.00
Rate for Payer: Aetna Commercial	$5,035.00
Rate for Payer: Aetna Medicare Advantage	$3,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,378.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,378.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,378.75
Rate for Payer: Cigna Commercial	$6,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,206.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,915.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,987.50
Rate for Payer: UnitedHealthcare Community & State	$319.32
Rate for Payer: Wellpoint Medicaid Managed Care	$351.12

SCREW 4X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705705
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 4X16MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705835
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 4X16MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705835
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 4X16MM

Facility

$1,495.00

Service Code	HCPCS C1713
Hospital Charge Code	270705764
Hospital Revenue Code	278
Min. Negotiated Rate	$36.03
Max. Negotiated Rate	$747.50
Rate for Payer: Aetna Commercial	$568.10
Rate for Payer: Aetna Medicare Advantage	$448.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$381.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$381.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$299.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$381.23
Rate for Payer: Cigna Commercial	$747.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$328.90
Rate for Payer: Qualcare PPO/HMO/WC	$224.25
Rate for Payer: UnitedHealthcare Community & State	$36.03
Rate for Payer: Wellpoint Medicaid Managed Care	$39.62

SCREW 4X16MM

Facility

$1,495.00

Service Code	HCPCS C1713
Hospital Charge Code	270705764
Hospital Revenue Code	278
Min. Negotiated Rate	$224.25
Max. Negotiated Rate	$361.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$299.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$328.90
Rate for Payer: Qualcare PPO/HMO/WC	$224.25

SCREW 4 X 44 PARTIAL THREAD

Facility

$1,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270664481
Hospital Revenue Code	278
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.50
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

SCREW 4 X 44 PARTIAL THREAD

Facility

$1,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270664481
Hospital Revenue Code	278
Min. Negotiated Rate	$25.91
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$408.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.50
Rate for Payer: Qualcare PPO/HMO/WC	$161.25
Rate for Payer: UnitedHealthcare Community & State	$25.91
Rate for Payer: Wellpoint Medicaid Managed Care	$28.49

Know your out-of-pocket cost for care.

All Charges