Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW 5.5X40MM

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270705895
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$532.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$330.00

SCREW 5.5X40MM

Facility

$1,174.50

Service Code	HCPCS C1713
Hospital Charge Code	270705150
Hospital Revenue Code	278
Min. Negotiated Rate	$28.31
Max. Negotiated Rate	$587.25
Rate for Payer: Aetna Commercial	$446.31
Rate for Payer: Aetna Medicare Advantage	$352.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$234.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.50
Rate for Payer: Cigna Commercial	$587.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$258.39
Rate for Payer: Qualcare PPO/HMO/WC	$176.18
Rate for Payer: UnitedHealthcare Community & State	$28.31
Rate for Payer: Wellpoint Medicaid Managed Care	$31.12

SCREW 5.5X40MM

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270705895
Hospital Revenue Code	278
Min. Negotiated Rate	$53.02
Max. Negotiated Rate	$1,100.00
Rate for Payer: Aetna Commercial	$836.00
Rate for Payer: Aetna Medicare Advantage	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$561.00
Rate for Payer: Cigna Commercial	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$330.00
Rate for Payer: UnitedHealthcare Community & State	$53.02
Rate for Payer: Wellpoint Medicaid Managed Care	$58.30

SCREW 5.5X40MM

Facility

$1,174.50

Service Code	HCPCS C1713
Hospital Charge Code	270705150
Hospital Revenue Code	278
Min. Negotiated Rate	$176.18
Max. Negotiated Rate	$284.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$234.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$258.39
Rate for Payer: Qualcare PPO/HMO/WC	$176.18

SCREW 5.5X45MM

Facility

$5,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270704011
Hospital Revenue Code	278
Min. Negotiated Rate	$817.50
Max. Negotiated Rate	$1,318.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,090.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,318.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,199.00
Rate for Payer: Qualcare PPO/HMO/WC	$817.50

SCREW 5.5X45MM

Facility

$5,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270704011
Hospital Revenue Code	278
Min. Negotiated Rate	$131.34
Max. Negotiated Rate	$2,725.00
Rate for Payer: Aetna Commercial	$2,071.00
Rate for Payer: Aetna Medicare Advantage	$1,635.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,389.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,389.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,090.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,389.75
Rate for Payer: Cigna Commercial	$2,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,318.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,199.00
Rate for Payer: Qualcare PPO/HMO/WC	$817.50
Rate for Payer: UnitedHealthcare Community & State	$131.34
Rate for Payer: Wellpoint Medicaid Managed Care	$144.43

SCREW 5.5X75MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270699317
Hospital Revenue Code	278
Min. Negotiated Rate	$162.43
Max. Negotiated Rate	$3,370.00
Rate for Payer: Aetna Commercial	$2,561.20
Rate for Payer: Aetna Medicare Advantage	$2,022.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,718.70
Rate for Payer: Cigna Commercial	$3,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,482.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00
Rate for Payer: UnitedHealthcare Community & State	$162.43
Rate for Payer: Wellpoint Medicaid Managed Care	$178.61

SCREW 5.5X75MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270699317
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$1,631.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,482.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

SCREW 56 X 12 MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270687499
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 56 X 12 MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270687499
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 5CT

Facility

$2,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270665095
Hospital Revenue Code	278
Min. Negotiated Rate	$69.89
Max. Negotiated Rate	$1,450.00
Rate for Payer: Aetna Commercial	$1,102.00
Rate for Payer: Aetna Medicare Advantage	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$739.50
Rate for Payer: Cigna Commercial	$1,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$638.00
Rate for Payer: Qualcare PPO/HMO/WC	$435.00
Rate for Payer: UnitedHealthcare Community & State	$69.89
Rate for Payer: Wellpoint Medicaid Managed Care	$76.85

SCREW 5CT

Facility

$2,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270665095
Hospital Revenue Code	278
Min. Negotiated Rate	$435.00
Max. Negotiated Rate	$701.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$638.00
Rate for Payer: Qualcare PPO/HMO/WC	$435.00

SCREW 5L30

Facility

$1,250.00

Hospital Charge Code	270703488
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 5L30

Facility

$1,250.00

Hospital Charge Code	270703488
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 5MM LOCKING 75MM

Facility

$14,942.05

Service Code	HCPCS C1713
Hospital Charge Code	270693022
Hospital Revenue Code	278
Min. Negotiated Rate	$360.10
Max. Negotiated Rate	$7,471.02
Rate for Payer: Aetna Commercial	$5,677.98
Rate for Payer: Aetna Medicare Advantage	$4,482.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,810.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,810.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,988.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,810.22
Rate for Payer: Cigna Commercial	$7,471.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,615.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,287.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,241.31
Rate for Payer: UnitedHealthcare Community & State	$360.10
Rate for Payer: Wellpoint Medicaid Managed Care	$395.96

SCREW 5MM LOCKING 75MM

Facility

$14,942.05

Service Code	HCPCS C1713
Hospital Charge Code	270693022
Hospital Revenue Code	278
Min. Negotiated Rate	$2,241.31
Max. Negotiated Rate	$3,615.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,988.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,615.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,287.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,241.31

SCREW 5MM LOCKING 80MM

Facility

$1,245.45

Service Code	HCPCS C1713
Hospital Charge Code	270693023
Hospital Revenue Code	278
Min. Negotiated Rate	$30.02
Max. Negotiated Rate	$622.73
Rate for Payer: Aetna Commercial	$473.27
Rate for Payer: Aetna Medicare Advantage	$373.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$317.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$317.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$317.59
Rate for Payer: Cigna Commercial	$622.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$274.00
Rate for Payer: Qualcare PPO/HMO/WC	$186.82
Rate for Payer: UnitedHealthcare Community & State	$30.02
Rate for Payer: Wellpoint Medicaid Managed Care	$33.00

SCREW 5MM LOCKING 80MM

Facility

$1,245.45

Service Code	HCPCS C1713
Hospital Charge Code	270693023
Hospital Revenue Code	278
Min. Negotiated Rate	$186.82
Max. Negotiated Rate	$301.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$274.00
Rate for Payer: Qualcare PPO/HMO/WC	$186.82

SCREW 5mm MTRX 04.503.225.01

Facility

$383.25

Hospital Charge Code	270640447
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 5mm MTRX 04.503.225.01

Facility

$383.25

Hospital Charge Code	270640447
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 5mm X 40mm 14-405040

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270640292
Hospital Revenue Code	278
Min. Negotiated Rate	$25.30
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$399.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50
Rate for Payer: UnitedHealthcare Community & State	$25.30
Rate for Payer: Wellpoint Medicaid Managed Care	$27.82

SCREW 5mm X 40mm 14-405040

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270640292
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SCREW 5X17.5MM

Facility

$1,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270704777
Hospital Revenue Code	278
Min. Negotiated Rate	$37.96
Max. Negotiated Rate	$787.50
Rate for Payer: Aetna Commercial	$598.50
Rate for Payer: Aetna Medicare Advantage	$472.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$401.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$401.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$401.62
Rate for Payer: Cigna Commercial	$787.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$381.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$346.50
Rate for Payer: Qualcare PPO/HMO/WC	$236.25
Rate for Payer: UnitedHealthcare Community & State	$37.96
Rate for Payer: Wellpoint Medicaid Managed Care	$41.74

SCREW 5X17.5MM

Facility

$1,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270704777
Hospital Revenue Code	278
Min. Negotiated Rate	$236.25
Max. Negotiated Rate	$381.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$315.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$381.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$346.50
Rate for Payer: Qualcare PPO/HMO/WC	$236.25

SCREW 5X20MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704663
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

Know your out-of-pocket cost for care.

All Charges