Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW 6.5MM CANCELLOUS 55MM

Facility

$139.05

Service Code	HCPCS C1713
Hospital Charge Code	270656181
Hospital Revenue Code	278
Min. Negotiated Rate	$20.86
Max. Negotiated Rate	$33.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.59
Rate for Payer: Qualcare PPO/HMO/WC	$20.86

SCREW 6.5MM CANCELLOUS 55MM

Facility

$139.05

Service Code	HCPCS C1713
Hospital Charge Code	270656181
Hospital Revenue Code	278
Min. Negotiated Rate	$3.35
Max. Negotiated Rate	$69.53
Rate for Payer: Aetna Commercial	$52.84
Rate for Payer: Aetna Medicare Advantage	$41.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.46
Rate for Payer: Cigna Commercial	$69.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.59
Rate for Payer: Qualcare PPO/HMO/WC	$20.86
Rate for Payer: UnitedHealthcare Community & State	$3.35
Rate for Payer: Wellpoint Medicaid Managed Care	$3.68

SCREW 6.5MM CANCELLOUS 60MM

Facility

$139.05

Service Code	HCPCS C1713
Hospital Charge Code	270656182
Hospital Revenue Code	278
Min. Negotiated Rate	$3.35
Max. Negotiated Rate	$69.53
Rate for Payer: Aetna Commercial	$52.84
Rate for Payer: Aetna Medicare Advantage	$41.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.46
Rate for Payer: Cigna Commercial	$69.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.59
Rate for Payer: Qualcare PPO/HMO/WC	$20.86
Rate for Payer: UnitedHealthcare Community & State	$3.35
Rate for Payer: Wellpoint Medicaid Managed Care	$3.68

SCREW 6.5MM CANCELLOUS 60MM

Facility

$139.05

Service Code	HCPCS C1713
Hospital Charge Code	270656182
Hospital Revenue Code	278
Min. Negotiated Rate	$20.86
Max. Negotiated Rate	$33.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.59
Rate for Payer: Qualcare PPO/HMO/WC	$20.86

SCREW 6.5MM CANCELLOUS 65MM

Facility

$139.05

Service Code	HCPCS C1713
Hospital Charge Code	270656183
Hospital Revenue Code	278
Min. Negotiated Rate	$3.35
Max. Negotiated Rate	$69.53
Rate for Payer: Aetna Commercial	$52.84
Rate for Payer: Aetna Medicare Advantage	$41.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.46
Rate for Payer: Cigna Commercial	$69.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.59
Rate for Payer: Qualcare PPO/HMO/WC	$20.86
Rate for Payer: UnitedHealthcare Community & State	$3.35
Rate for Payer: Wellpoint Medicaid Managed Care	$3.68

SCREW 6.5MM CANCELLOUS 65MM

Facility

$139.05

Service Code	HCPCS C1713
Hospital Charge Code	270656183
Hospital Revenue Code	278
Min. Negotiated Rate	$20.86
Max. Negotiated Rate	$33.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.59
Rate for Payer: Qualcare PPO/HMO/WC	$20.86

SCREW 6.5MM CANCELLOUS 70MM

Facility

$135.00

Hospital Charge Code	270656184
Hospital Revenue Code	278
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$32.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

SCREW 6.5MM CANCELLOUS 70MM

Facility

$135.00

Hospital Charge Code	270656184
Hospital Revenue Code	278
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$51.30
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.42
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.25
Rate for Payer: UnitedHealthcare Community & State	$3.25
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

SCREW 6.5MM CANCELLOUS 75MM

Facility

$135.00

Hospital Charge Code	270656185
Hospital Revenue Code	278
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$32.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

SCREW 6.5MM CANCELLOUS 75MM

Facility

$135.00

Hospital Charge Code	270656185
Hospital Revenue Code	278
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$51.30
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.42
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.25
Rate for Payer: UnitedHealthcare Community & State	$3.25
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

SCREW 6.5MM CANCELLOUS 80MM

Facility

$135.00

Hospital Charge Code	270656186
Hospital Revenue Code	278
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$32.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

SCREW 6.5MM CANCELLOUS 80MM

Facility

$135.00

Hospital Charge Code	270656186
Hospital Revenue Code	278
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$51.30
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.42
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.25
Rate for Payer: UnitedHealthcare Community & State	$3.25
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

SCREW 6.5MM CANCELLOUS 85MM

Facility

$145.50

Hospital Charge Code	270656187
Hospital Revenue Code	278
Min. Negotiated Rate	$21.82
Max. Negotiated Rate	$35.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.01
Rate for Payer: Qualcare PPO/HMO/WC	$21.82

SCREW 6.5MM CANCELLOUS 85MM

Facility

$145.50

Hospital Charge Code	270656187
Hospital Revenue Code	278
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$72.75
Rate for Payer: Aetna Commercial	$55.29
Rate for Payer: Aetna Medicare Advantage	$43.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.10
Rate for Payer: Cigna Commercial	$72.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.01
Rate for Payer: Qualcare PPO/HMO/WC	$21.82
Rate for Payer: UnitedHealthcare Community & State	$3.51
Rate for Payer: Wellpoint Medicaid Managed Care	$3.86

SCREW 6.5MM CANCELLOUS 90MM

Facility

$145.50

Hospital Charge Code	270656188
Hospital Revenue Code	278
Min. Negotiated Rate	$21.82
Max. Negotiated Rate	$35.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.01
Rate for Payer: Qualcare PPO/HMO/WC	$21.82

SCREW 6.5MM CANCELLOUS 90MM

Facility

$145.50

Hospital Charge Code	270656188
Hospital Revenue Code	278
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$72.75
Rate for Payer: Aetna Commercial	$55.29
Rate for Payer: Aetna Medicare Advantage	$43.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.10
Rate for Payer: Cigna Commercial	$72.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.01
Rate for Payer: Qualcare PPO/HMO/WC	$21.82
Rate for Payer: UnitedHealthcare Community & State	$3.51
Rate for Payer: Wellpoint Medicaid Managed Care	$3.86

SCREW 6.5MM CANCELLOUS 95MM

Facility

$145.50

Hospital Charge Code	270656189
Hospital Revenue Code	278
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$72.75
Rate for Payer: Aetna Commercial	$55.29
Rate for Payer: Aetna Medicare Advantage	$43.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.10
Rate for Payer: Cigna Commercial	$72.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.01
Rate for Payer: Qualcare PPO/HMO/WC	$21.82
Rate for Payer: UnitedHealthcare Community & State	$3.51
Rate for Payer: Wellpoint Medicaid Managed Care	$3.86

SCREW 6.5MM CANCELLOUS 95MM

Facility

$145.50

Hospital Charge Code	270656189
Hospital Revenue Code	278
Min. Negotiated Rate	$21.82
Max. Negotiated Rate	$35.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.01
Rate for Payer: Qualcare PPO/HMO/WC	$21.82

SCREW 6.5MM CANC FULL

Facility

$143.75

Hospital Charge Code	272656204
Hospital Revenue Code	278
Min. Negotiated Rate	$21.56
Max. Negotiated Rate	$34.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$31.62
Rate for Payer: Qualcare PPO/HMO/WC	$21.56

SCREW 6.5MM CANC FULL

Facility

$135.00

Hospital Charge Code	270656204
Hospital Revenue Code	278
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$32.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

SCREW 6.5MM CANC FULL

Facility

$135.00

Hospital Charge Code	270656201
Hospital Revenue Code	278
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$32.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

SCREW 6.5MM CANC FULL

Facility

$135.00

Hospital Charge Code	270656202
Hospital Revenue Code	278
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$51.30
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.42
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.25
Rate for Payer: UnitedHealthcare Community & State	$3.25
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

SCREW 6.5MM CANC FULL

Facility

$135.00

Hospital Charge Code	270656202
Hospital Revenue Code	278
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$32.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

SCREW 6.5MM CANC FULL

Facility

$135.00

Hospital Charge Code	270656197
Hospital Revenue Code	278
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$51.30
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.42
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.25
Rate for Payer: UnitedHealthcare Community & State	$3.25
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

SCREW 6.5MM CANC FULL

Facility

$135.00

Hospital Charge Code	270656201
Hospital Revenue Code	278
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$51.30
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.42
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.25
Rate for Payer: UnitedHealthcare Community & State	$3.25
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

Know your out-of-pocket cost for care.

All Charges