Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW 6.5X65MM 015.3287

Facility

$4,450.00

Hospital Charge Code	270702564
Hospital Revenue Code	278
Min. Negotiated Rate	$667.50
Max. Negotiated Rate	$1,076.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$890.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,076.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$979.00
Rate for Payer: Qualcare PPO/HMO/WC	$667.50

SCREW 6.5 X 80MM

Facility

$3,525.00

Service Code	HCPCS C1713
Hospital Charge Code	270686221
Hospital Revenue Code	278
Min. Negotiated Rate	$84.95
Max. Negotiated Rate	$1,762.50
Rate for Payer: Aetna Commercial	$1,339.50
Rate for Payer: Aetna Medicare Advantage	$1,057.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$898.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$898.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$705.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$898.88
Rate for Payer: Cigna Commercial	$1,762.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$853.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$775.50
Rate for Payer: Qualcare PPO/HMO/WC	$528.75
Rate for Payer: UnitedHealthcare Community & State	$84.95
Rate for Payer: Wellpoint Medicaid Managed Care	$93.41

SCREW 6.5 X 80MM

Facility

$3,525.00

Service Code	HCPCS C1713
Hospital Charge Code	270686221
Hospital Revenue Code	278
Min. Negotiated Rate	$528.75
Max. Negotiated Rate	$853.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$705.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$853.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$775.50
Rate for Payer: Qualcare PPO/HMO/WC	$528.75

SCREW 6MM

Facility

$415.00

Service Code	HCPCS C1713
Hospital Charge Code	270680773
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 6MM

Facility

$415.00

Service Code	HCPCS C1713
Hospital Charge Code	270680773
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 6 X 35 MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270684235
Hospital Revenue Code	278
Min. Negotiated Rate	$210.88
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$210.88
Rate for Payer: Wellpoint Medicaid Managed Care	$231.88

SCREW 6 X 35 MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270684235
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

SCREW 70MM LOW PROFILE

Facility

$350.00

Hospital Charge Code	270648243
Hospital Revenue Code	278
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$84.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$77.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

SCREW 70MM LOW PROFILE

Facility

$350.00

Hospital Charge Code	270648243
Hospital Revenue Code	278
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$133.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$77.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Community & State	$8.44
Rate for Payer: Wellpoint Medicaid Managed Care	$9.28

SCREW 7.3 LOCKING CANNUL 45

Facility

$1,203.00

Hospital Charge Code	270661931
Hospital Revenue Code	278
Min. Negotiated Rate	$180.45
Max. Negotiated Rate	$291.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$264.66
Rate for Payer: Qualcare PPO/HMO/WC	$180.45

SCREW 7.3 LOCKING CANNUL 45

Facility

$1,203.00

Hospital Charge Code	270661931
Hospital Revenue Code	278
Min. Negotiated Rate	$28.99
Max. Negotiated Rate	$601.50
Rate for Payer: Aetna Commercial	$457.14
Rate for Payer: Aetna Medicare Advantage	$360.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$306.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$306.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$306.76
Rate for Payer: Cigna Commercial	$601.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$264.66
Rate for Payer: Qualcare PPO/HMO/WC	$180.45
Rate for Payer: UnitedHealthcare Community & State	$28.99
Rate for Payer: Wellpoint Medicaid Managed Care	$31.88

SCREW 75 MM ANTIROTATION

Facility

$1,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270687504
Hospital Revenue Code	278
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$441.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$441.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$401.50
Rate for Payer: Qualcare PPO/HMO/WC	$273.75

SCREW 75 MM ANTIROTATION

Facility

$1,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270687504
Hospital Revenue Code	278
Min. Negotiated Rate	$43.98
Max. Negotiated Rate	$912.50
Rate for Payer: Aetna Commercial	$693.50
Rate for Payer: Aetna Medicare Advantage	$547.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$365.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.38
Rate for Payer: Cigna Commercial	$912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$441.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$401.50
Rate for Payer: Qualcare PPO/HMO/WC	$273.75
Rate for Payer: UnitedHealthcare Community & State	$43.98
Rate for Payer: Wellpoint Medicaid Managed Care	$48.36

SCREW 7.5MMX40MM POLY RELINE

Facility

$6,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270691824
Hospital Revenue Code	278
Min. Negotiated Rate	$1,031.25
Max. Negotiated Rate	$1,663.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,663.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,031.25

SCREW 7.5MMX40MM POLY RELINE

Facility

$6,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270691824
Hospital Revenue Code	278
Min. Negotiated Rate	$165.69
Max. Negotiated Rate	$3,437.50
Rate for Payer: Aetna Commercial	$2,612.50
Rate for Payer: Aetna Medicare Advantage	$2,062.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,753.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,753.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,753.12
Rate for Payer: Cigna Commercial	$3,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,663.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,031.25
Rate for Payer: UnitedHealthcare Community & State	$165.69
Rate for Payer: Wellpoint Medicaid Managed Care	$182.19

SCREW 7.5X30MM

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270705027
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 7.5X30MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270703860
Hospital Revenue Code	278
Min. Negotiated Rate	$48.20
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$48.20
Rate for Payer: Wellpoint Medicaid Managed Care	$53.00

SCREW 7.5X30MM

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270705027
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 7.5X30MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270703860
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

SCREW 7.5X35MM

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270704760
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 7.5X35MM

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270704760
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 7.5X40 INVICTUS MIS CNXT

Facility

$6,250.00

Hospital Charge Code	270703002
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

SCREW 7.5X40 INVICTUS MIS CNXT

Facility

$6,250.00

Hospital Charge Code	270703002
Hospital Revenue Code	278
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

SCREW 7.5 X 40 MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270692469
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 7.5 X 40 MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270692469
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

Know your out-of-pocket cost for care.

All Charges