Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW BIO TENODESIS AR-1680B

Facility

$1,837.50

Hospital Charge Code	270638708
Hospital Revenue Code	278
Min. Negotiated Rate	$275.62
Max. Negotiated Rate	$444.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$367.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$444.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$404.25
Rate for Payer: Qualcare PPO/HMO/WC	$275.62

SCREW BITE LONG THREAD 2X10MM

Facility

$1,069.75

Service Code	HCPCS C1713
Hospital Charge Code	270700631
Hospital Revenue Code	278
Min. Negotiated Rate	$160.46
Max. Negotiated Rate	$258.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.34
Rate for Payer: Qualcare PPO/HMO/WC	$160.46

SCREW BITE LONG THREAD 2X10MM

Facility

$1,069.75

Service Code	HCPCS C1713
Hospital Charge Code	270700631
Hospital Revenue Code	278
Min. Negotiated Rate	$25.78
Max. Negotiated Rate	$534.88
Rate for Payer: Aetna Commercial	$406.50
Rate for Payer: Aetna Medicare Advantage	$320.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.79
Rate for Payer: Cigna Commercial	$534.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.34
Rate for Payer: Qualcare PPO/HMO/WC	$160.46
Rate for Payer: UnitedHealthcare Community & State	$25.78
Rate for Payer: Wellpoint Medicaid Managed Care	$28.35

SCREW BLADE LOCKING 5.2MM S/P

Facility

$41.25

Hospital Charge Code	270669561
Hospital Revenue Code	272
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$20.62
Rate for Payer: Aetna Commercial	$15.68
Rate for Payer: Aetna Medicare Advantage	$12.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.52
Rate for Payer: Cigna Commercial	$20.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.38
Rate for Payer: Oxford Commercial	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$6.19
Rate for Payer: UnitedHealthcare Commercial	$8.25
Rate for Payer: UnitedHealthcare Community & State	$0.99
Rate for Payer: Wellpoint Medicaid Managed Care	$1.09

SCREW BLADE LOCKING 5.2MM S/P

Facility

$41.25

Hospital Charge Code	270669561
Hospital Revenue Code	272
Min. Negotiated Rate	$6.19
Max. Negotiated Rate	$6.19
Rate for Payer: Qualcare PPO/HMO/WC	$6.19

SCREW BLADE RETEN 3.4MM S/P

Facility

$37.92

Hospital Charge Code	270669560
Hospital Revenue Code	272
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$18.96
Rate for Payer: Aetna Commercial	$14.41
Rate for Payer: Aetna Medicare Advantage	$11.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.67
Rate for Payer: Cigna Commercial	$18.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.38
Rate for Payer: Oxford Commercial	$7.58
Rate for Payer: Qualcare PPO/HMO/WC	$5.69
Rate for Payer: UnitedHealthcare Commercial	$7.58
Rate for Payer: UnitedHealthcare Community & State	$0.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

SCREW BLADE RETEN 3.4MM S/P

Facility

$37.92

Hospital Charge Code	270669560
Hospital Revenue Code	272
Min. Negotiated Rate	$5.69
Max. Negotiated Rate	$5.69
Rate for Payer: Qualcare PPO/HMO/WC	$5.69

SCREW BMT 5 25 113845

Facility

$510.95

Hospital Charge Code	270628129
Hospital Revenue Code	278
Min. Negotiated Rate	$76.64
Max. Negotiated Rate	$123.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$112.41
Rate for Payer: Qualcare PPO/HMO/WC	$76.64

SCREW BMT 5 25 113845

Facility

$510.95

Hospital Charge Code	270628129
Hospital Revenue Code	278
Min. Negotiated Rate	$12.31
Max. Negotiated Rate	$255.47
Rate for Payer: Aetna Commercial	$194.16
Rate for Payer: Aetna Medicare Advantage	$153.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.29
Rate for Payer: Cigna Commercial	$255.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$112.41
Rate for Payer: Qualcare PPO/HMO/WC	$76.64
Rate for Payer: UnitedHealthcare Community & State	$12.31
Rate for Payer: Wellpoint Medicaid Managed Care	$13.54

SCREW BMT 5 30 113846

Facility

$510.95

Hospital Charge Code	270628130
Hospital Revenue Code	278
Min. Negotiated Rate	$76.64
Max. Negotiated Rate	$123.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$112.41
Rate for Payer: Qualcare PPO/HMO/WC	$76.64

SCREW BMT 5 30 113846

Facility

$510.95

Hospital Charge Code	270628130
Hospital Revenue Code	278
Min. Negotiated Rate	$12.31
Max. Negotiated Rate	$255.47
Rate for Payer: Aetna Commercial	$194.16
Rate for Payer: Aetna Medicare Advantage	$153.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.29
Rate for Payer: Cigna Commercial	$255.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$112.41
Rate for Payer: Qualcare PPO/HMO/WC	$76.64
Rate for Payer: UnitedHealthcare Community & State	$12.31
Rate for Payer: Wellpoint Medicaid Managed Care	$13.54

SCREW BMT 6.3 100 345632

Facility

$897.65

Hospital Charge Code	270614888
Hospital Revenue Code	278
Min. Negotiated Rate	$134.65
Max. Negotiated Rate	$217.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$197.48
Rate for Payer: Qualcare PPO/HMO/WC	$134.65

SCREW BMT 6.3 100 345632

Facility

$897.65

Hospital Charge Code	270614888
Hospital Revenue Code	278
Min. Negotiated Rate	$21.63
Max. Negotiated Rate	$448.82
Rate for Payer: Aetna Commercial	$341.11
Rate for Payer: Aetna Medicare Advantage	$269.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$228.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$228.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$228.90
Rate for Payer: Cigna Commercial	$448.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$197.48
Rate for Payer: Qualcare PPO/HMO/WC	$134.65
Rate for Payer: UnitedHealthcare Community & State	$21.63
Rate for Payer: Wellpoint Medicaid Managed Care	$23.79

SCREW BMT 6.3 95 345630

Facility

$897.65

Hospital Charge Code	270614898
Hospital Revenue Code	278
Min. Negotiated Rate	$134.65
Max. Negotiated Rate	$217.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$197.48
Rate for Payer: Qualcare PPO/HMO/WC	$134.65

SCREW BMT 6.3 95 345630

Facility

$897.65

Hospital Charge Code	270614898
Hospital Revenue Code	278
Min. Negotiated Rate	$21.63
Max. Negotiated Rate	$448.82
Rate for Payer: Aetna Commercial	$341.11
Rate for Payer: Aetna Medicare Advantage	$269.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$228.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$228.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$228.90
Rate for Payer: Cigna Commercial	$448.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$197.48
Rate for Payer: Qualcare PPO/HMO/WC	$134.65
Rate for Payer: UnitedHealthcare Community & State	$21.63
Rate for Payer: Wellpoint Medicaid Managed Care	$23.79

SCREW BMT BUTT FT 5 30 345422

Facility

$813.65

Hospital Charge Code	270609857
Hospital Revenue Code	278
Min. Negotiated Rate	$122.05
Max. Negotiated Rate	$196.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$179.00
Rate for Payer: Qualcare PPO/HMO/WC	$122.05

SCREW BMT BUTT FT 5 30 345422

Facility

$813.65

Hospital Charge Code	270609857
Hospital Revenue Code	278
Min. Negotiated Rate	$19.61
Max. Negotiated Rate	$406.82
Rate for Payer: Aetna Commercial	$309.19
Rate for Payer: Aetna Medicare Advantage	$244.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.48
Rate for Payer: Cigna Commercial	$406.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$179.00
Rate for Payer: Qualcare PPO/HMO/WC	$122.05
Rate for Payer: UnitedHealthcare Community & State	$19.61
Rate for Payer: Wellpoint Medicaid Managed Care	$21.56

SCREW BMT BUTT FT 6 40 345524

Facility

$588.00

Hospital Charge Code	270621868
Hospital Revenue Code	278
Min. Negotiated Rate	$88.20
Max. Negotiated Rate	$142.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$129.36
Rate for Payer: Qualcare PPO/HMO/WC	$88.20

SCREW BMT BUTT FT 6 40 345524

Facility

$588.00

Hospital Charge Code	270621868
Hospital Revenue Code	278
Min. Negotiated Rate	$14.17
Max. Negotiated Rate	$294.00
Rate for Payer: Aetna Commercial	$223.44
Rate for Payer: Aetna Medicare Advantage	$176.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.94
Rate for Payer: Cigna Commercial	$294.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$129.36
Rate for Payer: Qualcare PPO/HMO/WC	$88.20
Rate for Payer: UnitedHealthcare Community & State	$14.17
Rate for Payer: Wellpoint Medicaid Managed Care	$15.58

SCREW BMT BUTT FT 6 45 345526

Facility

$588.00

Hospital Charge Code	270621869
Hospital Revenue Code	278
Min. Negotiated Rate	$88.20
Max. Negotiated Rate	$142.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$129.36
Rate for Payer: Qualcare PPO/HMO/WC	$88.20

SCREW BMT BUTT FT 6 45 345526

Facility

$588.00

Hospital Charge Code	270621869
Hospital Revenue Code	278
Min. Negotiated Rate	$14.17
Max. Negotiated Rate	$294.00
Rate for Payer: Aetna Commercial	$223.44
Rate for Payer: Aetna Medicare Advantage	$176.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.94
Rate for Payer: Cigna Commercial	$294.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$129.36
Rate for Payer: Qualcare PPO/HMO/WC	$88.20
Rate for Payer: UnitedHealthcare Community & State	$14.17
Rate for Payer: Wellpoint Medicaid Managed Care	$15.58

SCREW BMT CANC 6.5 45 16235245

Facility

$203.25

Hospital Charge Code	270624446
Hospital Revenue Code	278
Min. Negotiated Rate	$4.90
Max. Negotiated Rate	$101.62
Rate for Payer: Aetna Commercial	$77.23
Rate for Payer: Aetna Medicare Advantage	$60.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.83
Rate for Payer: Cigna Commercial	$101.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.72
Rate for Payer: Qualcare PPO/HMO/WC	$30.49
Rate for Payer: UnitedHealthcare Community & State	$4.90
Rate for Payer: Wellpoint Medicaid Managed Care	$5.39

SCREW BMT CANC 6.5 45 16235245

Facility

$203.25

Hospital Charge Code	270624446
Hospital Revenue Code	278
Min. Negotiated Rate	$30.49
Max. Negotiated Rate	$49.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.72
Rate for Payer: Qualcare PPO/HMO/WC	$30.49

SCREW BMT CANN 7 100 345732

Facility

$973.65

Hospital Charge Code	270618655
Hospital Revenue Code	278
Min. Negotiated Rate	$146.05
Max. Negotiated Rate	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.20
Rate for Payer: Qualcare PPO/HMO/WC	$146.05

SCREW BMT CANN 7 100 345732

Facility

$973.65

Hospital Charge Code	270618655
Hospital Revenue Code	278
Min. Negotiated Rate	$23.46
Max. Negotiated Rate	$486.82
Rate for Payer: Aetna Commercial	$369.99
Rate for Payer: Aetna Medicare Advantage	$292.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.28
Rate for Payer: Cigna Commercial	$486.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.20
Rate for Payer: Qualcare PPO/HMO/WC	$146.05
Rate for Payer: UnitedHealthcare Community & State	$23.46
Rate for Payer: Wellpoint Medicaid Managed Care	$25.80

Know your out-of-pocket cost for care.

All Charges