Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE 4.5mm x75mm LOCKING

Facility

$535.00

Hospital Charge Code	270643716
Hospital Revenue Code	278
Min. Negotiated Rate	$80.25
Max. Negotiated Rate	$129.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.70
Rate for Payer: Qualcare PPO/HMO/WC	$80.25

SCREW BONE 4.5mm x75mm LOCKING

Facility

$428.00

Hospital Charge Code	272643716
Hospital Revenue Code	278
Min. Negotiated Rate	$64.20
Max. Negotiated Rate	$103.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$94.16
Rate for Payer: Qualcare PPO/HMO/WC	$64.20

SCREW BONE 4.5mm x75mm LOCKING

Facility

$535.00

Hospital Charge Code	270643716
Hospital Revenue Code	278
Min. Negotiated Rate	$12.89
Max. Negotiated Rate	$267.50
Rate for Payer: Aetna Commercial	$203.30
Rate for Payer: Aetna Medicare Advantage	$160.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.43
Rate for Payer: Cigna Commercial	$267.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.70
Rate for Payer: Qualcare PPO/HMO/WC	$80.25
Rate for Payer: UnitedHealthcare Community & State	$12.89
Rate for Payer: Wellpoint Medicaid Managed Care	$14.18

SCREW BONE 4.5mm x75mm LOCKING

Facility

$428.00

Hospital Charge Code	272643716
Hospital Revenue Code	278
Min. Negotiated Rate	$10.31
Max. Negotiated Rate	$214.00
Rate for Payer: Aetna Commercial	$162.64
Rate for Payer: Aetna Medicare Advantage	$128.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.14
Rate for Payer: Cigna Commercial	$214.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$94.16
Rate for Payer: Qualcare PPO/HMO/WC	$64.20
Rate for Payer: UnitedHealthcare Community & State	$10.31
Rate for Payer: Wellpoint Medicaid Managed Care	$11.34

SCREW BONE 4.5mm x80mm LOCKING

Facility

$535.00

Service Code	HCPCS C1713
Hospital Charge Code	270643718
Hospital Revenue Code	278
Min. Negotiated Rate	$12.89
Max. Negotiated Rate	$267.50
Rate for Payer: Aetna Commercial	$203.30
Rate for Payer: Aetna Medicare Advantage	$160.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.43
Rate for Payer: Cigna Commercial	$267.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.70
Rate for Payer: Qualcare PPO/HMO/WC	$80.25
Rate for Payer: UnitedHealthcare Community & State	$12.89
Rate for Payer: Wellpoint Medicaid Managed Care	$14.18

SCREW BONE 4.5mm x80mm LOCKING

Facility

$535.00

Service Code	HCPCS C1713
Hospital Charge Code	270643718
Hospital Revenue Code	278
Min. Negotiated Rate	$80.25
Max. Negotiated Rate	$129.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.70
Rate for Payer: Qualcare PPO/HMO/WC	$80.25

SCREW BONE 4.5mm x85mm LOCKING

Facility

$428.00

Hospital Charge Code	270643717
Hospital Revenue Code	278
Min. Negotiated Rate	$10.31
Max. Negotiated Rate	$214.00
Rate for Payer: Aetna Commercial	$162.64
Rate for Payer: Aetna Medicare Advantage	$128.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.14
Rate for Payer: Cigna Commercial	$214.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$94.16
Rate for Payer: Qualcare PPO/HMO/WC	$64.20
Rate for Payer: UnitedHealthcare Community & State	$10.31
Rate for Payer: Wellpoint Medicaid Managed Care	$11.34

SCREW BONE 4.5mm x85mm LOCKING

Facility

$428.00

Hospital Charge Code	270643717
Hospital Revenue Code	278
Min. Negotiated Rate	$64.20
Max. Negotiated Rate	$103.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$94.16
Rate for Payer: Qualcare PPO/HMO/WC	$64.20

SCREW BONE 4.5x40MM

Facility

$136.50

Hospital Charge Code	270673226
Hospital Revenue Code	278
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$33.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.03
Rate for Payer: Qualcare PPO/HMO/WC	$20.48

SCREW BONE 4.5x40MM

Facility

$136.50

Hospital Charge Code	270673226
Hospital Revenue Code	278
Min. Negotiated Rate	$3.29
Max. Negotiated Rate	$68.25
Rate for Payer: Aetna Commercial	$51.87
Rate for Payer: Aetna Medicare Advantage	$40.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.81
Rate for Payer: Cigna Commercial	$68.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.03
Rate for Payer: Qualcare PPO/HMO/WC	$20.48
Rate for Payer: UnitedHealthcare Community & State	$3.29
Rate for Payer: Wellpoint Medicaid Managed Care	$3.62

SCREW BONE 4.5x50MM

Facility

$136.50

Service Code	HCPCS C1713
Hospital Charge Code	270663622
Hospital Revenue Code	278
Min. Negotiated Rate	$3.29
Max. Negotiated Rate	$68.25
Rate for Payer: Aetna Commercial	$51.87
Rate for Payer: Aetna Medicare Advantage	$40.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.81
Rate for Payer: Cigna Commercial	$68.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.03
Rate for Payer: Qualcare PPO/HMO/WC	$20.48
Rate for Payer: UnitedHealthcare Community & State	$3.29
Rate for Payer: Wellpoint Medicaid Managed Care	$3.62

SCREW BONE 4.5x50MM

Facility

$136.50

Service Code	HCPCS C1713
Hospital Charge Code	270663622
Hospital Revenue Code	278
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$33.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.03
Rate for Payer: Qualcare PPO/HMO/WC	$20.48

SCREW BONE 4.5x55MM

Facility

$136.50

Service Code	HCPCS C1713
Hospital Charge Code	270673228
Hospital Revenue Code	278
Min. Negotiated Rate	$3.29
Max. Negotiated Rate	$68.25
Rate for Payer: Aetna Commercial	$51.87
Rate for Payer: Aetna Medicare Advantage	$40.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.81
Rate for Payer: Cigna Commercial	$68.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.03
Rate for Payer: Qualcare PPO/HMO/WC	$20.48
Rate for Payer: UnitedHealthcare Community & State	$3.29
Rate for Payer: Wellpoint Medicaid Managed Care	$3.62

SCREW BONE 4.5x55MM

Facility

$136.50

Service Code	HCPCS C1713
Hospital Charge Code	270673228
Hospital Revenue Code	278
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$33.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.03
Rate for Payer: Qualcare PPO/HMO/WC	$20.48

SCREW BONE 4.5x60MM

Facility

$136.50

Service Code	HCPCS C1713
Hospital Charge Code	270673227
Hospital Revenue Code	278
Min. Negotiated Rate	$3.29
Max. Negotiated Rate	$68.25
Rate for Payer: Aetna Commercial	$51.87
Rate for Payer: Aetna Medicare Advantage	$40.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.81
Rate for Payer: Cigna Commercial	$68.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.03
Rate for Payer: Qualcare PPO/HMO/WC	$20.48
Rate for Payer: UnitedHealthcare Community & State	$3.29
Rate for Payer: Wellpoint Medicaid Managed Care	$3.62

SCREW BONE 4.5x60MM

Facility

$136.50

Service Code	HCPCS C1713
Hospital Charge Code	270673227
Hospital Revenue Code	278
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$33.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.03
Rate for Payer: Qualcare PPO/HMO/WC	$20.48

SCREW BONE 49 MM ALTREON 6.5 M

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270689640
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

SCREW BONE 49 MM ALTREON 6.5 M

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270689640
Hospital Revenue Code	278
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

SCREW BONE 5.5MM X 25MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692701
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 BONE 5.5MM X 25MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692701
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 BONE 5.5MM X 30 MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692702
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 BONE 5.5MM X 30 MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692702
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 BONE 5X48MM CORTICAL

Facility

$1,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270701853
Hospital Revenue Code	278
Min. Negotiated Rate	$38.56
Max. Negotiated Rate	$800.00
Rate for Payer: Aetna Commercial	$608.00
Rate for Payer: Aetna Medicare Advantage	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$408.00
Rate for Payer: Cigna Commercial	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$352.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00
Rate for Payer: UnitedHealthcare Community & State	$38.56
Rate for Payer: Wellpoint Medicaid Managed Care	$42.40

SCREW BONE 5X48MM CORTICAL

Facility

$1,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270701853
Hospital Revenue Code	278
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$387.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$352.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

SCREW BONE 6.5 DIA 15MM

Facility

$660.00

Hospital Charge Code	270669160
Hospital Revenue Code	278
Min. Negotiated Rate	$15.91
Max. Negotiated Rate	$330.00
Rate for Payer: Aetna Commercial	$250.80
Rate for Payer: Aetna Medicare Advantage	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.30
Rate for Payer: Cigna Commercial	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.00
Rate for Payer: UnitedHealthcare Community & State	$15.91
Rate for Payer: Wellpoint Medicaid Managed Care	$17.49

Know your out-of-pocket cost for care.

All Charges