Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE 6.5 X 30 MM SELFTAP

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270692346
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 6.5 X 30 MM SELFTAP

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270692346
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 6.5 X 30 SELF TAP

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270628648
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 6.5 X 30 SELF TAP

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270628648
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 ACET 30MM

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	270692217
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

SCREW BONE ACET 30MM

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	270692217
Hospital Revenue Code	278
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

SCREW BONE ACET 35MM

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	270692212
Hospital Revenue Code	278
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

SCREW BONE ACET 35MM

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	270692212
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

SCREW BONE ACET 36MM

Facility

$7,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270692216
Hospital Revenue Code	278
Min. Negotiated Rate	$189.79
Max. Negotiated Rate	$3,937.50
Rate for Payer: Aetna Commercial	$2,992.50
Rate for Payer: Aetna Medicare Advantage	$2,362.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,008.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,008.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,008.12
Rate for Payer: Cigna Commercial	$3,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,905.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,732.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25
Rate for Payer: UnitedHealthcare Community & State	$189.79
Rate for Payer: Wellpoint Medicaid Managed Care	$208.69

SCREW BONE ACET 36MM

Facility

$7,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270692216
Hospital Revenue Code	278
Min. Negotiated Rate	$1,181.25
Max. Negotiated Rate	$1,905.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,905.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,732.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25

SCREW BONE ACET 6.5X30MM

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	270692219
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

SCREW BONE ACET 6.5X30MM

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	270692219
Hospital Revenue Code	278
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

SCREW BONE CAN 6.5MMX30MM

Facility

$650.00

Service Code	HCPCS C1713
Hospital Charge Code	270646341
Hospital Revenue Code	278
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

SCREW BONE CAN 6.5MMX30MM

Facility

$650.00

Service Code	HCPCS C1713
Hospital Charge Code	270646341
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

SCREW BONE CAN 6.5MMX40MM

Facility

$650.00

Service Code	HCPCS C1713
Hospital Charge Code	270679972
Hospital Revenue Code	278
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

SCREW BONE CAN 6.5MMX40MM

Facility

$650.00

Service Code	HCPCS C1713
Hospital Charge Code	270679972
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

SCREW BONE CAN 6.5MMX50MM

Facility

$733.50

Service Code	HCPCS C1713
Hospital Charge Code	270646340
Hospital Revenue Code	278
Min. Negotiated Rate	$17.68
Max. Negotiated Rate	$366.75
Rate for Payer: Aetna Commercial	$278.73
Rate for Payer: Aetna Medicare Advantage	$220.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$187.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$187.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$187.04
Rate for Payer: Cigna Commercial	$366.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$161.37
Rate for Payer: Qualcare PPO/HMO/WC	$110.03
Rate for Payer: UnitedHealthcare Community & State	$17.68
Rate for Payer: Wellpoint Medicaid Managed Care	$19.44

SCREW BONE CAN 6.5MMX50MM

Facility

$733.50

Service Code	HCPCS C1713
Hospital Charge Code	270646340
Hospital Revenue Code	278
Min. Negotiated Rate	$110.03
Max. Negotiated Rate	$177.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$161.37
Rate for Payer: Qualcare PPO/HMO/WC	$110.03

SCREW BONE CANC 6.5x25MM

Facility

$296.65

Service Code	HCPCS C1713
Hospital Charge Code	270676581
Hospital Revenue Code	278
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$148.32
Rate for Payer: Aetna Commercial	$112.73
Rate for Payer: Aetna Medicare Advantage	$89.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.65
Rate for Payer: Cigna Commercial	$148.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.26
Rate for Payer: Qualcare PPO/HMO/WC	$44.50
Rate for Payer: UnitedHealthcare Community & State	$7.15
Rate for Payer: Wellpoint Medicaid Managed Care	$7.86

SCREW BONE CANC 6.5x25MM

Facility

$296.65

Service Code	HCPCS C1713
Hospital Charge Code	270676581
Hospital Revenue Code	278
Min. Negotiated Rate	$44.50
Max. Negotiated Rate	$71.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.26
Rate for Payer: Qualcare PPO/HMO/WC	$44.50

SCREW BONE CANCELLOUS 6.5x15MM

Facility

$500.00

Hospital Charge Code	270672543
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW BONE CANCELLOUS 6.5x15MM

Facility

$500.00

Hospital Charge Code	270672543
Hospital Revenue Code	278
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

SCREW BONE CANCELLOUS 6.5x16MM

Facility

$432.00

Service Code	HCPCS C1713
Hospital Charge Code	270676686
Hospital Revenue Code	278
Min. Negotiated Rate	$10.41
Max. Negotiated Rate	$216.00
Rate for Payer: Aetna Commercial	$164.16
Rate for Payer: Aetna Medicare Advantage	$129.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.16
Rate for Payer: Cigna Commercial	$216.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$95.04
Rate for Payer: Qualcare PPO/HMO/WC	$64.80
Rate for Payer: UnitedHealthcare Community & State	$10.41
Rate for Payer: Wellpoint Medicaid Managed Care	$11.45

SCREW BONE CANCELLOUS 6.5x16MM

Facility

$432.00

Service Code	HCPCS C1713
Hospital Charge Code	270676686
Hospital Revenue Code	278
Min. Negotiated Rate	$64.80
Max. Negotiated Rate	$104.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$95.04
Rate for Payer: Qualcare PPO/HMO/WC	$64.80

SCREW BONE CANCELLOUS 6.5x25MM

Facility

$500.00

Hospital Charge Code	270672544
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

Know your out-of-pocket cost for care.

All Charges