Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE FUL THD 2.4 X 26MM

Facility

$770.85

Service Code	HCPCS C1713
Hospital Charge Code	270705671
Hospital Revenue Code	278
Min. Negotiated Rate	$18.58
Max. Negotiated Rate	$385.43
Rate for Payer: Aetna Commercial	$292.92
Rate for Payer: Aetna Medicare Advantage	$231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.57
Rate for Payer: Cigna Commercial	$385.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$169.59
Rate for Payer: Qualcare PPO/HMO/WC	$115.63
Rate for Payer: UnitedHealthcare Community & State	$18.58
Rate for Payer: Wellpoint Medicaid Managed Care	$20.43

SCREW BONE FUL THD 2.4 X 26MM

Facility

$770.85

Service Code	HCPCS C1713
Hospital Charge Code	270705671
Hospital Revenue Code	278
Min. Negotiated Rate	$115.63
Max. Negotiated Rate	$186.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$169.59
Rate for Payer: Qualcare PPO/HMO/WC	$115.63

SCREW BONE INBONE

Facility

$680.00

Service Code	HCPCS C1713
Hospital Charge Code	270670899
Hospital Revenue Code	278
Min. Negotiated Rate	$102.00
Max. Negotiated Rate	$164.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$149.60
Rate for Payer: Qualcare PPO/HMO/WC	$102.00

SCREW BONE INBONE

Facility

$680.00

Service Code	HCPCS C1713
Hospital Charge Code	270670899
Hospital Revenue Code	278
Min. Negotiated Rate	$16.39
Max. Negotiated Rate	$340.00
Rate for Payer: Aetna Commercial	$258.40
Rate for Payer: Aetna Medicare Advantage	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.40
Rate for Payer: Cigna Commercial	$340.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$149.60
Rate for Payer: Qualcare PPO/HMO/WC	$102.00
Rate for Payer: UnitedHealthcare Community & State	$16.39
Rate for Payer: Wellpoint Medicaid Managed Care	$18.02

SCREW BONE LOCKING 1.7X 10MM

Facility

$705.00

Service Code	HCPCS C1713
Hospital Charge Code	270655375
Hospital Revenue Code	278
Min. Negotiated Rate	$105.75
Max. Negotiated Rate	$170.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$155.10
Rate for Payer: Qualcare PPO/HMO/WC	$105.75

SCREW BONE LOCKING 1.7X 10MM

Facility

$705.00

Service Code	HCPCS C1713
Hospital Charge Code	270655375
Hospital Revenue Code	278
Min. Negotiated Rate	$16.99
Max. Negotiated Rate	$352.50
Rate for Payer: Aetna Commercial	$267.90
Rate for Payer: Aetna Medicare Advantage	$211.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.78
Rate for Payer: Cigna Commercial	$352.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$155.10
Rate for Payer: Qualcare PPO/HMO/WC	$105.75
Rate for Payer: UnitedHealthcare Community & State	$16.99
Rate for Payer: Wellpoint Medicaid Managed Care	$18.68

SCREW BONE LOCKING 1.7X7MM

Facility

$705.00

Service Code	HCPCS C1713
Hospital Charge Code	270656394
Hospital Revenue Code	278
Min. Negotiated Rate	$16.99
Max. Negotiated Rate	$352.50
Rate for Payer: Aetna Commercial	$267.90
Rate for Payer: Aetna Medicare Advantage	$211.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.78
Rate for Payer: Cigna Commercial	$352.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$155.10
Rate for Payer: Qualcare PPO/HMO/WC	$105.75
Rate for Payer: UnitedHealthcare Community & State	$16.99
Rate for Payer: Wellpoint Medicaid Managed Care	$18.68

SCREW BONE LOCKING 1.7X7MM

Facility

$705.00

Service Code	HCPCS C1713
Hospital Charge Code	270656394
Hospital Revenue Code	278
Min. Negotiated Rate	$105.75
Max. Negotiated Rate	$170.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$155.10
Rate for Payer: Qualcare PPO/HMO/WC	$105.75

SCREW BONE LOCKING 1.7X8MM

Facility

$705.00

Service Code	HCPCS C1713
Hospital Charge Code	270656396
Hospital Revenue Code	278
Min. Negotiated Rate	$105.75
Max. Negotiated Rate	$170.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$155.10
Rate for Payer: Qualcare PPO/HMO/WC	$105.75

SCREW BONE LOCKING 1.7X8MM

Facility

$705.00

Service Code	HCPCS C1713
Hospital Charge Code	270656396
Hospital Revenue Code	278
Min. Negotiated Rate	$16.99
Max. Negotiated Rate	$352.50
Rate for Payer: Aetna Commercial	$267.90
Rate for Payer: Aetna Medicare Advantage	$211.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.78
Rate for Payer: Cigna Commercial	$352.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$155.10
Rate for Payer: Qualcare PPO/HMO/WC	$105.75
Rate for Payer: UnitedHealthcare Community & State	$16.99
Rate for Payer: Wellpoint Medicaid Managed Care	$18.68

SCREW BONE LOCKING 2.0x18mm

Facility

$875.00

Hospital Charge Code	270666944
Hospital Revenue Code	278
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

SCREW BONE LOCKING 2.0x18mm

Facility

$875.00

Hospital Charge Code	270666944
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SCREW BONE LOCKING 2.3x10MM

Facility

$790.00

Service Code	HCPCS C1713
Hospital Charge Code	270657991
Hospital Revenue Code	278
Min. Negotiated Rate	$118.50
Max. Negotiated Rate	$191.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$173.80
Rate for Payer: Qualcare PPO/HMO/WC	$118.50

SCREW BONE LOCKING 2.3x10MM

Facility

$790.00

Service Code	HCPCS C1713
Hospital Charge Code	270657991
Hospital Revenue Code	278
Min. Negotiated Rate	$19.04
Max. Negotiated Rate	$395.00
Rate for Payer: Aetna Commercial	$300.20
Rate for Payer: Aetna Medicare Advantage	$237.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.45
Rate for Payer: Cigna Commercial	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$173.80
Rate for Payer: Qualcare PPO/HMO/WC	$118.50
Rate for Payer: UnitedHealthcare Community & State	$19.04
Rate for Payer: Wellpoint Medicaid Managed Care	$20.93

SCREW BONE LOCKING 2.3x12MM

Facility

$750.00

Hospital Charge Code	270665822
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

SCREW BONE LOCKING 2.3x12MM

Facility

$750.00

Hospital Charge Code	270665822
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW BONE LOCKING 2.3X14MM

Facility

$750.00

Hospital Charge Code	270667936
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

SCREW BONE LOCKING 2.3X14MM

Facility

$750.00

Hospital Charge Code	270667936
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW BONE MULCH 907325

Facility

$2,812.85

Hospital Charge Code	270620400
Hospital Revenue Code	278
Min. Negotiated Rate	$421.93
Max. Negotiated Rate	$680.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$562.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$680.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$618.83
Rate for Payer: Qualcare PPO/HMO/WC	$421.93

SCREW BONE MULCH 907325

Facility

$2,812.85

Hospital Charge Code	270620400
Hospital Revenue Code	278
Min. Negotiated Rate	$67.79
Max. Negotiated Rate	$1,406.42
Rate for Payer: Aetna Commercial	$1,068.88
Rate for Payer: Aetna Medicare Advantage	$843.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$717.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$717.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$562.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$717.28
Rate for Payer: Cigna Commercial	$1,406.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$680.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$618.83
Rate for Payer: Qualcare PPO/HMO/WC	$421.93
Rate for Payer: UnitedHealthcare Community & State	$67.79
Rate for Payer: Wellpoint Medicaid Managed Care	$74.54

SCREW BONE MULCH 907340

Facility

$2,812.85

Hospital Charge Code	270620401
Hospital Revenue Code	278
Min. Negotiated Rate	$421.93
Max. Negotiated Rate	$680.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$562.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$680.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$618.83
Rate for Payer: Qualcare PPO/HMO/WC	$421.93

SCREW BONE MULCH 907340

Facility

$2,812.85

Hospital Charge Code	270620401
Hospital Revenue Code	278
Min. Negotiated Rate	$67.79
Max. Negotiated Rate	$1,406.42
Rate for Payer: Aetna Commercial	$1,068.88
Rate for Payer: Aetna Medicare Advantage	$843.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$717.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$717.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$562.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$717.28
Rate for Payer: Cigna Commercial	$1,406.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$680.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$618.83
Rate for Payer: Qualcare PPO/HMO/WC	$421.93
Rate for Payer: UnitedHealthcare Community & State	$67.79
Rate for Payer: Wellpoint Medicaid Managed Care	$74.54

SCREW BONE N/LOCKING 2.3x16mm

Facility

$507.00

Hospital Charge Code	270672689
Hospital Revenue Code	278
Min. Negotiated Rate	$76.05
Max. Negotiated Rate	$122.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.54
Rate for Payer: Qualcare PPO/HMO/WC	$76.05

SCREW BONE N/LOCKING 2.3x16mm

Facility

$507.00

Hospital Charge Code	270672689
Hospital Revenue Code	278
Min. Negotiated Rate	$12.22
Max. Negotiated Rate	$253.50
Rate for Payer: Aetna Commercial	$192.66
Rate for Payer: Aetna Medicare Advantage	$152.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$129.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$129.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$129.28
Rate for Payer: Cigna Commercial	$253.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.54
Rate for Payer: Qualcare PPO/HMO/WC	$76.05
Rate for Payer: UnitedHealthcare Community & State	$12.22
Rate for Payer: Wellpoint Medicaid Managed Care	$13.44

SCREW BONE N/LOCKING 2.3x18mm

Facility

$507.00

Service Code	HCPCS C1713
Hospital Charge Code	270672694
Hospital Revenue Code	278
Min. Negotiated Rate	$76.05
Max. Negotiated Rate	$122.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.54
Rate for Payer: Qualcare PPO/HMO/WC	$76.05

Know your out-of-pocket cost for care.

All Charges