Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE N/LOCKING 2.3x18mm

Facility

$507.00

Service Code	HCPCS C1713
Hospital Charge Code	270672694
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 2.7x16mm

Facility

$507.00

Hospital Charge Code	270643446
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 2.7x16mm

Facility

$507.00

Hospital Charge Code	270643446
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 2.7x20

Facility

$675.00

Hospital Charge Code	270660618
Hospital Revenue Code	278
Min. Negotiated Rate	$101.25
Max. Negotiated Rate	$163.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.50
Rate for Payer: Qualcare PPO/HMO/WC	$101.25

SCREW BONE N/LOCKING 2.7x20

Facility

$675.00

Hospital Charge Code	270660618
Hospital Revenue Code	278
Min. Negotiated Rate	$16.27
Max. Negotiated Rate	$337.50
Rate for Payer: Aetna Commercial	$256.50
Rate for Payer: Aetna Medicare Advantage	$202.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.12
Rate for Payer: Cigna Commercial	$337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.50
Rate for Payer: Qualcare PPO/HMO/WC	$101.25
Rate for Payer: UnitedHealthcare Community & State	$16.27
Rate for Payer: Wellpoint Medicaid Managed Care	$17.89

SCREW BONE NON LOCKIN 3.5X50MM

Facility

$655.00

Service Code	HCPCS C1713
Hospital Charge Code	270669919
Hospital Revenue Code	278
Min. Negotiated Rate	$98.25
Max. Negotiated Rate	$158.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$144.10
Rate for Payer: Qualcare PPO/HMO/WC	$98.25

SCREW BONE NON LOCKIN 3.5X50MM

Facility

$655.00

Service Code	HCPCS C1713
Hospital Charge Code	270669919
Hospital Revenue Code	278
Min. Negotiated Rate	$15.79
Max. Negotiated Rate	$327.50
Rate for Payer: Aetna Commercial	$248.90
Rate for Payer: Aetna Medicare Advantage	$196.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.03
Rate for Payer: Cigna Commercial	$327.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$144.10
Rate for Payer: Qualcare PPO/HMO/WC	$98.25
Rate for Payer: UnitedHealthcare Community & State	$15.79
Rate for Payer: Wellpoint Medicaid Managed Care	$17.36

SCREW BONE SELF TAP 2.7x12MM

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270672586
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$165.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$150.70
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

SCREW BONE SELF TAP 2.7x12MM

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270672586
Hospital Revenue Code	278
Min. Negotiated Rate	$16.51
Max. Negotiated Rate	$342.50
Rate for Payer: Aetna Commercial	$260.30
Rate for Payer: Aetna Medicare Advantage	$205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.68
Rate for Payer: Cigna Commercial	$342.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$150.70
Rate for Payer: Qualcare PPO/HMO/WC	$102.75
Rate for Payer: UnitedHealthcare Community & State	$16.51
Rate for Payer: Wellpoint Medicaid Managed Care	$18.15

SCREW BONE SELF TAP 2.7x24MM

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270672958
Hospital Revenue Code	278
Min. Negotiated Rate	$16.51
Max. Negotiated Rate	$342.50
Rate for Payer: Aetna Commercial	$260.30
Rate for Payer: Aetna Medicare Advantage	$205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.68
Rate for Payer: Cigna Commercial	$342.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$150.70
Rate for Payer: Qualcare PPO/HMO/WC	$102.75
Rate for Payer: UnitedHealthcare Community & State	$16.51
Rate for Payer: Wellpoint Medicaid Managed Care	$18.15

SCREW BONE SELF TAP 2.7x24MM

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270672958
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$165.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$150.70
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

SCREW BONE SELF TAP 3.5x12mm

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270662025
Hospital Revenue Code	278
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$218.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$126.50
Rate for Payer: Qualcare PPO/HMO/WC	$86.25
Rate for Payer: UnitedHealthcare Community & State	$13.86
Rate for Payer: Wellpoint Medicaid Managed Care	$15.24

SCREW BONE SELF TAP 3.5x12mm

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270662025
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$126.50
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

SCREW BONE SELF TAP 3.5x14mm

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270669708
Hospital Revenue Code	278
Min. Negotiated Rate	$16.51
Max. Negotiated Rate	$342.50
Rate for Payer: Aetna Commercial	$260.30
Rate for Payer: Aetna Medicare Advantage	$205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.68
Rate for Payer: Cigna Commercial	$342.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$150.70
Rate for Payer: Qualcare PPO/HMO/WC	$102.75
Rate for Payer: UnitedHealthcare Community & State	$16.51
Rate for Payer: Wellpoint Medicaid Managed Care	$18.15

SCREW BONE SELF TAP 3.5x14mm

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270669708
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$165.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$150.70
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

SCREW BONE SELF TAP 3.5x16mm

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270648602
Hospital Revenue Code	278
Min. Negotiated Rate	$16.51
Max. Negotiated Rate	$342.50
Rate for Payer: Aetna Commercial	$260.30
Rate for Payer: Aetna Medicare Advantage	$205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.68
Rate for Payer: Cigna Commercial	$342.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$150.70
Rate for Payer: Qualcare PPO/HMO/WC	$102.75
Rate for Payer: UnitedHealthcare Community & State	$16.51
Rate for Payer: Wellpoint Medicaid Managed Care	$18.15

SCREW BONE SELF TAP 3.5x16mm

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270648602
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$165.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$150.70
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

SCREW BONE SELF TAP 3.5x18mm

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270648603
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$165.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$150.70
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

SCREW BONE SELF TAP 3.5x18mm

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270648603
Hospital Revenue Code	278
Min. Negotiated Rate	$16.51
Max. Negotiated Rate	$342.50
Rate for Payer: Aetna Commercial	$260.30
Rate for Payer: Aetna Medicare Advantage	$205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.68
Rate for Payer: Cigna Commercial	$342.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$150.70
Rate for Payer: Qualcare PPO/HMO/WC	$102.75
Rate for Payer: UnitedHealthcare Community & State	$16.51
Rate for Payer: Wellpoint Medicaid Managed Care	$18.15

SCREW BONE SELFTAP 6.5x25mm

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270663510
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 SELFTAP 6.5x25mm

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270663510
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 SELFTAP 6.5x35mm

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270626109
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 SELFTAP 6.5x35mm

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270626109
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 SELFTAP 6.5x40mm

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270677528
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 SELFTAP 6.5x40mm

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270677528
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

Know your out-of-pocket cost for care.

All Charges