Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE SELFTAP 6.5 x 50mm

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270686594
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 6.5 x 50mm

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270686594
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 SELF-TAP 7.5X55MM

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270693733
Hospital Revenue Code	278
Min. Negotiated Rate	$120.50
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$120.50
Rate for Payer: Wellpoint Medicaid Managed Care	$132.50

SCREW BONE SELF-TAP 7.5X55MM

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270693733
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

SCREW BONE SLF TAP 3.5X10MM

Facility

$685.00

Hospital Charge Code	270670988
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 SLF TAP 3.5X10MM

Facility

$685.00

Hospital Charge Code	270670988
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 S/TAPPING 6.5x20mm

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	270616307
Hospital Revenue Code	278
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.60

SCREW BONE S/TAPPING 6.5x20mm

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	270616307
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

SCREW BONE S/TAPPING 6.5x35mm

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	270612165
Hospital Revenue Code	278
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.60

SCREW BONE S/TAPPING 6.5x35mm

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	270612165
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

SCREW BONE T10 3.5 X 20MM

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	270667256
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 T10 3.5 X 20MM

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	270667256
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 T10 3.5X24MM

Facility

$655.00

Service Code	HCPCS C1713
Hospital Charge Code	270670010
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 T10 3.5X24MM

Facility

$655.00

Service Code	HCPCS C1713
Hospital Charge Code	270670010
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 T10 3.5x30MM

Facility

$655.00

Service Code	HCPCS C1713
Hospital Charge Code	270673998
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 T10 3.5x30MM

Facility

$655.00

Service Code	HCPCS C1713
Hospital Charge Code	270673998
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 T10 FT 3.5X32MM

Facility

$711.55

Service Code	HCPCS C1713
Hospital Charge Code	270692173
Hospital Revenue Code	278
Min. Negotiated Rate	$17.15
Max. Negotiated Rate	$355.77
Rate for Payer: Aetna Commercial	$270.39
Rate for Payer: Aetna Medicare Advantage	$213.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.45
Rate for Payer: Cigna Commercial	$355.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$156.54
Rate for Payer: Qualcare PPO/HMO/WC	$106.73
Rate for Payer: UnitedHealthcare Community & State	$17.15
Rate for Payer: Wellpoint Medicaid Managed Care	$18.86

SCREW BONE T10 FT 3.5X32MM

Facility

$711.55

Service Code	HCPCS C1713
Hospital Charge Code	270692173
Hospital Revenue Code	278
Min. Negotiated Rate	$106.73
Max. Negotiated Rate	$172.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$156.54
Rate for Payer: Qualcare PPO/HMO/WC	$106.73

SCREW BONE T10 FT 3.5X38MM

Facility

$711.55

Service Code	HCPCS C1713
Hospital Charge Code	270692174
Hospital Revenue Code	278
Min. Negotiated Rate	$17.15
Max. Negotiated Rate	$355.77
Rate for Payer: Aetna Commercial	$270.39
Rate for Payer: Aetna Medicare Advantage	$213.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.45
Rate for Payer: Cigna Commercial	$355.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$156.54
Rate for Payer: Qualcare PPO/HMO/WC	$106.73
Rate for Payer: UnitedHealthcare Community & State	$17.15
Rate for Payer: Wellpoint Medicaid Managed Care	$18.86

SCREW BONE T10 FT 3.5X38MM

Facility

$711.55

Service Code	HCPCS C1713
Hospital Charge Code	270692174
Hospital Revenue Code	278
Min. Negotiated Rate	$106.73
Max. Negotiated Rate	$172.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$156.54
Rate for Payer: Qualcare PPO/HMO/WC	$106.73

SCREW BONE T10 FT 3.5X40MM

Facility

$711.55

Service Code	HCPCS C1713
Hospital Charge Code	270692175
Hospital Revenue Code	278
Min. Negotiated Rate	$106.73
Max. Negotiated Rate	$172.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$156.54
Rate for Payer: Qualcare PPO/HMO/WC	$106.73

SCREW BONE T10 FT 3.5X40MM

Facility

$711.55

Service Code	HCPCS C1713
Hospital Charge Code	270692175
Hospital Revenue Code	278
Min. Negotiated Rate	$17.15
Max. Negotiated Rate	$355.77
Rate for Payer: Aetna Commercial	$270.39
Rate for Payer: Aetna Medicare Advantage	$213.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.45
Rate for Payer: Cigna Commercial	$355.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$156.54
Rate for Payer: Qualcare PPO/HMO/WC	$106.73
Rate for Payer: UnitedHealthcare Community & State	$17.15
Rate for Payer: Wellpoint Medicaid Managed Care	$18.86

SCREW BONE T10 FT 3.5X42MM

Facility

$711.55

Service Code	HCPCS C1713
Hospital Charge Code	270692176
Hospital Revenue Code	278
Min. Negotiated Rate	$106.73
Max. Negotiated Rate	$172.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$156.54
Rate for Payer: Qualcare PPO/HMO/WC	$106.73

SCREW BONE T10 FT 3.5X42MM

Facility

$711.55

Service Code	HCPCS C1713
Hospital Charge Code	270692176
Hospital Revenue Code	278
Min. Negotiated Rate	$17.15
Max. Negotiated Rate	$355.77
Rate for Payer: Aetna Commercial	$270.39
Rate for Payer: Aetna Medicare Advantage	$213.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.45
Rate for Payer: Cigna Commercial	$355.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$156.54
Rate for Payer: Qualcare PPO/HMO/WC	$106.73
Rate for Payer: UnitedHealthcare Community & State	$17.15
Rate for Payer: Wellpoint Medicaid Managed Care	$18.86

SCREW BONE T8 2.7X14MM

Facility

$1,055.00

Service Code	HCPCS C1713
Hospital Charge Code	270699915
Hospital Revenue Code	278
Min. Negotiated Rate	$25.43
Max. Negotiated Rate	$527.50
Rate for Payer: Aetna Commercial	$400.90
Rate for Payer: Aetna Medicare Advantage	$316.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.02
Rate for Payer: Cigna Commercial	$527.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$232.10
Rate for Payer: Qualcare PPO/HMO/WC	$158.25
Rate for Payer: UnitedHealthcare Community & State	$25.43
Rate for Payer: Wellpoint Medicaid Managed Care	$27.96

Know your out-of-pocket cost for care.

All Charges