Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE T8 2.7X14MM

Facility

$1,055.00

Service Code	HCPCS C1713
Hospital Charge Code	270699915
Hospital Revenue Code	278
Min. Negotiated Rate	$158.25
Max. Negotiated Rate	$255.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.00
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

SCREW BONE T8 FUL THD 2.7 28MM

Facility

$770.85

Service Code	HCPCS C1713
Hospital Charge Code	270703685
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 T8 FUL THD 2.7 28MM

Facility

$770.85

Service Code	HCPCS C1713
Hospital Charge Code	270703685
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 THD 3.5MM X L26MM

Facility

$752.45

Service Code	HCPCS C1713
Hospital Charge Code	270700877
Hospital Revenue Code	278
Min. Negotiated Rate	$18.13
Max. Negotiated Rate	$376.23
Rate for Payer: Aetna Commercial	$285.93
Rate for Payer: Aetna Medicare Advantage	$225.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.87
Rate for Payer: Cigna Commercial	$376.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.54
Rate for Payer: Qualcare PPO/HMO/WC	$112.87
Rate for Payer: UnitedHealthcare Community & State	$18.13
Rate for Payer: Wellpoint Medicaid Managed Care	$19.94

SCREW BONE THD 3.5MM X L26MM

Facility

$752.45

Service Code	HCPCS C1713
Hospital Charge Code	270700877
Hospital Revenue Code	278
Min. Negotiated Rate	$112.87
Max. Negotiated Rate	$182.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.54
Rate for Payer: Qualcare PPO/HMO/WC	$112.87

SCREW BONE TI 1.7x12mm

Facility

$685.00

Hospital Charge Code	270669955
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 TI 1.7x12mm

Facility

$685.00

Hospital Charge Code	270669955
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 TI 2.3x16mm

Facility

$685.00

Hospital Charge Code	270669954
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 TI 2.3x16mm

Facility

$685.00

Hospital Charge Code	270669954
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 VARIAX 3.5X24MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270694743
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$225.50
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

SCREW BONE VARIAX 3.5X24MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270694743
Hospital Revenue Code	278
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$389.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$225.50
Rate for Payer: Qualcare PPO/HMO/WC	$153.75
Rate for Payer: UnitedHealthcare Community & State	$24.70
Rate for Payer: Wellpoint Medicaid Managed Care	$27.16

SCREW BONW FULL THD 2.4 X L22M

Facility

$770.85

Service Code	HCPCS C1713
Hospital Charge Code	270705690
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 BONW FULL THD 2.4 X L22M

Facility

$770.85

Service Code	HCPCS C1713
Hospital Charge Code	270705690
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 BREAK OFF 1/2 2X 12 MM

Facility

$1,069.75

Service Code	HCPCS C1713
Hospital Charge Code	270701230
Hospital Revenue Code	278
Min. Negotiated Rate	$160.46
Max. Negotiated Rate	$258.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.34
Rate for Payer: Qualcare PPO/HMO/WC	$160.46

SCREW BREAK OFF 1/2 2X 12 MM

Facility

$1,069.75

Service Code	HCPCS C1713
Hospital Charge Code	270701230
Hospital Revenue Code	278
Min. Negotiated Rate	$25.78
Max. Negotiated Rate	$534.88
Rate for Payer: Aetna Commercial	$406.50
Rate for Payer: Aetna Medicare Advantage	$320.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.79
Rate for Payer: Cigna Commercial	$534.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.34
Rate for Payer: Qualcare PPO/HMO/WC	$160.46
Rate for Payer: UnitedHealthcare Community & State	$25.78
Rate for Payer: Wellpoint Medicaid Managed Care	$28.35

SCREW BREAK OFF 1/2 THRD 2X13M

Facility

$991.95

Hospital Charge Code	270701186
Hospital Revenue Code	278
Min. Negotiated Rate	$148.79
Max. Negotiated Rate	$240.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$218.23
Rate for Payer: Qualcare PPO/HMO/WC	$148.79

SCREW BREAK OFF 1/2 THRD 2X13M

Facility

$991.95

Hospital Charge Code	270701186
Hospital Revenue Code	278
Min. Negotiated Rate	$23.91
Max. Negotiated Rate	$495.98
Rate for Payer: Aetna Commercial	$376.94
Rate for Payer: Aetna Medicare Advantage	$297.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.95
Rate for Payer: Cigna Commercial	$495.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$218.23
Rate for Payer: Qualcare PPO/HMO/WC	$148.79
Rate for Payer: UnitedHealthcare Community & State	$23.91
Rate for Payer: Wellpoint Medicaid Managed Care	$26.29

SCREW BUTTRES HEXHED 12mmx36cm

Facility

$614.45

Hospital Charge Code	270626963
Hospital Revenue Code	278
Min. Negotiated Rate	$92.17
Max. Negotiated Rate	$148.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.18
Rate for Payer: Qualcare PPO/HMO/WC	$92.17

SCREW BUTTRES HEXHED 12mmx36cm

Facility

$614.45

Hospital Charge Code	270626963
Hospital Revenue Code	278
Min. Negotiated Rate	$14.81
Max. Negotiated Rate	$307.23
Rate for Payer: Aetna Commercial	$233.49
Rate for Payer: Aetna Medicare Advantage	$184.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.68
Rate for Payer: Cigna Commercial	$307.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.18
Rate for Payer: Qualcare PPO/HMO/WC	$92.17
Rate for Payer: UnitedHealthcare Community & State	$14.81
Rate for Payer: Wellpoint Medicaid Managed Care	$16.28

SCREW BUTTRESS 30MM

Facility

$4,030.00

Service Code	HCPCS C1713
Hospital Charge Code	270671021
Hospital Revenue Code	278
Min. Negotiated Rate	$604.50
Max. Negotiated Rate	$975.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$806.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$975.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$886.60
Rate for Payer: Qualcare PPO/HMO/WC	$604.50

SCREW BUTTRESS 30MM

Facility

$4,030.00

Service Code	HCPCS C1713
Hospital Charge Code	270671021
Hospital Revenue Code	278
Min. Negotiated Rate	$97.12
Max. Negotiated Rate	$2,015.00
Rate for Payer: Aetna Commercial	$1,531.40
Rate for Payer: Aetna Medicare Advantage	$1,209.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,027.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,027.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$806.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,027.65
Rate for Payer: Cigna Commercial	$2,015.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$975.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$886.60
Rate for Payer: Qualcare PPO/HMO/WC	$604.50
Rate for Payer: UnitedHealthcare Community & State	$97.12
Rate for Payer: Wellpoint Medicaid Managed Care	$106.80

SCREW BX FL THD 2.7 16 222716

Facility

$959.25

Hospital Charge Code	270620185
Hospital Revenue Code	278
Min. Negotiated Rate	$143.89
Max. Negotiated Rate	$232.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.03
Rate for Payer: Qualcare PPO/HMO/WC	$143.89

SCREW BX FL THD 2.7 16 222716

Facility

$959.25

Hospital Charge Code	270620185
Hospital Revenue Code	278
Min. Negotiated Rate	$23.12
Max. Negotiated Rate	$479.62
Rate for Payer: Aetna Commercial	$364.51
Rate for Payer: Aetna Medicare Advantage	$287.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244.61
Rate for Payer: Cigna Commercial	$479.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.03
Rate for Payer: Qualcare PPO/HMO/WC	$143.89
Rate for Payer: UnitedHealthcare Community & State	$23.12
Rate for Payer: Wellpoint Medicaid Managed Care	$25.42

SCREW BX FL THD 2.7 18 222718

Facility

$959.25

Hospital Charge Code	270620186
Hospital Revenue Code	278
Min. Negotiated Rate	$23.12
Max. Negotiated Rate	$479.62
Rate for Payer: Aetna Commercial	$364.51
Rate for Payer: Aetna Medicare Advantage	$287.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244.61
Rate for Payer: Cigna Commercial	$479.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.03
Rate for Payer: Qualcare PPO/HMO/WC	$143.89
Rate for Payer: UnitedHealthcare Community & State	$23.12
Rate for Payer: Wellpoint Medicaid Managed Care	$25.42

SCREW BX FL THD 2.7 18 222718

Facility

$959.25

Hospital Charge Code	270620186
Hospital Revenue Code	278
Min. Negotiated Rate	$143.89
Max. Negotiated Rate	$232.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.03
Rate for Payer: Qualcare PPO/HMO/WC	$143.89

Know your out-of-pocket cost for care.

All Charges