Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANC BONE 6.5X35

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694025
Hospital Revenue Code	278
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

SCREW CANC BONE 6.5X35

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694025
Hospital Revenue Code	278
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

SCREW CANCEL 4.0mmX16mm CA4160

Facility

$300.00

Hospital Charge Code	270638667
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SCREW CANCEL 4.0mmX16mm CA4160

Facility

$300.00

Hospital Charge Code	270638667
Hospital Revenue Code	278
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

SCREW CANCELLOS S 4.0 X 32MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270665936
Hospital Revenue Code	278
Min. Negotiated Rate	$19.28
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$21.20

SCREW CANCELLOS S 4.0 X 32MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270665936
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

SCREW CANCELLOUS 25-65MM ALTA

Facility

$541.00

Hospital Charge Code	270335178
Hospital Revenue Code	278
Min. Negotiated Rate	$13.04
Max. Negotiated Rate	$270.50
Rate for Payer: Aetna Commercial	$205.58
Rate for Payer: Aetna Medicare Advantage	$162.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.96
Rate for Payer: Cigna Commercial	$270.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.02
Rate for Payer: Qualcare PPO/HMO/WC	$81.15
Rate for Payer: UnitedHealthcare Community & State	$13.04
Rate for Payer: Wellpoint Medicaid Managed Care	$14.34

SCREW CANCELLOUS 25-65MM ALTA

Facility

$541.00

Hospital Charge Code	270335178
Hospital Revenue Code	278
Min. Negotiated Rate	$81.15
Max. Negotiated Rate	$130.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.02
Rate for Payer: Qualcare PPO/HMO/WC	$81.15

SCREW CANCELLOUS 3.0X12MM

Facility

$440.00

Hospital Charge Code	270669462
Hospital Revenue Code	278
Min. Negotiated Rate	$10.60
Max. Negotiated Rate	$220.00
Rate for Payer: Aetna Commercial	$167.20
Rate for Payer: Aetna Medicare Advantage	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.20
Rate for Payer: Cigna Commercial	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$66.00
Rate for Payer: UnitedHealthcare Community & State	$10.60
Rate for Payer: Wellpoint Medicaid Managed Care	$11.66

SCREW CANCELLOUS 3.0X12MM

Facility

$440.00

Hospital Charge Code	270669462
Hospital Revenue Code	278
Min. Negotiated Rate	$66.00
Max. Negotiated Rate	$106.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$66.00

SCREW CANCELLOUS 32 MM 6.5 MM

Facility

$143.20

Service Code	HCPCS C1713
Hospital Charge Code	270684680
Hospital Revenue Code	278
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$71.60
Rate for Payer: Aetna Commercial	$54.42
Rate for Payer: Aetna Medicare Advantage	$42.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.52
Rate for Payer: Cigna Commercial	$71.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$21.48
Rate for Payer: UnitedHealthcare Community & State	$3.45
Rate for Payer: Wellpoint Medicaid Managed Care	$3.79

SCREW CANCELLOUS 32 MM 6.5 MM

Facility

$143.20

Service Code	HCPCS C1713
Hospital Charge Code	270684680
Hospital Revenue Code	278
Min. Negotiated Rate	$21.48
Max. Negotiated Rate	$34.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$21.48

SCREW CANCELLOUS 36mm 3454-36

Facility

$105.00

Hospital Charge Code	270640110
Hospital Revenue Code	278
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$25.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

SCREW CANCELLOUS 36mm 3454-36

Facility

$105.00

Hospital Charge Code	270640110
Hospital Revenue Code	278
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$52.50
Rate for Payer: Aetna Commercial	$39.90
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Community & State	$2.53
Rate for Payer: Wellpoint Medicaid Managed Care	$2.78

SCREW CANCELLOUS 4.0 36MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270665938
Hospital Revenue Code	278
Min. Negotiated Rate	$19.28
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$21.20

SCREW CANCELLOUS 4.0 36MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270665938
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

SCREW CANCELLOUS 40mm 3454-40

Facility

$105.00

Hospital Charge Code	270640111
Hospital Revenue Code	278
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$52.50
Rate for Payer: Aetna Commercial	$39.90
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Community & State	$2.53
Rate for Payer: Wellpoint Medicaid Managed Care	$2.78

SCREW CANCELLOUS 40mm 3454-40

Facility

$105.00

Hospital Charge Code	270640111
Hospital Revenue Code	278
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$25.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

SCREW CANCELLOUS 4.0 X 14 MM

Facility

$195.00

Service Code	HCPCS C1713
Hospital Charge Code	270669258
Hospital Revenue Code	278
Min. Negotiated Rate	$4.70
Max. Negotiated Rate	$97.50
Rate for Payer: Aetna Commercial	$74.10
Rate for Payer: Aetna Medicare Advantage	$58.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.73
Rate for Payer: Cigna Commercial	$97.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$42.90
Rate for Payer: Qualcare PPO/HMO/WC	$29.25
Rate for Payer: UnitedHealthcare Community & State	$4.70
Rate for Payer: Wellpoint Medicaid Managed Care	$5.17

SCREW CANCELLOUS 4.0 X 14 MM

Facility

$195.00

Service Code	HCPCS C1713
Hospital Charge Code	270669258
Hospital Revenue Code	278
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$42.90
Rate for Payer: Qualcare PPO/HMO/WC	$29.25

SCREW CANCELLOUS 4.0X16

Facility

$175.00

Hospital Charge Code	270661847
Hospital Revenue Code	278
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$42.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

SCREW CANCELLOUS 4.0X16

Facility

$175.00

Hospital Charge Code	270661847
Hospital Revenue Code	278
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.64

SCREW CANCELLOUS 4.0X18

Facility

$175.00

Hospital Charge Code	270661844
Hospital Revenue Code	278
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.64

SCREW CANCELLOUS 4.0X18

Facility

$175.00

Hospital Charge Code	270661844
Hospital Revenue Code	278
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$42.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

SCREW CANCELLOUS 4.0X18 CA4180

Facility

$300.00

Hospital Charge Code	270638172
Hospital Revenue Code	278
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

Know your out-of-pocket cost for care.

All Charges