Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANCELLOUS 4.0 X 44MM

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270679453
Hospital Revenue Code	278
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$212.80
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$123.20
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: Wellpoint Medicaid Managed Care	$14.84

SCREW CANCELLOUS 4.0 X 44MM

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270679453
Hospital Revenue Code	278
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$135.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$123.20
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

SCREW CANCELLOUS 4.0 X 46MM

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270679454
Hospital Revenue Code	278
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$212.80
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$123.20
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: Wellpoint Medicaid Managed Care	$14.84

SCREW CANCELLOUS 4.0 X 46MM

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270679454
Hospital Revenue Code	278
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$135.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$123.20
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

SCREW CANCELLOUS 4.8X42MM

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270694688
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 CANCELLOUS 4.8X42MM

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270694688
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 CANCELLOUS 4.8X44MM

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270694689
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 CANCELLOUS 4.8X44MM

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270694689
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 CANCELLOUS 4X16MM

Facility

$468.00

Service Code	HCPCS C1713
Hospital Charge Code	270705087
Hospital Revenue Code	278
Min. Negotiated Rate	$11.28
Max. Negotiated Rate	$234.00
Rate for Payer: Aetna Commercial	$177.84
Rate for Payer: Aetna Medicare Advantage	$140.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.34
Rate for Payer: Cigna Commercial	$234.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$102.96
Rate for Payer: Qualcare PPO/HMO/WC	$70.20
Rate for Payer: UnitedHealthcare Community & State	$11.28
Rate for Payer: Wellpoint Medicaid Managed Care	$12.40

SCREW CANCELLOUS 4X16MM

Facility

$468.00

Service Code	HCPCS C1713
Hospital Charge Code	270705087
Hospital Revenue Code	278
Min. Negotiated Rate	$70.20
Max. Negotiated Rate	$113.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$102.96
Rate for Payer: Qualcare PPO/HMO/WC	$70.20

SCREW CANCELLOUS 5.5mm x 45mm

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270678709
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

SCREW CANCELLOUS 5.5mm x 45mm

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270678709
Hospital Revenue Code	278
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

SCREW CANCELLOUS 5x34 RD156934

Facility

$1,056.50

Hospital Charge Code	270632871
Hospital Revenue Code	278
Min. Negotiated Rate	$25.46
Max. Negotiated Rate	$528.25
Rate for Payer: Aetna Commercial	$401.47
Rate for Payer: Aetna Medicare Advantage	$316.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.41
Rate for Payer: Cigna Commercial	$528.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$232.43
Rate for Payer: Qualcare PPO/HMO/WC	$158.47
Rate for Payer: UnitedHealthcare Community & State	$25.46
Rate for Payer: Wellpoint Medicaid Managed Care	$28.00

SCREW CANCELLOUS 5x34 RD156934

Facility

$1,056.50

Hospital Charge Code	270632871
Hospital Revenue Code	278
Min. Negotiated Rate	$158.47
Max. Negotiated Rate	$255.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$232.43
Rate for Payer: Qualcare PPO/HMO/WC	$158.47

SCREW CANCELLOUS 5X37.5MM

Facility

$995.00

Hospital Charge Code	270671058
Hospital Revenue Code	278
Min. Negotiated Rate	$149.25
Max. Negotiated Rate	$240.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$218.90
Rate for Payer: Qualcare PPO/HMO/WC	$149.25

SCREW CANCELLOUS 5X37.5MM

Facility

$995.00

Hospital Charge Code	270671058
Hospital Revenue Code	278
Min. Negotiated Rate	$23.98
Max. Negotiated Rate	$497.50
Rate for Payer: Aetna Commercial	$378.10
Rate for Payer: Aetna Medicare Advantage	$298.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.72
Rate for Payer: Cigna Commercial	$497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$218.90
Rate for Payer: Qualcare PPO/HMO/WC	$149.25
Rate for Payer: UnitedHealthcare Community & State	$23.98
Rate for Payer: Wellpoint Medicaid Managed Care	$26.37

SCREW CANCELLOUS 5X40MM

Facility

$995.00

Hospital Charge Code	270671059
Hospital Revenue Code	278
Min. Negotiated Rate	$149.25
Max. Negotiated Rate	$240.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$218.90
Rate for Payer: Qualcare PPO/HMO/WC	$149.25

SCREW CANCELLOUS 5X40MM

Facility

$995.00

Hospital Charge Code	270671059
Hospital Revenue Code	278
Min. Negotiated Rate	$23.98
Max. Negotiated Rate	$497.50
Rate for Payer: Aetna Commercial	$378.10
Rate for Payer: Aetna Medicare Advantage	$298.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.72
Rate for Payer: Cigna Commercial	$497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$218.90
Rate for Payer: Qualcare PPO/HMO/WC	$149.25
Rate for Payer: UnitedHealthcare Community & State	$23.98
Rate for Payer: Wellpoint Medicaid Managed Care	$26.37

screw cancellous 6.5x30

Facility

$143.20

Service Code	HCPCS C1713
Hospital Charge Code	270684679
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 6.5x30

Facility

$143.20

Service Code	HCPCS C1713
Hospital Charge Code	270684679
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 6.5 X 35MM

Facility

$320.00

Hospital Charge Code	270668343
Hospital Revenue Code	278
Min. Negotiated Rate	$7.71
Max. Negotiated Rate	$160.00
Rate for Payer: Aetna Commercial	$121.60
Rate for Payer: Aetna Medicare Advantage	$96.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.60
Rate for Payer: Cigna Commercial	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$70.40
Rate for Payer: Qualcare PPO/HMO/WC	$48.00
Rate for Payer: UnitedHealthcare Community & State	$7.71
Rate for Payer: Wellpoint Medicaid Managed Care	$8.48

SCREW CANCELLOUS 6.5 X 35MM

Facility

$320.00

Hospital Charge Code	270668343
Hospital Revenue Code	278
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$77.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$70.40
Rate for Payer: Qualcare PPO/HMO/WC	$48.00

screw cancellous 6.5x80

Facility

$143.20

Service Code	HCPCS C1713
Hospital Charge Code	270384680
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 6.5x80

Facility

$143.20

Service Code	HCPCS C1713
Hospital Charge Code	270384680
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 BONE 6.5 MM 2

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270688632
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

Know your out-of-pocket cost for care.

All Charges