Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CERES ST FIX 4.0X16MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698553
Hospital Revenue Code	278
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

SCREW CERES ST FIX 4.0X16MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698553
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW CERV 4.0MM L13MM

Facility

$750.00

Hospital Charge Code	270701863
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW CERV 4.0MM L13MM

Facility

$750.00

Hospital Charge Code	270701863
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

SCREW CERV 4.0MM L15MM

Facility

$750.00

Hospital Charge Code	270701864
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW CERV 4.0MM L15MM

Facility

$750.00

Hospital Charge Code	270701864
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

SCREW CERVICAL SD TI UNI 15mm

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270679012
Hospital Revenue Code	278
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$474.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$431.20
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

SCREW CERVICAL SD TI UNI 15mm

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270679012
Hospital Revenue Code	278
Min. Negotiated Rate	$47.24
Max. Negotiated Rate	$980.00
Rate for Payer: Aetna Commercial	$744.80
Rate for Payer: Aetna Medicare Advantage	$588.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$499.80
Rate for Payer: Cigna Commercial	$980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$431.20
Rate for Payer: Qualcare PPO/HMO/WC	$294.00
Rate for Payer: UnitedHealthcare Community & State	$47.24
Rate for Payer: Wellpoint Medicaid Managed Care	$51.94

SCREWCERVINTERFIXSDDL3.5X12MM

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270697766
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SCREWCERVINTERFIXSDDL3.5X12MM

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270697766
Hospital Revenue Code	278
Min. Negotiated Rate	$25.30
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$399.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50
Rate for Payer: UnitedHealthcare Community & State	$25.30
Rate for Payer: Wellpoint Medicaid Managed Care	$27.82

SCREW CERV SSVA OZARK 4.5X16MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270699420
Hospital Revenue Code	278
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

SCREW CERV SSVA OZARK 4.5X16MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270699420
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW CERV SS VA OZARK 4X16MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270699419
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW CERV SS VA OZARK 4X16MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270699419
Hospital Revenue Code	278
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

SCREW CERV ST ANG 3.7X18 MM

Facility

$1,209.05

Service Code	HCPCS C1713
Hospital Charge Code	270692399
Hospital Revenue Code	278
Min. Negotiated Rate	$29.14
Max. Negotiated Rate	$604.52
Rate for Payer: Aetna Commercial	$459.44
Rate for Payer: Aetna Medicare Advantage	$362.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.31
Rate for Payer: Cigna Commercial	$604.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$265.99
Rate for Payer: Qualcare PPO/HMO/WC	$181.36
Rate for Payer: UnitedHealthcare Community & State	$29.14
Rate for Payer: Wellpoint Medicaid Managed Care	$32.04

SCREW CERV ST ANG 3.7X18 MM

Facility

$1,209.05

Service Code	HCPCS C1713
Hospital Charge Code	270692399
Hospital Revenue Code	278
Min. Negotiated Rate	$181.36
Max. Negotiated Rate	$292.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$265.99
Rate for Payer: Qualcare PPO/HMO/WC	$181.36

SCREW C FL THD 5.0x48 11425048

Facility

$530.75

Hospital Charge Code	270631228
Hospital Revenue Code	278
Min. Negotiated Rate	$79.61
Max. Negotiated Rate	$128.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.77
Rate for Payer: Qualcare PPO/HMO/WC	$79.61

SCREW C FL THD 5.0x48 11425048

Facility

$530.75

Hospital Charge Code	270631228
Hospital Revenue Code	278
Min. Negotiated Rate	$12.79
Max. Negotiated Rate	$265.38
Rate for Payer: Aetna Commercial	$201.69
Rate for Payer: Aetna Medicare Advantage	$159.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.34
Rate for Payer: Cigna Commercial	$265.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.77
Rate for Payer: Qualcare PPO/HMO/WC	$79.61
Rate for Payer: UnitedHealthcare Community & State	$12.79
Rate for Payer: Wellpoint Medicaid Managed Care	$14.06

SCREW CMPRSN3.0mmx20mm NCS3020

Facility

$1,325.00

Hospital Charge Code	270643528
Hospital Revenue Code	278
Min. Negotiated Rate	$31.93
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$31.93
Rate for Payer: Wellpoint Medicaid Managed Care	$35.11

SCREW CMPRSN3.0mmx20mm NCS3020

Facility

$1,325.00

Hospital Charge Code	270643528
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

SCREW CMPRSN3.0mmx20mm NCS3022

Facility

$1,325.00

Hospital Charge Code	270643529
Hospital Revenue Code	278
Min. Negotiated Rate	$31.93
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$31.93
Rate for Payer: Wellpoint Medicaid Managed Care	$35.11

SCREW CMPRSN3.0mmx20mm NCS3022

Facility

$1,325.00

Hospital Charge Code	270643529
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

SCREW CMPRSN 3.mmx18mm NCS3018

Facility

$1,325.00

Hospital Charge Code	270643635
Hospital Revenue Code	278
Min. Negotiated Rate	$31.93
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$31.93
Rate for Payer: Wellpoint Medicaid Managed Care	$35.11

SCREW CMPRSN 3.mmx18mm NCS3018

Facility

$1,325.00

Hospital Charge Code	270643635
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

SCREW CMPRSSN 3.0x16 NCS-3016

Facility

$1,390.00

Hospital Charge Code	270658884
Hospital Revenue Code	278
Min. Negotiated Rate	$33.50
Max. Negotiated Rate	$695.00
Rate for Payer: Aetna Commercial	$528.20
Rate for Payer: Aetna Medicare Advantage	$417.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$354.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$354.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$278.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$354.45
Rate for Payer: Cigna Commercial	$695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$336.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$305.80
Rate for Payer: Qualcare PPO/HMO/WC	$208.50
Rate for Payer: UnitedHealthcare Community & State	$33.50
Rate for Payer: Wellpoint Medicaid Managed Care	$36.84

Know your out-of-pocket cost for care.

All Charges