Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CONCENTR GLENOSPH 36x2MM

Facility

$12,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270671582
Hospital Revenue Code	278
Min. Negotiated Rate	$301.25
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$4,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00
Rate for Payer: UnitedHealthcare Community & State	$301.25
Rate for Payer: Wellpoint Medicaid Managed Care	$331.25

SCREW CONICAL CANN 7.3X85MM

Facility

$1,180.00

Hospital Charge Code	270638843
Hospital Revenue Code	278
Min. Negotiated Rate	$28.44
Max. Negotiated Rate	$590.00
Rate for Payer: Aetna Commercial	$448.40
Rate for Payer: Aetna Medicare Advantage	$354.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$300.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$300.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$236.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$300.90
Rate for Payer: Cigna Commercial	$590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$285.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$259.60
Rate for Payer: Qualcare PPO/HMO/WC	$177.00
Rate for Payer: UnitedHealthcare Community & State	$28.44
Rate for Payer: Wellpoint Medicaid Managed Care	$31.27

SCREW CONICAL CANN 7.3X85MM

Facility

$1,180.00

Hospital Charge Code	270638843
Hospital Revenue Code	278
Min. Negotiated Rate	$177.00
Max. Negotiated Rate	$285.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$236.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$285.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$259.60
Rate for Payer: Qualcare PPO/HMO/WC	$177.00

SCREW CONICAL EXTRACTION 2.5MM

Facility

$273.00

Hospital Charge Code	270654497
Hospital Revenue Code	278
Min. Negotiated Rate	$40.95
Max. Negotiated Rate	$66.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.06
Rate for Payer: Qualcare PPO/HMO/WC	$40.95

SCREW CONICAL EXTRACTION 2.5MM

Facility

$273.00

Hospital Charge Code	270654497
Hospital Revenue Code	278
Min. Negotiated Rate	$6.58
Max. Negotiated Rate	$136.50
Rate for Payer: Aetna Commercial	$103.74
Rate for Payer: Aetna Medicare Advantage	$81.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.61
Rate for Payer: Cigna Commercial	$136.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.06
Rate for Payer: Qualcare PPO/HMO/WC	$40.95
Rate for Payer: UnitedHealthcare Community & State	$6.58
Rate for Payer: Wellpoint Medicaid Managed Care	$7.23

SCREW CONNECTING SDRVE LOCKING

Facility

$969.80

Service Code	HCPCS C1713
Hospital Charge Code	270693775
Hospital Revenue Code	278
Min. Negotiated Rate	$145.47
Max. Negotiated Rate	$234.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$213.36
Rate for Payer: Qualcare PPO/HMO/WC	$145.47

SCREW CONNECTING SDRVE LOCKING

Facility

$969.80

Service Code	HCPCS C1713
Hospital Charge Code	270693775
Hospital Revenue Code	278
Min. Negotiated Rate	$23.37
Max. Negotiated Rate	$484.90
Rate for Payer: Aetna Commercial	$368.52
Rate for Payer: Aetna Medicare Advantage	$290.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.30
Rate for Payer: Cigna Commercial	$484.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$213.36
Rate for Payer: Qualcare PPO/HMO/WC	$145.47
Rate for Payer: UnitedHealthcare Community & State	$23.37
Rate for Payer: Wellpoint Medicaid Managed Care	$25.70

SCREW CORDICAL 36MM 4.5CM

Facility

$109.55

Hospital Charge Code	270654981
Hospital Revenue Code	278
Min. Negotiated Rate	$16.43
Max. Negotiated Rate	$26.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$24.10
Rate for Payer: Qualcare PPO/HMO/WC	$16.43

SCREW CORDICAL 36MM 4.5CM

Facility

$109.55

Hospital Charge Code	270654981
Hospital Revenue Code	278
Min. Negotiated Rate	$2.64
Max. Negotiated Rate	$54.77
Rate for Payer: Aetna Commercial	$41.63
Rate for Payer: Aetna Medicare Advantage	$32.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.94
Rate for Payer: Cigna Commercial	$54.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$24.10
Rate for Payer: Qualcare PPO/HMO/WC	$16.43
Rate for Payer: UnitedHealthcare Community & State	$2.64
Rate for Payer: Wellpoint Medicaid Managed Care	$2.90

SCREW CORICAL 3.5x22 23472022

Facility

$111.40

Hospital Charge Code	270639424
Hospital Revenue Code	278
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$55.70
Rate for Payer: Aetna Commercial	$42.33
Rate for Payer: Aetna Medicare Advantage	$33.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.41
Rate for Payer: Cigna Commercial	$55.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$24.51
Rate for Payer: Qualcare PPO/HMO/WC	$16.71
Rate for Payer: UnitedHealthcare Community & State	$2.68
Rate for Payer: Wellpoint Medicaid Managed Care	$2.95

SCREW CORICAL 3.5x22 23472022

Facility

$111.40

Hospital Charge Code	270639424
Hospital Revenue Code	278
Min. Negotiated Rate	$16.71
Max. Negotiated Rate	$26.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$24.51
Rate for Payer: Qualcare PPO/HMO/WC	$16.71

SCREW CORITAL 3.5 MM X 22 MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270684010
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 CORITAL 3.5 MM X 22 MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270684010
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 CORLOCK STARDRIVE 3.5x24

Facility

$148.50

Service Code	HCPCS C1713
Hospital Charge Code	270660900
Hospital Revenue Code	278
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$35.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$22.27

SCREW CORLOCK STARDRIVE 3.5x24

Facility

$148.50

Service Code	HCPCS C1713
Hospital Charge Code	270660900
Hospital Revenue Code	278
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$74.25
Rate for Payer: Aetna Commercial	$56.43
Rate for Payer: Aetna Medicare Advantage	$44.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.87
Rate for Payer: Cigna Commercial	$74.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$22.27
Rate for Payer: UnitedHealthcare Community & State	$3.58
Rate for Payer: Wellpoint Medicaid Managed Care	$3.94

SCREW CORLOCK STARDRIVE 3.5x28

Facility

$148.50

Service Code	HCPCS C1713
Hospital Charge Code	270668476
Hospital Revenue Code	278
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$35.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$22.27

SCREW CORLOCK STARDRIVE 3.5x28

Facility

$148.50

Service Code	HCPCS C1713
Hospital Charge Code	270668476
Hospital Revenue Code	278
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$74.25
Rate for Payer: Aetna Commercial	$56.43
Rate for Payer: Aetna Medicare Advantage	$44.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.87
Rate for Payer: Cigna Commercial	$74.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$22.27
Rate for Payer: UnitedHealthcare Community & State	$3.58
Rate for Payer: Wellpoint Medicaid Managed Care	$3.94

SCREW CORLOCK STARDRIVE 3.5x34

Facility

$148.50

Service Code	HCPCS C1713
Hospital Charge Code	270660897
Hospital Revenue Code	278
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$74.25
Rate for Payer: Aetna Commercial	$56.43
Rate for Payer: Aetna Medicare Advantage	$44.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.87
Rate for Payer: Cigna Commercial	$74.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$22.27
Rate for Payer: UnitedHealthcare Community & State	$3.58
Rate for Payer: Wellpoint Medicaid Managed Care	$3.94

SCREW CORLOCK STARDRIVE 3.5x34

Facility

$148.50

Service Code	HCPCS C1713
Hospital Charge Code	270660897
Hospital Revenue Code	278
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$35.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$22.27

SCREW COROENT SP INTRLK 4X15MM

Facility

$2,775.00

Service Code	HCPCS C1713
Hospital Charge Code	270693752
Hospital Revenue Code	278
Min. Negotiated Rate	$66.88
Max. Negotiated Rate	$1,387.50
Rate for Payer: Aetna Commercial	$1,054.50
Rate for Payer: Aetna Medicare Advantage	$832.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$707.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$707.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$707.62
Rate for Payer: Cigna Commercial	$1,387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$671.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$610.50
Rate for Payer: Qualcare PPO/HMO/WC	$416.25
Rate for Payer: UnitedHealthcare Community & State	$66.88
Rate for Payer: Wellpoint Medicaid Managed Care	$73.54

SCREW COROENT SP INTRLK 4X15MM

Facility

$2,775.00

Service Code	HCPCS C1713
Hospital Charge Code	270693752
Hospital Revenue Code	278
Min. Negotiated Rate	$416.25
Max. Negotiated Rate	$671.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$555.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$671.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$610.50
Rate for Payer: Qualcare PPO/HMO/WC	$416.25

SCREW COROENT XLF VAR 5.5X40MM

Facility

$5,735.00

Service Code	HCPCS C1713
Hospital Charge Code	270697555
Hospital Revenue Code	278
Min. Negotiated Rate	$138.21
Max. Negotiated Rate	$2,867.50
Rate for Payer: Aetna Commercial	$2,179.30
Rate for Payer: Aetna Medicare Advantage	$1,720.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,462.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,462.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,147.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,462.42
Rate for Payer: Cigna Commercial	$2,867.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,387.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,261.70
Rate for Payer: Qualcare PPO/HMO/WC	$860.25
Rate for Payer: UnitedHealthcare Community & State	$138.21
Rate for Payer: Wellpoint Medicaid Managed Care	$151.98

SCREW COROENT XLF VAR 5.5X40MM

Facility

$5,735.00

Service Code	HCPCS C1713
Hospital Charge Code	270697555
Hospital Revenue Code	278
Min. Negotiated Rate	$860.25
Max. Negotiated Rate	$1,387.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,147.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,387.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,261.70
Rate for Payer: Qualcare PPO/HMO/WC	$860.25

SCREW COROENT XLFVAR 5.5X45MM

Facility

$5,735.00

Service Code	HCPCS C1713
Hospital Charge Code	270695491
Hospital Revenue Code	278
Min. Negotiated Rate	$860.25
Max. Negotiated Rate	$1,387.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,147.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,387.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,261.70
Rate for Payer: Qualcare PPO/HMO/WC	$860.25

SCREW COROENT XLFVAR 5.5X45MM

Facility

$5,735.00

Service Code	HCPCS C1713
Hospital Charge Code	270695491
Hospital Revenue Code	278
Min. Negotiated Rate	$138.21
Max. Negotiated Rate	$2,867.50
Rate for Payer: Aetna Commercial	$2,179.30
Rate for Payer: Aetna Medicare Advantage	$1,720.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,462.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,462.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,147.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,462.42
Rate for Payer: Cigna Commercial	$2,867.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,387.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,261.70
Rate for Payer: Qualcare PPO/HMO/WC	$860.25
Rate for Payer: UnitedHealthcare Community & State	$138.21
Rate for Payer: Wellpoint Medicaid Managed Care	$151.98

Know your out-of-pocket cost for care.

All Charges