Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW COR TI 5x50 DBL 14405050

Facility

$905.00

Service Code	HCPCS C1713
Hospital Charge Code	270641911
Hospital Revenue Code	278
Min. Negotiated Rate	$21.81
Max. Negotiated Rate	$452.50
Rate for Payer: Aetna Commercial	$343.90
Rate for Payer: Aetna Medicare Advantage	$271.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.78
Rate for Payer: Cigna Commercial	$452.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.10
Rate for Payer: Qualcare PPO/HMO/WC	$135.75
Rate for Payer: UnitedHealthcare Community & State	$21.81
Rate for Payer: Wellpoint Medicaid Managed Care	$23.98

SCREW CORTICAL

Facility

$1,540.00

Hospital Charge Code	270668100
Hospital Revenue Code	278
Min. Negotiated Rate	$231.00
Max. Negotiated Rate	$372.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$308.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$338.80
Rate for Payer: Qualcare PPO/HMO/WC	$231.00

SCREW CORTICAL

Facility

$1,540.00

Hospital Charge Code	270668100
Hospital Revenue Code	278
Min. Negotiated Rate	$37.11
Max. Negotiated Rate	$770.00
Rate for Payer: Aetna Commercial	$585.20
Rate for Payer: Aetna Medicare Advantage	$462.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$392.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$392.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$308.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$392.70
Rate for Payer: Cigna Commercial	$770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$338.80
Rate for Payer: Qualcare PPO/HMO/WC	$231.00
Rate for Payer: UnitedHealthcare Community & State	$37.11
Rate for Payer: Wellpoint Medicaid Managed Care	$40.81

SCREW CORTICAL 110X30 A6011030

Facility

$540.70

Hospital Charge Code	270634733
Hospital Revenue Code	278
Min. Negotiated Rate	$13.03
Max. Negotiated Rate	$270.35
Rate for Payer: Aetna Commercial	$205.47
Rate for Payer: Aetna Medicare Advantage	$162.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.88
Rate for Payer: Cigna Commercial	$270.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.95
Rate for Payer: Qualcare PPO/HMO/WC	$81.11
Rate for Payer: UnitedHealthcare Community & State	$13.03
Rate for Payer: Wellpoint Medicaid Managed Care	$14.33

SCREW CORTICAL 110X30 A6011030

Facility

$540.70

Hospital Charge Code	270634733
Hospital Revenue Code	278
Min. Negotiated Rate	$81.11
Max. Negotiated Rate	$130.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.95
Rate for Payer: Qualcare PPO/HMO/WC	$81.11

SCREW CORTICAL 110X40 A6011040

Facility

$540.70

Hospital Charge Code	270634734
Hospital Revenue Code	278
Min. Negotiated Rate	$81.11
Max. Negotiated Rate	$130.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.95
Rate for Payer: Qualcare PPO/HMO/WC	$81.11

SCREW CORTICAL 110X40 A6011040

Facility

$540.70

Hospital Charge Code	270634734
Hospital Revenue Code	278
Min. Negotiated Rate	$13.03
Max. Negotiated Rate	$270.35
Rate for Payer: Aetna Commercial	$205.47
Rate for Payer: Aetna Medicare Advantage	$162.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.88
Rate for Payer: Cigna Commercial	$270.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.95
Rate for Payer: Qualcare PPO/HMO/WC	$81.11
Rate for Payer: UnitedHealthcare Community & State	$13.03
Rate for Payer: Wellpoint Medicaid Managed Care	$14.33

SCREW CORTICAL 13MM

Facility

$540.00

Hospital Charge Code	270658043
Hospital Revenue Code	278
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$270.00
Rate for Payer: Aetna Commercial	$205.20
Rate for Payer: Aetna Medicare Advantage	$162.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.70
Rate for Payer: Cigna Commercial	$270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.80
Rate for Payer: Qualcare PPO/HMO/WC	$81.00
Rate for Payer: UnitedHealthcare Community & State	$13.01
Rate for Payer: Wellpoint Medicaid Managed Care	$14.31

SCREW CORTICAL 13MM

Facility

$540.00

Hospital Charge Code	270658043
Hospital Revenue Code	278
Min. Negotiated Rate	$81.00
Max. Negotiated Rate	$130.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.80
Rate for Payer: Qualcare PPO/HMO/WC	$81.00

SCREW CORTICAL 20-50MM ALTA

Facility

$346.00

Hospital Charge Code	270335176
Hospital Revenue Code	278
Min. Negotiated Rate	$51.90
Max. Negotiated Rate	$83.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$76.12
Rate for Payer: Qualcare PPO/HMO/WC	$51.90

SCREW CORTICAL 20-50MM ALTA

Facility

$346.00

Hospital Charge Code	270335176
Hospital Revenue Code	278
Min. Negotiated Rate	$8.34
Max. Negotiated Rate	$173.00
Rate for Payer: Aetna Commercial	$131.48
Rate for Payer: Aetna Medicare Advantage	$103.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.23
Rate for Payer: Cigna Commercial	$173.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$76.12
Rate for Payer: Qualcare PPO/HMO/WC	$51.90
Rate for Payer: UnitedHealthcare Community & State	$8.34
Rate for Payer: Wellpoint Medicaid Managed Care	$9.17

SCREW CORTICAL 2.3 X 10

Facility

$6,965.00

Hospital Charge Code	270656419
Hospital Revenue Code	278
Min. Negotiated Rate	$1,044.75
Max. Negotiated Rate	$1,685.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,393.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,685.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,532.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,044.75

SCREW CORTICAL 2.3 X 10

Facility

$6,965.00

Hospital Charge Code	270656419
Hospital Revenue Code	278
Min. Negotiated Rate	$167.86
Max. Negotiated Rate	$3,482.50
Rate for Payer: Aetna Commercial	$2,646.70
Rate for Payer: Aetna Medicare Advantage	$2,089.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,776.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,776.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,393.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,776.08
Rate for Payer: Cigna Commercial	$3,482.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,685.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,532.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,044.75
Rate for Payer: UnitedHealthcare Community & State	$167.86
Rate for Payer: Wellpoint Medicaid Managed Care	$184.57

SCREW CORTICAL 2.4X18MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270693609
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

SCREW CORTICAL 2.4X18MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270693609
Hospital Revenue Code	278
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

SCREW CORTICAL 2.7MM SELF TAP

Facility

$109.55

Hospital Charge Code	270661359
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 CORTICAL 2.7MM SELF TAP

Facility

$109.55

Hospital Charge Code	270661359
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 CORTICAL 2.7 MM X 14 MM

Facility

$225.00

Service Code	HCPCS C1713
Hospital Charge Code	270684790
Hospital Revenue Code	278
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

SCREW CORTICAL 2.7 MM X 14 MM

Facility

$225.00

Service Code	HCPCS C1713
Hospital Charge Code	270684790
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

SCREW CORTICAL 2.7x10MM

Facility

$225.00

Hospital Charge Code	270671908
Hospital Revenue Code	278
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

SCREW CORTICAL 2.7x10MM

Facility

$225.00

Hospital Charge Code	270671908
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

SCREW CORTICAL 2.7x12MM

Facility

$225.00

Service Code	HCPCS C1713
Hospital Charge Code	270667346
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

SCREW CORTICAL 2.7x12MM

Facility

$225.00

Service Code	HCPCS C1713
Hospital Charge Code	270667346
Hospital Revenue Code	278
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

SCREW CORTICAL 2.7X16 3227116

Facility

$240.00

Hospital Charge Code	270643374
Hospital Revenue Code	278
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Community & State	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$6.36

SCREW CORTICAL 2.7X16 3227116

Facility

$240.00

Hospital Charge Code	270643374
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

Know your out-of-pocket cost for care.

All Charges