Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CORTICAL 2.7x16MM

Facility

$225.00

Service Code	HCPCS C1713
Hospital Charge Code	270667344
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 2.7x16MM

Facility

$225.00

Service Code	HCPCS C1713
Hospital Charge Code	270667344
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 2.7X18 3227118

Facility

$240.00

Hospital Charge Code	270643375
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 2.7X18 3227118

Facility

$240.00

Hospital Charge Code	270643375
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

SCREW CORTICAL 2.7X20 3227120

Facility

$240.00

Hospital Charge Code	270643376
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

SCREW CORTICAL 2.7X20 3227120

Facility

$240.00

Hospital Charge Code	270643376
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 2.7x20MM

Facility

$225.00

Hospital Charge Code	270671910
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 2.7x20MM

Facility

$225.00

Hospital Charge Code	270671910
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 2.7x22 3227122

Facility

$240.00

Hospital Charge Code	270643580
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

SCREW CORTICAL 2.7x22 3227122

Facility

$240.00

Hospital Charge Code	270643580
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 2.7x22MM

Facility

$240.00

Service Code	HCPCS C1713
Hospital Charge Code	270643580S
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

SCREW CORTICAL 2.7x22MM

Facility

$240.00

Service Code	HCPCS C1713
Hospital Charge Code	278643580S
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

SCREW CORTICAL 2.7x22MM

Facility

$240.00

Service Code	HCPCS C1713
Hospital Charge Code	278643580S
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 2.7x22MM

Facility

$240.00

Service Code	HCPCS C1713
Hospital Charge Code	270643580S
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 2.7x24MM

Facility

$225.00

Service Code	HCPCS C1713
Hospital Charge Code	270671912
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 2.7x24MM

Facility

$225.00

Service Code	HCPCS C1713
Hospital Charge Code	270671912
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 2.7X26

Facility

$225.00

Service Code	HCPCS C1713
Hospital Charge Code	270671913
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 2.7X26

Facility

$225.00

Service Code	HCPCS C1713
Hospital Charge Code	270671913
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 2.7x30MM

Facility

$225.00

Hospital Charge Code	270671915
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 2.7x30MM

Facility

$225.00

Hospital Charge Code	270671915
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 28mm 3386-28

Facility

$105.00

Hospital Charge Code	270640109
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 CORTICAL 28mm 3386-28

Facility

$105.00

Hospital Charge Code	270640109
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 CORTICAL 3.0X20MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270670804
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 3.0X20MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270670804
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 3.0X36MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270670954
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

Know your out-of-pocket cost for care.

All Charges