Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CORTICAL 3.5x16 23472016

Facility

$111.40

Hospital Charge Code	270639426
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 CORTICAL 3.5x16mm

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270676941
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 CORTICAL 3.5x16mm

Facility

$585.00

Hospital Charge Code	270638282
Hospital Revenue Code	278
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$222.30
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.70
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Community & State	$14.10
Rate for Payer: Wellpoint Medicaid Managed Care	$15.50

SCREW CORTICAL 3.5x16mm

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270676941
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 CORTICAL 3.5x16mm

Facility

$585.00

Hospital Charge Code	270638282
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$141.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.70
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW CORTICAL 3.5x16MM

Facility

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	270661507
Hospital Revenue Code	278
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$42.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

SCREW CORTICAL 3.5x16MM

Facility

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	270661507
Hospital Revenue Code	278
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.64

SCREW CORTICAL 3.5x16mm CS-16

Facility

$347.25

Hospital Charge Code	270635663
Hospital Revenue Code	278
Min. Negotiated Rate	$8.37
Max. Negotiated Rate	$173.62
Rate for Payer: Aetna Commercial	$131.96
Rate for Payer: Aetna Medicare Advantage	$104.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.55
Rate for Payer: Cigna Commercial	$173.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$76.39
Rate for Payer: Qualcare PPO/HMO/WC	$52.09
Rate for Payer: UnitedHealthcare Community & State	$8.37
Rate for Payer: Wellpoint Medicaid Managed Care	$9.20

SCREW CORTICAL 3.5x16mm CS-16

Facility

$347.25

Hospital Charge Code	270635663
Hospital Revenue Code	278
Min. Negotiated Rate	$52.09
Max. Negotiated Rate	$84.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$76.39
Rate for Payer: Qualcare PPO/HMO/WC	$52.09

SCREW CORTICAL 3.5x18

Facility

$111.40

Hospital Charge Code	270639414
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 CORTICAL 3.5x18

Facility

$111.40

Hospital Charge Code	270639414
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 CORTICAL 3.5x18 3235118

Facility

$240.00

Hospital Charge Code	270643572
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 3.5x18 3235118

Facility

$240.00

Hospital Charge Code	270643572
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 3 5X18 CO3180

Facility

$300.00

Hospital Charge Code	270638174
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 CORTICAL 3 5X18 CO3180

Facility

$300.00

Hospital Charge Code	270638174
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 CORTICAL 3.5x18mm

Facility

$570.00

Service Code	HCPCS C1713
Hospital Charge Code	270685332
Hospital Revenue Code	278
Min. Negotiated Rate	$85.50
Max. Negotiated Rate	$137.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.40
Rate for Payer: Qualcare PPO/HMO/WC	$85.50

SCREW CORTICAL 3.5x18mm

Facility

$570.00

Service Code	HCPCS C1713
Hospital Charge Code	270685332
Hospital Revenue Code	278
Min. Negotiated Rate	$13.74
Max. Negotiated Rate	$285.00
Rate for Payer: Aetna Commercial	$216.60
Rate for Payer: Aetna Medicare Advantage	$171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.35
Rate for Payer: Cigna Commercial	$285.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.40
Rate for Payer: Qualcare PPO/HMO/WC	$85.50
Rate for Payer: UnitedHealthcare Community & State	$13.74
Rate for Payer: Wellpoint Medicaid Managed Care	$15.11

SCREW CORTICAL 3.5x18MM

Facility

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	270659874
Hospital Revenue Code	278
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.64

SCREW CORTICAL 3.5x18MM

Facility

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	270659874
Hospital Revenue Code	278
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$42.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

SCREW CORTICAL 3.5 X 20

Facility

$300.00

Hospital Charge Code	270638094
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 CORTICAL 3.5 X 20

Facility

$300.00

Hospital Charge Code	270638094
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 CORTICAL 3.5x20 23472020

Facility

$111.40

Hospital Charge Code	270639425
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 CORTICAL 3.5x20 23472020

Facility

$111.40

Hospital Charge Code	270639425
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 CORTICAL 3.5x20mm

Facility

$570.00

Service Code	HCPCS C1713
Hospital Charge Code	270685333
Hospital Revenue Code	278
Min. Negotiated Rate	$13.74
Max. Negotiated Rate	$285.00
Rate for Payer: Aetna Commercial	$216.60
Rate for Payer: Aetna Medicare Advantage	$171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.35
Rate for Payer: Cigna Commercial	$285.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.40
Rate for Payer: Qualcare PPO/HMO/WC	$85.50
Rate for Payer: UnitedHealthcare Community & State	$13.74
Rate for Payer: Wellpoint Medicaid Managed Care	$15.11

SCREW CORTICAL 3.5x20mm

Facility

$570.00

Service Code	HCPCS C1713
Hospital Charge Code	270685333
Hospital Revenue Code	278
Min. Negotiated Rate	$85.50
Max. Negotiated Rate	$137.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.40
Rate for Payer: Qualcare PPO/HMO/WC	$85.50

Know your out-of-pocket cost for care.

All Charges