Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CORTICAL 4.5 X 30

Facility

$245.00

Service Code	HCPCS C1713
Hospital Charge Code	270663310
Hospital Revenue Code	278
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$59.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.90
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

SCREW CORTICAL 4.5x30mm

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	270685127
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

SCREW CORTICAL 4.5x30mm

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	270685127
Hospital Revenue Code	278
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.60

SCREW CORTICAL 4.5x34mm

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	270685126
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

SCREW CORTICAL 4.5x34mm

Facility

$260.00

Service Code	HCPCS C1713
Hospital Charge Code	270668434
Hospital Revenue Code	278
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$62.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$57.20
Rate for Payer: Qualcare PPO/HMO/WC	$39.00

SCREW CORTICAL 4.5x34mm

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	270685126
Hospital Revenue Code	278
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.60

SCREW CORTICAL 4.5x34mm

Facility

$260.00

Service Code	HCPCS C1713
Hospital Charge Code	270668434
Hospital Revenue Code	278
Min. Negotiated Rate	$6.27
Max. Negotiated Rate	$130.00
Rate for Payer: Aetna Commercial	$98.80
Rate for Payer: Aetna Medicare Advantage	$78.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.30
Rate for Payer: Cigna Commercial	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$57.20
Rate for Payer: Qualcare PPO/HMO/WC	$39.00
Rate for Payer: UnitedHealthcare Community & State	$6.27
Rate for Payer: Wellpoint Medicaid Managed Care	$6.89

SCREW CORTICAL 4.5 X 38

Facility

$245.00

Service Code	HCPCS C1713
Hospital Charge Code	270663311
Hospital Revenue Code	278
Min. Negotiated Rate	$5.90
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial	$93.10
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.90
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Community & State	$5.90
Rate for Payer: Wellpoint Medicaid Managed Care	$6.49

SCREW CORTICAL 4.5 X 38

Facility

$245.00

Service Code	HCPCS C1713
Hospital Charge Code	270663311
Hospital Revenue Code	278
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$59.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.90
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

SCREW CORTICAL 4.5x38mm

Facility

$70.00

Hospital Charge Code	270621657
Hospital Revenue Code	278
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$16.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.40
Rate for Payer: Qualcare PPO/HMO/WC	$10.50

SCREW CORTICAL 4.5x38mm

Facility

$70.00

Hospital Charge Code	270621657
Hospital Revenue Code	278
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$35.00
Rate for Payer: Aetna Commercial	$26.60
Rate for Payer: Aetna Medicare Advantage	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.85
Rate for Payer: Cigna Commercial	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.40
Rate for Payer: Qualcare PPO/HMO/WC	$10.50
Rate for Payer: UnitedHealthcare Community & State	$1.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

SCREW CORTICAL 4.5X75MM

Facility

$245.00

Hospital Charge Code	270668431
Hospital Revenue Code	278
Min. Negotiated Rate	$5.90
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial	$93.10
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.90
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Community & State	$5.90
Rate for Payer: Wellpoint Medicaid Managed Care	$6.49

SCREW CORTICAL 4.5X75MM

Facility

$245.00

Hospital Charge Code	270668431
Hospital Revenue Code	278
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$59.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.90
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

SCREW CORTICAL 4.5X80MM

Facility

$245.00

Hospital Charge Code	270668435
Hospital Revenue Code	278
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$59.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.90
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

SCREW CORTICAL 4.5X80MM

Facility

$245.00

Hospital Charge Code	270668435
Hospital Revenue Code	278
Min. Negotiated Rate	$5.90
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial	$93.10
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.90
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Community & State	$5.90
Rate for Payer: Wellpoint Medicaid Managed Care	$6.49

SCREW CORTICAL 5.0MM X 32MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270687402
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

SCREW CORTICAL 5.0MM X 32MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270687402
Hospital Revenue Code	278
Min. Negotiated Rate	$19.28
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$21.20

SCREW CORTICAL 5.0MMX36MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270695287
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

SCREW CORTICAL 5.0MMX36MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270695287
Hospital Revenue Code	278
Min. Negotiated Rate	$19.28
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$21.20

SCREW CORTICAL 5.0X36MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270695827
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

SCREW CORTICAL 5.0X36MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270695827
Hospital Revenue Code	278
Min. Negotiated Rate	$19.28
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$21.20

SCREW CORTICAL 5.0 X 60MM

Facility

$717.00

Hospital Charge Code	270663322
Hospital Revenue Code	278
Min. Negotiated Rate	$107.55
Max. Negotiated Rate	$173.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$157.74
Rate for Payer: Qualcare PPO/HMO/WC	$107.55

SCREW CORTICAL 5.0 X 60MM

Facility

$717.00

Hospital Charge Code	270663322
Hospital Revenue Code	278
Min. Negotiated Rate	$17.28
Max. Negotiated Rate	$358.50
Rate for Payer: Aetna Commercial	$272.46
Rate for Payer: Aetna Medicare Advantage	$215.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.84
Rate for Payer: Cigna Commercial	$358.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$157.74
Rate for Payer: Qualcare PPO/HMO/WC	$107.55
Rate for Payer: UnitedHealthcare Community & State	$17.28
Rate for Payer: Wellpoint Medicaid Managed Care	$19.00

SCREW CORTICAL 55-85MM ALTA

Facility

$541.00

Hospital Charge Code	270335177
Hospital Revenue Code	278
Min. Negotiated Rate	$13.04
Max. Negotiated Rate	$270.50
Rate for Payer: Aetna Commercial	$205.58
Rate for Payer: Aetna Medicare Advantage	$162.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.96
Rate for Payer: Cigna Commercial	$270.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.02
Rate for Payer: Qualcare PPO/HMO/WC	$81.15
Rate for Payer: UnitedHealthcare Community & State	$13.04
Rate for Payer: Wellpoint Medicaid Managed Care	$14.34

SCREW CORTICAL 55-85MM ALTA

Facility

$541.00

Hospital Charge Code	270335177
Hospital Revenue Code	278
Min. Negotiated Rate	$81.15
Max. Negotiated Rate	$130.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.02
Rate for Payer: Qualcare PPO/HMO/WC	$81.15

Know your out-of-pocket cost for care.

All Charges