Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CORTICAL 5X42MM

Facility

$1,650.00

Hospital Charge Code	270702709
Hospital Revenue Code	278
Min. Negotiated Rate	$247.50
Max. Negotiated Rate	$399.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$399.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$247.50

SCREW CORTICAL 5X42MM

Facility

$1,650.00

Hospital Charge Code	270702709
Hospital Revenue Code	278
Min. Negotiated Rate	$39.77
Max. Negotiated Rate	$825.00
Rate for Payer: Aetna Commercial	$627.00
Rate for Payer: Aetna Medicare Advantage	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.75
Rate for Payer: Cigna Commercial	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$399.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$247.50
Rate for Payer: UnitedHealthcare Community & State	$39.77
Rate for Payer: Wellpoint Medicaid Managed Care	$43.73

SCREW CORTICAL 5X46MM

Facility

$1,650.00

Hospital Charge Code	270702710
Hospital Revenue Code	278
Min. Negotiated Rate	$247.50
Max. Negotiated Rate	$399.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$399.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$247.50

SCREW CORTICAL 5X46MM

Facility

$1,650.00

Hospital Charge Code	270702710
Hospital Revenue Code	278
Min. Negotiated Rate	$39.77
Max. Negotiated Rate	$825.00
Rate for Payer: Aetna Commercial	$627.00
Rate for Payer: Aetna Medicare Advantage	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.75
Rate for Payer: Cigna Commercial	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$399.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$247.50
Rate for Payer: UnitedHealthcare Community & State	$39.77
Rate for Payer: Wellpoint Medicaid Managed Care	$43.73

SCREW CORTICAL 5x60 14-405060

Facility

$860.00

Service Code	HCPCS C1713
Hospital Charge Code	270641745
Hospital Revenue Code	278
Min. Negotiated Rate	$129.00
Max. Negotiated Rate	$208.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$189.20
Rate for Payer: Qualcare PPO/HMO/WC	$129.00

SCREW CORTICAL 5x60 14-405060

Facility

$860.00

Service Code	HCPCS C1713
Hospital Charge Code	270641745
Hospital Revenue Code	278
Min. Negotiated Rate	$20.73
Max. Negotiated Rate	$430.00
Rate for Payer: Aetna Commercial	$326.80
Rate for Payer: Aetna Medicare Advantage	$258.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.30
Rate for Payer: Cigna Commercial	$430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$189.20
Rate for Payer: Qualcare PPO/HMO/WC	$129.00
Rate for Payer: UnitedHealthcare Community & State	$20.73
Rate for Payer: Wellpoint Medicaid Managed Care	$22.79

SCREW CORTICAL 5x70 14-405070

Facility

$860.00

Service Code	HCPCS C1713
Hospital Charge Code	270641746
Hospital Revenue Code	278
Min. Negotiated Rate	$129.00
Max. Negotiated Rate	$208.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$189.20
Rate for Payer: Qualcare PPO/HMO/WC	$129.00

SCREW CORTICAL 5x70 14-405070

Facility

$860.00

Service Code	HCPCS C1713
Hospital Charge Code	270641746
Hospital Revenue Code	278
Min. Negotiated Rate	$20.73
Max. Negotiated Rate	$430.00
Rate for Payer: Aetna Commercial	$326.80
Rate for Payer: Aetna Medicare Advantage	$258.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.30
Rate for Payer: Cigna Commercial	$430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$189.20
Rate for Payer: Qualcare PPO/HMO/WC	$129.00
Rate for Payer: UnitedHealthcare Community & State	$20.73
Rate for Payer: Wellpoint Medicaid Managed Care	$22.79

SCREW CORTICAL 7 X 55MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270684985
Hospital Revenue Code	278
Min. Negotiated Rate	$210.88
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$210.88
Rate for Payer: Wellpoint Medicaid Managed Care	$231.88

SCREW CORTICAL 7 X 55MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270684985
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

SCREW CORTICAL BONE 5.0MMX26MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270689826
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 BONE 5.0MMX26MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270689826
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 BONE 5.0x34mm

Facility

$768.00

Service Code	HCPCS C1713
Hospital Charge Code	270650493
Hospital Revenue Code	278
Min. Negotiated Rate	$18.51
Max. Negotiated Rate	$384.00
Rate for Payer: Aetna Commercial	$291.84
Rate for Payer: Aetna Medicare Advantage	$230.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.84
Rate for Payer: Cigna Commercial	$384.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$168.96
Rate for Payer: Qualcare PPO/HMO/WC	$115.20
Rate for Payer: UnitedHealthcare Community & State	$18.51
Rate for Payer: Wellpoint Medicaid Managed Care	$20.35

SCREW CORTICAL BONE 5.0x34mm

Facility

$768.00

Service Code	HCPCS C1713
Hospital Charge Code	270650493
Hospital Revenue Code	278
Min. Negotiated Rate	$115.20
Max. Negotiated Rate	$185.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$168.96
Rate for Payer: Qualcare PPO/HMO/WC	$115.20

SCREW CORTICAL BONE 5 MM

Facility

$1,540.00

Service Code	HCPCS C1713
Hospital Charge Code	270702101
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 BONE 5 MM

Facility

$1,540.00

Service Code	HCPCS C1713
Hospital Charge Code	270702101
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 FIX 4.35x30MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270676389
Hospital Revenue Code	278
Min. Negotiated Rate	$210.88
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$210.88
Rate for Payer: Wellpoint Medicaid Managed Care	$231.88

SCREW CORTICAL FIX 4.35x30MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270676389
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

SCREW CORTICAL FIX 4.35x35MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270676390
Hospital Revenue Code	278
Min. Negotiated Rate	$210.88
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$210.88
Rate for Payer: Wellpoint Medicaid Managed Care	$231.88

SCREW CORTICAL FIX 4.35x35MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270676390
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

SCREW CORTICAL FIX 4.35x40MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270676391
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

SCREW CORTICAL FIX 4.35x40MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270676391
Hospital Revenue Code	278
Min. Negotiated Rate	$210.88
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$210.88
Rate for Payer: Wellpoint Medicaid Managed Care	$231.88

SCREW CORTICAL FIX 4.35x45MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270675214
Hospital Revenue Code	278
Min. Negotiated Rate	$210.88
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$210.88
Rate for Payer: Wellpoint Medicaid Managed Care	$231.88

SCREW CORTICAL FIX 4.35x45MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270675214
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

SCREW CORTICAL FIX 5x45MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270673340
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

Know your out-of-pocket cost for care.

All Charges