Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CORTICAL LO PRO 2.4X20MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270669483
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 LO PRO 2.4X22MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270669484
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 LO PRO 2.4X22MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270669484
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 LOW PROFILE 3.5

Facility

$370.00

Hospital Charge Code	270665191
Hospital Revenue Code	278
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$89.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$81.40
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

SCREW CORTICAL LOW PROFILE 3.5

Facility

$370.00

Hospital Charge Code	270665191
Hospital Revenue Code	278
Min. Negotiated Rate	$8.92
Max. Negotiated Rate	$185.00
Rate for Payer: Aetna Commercial	$140.60
Rate for Payer: Aetna Medicare Advantage	$111.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.35
Rate for Payer: Cigna Commercial	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$81.40
Rate for Payer: Qualcare PPO/HMO/WC	$55.50
Rate for Payer: UnitedHealthcare Community & State	$8.92
Rate for Payer: Wellpoint Medicaid Managed Care	$9.80

SCREW CORTICAL LP 2.4X8MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270694819
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 LP 2.4X8MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270694819
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 MSP 2.4X18MM

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270693634
Hospital Revenue Code	278
Min. Negotiated Rate	$25.30
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$399.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50
Rate for Payer: UnitedHealthcare Community & State	$25.30
Rate for Payer: Wellpoint Medicaid Managed Care	$27.82

SCREW CORTICAL MSP 2.4X18MM

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270693634
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SCREW CORTICAL NL 3.5X11MM

Facility

$513.00

Service Code	HCPCS C1713
Hospital Charge Code	270661774
Hospital Revenue Code	278
Min. Negotiated Rate	$76.95
Max. Negotiated Rate	$124.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$112.86
Rate for Payer: Qualcare PPO/HMO/WC	$76.95

SCREW CORTICAL NL 3.5X11MM

Facility

$513.00

Service Code	HCPCS C1713
Hospital Charge Code	270661774
Hospital Revenue Code	278
Min. Negotiated Rate	$12.36
Max. Negotiated Rate	$256.50
Rate for Payer: Aetna Commercial	$194.94
Rate for Payer: Aetna Medicare Advantage	$153.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.81
Rate for Payer: Cigna Commercial	$256.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$112.86
Rate for Payer: Qualcare PPO/HMO/WC	$76.95
Rate for Payer: UnitedHealthcare Community & State	$12.36
Rate for Payer: Wellpoint Medicaid Managed Care	$13.59

SCREW CORTICAL NONLCK 3.5x16MM

Facility

$520.00

Service Code	HCPCS C1713
Hospital Charge Code	270661779
Hospital Revenue Code	278
Min. Negotiated Rate	$78.00
Max. Negotiated Rate	$125.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.40
Rate for Payer: Qualcare PPO/HMO/WC	$78.00

SCREW CORTICAL NONLCK 3.5x16MM

Facility

$520.00

Service Code	HCPCS C1713
Hospital Charge Code	270661779
Hospital Revenue Code	278
Min. Negotiated Rate	$12.53
Max. Negotiated Rate	$260.00
Rate for Payer: Aetna Commercial	$197.60
Rate for Payer: Aetna Medicare Advantage	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.60
Rate for Payer: Cigna Commercial	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.40
Rate for Payer: Qualcare PPO/HMO/WC	$78.00
Rate for Payer: UnitedHealthcare Community & State	$12.53
Rate for Payer: Wellpoint Medicaid Managed Care	$13.78

SCREW CORTICAL TI 5mmx48mm

Facility

$975.00

Service Code	HCPCS C1713
Hospital Charge Code	270645512
Hospital Revenue Code	278
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

SCREW CORTICAL TI 5mmx48mm

Facility

$975.00

Service Code	HCPCS C1713
Hospital Charge Code	270645512
Hospital Revenue Code	278
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$235.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

SCREW CORTICAL TI 5X22MM

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270656935
Hospital Revenue Code	278
Min. Negotiated Rate	$25.30
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$399.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50
Rate for Payer: UnitedHealthcare Community & State	$25.30
Rate for Payer: Wellpoint Medicaid Managed Care	$27.82

SCREW CORTICAL TI 5X22MM

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270656935
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SCREW CORTICAL TI 5x28mm

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270642558
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SCREW CORTICAL TI 5x28mm

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270642558
Hospital Revenue Code	278
Min. Negotiated Rate	$25.30
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$399.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50
Rate for Payer: UnitedHealthcare Community & State	$25.30
Rate for Payer: Wellpoint Medicaid Managed Care	$27.82

SCREW CORTICAL TI 5x32mm

Facility

$864.00

Service Code	HCPCS C1713
Hospital Charge Code	270642580
Hospital Revenue Code	278
Min. Negotiated Rate	$20.82
Max. Negotiated Rate	$432.00
Rate for Payer: Aetna Commercial	$328.32
Rate for Payer: Aetna Medicare Advantage	$259.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$220.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$220.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$220.32
Rate for Payer: Cigna Commercial	$432.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$190.08
Rate for Payer: Qualcare PPO/HMO/WC	$129.60
Rate for Payer: UnitedHealthcare Community & State	$20.82
Rate for Payer: Wellpoint Medicaid Managed Care	$22.90

SCREW CORTICAL TI 5x32mm

Facility

$864.00

Service Code	HCPCS C1713
Hospital Charge Code	270642580
Hospital Revenue Code	278
Min. Negotiated Rate	$129.60
Max. Negotiated Rate	$209.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$190.08
Rate for Payer: Qualcare PPO/HMO/WC	$129.60

SCREW CORTICAL TI 5x34MM

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270640513
Hospital Revenue Code	278
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

SCREW CORTICAL TI 5x34MM

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270640513
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

SCREW CORTICAL TI 5x42MM

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270642452
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SCREW CORTICAL TI 5x42MM

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270642452
Hospital Revenue Code	278
Min. Negotiated Rate	$25.30
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$399.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50
Rate for Payer: UnitedHealthcare Community & State	$25.30
Rate for Payer: Wellpoint Medicaid Managed Care	$27.82

Know your out-of-pocket cost for care.

All Charges