Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CORT TI 5x26MM 14405026

Facility

$905.00

Service Code	HCPCS C1713
Hospital Charge Code	270643149
Hospital Revenue Code	278
Min. Negotiated Rate	$135.75
Max. Negotiated Rate	$219.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.10
Rate for Payer: Qualcare PPO/HMO/WC	$135.75

SCREW CORT TI 5x26MM 14405026

Facility

$905.00

Service Code	HCPCS C1713
Hospital Charge Code	270643149
Hospital Revenue Code	278
Min. Negotiated Rate	$21.81
Max. Negotiated Rate	$452.50
Rate for Payer: Aetna Commercial	$343.90
Rate for Payer: Aetna Medicare Advantage	$271.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.78
Rate for Payer: Cigna Commercial	$452.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.10
Rate for Payer: Qualcare PPO/HMO/WC	$135.75
Rate for Payer: UnitedHealthcare Community & State	$21.81
Rate for Payer: Wellpoint Medicaid Managed Care	$23.98

SCREW CORT TI 5x38 14405038

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270643296
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 CORT TI 5x38 14405038

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270643296
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 CORT TI 5x56mm 14405056

Facility

$905.00

Hospital Charge Code	270645005
Hospital Revenue Code	278
Min. Negotiated Rate	$135.75
Max. Negotiated Rate	$219.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.10
Rate for Payer: Qualcare PPO/HMO/WC	$135.75

SCREW CORT TI 5x56mm 14405056

Facility

$905.00

Hospital Charge Code	270645005
Hospital Revenue Code	278
Min. Negotiated Rate	$21.81
Max. Negotiated Rate	$452.50
Rate for Payer: Aetna Commercial	$343.90
Rate for Payer: Aetna Medicare Advantage	$271.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.78
Rate for Payer: Cigna Commercial	$452.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.10
Rate for Payer: Qualcare PPO/HMO/WC	$135.75
Rate for Payer: UnitedHealthcare Community & State	$21.81
Rate for Payer: Wellpoint Medicaid Managed Care	$23.98

SCREW CORT TI-DOB

Facility

$2,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270705501
Hospital Revenue Code	278
Min. Negotiated Rate	$65.07
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$1,026.00
Rate for Payer: Aetna Medicare Advantage	$810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$688.50
Rate for Payer: Cigna Commercial	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$594.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00
Rate for Payer: UnitedHealthcare Community & State	$65.07
Rate for Payer: Wellpoint Medicaid Managed Care	$71.55

SCREW CORT TI-DOB

Facility

$2,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270705501
Hospital Revenue Code	278
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$653.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$594.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00

SCREW CORT TITN 3.5/1MM

Facility

$35.60

Hospital Charge Code	270603160
Hospital Revenue Code	279
Min. Negotiated Rate	$5.34
Max. Negotiated Rate	$5.34
Rate for Payer: Qualcare PPO/HMO/WC	$5.34

SCREW CORT TITN 3.5/1MM

Facility

$35.60

Hospital Charge Code	270603160
Hospital Revenue Code	279
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$17.80
Rate for Payer: Aetna Commercial	$13.53
Rate for Payer: Aetna Medicare Advantage	$10.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.08
Rate for Payer: Cigna Commercial	$17.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.68
Rate for Payer: Oxford Commercial	$7.12
Rate for Payer: Qualcare PPO/HMO/WC	$5.34
Rate for Payer: UnitedHealthcare Commercial	$7.12
Rate for Payer: UnitedHealthcare Community & State	$0.86
Rate for Payer: Wellpoint Medicaid Managed Care	$0.94

SCREW CORTX 2.4 SLFTP T8SD12MM

Facility

$246.90

Service Code	HCPCS C1713
Hospital Charge Code	270659970
Hospital Revenue Code	278
Min. Negotiated Rate	$5.95
Max. Negotiated Rate	$123.45
Rate for Payer: Aetna Commercial	$93.82
Rate for Payer: Aetna Medicare Advantage	$74.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.96
Rate for Payer: Cigna Commercial	$123.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.32
Rate for Payer: Qualcare PPO/HMO/WC	$37.03
Rate for Payer: UnitedHealthcare Community & State	$5.95
Rate for Payer: Wellpoint Medicaid Managed Care	$6.54

SCREW CORTX 2.4 SLFTP T8SD12MM

Facility

$246.90

Service Code	HCPCS C1713
Hospital Charge Code	270659970
Hospital Revenue Code	278
Min. Negotiated Rate	$37.03
Max. Negotiated Rate	$59.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.32
Rate for Payer: Qualcare PPO/HMO/WC	$37.03

SCREW CORT Z NAIL 5.0 X 30

Facility

$1,110.00

Hospital Charge Code	270658847
Hospital Revenue Code	278
Min. Negotiated Rate	$26.75
Max. Negotiated Rate	$555.00
Rate for Payer: Aetna Commercial	$421.80
Rate for Payer: Aetna Medicare Advantage	$333.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$283.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$283.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$283.05
Rate for Payer: Cigna Commercial	$555.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$244.20
Rate for Payer: Qualcare PPO/HMO/WC	$166.50
Rate for Payer: UnitedHealthcare Community & State	$26.75
Rate for Payer: Wellpoint Medicaid Managed Care	$29.41

SCREW CORT Z NAIL 5.0 X 30

Facility

$1,110.00

Hospital Charge Code	270658847
Hospital Revenue Code	278
Min. Negotiated Rate	$166.50
Max. Negotiated Rate	$268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$244.20
Rate for Payer: Qualcare PPO/HMO/WC	$166.50

SCREW CORT Z NAIL 5.0 X 40

Facility

$1,110.00

Hospital Charge Code	270658857
Hospital Revenue Code	278
Min. Negotiated Rate	$166.50
Max. Negotiated Rate	$268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$244.20
Rate for Payer: Qualcare PPO/HMO/WC	$166.50

SCREW CORT Z NAIL 5.0 X 40

Facility

$1,110.00

Hospital Charge Code	270658857
Hospital Revenue Code	278
Min. Negotiated Rate	$26.75
Max. Negotiated Rate	$555.00
Rate for Payer: Aetna Commercial	$421.80
Rate for Payer: Aetna Medicare Advantage	$333.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$283.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$283.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$283.05
Rate for Payer: Cigna Commercial	$555.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$244.20
Rate for Payer: Qualcare PPO/HMO/WC	$166.50
Rate for Payer: UnitedHealthcare Community & State	$26.75
Rate for Payer: Wellpoint Medicaid Managed Care	$29.41

SCREW CORT Z NAIL 5.0 X 42.5

Facility

$1,110.00

Hospital Charge Code	270658848
Hospital Revenue Code	278
Min. Negotiated Rate	$26.75
Max. Negotiated Rate	$555.00
Rate for Payer: Aetna Commercial	$421.80
Rate for Payer: Aetna Medicare Advantage	$333.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$283.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$283.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$283.05
Rate for Payer: Cigna Commercial	$555.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$244.20
Rate for Payer: Qualcare PPO/HMO/WC	$166.50
Rate for Payer: UnitedHealthcare Community & State	$26.75
Rate for Payer: Wellpoint Medicaid Managed Care	$29.41

SCREW CORT Z NAIL 5.0 X 42.5

Facility

$1,110.00

Hospital Charge Code	270658848
Hospital Revenue Code	278
Min. Negotiated Rate	$166.50
Max. Negotiated Rate	$268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$244.20
Rate for Payer: Qualcare PPO/HMO/WC	$166.50

SCREW CORT Z NAIL 5.0 X 50

Facility

$1,110.00

Hospital Charge Code	270658858
Hospital Revenue Code	278
Min. Negotiated Rate	$166.50
Max. Negotiated Rate	$268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$244.20
Rate for Payer: Qualcare PPO/HMO/WC	$166.50

SCREW CORT Z NAIL 5.0 X 50

Facility

$1,110.00

Hospital Charge Code	270658858
Hospital Revenue Code	278
Min. Negotiated Rate	$26.75
Max. Negotiated Rate	$555.00
Rate for Payer: Aetna Commercial	$421.80
Rate for Payer: Aetna Medicare Advantage	$333.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$283.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$283.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$283.05
Rate for Payer: Cigna Commercial	$555.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$244.20
Rate for Payer: Qualcare PPO/HMO/WC	$166.50
Rate for Payer: UnitedHealthcare Community & State	$26.75
Rate for Payer: Wellpoint Medicaid Managed Care	$29.41

SCREW COT LG 5.5 X 70 22537055

Facility

$672.65

Hospital Charge Code	270625980
Hospital Revenue Code	278
Min. Negotiated Rate	$16.21
Max. Negotiated Rate	$336.32
Rate for Payer: Aetna Commercial	$255.61
Rate for Payer: Aetna Medicare Advantage	$201.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.53
Rate for Payer: Cigna Commercial	$336.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.98
Rate for Payer: Qualcare PPO/HMO/WC	$100.90
Rate for Payer: UnitedHealthcare Community & State	$16.21
Rate for Payer: Wellpoint Medicaid Managed Care	$17.83

SCREW COT LG 5.5 X 70 22537055

Facility

$672.65

Hospital Charge Code	270625980
Hospital Revenue Code	278
Min. Negotiated Rate	$100.90
Max. Negotiated Rate	$162.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.98
Rate for Payer: Qualcare PPO/HMO/WC	$100.90

SCREW COT LG 5.5 X 80 22538055

Facility

$539.25

Hospital Charge Code	270625979
Hospital Revenue Code	278
Min. Negotiated Rate	$80.89
Max. Negotiated Rate	$130.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.64
Rate for Payer: Qualcare PPO/HMO/WC	$80.89

SCREW COT LG 5.5 X 80 22538055

Facility

$539.25

Hospital Charge Code	270625979
Hospital Revenue Code	278
Min. Negotiated Rate	$13.00
Max. Negotiated Rate	$269.62
Rate for Payer: Aetna Commercial	$204.91
Rate for Payer: Aetna Medicare Advantage	$161.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.51
Rate for Payer: Cigna Commercial	$269.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.64
Rate for Payer: Qualcare PPO/HMO/WC	$80.89
Rate for Payer: UnitedHealthcare Community & State	$13.00
Rate for Payer: Wellpoint Medicaid Managed Care	$14.29

SCREW COUNTER SINK 1.5- 2.0MM

Facility

$624.20

Hospital Charge Code	270663617
Hospital Revenue Code	278
Min. Negotiated Rate	$93.63
Max. Negotiated Rate	$151.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.32
Rate for Payer: Qualcare PPO/HMO/WC	$93.63

Know your out-of-pocket cost for care.

All Charges