Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW DF HEAD COMP PT 3.5X24MM

Facility

$1,055.60

Service Code	HCPCS C1713
Hospital Charge Code	270700382
Hospital Revenue Code	278
Min. Negotiated Rate	$25.44
Max. Negotiated Rate	$527.80
Rate for Payer: Aetna Commercial	$401.13
Rate for Payer: Aetna Medicare Advantage	$316.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.18
Rate for Payer: Cigna Commercial	$527.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$232.23
Rate for Payer: Qualcare PPO/HMO/WC	$158.34
Rate for Payer: UnitedHealthcare Community & State	$25.44
Rate for Payer: Wellpoint Medicaid Managed Care	$27.97

SCREW DF HEAD COMP PT 3.5X24MM

Facility

$1,055.60

Service Code	HCPCS C1713
Hospital Charge Code	270700382
Hospital Revenue Code	278
Min. Negotiated Rate	$158.34
Max. Negotiated Rate	$255.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$232.23
Rate for Payer: Qualcare PPO/HMO/WC	$158.34

SCREW DF HEAD COMP PT 3.5X28MM

Facility

$1,055.60

Service Code	HCPCS C1713
Hospital Charge Code	270700383
Hospital Revenue Code	278
Min. Negotiated Rate	$25.44
Max. Negotiated Rate	$527.80
Rate for Payer: Aetna Commercial	$401.13
Rate for Payer: Aetna Medicare Advantage	$316.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.18
Rate for Payer: Cigna Commercial	$527.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$232.23
Rate for Payer: Qualcare PPO/HMO/WC	$158.34
Rate for Payer: UnitedHealthcare Community & State	$25.44
Rate for Payer: Wellpoint Medicaid Managed Care	$27.97

SCREW DF HEAD COMP PT 3.5X28MM

Facility

$1,055.60

Service Code	HCPCS C1713
Hospital Charge Code	270700383
Hospital Revenue Code	278
Min. Negotiated Rate	$158.34
Max. Negotiated Rate	$255.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$232.23
Rate for Payer: Qualcare PPO/HMO/WC	$158.34

SCREW DF HEAD COMP PT 3.5X30MM

Facility

$1,055.60

Service Code	HCPCS C1713
Hospital Charge Code	270700381
Hospital Revenue Code	278
Min. Negotiated Rate	$25.44
Max. Negotiated Rate	$527.80
Rate for Payer: Aetna Commercial	$401.13
Rate for Payer: Aetna Medicare Advantage	$316.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.18
Rate for Payer: Cigna Commercial	$527.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$232.23
Rate for Payer: Qualcare PPO/HMO/WC	$158.34
Rate for Payer: UnitedHealthcare Community & State	$25.44
Rate for Payer: Wellpoint Medicaid Managed Care	$27.97

SCREW DF HEAD COMP PT 3.5X30MM

Facility

$1,055.60

Service Code	HCPCS C1713
Hospital Charge Code	270700381
Hospital Revenue Code	278
Min. Negotiated Rate	$158.34
Max. Negotiated Rate	$255.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$232.23
Rate for Payer: Qualcare PPO/HMO/WC	$158.34

SCREW DF HEAD COMP PT 3X20MM

Facility

$1,020.60

Service Code	HCPCS C1713
Hospital Charge Code	270700380
Hospital Revenue Code	278
Min. Negotiated Rate	$153.09
Max. Negotiated Rate	$246.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$224.53
Rate for Payer: Qualcare PPO/HMO/WC	$153.09

SCREW DF HEAD COMP PT 3X20MM

Facility

$1,020.60

Service Code	HCPCS C1713
Hospital Charge Code	270700380
Hospital Revenue Code	278
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$510.30
Rate for Payer: Aetna Commercial	$387.83
Rate for Payer: Aetna Medicare Advantage	$306.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.25
Rate for Payer: Cigna Commercial	$510.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$224.53
Rate for Payer: Qualcare PPO/HMO/WC	$153.09
Rate for Payer: UnitedHealthcare Community & State	$24.60
Rate for Payer: Wellpoint Medicaid Managed Care	$27.05

SCREW DHS COMPRES 280.99

Facility

$159.25

Hospital Charge Code	270603801
Hospital Revenue Code	278
Min. Negotiated Rate	$3.84
Max. Negotiated Rate	$79.62
Rate for Payer: Aetna Commercial	$60.52
Rate for Payer: Aetna Medicare Advantage	$47.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.61
Rate for Payer: Cigna Commercial	$79.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$35.03
Rate for Payer: Qualcare PPO/HMO/WC	$23.89
Rate for Payer: UnitedHealthcare Community & State	$3.84
Rate for Payer: Wellpoint Medicaid Managed Care	$4.22

SCREW DHS COMPRES 280.99

Facility

$159.25

Hospital Charge Code	270603801
Hospital Revenue Code	278
Min. Negotiated Rate	$23.89
Max. Negotiated Rate	$38.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$35.03
Rate for Payer: Qualcare PPO/HMO/WC	$23.89

SCREW DHS/DCS 90mm

Facility

$1,611.00

Hospital Charge Code	270671817
Hospital Revenue Code	278
Min. Negotiated Rate	$38.83
Max. Negotiated Rate	$805.50
Rate for Payer: Aetna Commercial	$612.18
Rate for Payer: Aetna Medicare Advantage	$483.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$322.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.81
Rate for Payer: Cigna Commercial	$805.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$354.42
Rate for Payer: Qualcare PPO/HMO/WC	$241.65
Rate for Payer: UnitedHealthcare Community & State	$38.83
Rate for Payer: Wellpoint Medicaid Managed Care	$42.69

SCREW DHS/DCS 90mm

Facility

$1,611.00

Hospital Charge Code	270671817
Hospital Revenue Code	278
Min. Negotiated Rate	$241.65
Max. Negotiated Rate	$389.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$322.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$354.42
Rate for Payer: Qualcare PPO/HMO/WC	$241.65

SCREW DHS LAG 12.7 105 280.05

Facility

$1,212.00

Hospital Charge Code	270603768
Hospital Revenue Code	278
Min. Negotiated Rate	$181.80
Max. Negotiated Rate	$293.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$242.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$293.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$266.64
Rate for Payer: Qualcare PPO/HMO/WC	$181.80

SCREW DHS LAG 12.7 105 280.05

Facility

$1,212.00

Hospital Charge Code	270603768
Hospital Revenue Code	278
Min. Negotiated Rate	$29.21
Max. Negotiated Rate	$606.00
Rate for Payer: Aetna Commercial	$460.56
Rate for Payer: Aetna Medicare Advantage	$363.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$309.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$309.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$242.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$309.06
Rate for Payer: Cigna Commercial	$606.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$293.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$266.64
Rate for Payer: Qualcare PPO/HMO/WC	$181.80
Rate for Payer: UnitedHealthcare Community & State	$29.21
Rate for Payer: Wellpoint Medicaid Managed Care	$32.12

SCREW DHS LAG 12.7 110 280.10

Facility

$1,212.00

Hospital Charge Code	270603769
Hospital Revenue Code	278
Min. Negotiated Rate	$29.21
Max. Negotiated Rate	$606.00
Rate for Payer: Aetna Commercial	$460.56
Rate for Payer: Aetna Medicare Advantage	$363.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$309.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$309.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$242.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$309.06
Rate for Payer: Cigna Commercial	$606.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$293.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$266.64
Rate for Payer: Qualcare PPO/HMO/WC	$181.80
Rate for Payer: UnitedHealthcare Community & State	$29.21
Rate for Payer: Wellpoint Medicaid Managed Care	$32.12

SCREW DHS LAG 12.7 110 280.10

Facility

$1,212.00

Hospital Charge Code	270603769
Hospital Revenue Code	278
Min. Negotiated Rate	$181.80
Max. Negotiated Rate	$293.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$242.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$293.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$266.64
Rate for Payer: Qualcare PPO/HMO/WC	$181.80

SCREW DHS LAG 12.7 115 280.15

Facility

$701.65

Hospital Charge Code	270603770
Hospital Revenue Code	278
Min. Negotiated Rate	$16.91
Max. Negotiated Rate	$350.82
Rate for Payer: Aetna Commercial	$266.63
Rate for Payer: Aetna Medicare Advantage	$210.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.92
Rate for Payer: Cigna Commercial	$350.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.36
Rate for Payer: Qualcare PPO/HMO/WC	$105.25
Rate for Payer: UnitedHealthcare Community & State	$16.91
Rate for Payer: Wellpoint Medicaid Managed Care	$18.59

SCREW DHS LAG 12.7 115 280.15

Facility

$701.65

Hospital Charge Code	270603770
Hospital Revenue Code	278
Min. Negotiated Rate	$105.25
Max. Negotiated Rate	$169.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.36
Rate for Payer: Qualcare PPO/HMO/WC	$105.25

SCREW DHS LAG 12.7 120 280.20

Facility

$1,212.00

Hospital Charge Code	270603771
Hospital Revenue Code	278
Min. Negotiated Rate	$181.80
Max. Negotiated Rate	$293.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$242.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$293.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$266.64
Rate for Payer: Qualcare PPO/HMO/WC	$181.80

SCREW DHS LAG 12.7 120 280.20

Facility

$1,212.00

Hospital Charge Code	270603771
Hospital Revenue Code	278
Min. Negotiated Rate	$29.21
Max. Negotiated Rate	$606.00
Rate for Payer: Aetna Commercial	$460.56
Rate for Payer: Aetna Medicare Advantage	$363.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$309.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$309.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$242.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$309.06
Rate for Payer: Cigna Commercial	$606.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$293.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$266.64
Rate for Payer: Qualcare PPO/HMO/WC	$181.80
Rate for Payer: UnitedHealthcare Community & State	$29.21
Rate for Payer: Wellpoint Medicaid Managed Care	$32.12

SCREW DHS LAG 12.7 125 280.25

Facility

$1,212.00

Hospital Charge Code	270603772
Hospital Revenue Code	278
Min. Negotiated Rate	$29.21
Max. Negotiated Rate	$606.00
Rate for Payer: Aetna Commercial	$460.56
Rate for Payer: Aetna Medicare Advantage	$363.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$309.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$309.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$242.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$309.06
Rate for Payer: Cigna Commercial	$606.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$293.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$266.64
Rate for Payer: Qualcare PPO/HMO/WC	$181.80
Rate for Payer: UnitedHealthcare Community & State	$29.21
Rate for Payer: Wellpoint Medicaid Managed Care	$32.12

SCREW DHS LAG 12.7 125 280.25

Facility

$1,212.00

Hospital Charge Code	270603772
Hospital Revenue Code	278
Min. Negotiated Rate	$181.80
Max. Negotiated Rate	$293.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$242.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$293.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$266.64
Rate for Payer: Qualcare PPO/HMO/WC	$181.80

SCREW DHS LAG 12.7 125 280525*

Facility

$525.00

Hospital Charge Code	270603796
Hospital Revenue Code	274
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

SCREW DHS LAG 12.7 125 280525*

Facility

$525.00

Hospital Charge Code	270603796
Hospital Revenue Code	274
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

SCREW DHS LAG 12.7 130 280.30

Facility

$1,212.00

Hospital Charge Code	270603773
Hospital Revenue Code	278
Min. Negotiated Rate	$29.21
Max. Negotiated Rate	$606.00
Rate for Payer: Aetna Commercial	$460.56
Rate for Payer: Aetna Medicare Advantage	$363.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$309.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$309.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$242.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$309.06
Rate for Payer: Cigna Commercial	$606.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$293.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$266.64
Rate for Payer: Qualcare PPO/HMO/WC	$181.80
Rate for Payer: UnitedHealthcare Community & State	$29.21
Rate for Payer: Wellpoint Medicaid Managed Care	$32.12

Know your out-of-pocket cost for care.

All Charges