Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW EXT TAB T20 7.5X45MM

Facility

$6,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270698047
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,687.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,534.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

SCREW FA 4.0 MM X L16MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688699
Hospital Revenue Code	278
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

SCREW FA 4.0 MM X L16MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688699
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW FACET 6.0X10MM

Facility

$44,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270696784
Hospital Revenue Code	278
Min. Negotiated Rate	$1,080.88
Max. Negotiated Rate	$22,425.00
Rate for Payer: Aetna Commercial	$17,043.00
Rate for Payer: Aetna Medicare Advantage	$13,455.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,436.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,436.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,970.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,436.75
Rate for Payer: Cigna Commercial	$22,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,853.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,867.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,727.50
Rate for Payer: UnitedHealthcare Community & State	$1,080.88
Rate for Payer: Wellpoint Medicaid Managed Care	$1,188.53

SCREW FACET 6.0X10MM

Facility

$44,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270696784
Hospital Revenue Code	278
Min. Negotiated Rate	$6,727.50
Max. Negotiated Rate	$10,853.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,970.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,853.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,867.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,727.50

SCREW FACET CANN 5X30MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270703619
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

SCREW FACET CANN 5X30MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270703619
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

SCREW FACET FIXX FT 4.5X25MM

Facility

$4,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693619
Hospital Revenue Code	278
Min. Negotiated Rate	$119.90
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,890.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,094.50
Rate for Payer: Qualcare PPO/HMO/WC	$746.25
Rate for Payer: UnitedHealthcare Community & State	$119.90
Rate for Payer: Wellpoint Medicaid Managed Care	$131.84

SCREW FACET FIXX FT 4.5X25MM

Facility

$4,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693619
Hospital Revenue Code	278
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$1,203.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,094.50
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

SCREW FACET FIXX FT 4.5X30MM

Facility

$4,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693620
Hospital Revenue Code	278
Min. Negotiated Rate	$119.90
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,890.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,094.50
Rate for Payer: Qualcare PPO/HMO/WC	$746.25
Rate for Payer: UnitedHealthcare Community & State	$119.90
Rate for Payer: Wellpoint Medicaid Managed Care	$131.84

SCREW FACET FIXX FT 4.5X30MM

Facility

$4,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693620
Hospital Revenue Code	278
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$1,203.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,094.50
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

SCREW FEMORAL 14MM

Facility

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	270676878
Hospital Revenue Code	278
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.64

SCREW FEMORAL 14MM

Facility

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	270676878
Hospital Revenue Code	278
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$42.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

SCREW FEMORAL AUG POST SZ1 5MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270680663
Hospital Revenue Code	278
Min. Negotiated Rate	$86.86
Max. Negotiated Rate	$1,802.00
Rate for Payer: Aetna Commercial	$1,369.52
Rate for Payer: Aetna Medicare Advantage	$1,081.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.02
Rate for Payer: Cigna Commercial	$1,802.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$792.88
Rate for Payer: Qualcare PPO/HMO/WC	$540.60
Rate for Payer: UnitedHealthcare Community & State	$86.86
Rate for Payer: Wellpoint Medicaid Managed Care	$95.51

SCREW FEMORAL AUG POST SZ1 5MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270680663
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$872.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$792.88
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL AUG SZ1 10MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270680664
Hospital Revenue Code	278
Min. Negotiated Rate	$86.86
Max. Negotiated Rate	$1,802.00
Rate for Payer: Aetna Commercial	$1,369.52
Rate for Payer: Aetna Medicare Advantage	$1,081.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.02
Rate for Payer: Cigna Commercial	$1,802.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$792.88
Rate for Payer: Qualcare PPO/HMO/WC	$540.60
Rate for Payer: UnitedHealthcare Community & State	$86.86
Rate for Payer: Wellpoint Medicaid Managed Care	$95.51

SCREW FEMORAL AUG SZ1 10MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270680664
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$872.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$792.88
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL AUG SZ3 10MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270676963
Hospital Revenue Code	278
Min. Negotiated Rate	$86.86
Max. Negotiated Rate	$1,802.00
Rate for Payer: Aetna Commercial	$1,369.52
Rate for Payer: Aetna Medicare Advantage	$1,081.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.02
Rate for Payer: Cigna Commercial	$1,802.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$792.88
Rate for Payer: Qualcare PPO/HMO/WC	$540.60
Rate for Payer: UnitedHealthcare Community & State	$86.86
Rate for Payer: Wellpoint Medicaid Managed Care	$95.51

SCREW FEMORAL AUG SZ3 10MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270676963
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$872.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$792.88
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL AUG SZ4 10MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270676558
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$872.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$792.88
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL AUG SZ4 10MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270676558
Hospital Revenue Code	278
Min. Negotiated Rate	$86.86
Max. Negotiated Rate	$1,802.00
Rate for Payer: Aetna Commercial	$1,369.52
Rate for Payer: Aetna Medicare Advantage	$1,081.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.02
Rate for Payer: Cigna Commercial	$1,802.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$792.88
Rate for Payer: Qualcare PPO/HMO/WC	$540.60
Rate for Payer: UnitedHealthcare Community & State	$86.86
Rate for Payer: Wellpoint Medicaid Managed Care	$95.51

SCREW FEMORAL AUG SZ5 10MM

Facility

$3,604.00

Hospital Charge Code	270676681
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$872.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$792.88
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL AUG SZ5 10MM

Facility

$3,604.00

Hospital Charge Code	270676681
Hospital Revenue Code	278
Min. Negotiated Rate	$86.86
Max. Negotiated Rate	$1,802.00
Rate for Payer: Aetna Commercial	$1,369.52
Rate for Payer: Aetna Medicare Advantage	$1,081.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.02
Rate for Payer: Cigna Commercial	$1,802.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$792.88
Rate for Payer: Qualcare PPO/HMO/WC	$540.60
Rate for Payer: UnitedHealthcare Community & State	$86.86
Rate for Payer: Wellpoint Medicaid Managed Care	$95.51

SCREW FEMORAL AUG SZ5 5MM

Facility

$3,604.00

Hospital Charge Code	270676680
Hospital Revenue Code	278
Min. Negotiated Rate	$86.86
Max. Negotiated Rate	$1,802.00
Rate for Payer: Aetna Commercial	$1,369.52
Rate for Payer: Aetna Medicare Advantage	$1,081.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.02
Rate for Payer: Cigna Commercial	$1,802.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$792.88
Rate for Payer: Qualcare PPO/HMO/WC	$540.60
Rate for Payer: UnitedHealthcare Community & State	$86.86
Rate for Payer: Wellpoint Medicaid Managed Care	$95.51

SCREW FEMORAL AUG SZ5 5MM

Facility

$3,604.00

Hospital Charge Code	270676680
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$872.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$792.88
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

Know your out-of-pocket cost for care.

All Charges