Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW FIXED SELFDRILL 4.0X14MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694450
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 FIXED SELFDRILL 4.0X14MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694450
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 FIXED S-T 3.75X16MM

Facility

$4,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270698900
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

SCREW FIXED S-T 3.75X16MM

Facility

$4,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270698900
Hospital Revenue Code	278
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

SCREW FIX MGNA 7DX65MM 32M TH

Facility

$890.45

Hospital Charge Code	270610408
Hospital Revenue Code	278
Min. Negotiated Rate	$133.57
Max. Negotiated Rate	$215.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$195.90
Rate for Payer: Qualcare PPO/HMO/WC	$133.57

SCREW FIX MGNA 7DX65MM 32M TH

Facility

$890.45

Hospital Charge Code	270610408
Hospital Revenue Code	278
Min. Negotiated Rate	$21.46
Max. Negotiated Rate	$445.23
Rate for Payer: Aetna Commercial	$338.37
Rate for Payer: Aetna Medicare Advantage	$267.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.06
Rate for Payer: Cigna Commercial	$445.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$195.90
Rate for Payer: Qualcare PPO/HMO/WC	$133.57
Rate for Payer: UnitedHealthcare Community & State	$21.46
Rate for Payer: Wellpoint Medicaid Managed Care	$23.60

SCREW FIXOS 5X48MM

Facility

$4,851.30

Service Code	HCPCS C1713
Hospital Charge Code	270704502
Hospital Revenue Code	278
Min. Negotiated Rate	$116.92
Max. Negotiated Rate	$2,425.65
Rate for Payer: Aetna Commercial	$1,843.49
Rate for Payer: Aetna Medicare Advantage	$1,455.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,237.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,237.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$970.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,237.08
Rate for Payer: Cigna Commercial	$2,425.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,174.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,067.29
Rate for Payer: Qualcare PPO/HMO/WC	$727.70
Rate for Payer: UnitedHealthcare Community & State	$116.92
Rate for Payer: Wellpoint Medicaid Managed Care	$128.56

SCREW FIXOS 5X48MM

Facility

$4,851.30

Service Code	HCPCS C1713
Hospital Charge Code	270704502
Hospital Revenue Code	278
Min. Negotiated Rate	$727.70
Max. Negotiated Rate	$1,174.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$970.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,174.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,067.29
Rate for Payer: Qualcare PPO/HMO/WC	$727.70

SCREW FIXOS ST COMP 2.5X24MM

Facility

$2,230.00

Service Code	HCPCS C1713
Hospital Charge Code	270699829
Hospital Revenue Code	278
Min. Negotiated Rate	$334.50
Max. Negotiated Rate	$539.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$446.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$539.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$490.60
Rate for Payer: Qualcare PPO/HMO/WC	$334.50

SCREW FIXOS ST COMP 2.5X24MM

Facility

$2,230.00

Service Code	HCPCS C1713
Hospital Charge Code	270699829
Hospital Revenue Code	278
Min. Negotiated Rate	$53.74
Max. Negotiated Rate	$1,115.00
Rate for Payer: Aetna Commercial	$847.40
Rate for Payer: Aetna Medicare Advantage	$669.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$568.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$568.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$446.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$568.65
Rate for Payer: Cigna Commercial	$1,115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$539.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$490.60
Rate for Payer: Qualcare PPO/HMO/WC	$334.50
Rate for Payer: UnitedHealthcare Community & State	$53.74
Rate for Payer: Wellpoint Medicaid Managed Care	$59.09

SCREW FIXOS TWIST-OFF 2X11MM

Facility

$2,615.00

Service Code	HCPCS C1713
Hospital Charge Code	270671307
Hospital Revenue Code	278
Min. Negotiated Rate	$392.25
Max. Negotiated Rate	$632.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$523.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$632.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$575.30
Rate for Payer: Qualcare PPO/HMO/WC	$392.25

SCREW FIXOS TWIST-OFF 2X11MM

Facility

$2,615.00

Service Code	HCPCS C1713
Hospital Charge Code	270671307
Hospital Revenue Code	278
Min. Negotiated Rate	$63.02
Max. Negotiated Rate	$1,307.50
Rate for Payer: Aetna Commercial	$993.70
Rate for Payer: Aetna Medicare Advantage	$784.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$666.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$666.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$523.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$666.83
Rate for Payer: Cigna Commercial	$1,307.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$632.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$575.30
Rate for Payer: Qualcare PPO/HMO/WC	$392.25
Rate for Payer: UnitedHealthcare Community & State	$63.02
Rate for Payer: Wellpoint Medicaid Managed Care	$69.30

SCREW FIX SELF DRILL 3.5X16MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270694463
Hospital Revenue Code	278
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

SCREW FIX SELF DRILL 3.5X16MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270694463
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW FORTE CANC FT 4.0X16MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270661146
Hospital Revenue Code	278
Min. Negotiated Rate	$190.89
Max. Negotiated Rate	$307.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$279.97
Rate for Payer: Qualcare PPO/HMO/WC	$190.89

SCREW FORTE CANC FT 4.0X16MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270661146
Hospital Revenue Code	278
Min. Negotiated Rate	$30.67
Max. Negotiated Rate	$636.30
Rate for Payer: Aetna Commercial	$483.59
Rate for Payer: Aetna Medicare Advantage	$381.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$324.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$324.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$324.51
Rate for Payer: Cigna Commercial	$636.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$279.97
Rate for Payer: Qualcare PPO/HMO/WC	$190.89
Rate for Payer: UnitedHealthcare Community & State	$30.67
Rate for Payer: Wellpoint Medicaid Managed Care	$33.72

SCREW FORTE CANC FULL THD

Facility

$200.50

Hospital Charge Code	270630838
Hospital Revenue Code	278
Min. Negotiated Rate	$30.07
Max. Negotiated Rate	$48.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.11
Rate for Payer: Qualcare PPO/HMO/WC	$30.07

SCREW FORTE CANC FULL THD

Facility

$200.50

Hospital Charge Code	270630839
Hospital Revenue Code	278
Min. Negotiated Rate	$4.83
Max. Negotiated Rate	$100.25
Rate for Payer: Aetna Commercial	$76.19
Rate for Payer: Aetna Medicare Advantage	$60.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.13
Rate for Payer: Cigna Commercial	$100.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.11
Rate for Payer: Qualcare PPO/HMO/WC	$30.07
Rate for Payer: UnitedHealthcare Community & State	$4.83
Rate for Payer: Wellpoint Medicaid Managed Care	$5.31

SCREW FORTE CANC FULL THD

Facility

$200.50

Hospital Charge Code	270630839
Hospital Revenue Code	278
Min. Negotiated Rate	$30.07
Max. Negotiated Rate	$48.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.11
Rate for Payer: Qualcare PPO/HMO/WC	$30.07

SCREW FORTE CANC FULL THD

Facility

$200.50

Hospital Charge Code	270630838
Hospital Revenue Code	278
Min. Negotiated Rate	$4.83
Max. Negotiated Rate	$100.25
Rate for Payer: Aetna Commercial	$76.19
Rate for Payer: Aetna Medicare Advantage	$60.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.13
Rate for Payer: Cigna Commercial	$100.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.11
Rate for Payer: Qualcare PPO/HMO/WC	$30.07
Rate for Payer: UnitedHealthcare Community & State	$4.83
Rate for Payer: Wellpoint Medicaid Managed Care	$5.31

SCREW FREE LOCK LAG STD

Facility

$490.05

Hospital Charge Code	270656365
Hospital Revenue Code	278
Min. Negotiated Rate	$11.81
Max. Negotiated Rate	$245.03
Rate for Payer: Aetna Commercial	$186.22
Rate for Payer: Aetna Medicare Advantage	$147.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.96
Rate for Payer: Cigna Commercial	$245.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$107.81
Rate for Payer: Qualcare PPO/HMO/WC	$73.51
Rate for Payer: UnitedHealthcare Community & State	$11.81
Rate for Payer: Wellpoint Medicaid Managed Care	$12.99

SCREW FREE LOCK LAG STD

Facility

$490.05

Hospital Charge Code	270656365
Hospital Revenue Code	278
Min. Negotiated Rate	$73.51
Max. Negotiated Rate	$118.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$107.81
Rate for Payer: Qualcare PPO/HMO/WC	$73.51

SCREW FREE LOCK LAG STD

Facility

$623.15

Hospital Charge Code	270656344
Hospital Revenue Code	278
Min. Negotiated Rate	$15.02
Max. Negotiated Rate	$311.57
Rate for Payer: Aetna Commercial	$236.80
Rate for Payer: Aetna Medicare Advantage	$186.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.90
Rate for Payer: Cigna Commercial	$311.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.09
Rate for Payer: Qualcare PPO/HMO/WC	$93.47
Rate for Payer: UnitedHealthcare Community & State	$15.02
Rate for Payer: Wellpoint Medicaid Managed Care	$16.51

SCREW FREE LOCK LAG STD

Facility

$623.15

Hospital Charge Code	270656344
Hospital Revenue Code	278
Min. Negotiated Rate	$93.47
Max. Negotiated Rate	$150.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.09
Rate for Payer: Qualcare PPO/HMO/WC	$93.47

SCREW FREE LOCK LAG STD 13TH.

Facility

$623.15

Hospital Charge Code	270656348
Hospital Revenue Code	278
Min. Negotiated Rate	$15.02
Max. Negotiated Rate	$311.57
Rate for Payer: Aetna Commercial	$236.80
Rate for Payer: Aetna Medicare Advantage	$186.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.90
Rate for Payer: Cigna Commercial	$311.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.09
Rate for Payer: Qualcare PPO/HMO/WC	$93.47
Rate for Payer: UnitedHealthcare Community & State	$15.02
Rate for Payer: Wellpoint Medicaid Managed Care	$16.51

Know your out-of-pocket cost for care.

All Charges