Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW FULL CORTICAL 3.5 X 14 M

Facility

$535.00

Service Code	HCPCS C1713
Hospital Charge Code	270701109
Hospital Revenue Code	278
Min. Negotiated Rate	$12.89
Max. Negotiated Rate	$267.50
Rate for Payer: Aetna Commercial	$203.30
Rate for Payer: Aetna Medicare Advantage	$160.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.43
Rate for Payer: Cigna Commercial	$267.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.70
Rate for Payer: Qualcare PPO/HMO/WC	$80.25
Rate for Payer: UnitedHealthcare Community & State	$12.89
Rate for Payer: Wellpoint Medicaid Managed Care	$14.18

SCREW FULL THREAD 3.5X10MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270695347
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$225.50
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

SCREW FULL THREAD 3.5X10MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270695347
Hospital Revenue Code	278
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$389.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$225.50
Rate for Payer: Qualcare PPO/HMO/WC	$153.75
Rate for Payer: UnitedHealthcare Community & State	$24.70
Rate for Payer: Wellpoint Medicaid Managed Care	$27.16

SCREW FULL THREAD 3.5X12MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270695343
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$225.50
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

SCREW FULL THREAD 3.5X12MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270695343
Hospital Revenue Code	278
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$389.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$225.50
Rate for Payer: Qualcare PPO/HMO/WC	$153.75
Rate for Payer: UnitedHealthcare Community & State	$24.70
Rate for Payer: Wellpoint Medicaid Managed Care	$27.16

SCREW FULL THREAD 3.5X14MM

Facility

$1,880.00

Service Code	HCPCS C1713
Hospital Charge Code	270695345
Hospital Revenue Code	278
Min. Negotiated Rate	$282.00
Max. Negotiated Rate	$454.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$454.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$413.60
Rate for Payer: Qualcare PPO/HMO/WC	$282.00

SCREW FULL THREAD 3.5X14MM

Facility

$1,880.00

Service Code	HCPCS C1713
Hospital Charge Code	270695345
Hospital Revenue Code	278
Min. Negotiated Rate	$45.31
Max. Negotiated Rate	$940.00
Rate for Payer: Aetna Commercial	$714.40
Rate for Payer: Aetna Medicare Advantage	$564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$479.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$479.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$479.40
Rate for Payer: Cigna Commercial	$940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$454.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$413.60
Rate for Payer: Qualcare PPO/HMO/WC	$282.00
Rate for Payer: UnitedHealthcare Community & State	$45.31
Rate for Payer: Wellpoint Medicaid Managed Care	$49.82

SCREW FULL THREAD 3.5X22MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270695346
Hospital Revenue Code	278
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$389.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$225.50
Rate for Payer: Qualcare PPO/HMO/WC	$153.75
Rate for Payer: UnitedHealthcare Community & State	$24.70
Rate for Payer: Wellpoint Medicaid Managed Care	$27.16

SCREW FULL THREAD 3.5X22MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270695346
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$225.50
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

SCREW FULL THREAD T10 3.5X20MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270694742
Hospital Revenue Code	278
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$389.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$225.50
Rate for Payer: Qualcare PPO/HMO/WC	$153.75
Rate for Payer: UnitedHealthcare Community & State	$24.70
Rate for Payer: Wellpoint Medicaid Managed Care	$27.16

SCREW FULL THREAD T10 3.5X20MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270694742
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$225.50
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

SCREW FULLY THREAD 20.13MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270700859
Hospital Revenue Code	278
Min. Negotiated Rate	$23.20
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$365.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$144.38
Rate for Payer: UnitedHealthcare Community & State	$23.20
Rate for Payer: Wellpoint Medicaid Managed Care	$25.51

SCREW FULLY THREAD 20.13MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270700859
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW FULLY THREADED 14MM

Facility

$650.00

Hospital Charge Code	270664023
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

SCREW FULLY THREADED 14MM

Facility

$650.00

Hospital Charge Code	270664023
Hospital Revenue Code	278
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

SCREW FULLY THREADED 24MM

Facility

$650.00

Hospital Charge Code	270664022
Hospital Revenue Code	278
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

SCREW FULLY THREADED 24MM

Facility

$650.00

Hospital Charge Code	270664022
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

SCREW FULLY THREADED 2.5X 12MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270700858
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW FULLY THREADED 2.5X 12MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270700858
Hospital Revenue Code	278
Min. Negotiated Rate	$23.20
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$365.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$144.38
Rate for Payer: UnitedHealthcare Community & State	$23.20
Rate for Payer: Wellpoint Medicaid Managed Care	$25.51

SCREW FULLY THREADED 4.0 X4

Facility

$2,135.00

Hospital Charge Code	270667928
Hospital Revenue Code	278
Min. Negotiated Rate	$51.45
Max. Negotiated Rate	$1,067.50
Rate for Payer: Aetna Commercial	$811.30
Rate for Payer: Aetna Medicare Advantage	$640.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$544.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$544.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$427.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$544.42
Rate for Payer: Cigna Commercial	$1,067.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$516.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$469.70
Rate for Payer: Qualcare PPO/HMO/WC	$320.25
Rate for Payer: UnitedHealthcare Community & State	$51.45
Rate for Payer: Wellpoint Medicaid Managed Care	$56.58

SCREW FULLY THREADED 4.0 X4

Facility

$2,135.00

Hospital Charge Code	270667928
Hospital Revenue Code	278
Min. Negotiated Rate	$320.25
Max. Negotiated Rate	$516.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$427.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$516.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$469.70
Rate for Payer: Qualcare PPO/HMO/WC	$320.25

SCREW FUL THD 6.5x75 815761075

Facility

$168.70

Hospital Charge Code	270633176
Hospital Revenue Code	278
Min. Negotiated Rate	$4.07
Max. Negotiated Rate	$84.35
Rate for Payer: Aetna Commercial	$64.11
Rate for Payer: Aetna Medicare Advantage	$50.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.02
Rate for Payer: Cigna Commercial	$84.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$37.11
Rate for Payer: Qualcare PPO/HMO/WC	$25.30
Rate for Payer: UnitedHealthcare Community & State	$4.07
Rate for Payer: Wellpoint Medicaid Managed Care	$4.47

SCREW FUL THD 6.5x75 815761075

Facility

$168.70

Hospital Charge Code	270633176
Hospital Revenue Code	278
Min. Negotiated Rate	$25.30
Max. Negotiated Rate	$40.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$37.11
Rate for Payer: Qualcare PPO/HMO/WC	$25.30

SCREW FX AGL M8 35x7.5 859-735

Facility

$3,422.45

Hospital Charge Code	270617305
Hospital Revenue Code	278
Min. Negotiated Rate	$513.37
Max. Negotiated Rate	$828.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$684.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$828.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$752.94
Rate for Payer: Qualcare PPO/HMO/WC	$513.37

SCREW FX AGL M8 35x7.5 859-735

Facility

$3,422.45

Hospital Charge Code	270617305
Hospital Revenue Code	278
Min. Negotiated Rate	$82.48
Max. Negotiated Rate	$1,711.22
Rate for Payer: Aetna Commercial	$1,300.53
Rate for Payer: Aetna Medicare Advantage	$1,026.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$872.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$872.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$684.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$872.72
Rate for Payer: Cigna Commercial	$1,711.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$828.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$752.94
Rate for Payer: Qualcare PPO/HMO/WC	$513.37
Rate for Payer: UnitedHealthcare Community & State	$82.48
Rate for Payer: Wellpoint Medicaid Managed Care	$90.69

Know your out-of-pocket cost for care.

All Charges