Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW FX AGL M8 40x6.5 859-640

Facility

$3,422.45

Hospital Charge Code	270617304
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

SCREW FX AGL M8 40x6.5 859-640

Facility

$3,422.45

Hospital Charge Code	270617304
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 45x6.5 859-645

Facility

$3,422.45

Hospital Charge Code	270617306
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 45x6.5 859-645

Facility

$3,422.45

Hospital Charge Code	270617306
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

SCREW G7 6.5MM 15MM

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270681466
Hospital Revenue Code	278
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

SCREW G7 6.5MM 15MM

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270681466
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

SCREW G7 6.5MM 25MM

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270681467
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

SCREW G7 6.5MM 25MM

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270681467
Hospital Revenue Code	278
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

SCREW GAMMA LAG 12/130MM

Facility

$778.00

Hospital Charge Code	1605575
Hospital Revenue Code	274
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$389.00
Rate for Payer: Aetna Commercial	$295.64
Rate for Payer: Aetna Medicare Advantage	$233.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.39
Rate for Payer: Cigna Commercial	$389.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$171.16
Rate for Payer: Qualcare PPO/HMO/WC	$116.70
Rate for Payer: UnitedHealthcare Community & State	$18.75
Rate for Payer: Wellpoint Medicaid Managed Care	$20.62

SCREW GAMMA LAG 12/130MM

Facility

$778.00

Hospital Charge Code	1605575
Hospital Revenue Code	274
Min. Negotiated Rate	$116.70
Max. Negotiated Rate	$188.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$171.16
Rate for Payer: Qualcare PPO/HMO/WC	$116.70

SCREW GAMMA LAG 12/80M

Facility

$778.00

Hospital Charge Code	1605567
Hospital Revenue Code	274
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$389.00
Rate for Payer: Aetna Commercial	$295.64
Rate for Payer: Aetna Medicare Advantage	$233.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.39
Rate for Payer: Cigna Commercial	$389.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$171.16
Rate for Payer: Qualcare PPO/HMO/WC	$116.70
Rate for Payer: UnitedHealthcare Community & State	$18.75
Rate for Payer: Wellpoint Medicaid Managed Care	$20.62

SCREW GAMMA LAG 12/80M

Facility

$778.00

Hospital Charge Code	1605567
Hospital Revenue Code	274
Min. Negotiated Rate	$116.70
Max. Negotiated Rate	$188.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$171.16
Rate for Payer: Qualcare PPO/HMO/WC	$116.70

SCREW GBA CANC 6.5 40 AR-1358

Facility

$783.25

Hospital Charge Code	270614979
Hospital Revenue Code	278
Min. Negotiated Rate	$117.49
Max. Negotiated Rate	$189.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$172.31
Rate for Payer: Qualcare PPO/HMO/WC	$117.49

SCREW GBA CANC 6.5 40 AR-1358

Facility

$783.25

Hospital Charge Code	270614979
Hospital Revenue Code	278
Min. Negotiated Rate	$18.88
Max. Negotiated Rate	$391.62
Rate for Payer: Aetna Commercial	$297.63
Rate for Payer: Aetna Medicare Advantage	$234.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.73
Rate for Payer: Cigna Commercial	$391.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$172.31
Rate for Payer: Qualcare PPO/HMO/WC	$117.49
Rate for Payer: UnitedHealthcare Community & State	$18.88
Rate for Payer: Wellpoint Medicaid Managed Care	$20.76

SCREW GBA SHTHD 8 23 AR-1380B

Facility

$1,242.45

Hospital Charge Code	270614981
Hospital Revenue Code	278
Min. Negotiated Rate	$186.37
Max. Negotiated Rate	$300.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.34
Rate for Payer: Qualcare PPO/HMO/WC	$186.37

SCREW GBA SHTHD 8 23 AR-1380B

Facility

$1,242.45

Hospital Charge Code	270614981
Hospital Revenue Code	278
Min. Negotiated Rate	$29.94
Max. Negotiated Rate	$621.23
Rate for Payer: Aetna Commercial	$472.13
Rate for Payer: Aetna Medicare Advantage	$372.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.82
Rate for Payer: Cigna Commercial	$621.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.34
Rate for Payer: Qualcare PPO/HMO/WC	$186.37
Rate for Payer: UnitedHealthcare Community & State	$29.94
Rate for Payer: Wellpoint Medicaid Managed Care	$32.92

SCREW GL 2.4mmx12MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270680719
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

SCREW GL 2.4mmx12MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270680719
Hospital Revenue Code	278
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$180.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Community & State	$11.45
Rate for Payer: Wellpoint Medicaid Managed Care	$12.59

SCREW GL 3.0mmx14MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270680720
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

SCREW GL 3.0mmx14MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270680720
Hospital Revenue Code	278
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$180.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Community & State	$11.45
Rate for Payer: Wellpoint Medicaid Managed Care	$12.59

SCREW GLENOID POLYAX LKG L22

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270691234
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

SCREW GLENOID POLYAX LKG L22

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270691234
Hospital Revenue Code	278
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

SCREW GLENOID POLYAX LOCKING 3

Facility

$125.00

Hospital Charge Code	270703559
Hospital Revenue Code	278
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

SCREW GLENOID POLYAX LOCKING 3

Facility

$125.00

Hospital Charge Code	270703559
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

SCREW GLENOID POLY LKG L14

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270696735
Hospital Revenue Code	278
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

Know your out-of-pocket cost for care.

All Charges