Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW HEADLESS 3.0MM X 12MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270685401
Hospital Revenue Code	278
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

SCREW HEADLESS 3.0MM X 12MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270685401
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW HEADLESS 3.0MM X 14MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270685402
Hospital Revenue Code	278
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

SCREW HEADLESS 3.0MM X 14MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270685402
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW HEADLESS 3.0 X 16

Facility

$1,410.00

Hospital Charge Code	270664329
Hospital Revenue Code	278
Min. Negotiated Rate	$33.98
Max. Negotiated Rate	$705.00
Rate for Payer: Aetna Commercial	$535.80
Rate for Payer: Aetna Medicare Advantage	$423.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$359.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$359.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$359.55
Rate for Payer: Cigna Commercial	$705.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$310.20
Rate for Payer: Qualcare PPO/HMO/WC	$211.50
Rate for Payer: UnitedHealthcare Community & State	$33.98
Rate for Payer: Wellpoint Medicaid Managed Care	$37.37

SCREW HEADLESS 3.0 X 16

Facility

$1,410.00

Hospital Charge Code	270664329
Hospital Revenue Code	278
Min. Negotiated Rate	$211.50
Max. Negotiated Rate	$341.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$310.20
Rate for Payer: Qualcare PPO/HMO/WC	$211.50

SCREW HEADLESS 3.0X 16

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270683324
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW HEADLESS 3.0X 16

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270683324
Hospital Revenue Code	278
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

SCREW HEADLESS 3.0x16MM

Facility

$750.00

Hospital Charge Code	270677437
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW HEADLESS 3.0x16MM

Facility

$750.00

Hospital Charge Code	270677437
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

SCREW HEADLESS 3.0 X 18

Facility

$1,410.00

Hospital Charge Code	270664328
Hospital Revenue Code	278
Min. Negotiated Rate	$211.50
Max. Negotiated Rate	$341.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$310.20
Rate for Payer: Qualcare PPO/HMO/WC	$211.50

SCREW HEADLESS 3.0 X 18

Facility

$1,410.00

Hospital Charge Code	270664328
Hospital Revenue Code	278
Min. Negotiated Rate	$33.98
Max. Negotiated Rate	$705.00
Rate for Payer: Aetna Commercial	$535.80
Rate for Payer: Aetna Medicare Advantage	$423.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$359.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$359.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$359.55
Rate for Payer: Cigna Commercial	$705.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$310.20
Rate for Payer: Qualcare PPO/HMO/WC	$211.50
Rate for Payer: UnitedHealthcare Community & State	$33.98
Rate for Payer: Wellpoint Medicaid Managed Care	$37.37

SCREW HEADLESS 3.0x18MM

Facility

$750.00

Hospital Charge Code	270677438
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW HEADLESS 3.0x18MM

Facility

$750.00

Hospital Charge Code	270677438
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

SCREW HEADLESS 3.0 X 20

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270683396
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

SCREW HEADLESS 3.0 X 20

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270683396
Hospital Revenue Code	278
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

SCREW HEADLESS 3.0X 20 MM

Facility

$1,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270690580
Hospital Revenue Code	278
Min. Negotiated Rate	$28.92
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$456.00
Rate for Payer: Aetna Medicare Advantage	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$306.00
Rate for Payer: Cigna Commercial	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$264.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.00
Rate for Payer: UnitedHealthcare Community & State	$28.92
Rate for Payer: Wellpoint Medicaid Managed Care	$31.80

SCREW HEADLESS 3.0X 20 MM

Facility

$1,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270690580
Hospital Revenue Code	278
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$290.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$264.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.00

SCREW HEADLESS 3.0 X 38

Facility

$1,130.00

Service Code	HCPCS C1713
Hospital Charge Code	270686774
Hospital Revenue Code	278
Min. Negotiated Rate	$27.23
Max. Negotiated Rate	$565.00
Rate for Payer: Aetna Commercial	$429.40
Rate for Payer: Aetna Medicare Advantage	$339.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$288.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$288.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$226.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$288.15
Rate for Payer: Cigna Commercial	$565.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$273.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$248.60
Rate for Payer: Qualcare PPO/HMO/WC	$169.50
Rate for Payer: UnitedHealthcare Community & State	$27.23
Rate for Payer: Wellpoint Medicaid Managed Care	$29.95

SCREW HEADLESS 3.0 X 38

Facility

$1,130.00

Service Code	HCPCS C1713
Hospital Charge Code	270686774
Hospital Revenue Code	278
Min. Negotiated Rate	$169.50
Max. Negotiated Rate	$273.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$226.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$273.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$248.60
Rate for Payer: Qualcare PPO/HMO/WC	$169.50

SCREW HEADLESS 3.5x22mm

Facility

$450.00

Service Code	HCPCS C1713
Hospital Charge Code	270681078
Hospital Revenue Code	278
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Community & State	$10.85
Rate for Payer: Wellpoint Medicaid Managed Care	$11.93

SCREW HEADLESS 3.5x22mm

Facility

$450.00

Service Code	HCPCS C1713
Hospital Charge Code	270681078
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$108.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

SCREW HEADLESS 3.5 X 36MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688802
Hospital Revenue Code	278
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

SCREW HEADLESS 3.5 X 36MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688802
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW HEADLESS 3.5 X 44MM

Facility

$1,141.25

Service Code	HCPCS C1713
Hospital Charge Code	270701530
Hospital Revenue Code	278
Min. Negotiated Rate	$171.19
Max. Negotiated Rate	$276.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$251.07
Rate for Payer: Qualcare PPO/HMO/WC	$171.19

Know your out-of-pocket cost for care.

All Charges