Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW IF VENTED BC 9MMX20 MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688545
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 IF VENTED BC 9MMX20 MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688545
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 IMF 2.0x8MM 50-20358

Facility

$583.45

Hospital Charge Code	270647582
Hospital Revenue Code	278
Min. Negotiated Rate	$87.52
Max. Negotiated Rate	$141.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.36
Rate for Payer: Qualcare PPO/HMO/WC	$87.52

SCREW IMF 2.0x8MM 50-20358

Facility

$583.45

Hospital Charge Code	270647582
Hospital Revenue Code	278
Min. Negotiated Rate	$14.06
Max. Negotiated Rate	$291.73
Rate for Payer: Aetna Commercial	$221.71
Rate for Payer: Aetna Medicare Advantage	$175.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.78
Rate for Payer: Cigna Commercial	$291.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.36
Rate for Payer: Qualcare PPO/HMO/WC	$87.52
Rate for Payer: UnitedHealthcare Community & State	$14.06
Rate for Payer: Wellpoint Medicaid Managed Care	$15.46

SCREW IMLG 5.5DIAX65 225306555

Facility

$615.95

Hospital Charge Code	270637424
Hospital Revenue Code	278
Min. Negotiated Rate	$14.84
Max. Negotiated Rate	$307.98
Rate for Payer: Aetna Commercial	$234.06
Rate for Payer: Aetna Medicare Advantage	$184.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.07
Rate for Payer: Cigna Commercial	$307.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.51
Rate for Payer: Qualcare PPO/HMO/WC	$92.39
Rate for Payer: UnitedHealthcare Community & State	$14.84
Rate for Payer: Wellpoint Medicaid Managed Care	$16.32

SCREW IMLG 5.5DIAX65 225306555

Facility

$615.95

Hospital Charge Code	270637424
Hospital Revenue Code	278
Min. Negotiated Rate	$92.39
Max. Negotiated Rate	$149.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.51
Rate for Payer: Qualcare PPO/HMO/WC	$92.39

SCREW IM LG 5.5x50 22535055

Facility

$672.65

Hospital Charge Code	270625705
Hospital Revenue Code	278
Min. Negotiated Rate	$16.21
Max. Negotiated Rate	$336.32
Rate for Payer: Aetna Commercial	$255.61
Rate for Payer: Aetna Medicare Advantage	$201.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.53
Rate for Payer: Cigna Commercial	$336.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.98
Rate for Payer: Qualcare PPO/HMO/WC	$100.90
Rate for Payer: UnitedHealthcare Community & State	$16.21
Rate for Payer: Wellpoint Medicaid Managed Care	$17.83

SCREW IM LG 5.5x50 22535055

Facility

$672.65

Hospital Charge Code	270625705
Hospital Revenue Code	278
Min. Negotiated Rate	$100.90
Max. Negotiated Rate	$162.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.98
Rate for Payer: Qualcare PPO/HMO/WC	$100.90

SCREW IM MED4.2x20 2253-20-42

Facility

$570.45

Hospital Charge Code	270630549
Hospital Revenue Code	278
Min. Negotiated Rate	$13.75
Max. Negotiated Rate	$285.23
Rate for Payer: Aetna Commercial	$216.77
Rate for Payer: Aetna Medicare Advantage	$171.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.46
Rate for Payer: Cigna Commercial	$285.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.50
Rate for Payer: Qualcare PPO/HMO/WC	$85.57
Rate for Payer: UnitedHealthcare Community & State	$13.75
Rate for Payer: Wellpoint Medicaid Managed Care	$15.12

SCREW IM MED4.2x20 2253-20-42

Facility

$570.45

Hospital Charge Code	270630549
Hospital Revenue Code	278
Min. Negotiated Rate	$85.57
Max. Negotiated Rate	$138.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.50
Rate for Payer: Qualcare PPO/HMO/WC	$85.57

SCREW INCAP HX 5.0x35 71642235

Facility

$778.75

Hospital Charge Code	270633372
Hospital Revenue Code	278
Min. Negotiated Rate	$116.81
Max. Negotiated Rate	$188.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$171.32
Rate for Payer: Qualcare PPO/HMO/WC	$116.81

SCREW INCAP HX 5.0x35 71642235

Facility

$778.75

Hospital Charge Code	270633372
Hospital Revenue Code	278
Min. Negotiated Rate	$18.77
Max. Negotiated Rate	$389.38
Rate for Payer: Aetna Commercial	$295.93
Rate for Payer: Aetna Medicare Advantage	$233.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.58
Rate for Payer: Cigna Commercial	$389.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$171.32
Rate for Payer: Qualcare PPO/HMO/WC	$116.81
Rate for Payer: UnitedHealthcare Community & State	$18.77
Rate for Payer: Wellpoint Medicaid Managed Care	$20.64

SCREW INCORE 3.5X24MM TI

Facility

$1,640.00

Service Code	HCPCS C1713
Hospital Charge Code	270688354
Hospital Revenue Code	278
Min. Negotiated Rate	$246.00
Max. Negotiated Rate	$396.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$328.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$360.80
Rate for Payer: Qualcare PPO/HMO/WC	$246.00

SCREW INCORE 3.5X24MM TI

Facility

$1,640.00

Service Code	HCPCS C1713
Hospital Charge Code	270688354
Hospital Revenue Code	278
Min. Negotiated Rate	$39.52
Max. Negotiated Rate	$820.00
Rate for Payer: Aetna Commercial	$623.20
Rate for Payer: Aetna Medicare Advantage	$492.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$418.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$418.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$328.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$418.20
Rate for Payer: Cigna Commercial	$820.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$360.80
Rate for Payer: Qualcare PPO/HMO/WC	$246.00
Rate for Payer: UnitedHealthcare Community & State	$39.52
Rate for Payer: Wellpoint Medicaid Managed Care	$43.46

SCREW INCORE 3.5X32MM IT

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270687067
Hospital Revenue Code	278
Min. Negotiated Rate	$207.00
Max. Negotiated Rate	$333.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$303.60
Rate for Payer: Qualcare PPO/HMO/WC	$207.00

SCREW INCORE 3.5X32MM IT

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270687067
Hospital Revenue Code	278
Min. Negotiated Rate	$33.26
Max. Negotiated Rate	$690.00
Rate for Payer: Aetna Commercial	$524.40
Rate for Payer: Aetna Medicare Advantage	$414.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$351.90
Rate for Payer: Cigna Commercial	$690.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$303.60
Rate for Payer: Qualcare PPO/HMO/WC	$207.00
Rate for Payer: UnitedHealthcare Community & State	$33.26
Rate for Payer: Wellpoint Medicaid Managed Care	$36.57

SCREW INCORE 3.5X38MM TI

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270688352
Hospital Revenue Code	278
Min. Negotiated Rate	$33.26
Max. Negotiated Rate	$690.00
Rate for Payer: Aetna Commercial	$524.40
Rate for Payer: Aetna Medicare Advantage	$414.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$351.90
Rate for Payer: Cigna Commercial	$690.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$303.60
Rate for Payer: Qualcare PPO/HMO/WC	$207.00
Rate for Payer: UnitedHealthcare Community & State	$33.26
Rate for Payer: Wellpoint Medicaid Managed Care	$36.57

SCREW INCORE 3.5X38MM TI

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270688352
Hospital Revenue Code	278
Min. Negotiated Rate	$207.00
Max. Negotiated Rate	$333.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$303.60
Rate for Payer: Qualcare PPO/HMO/WC	$207.00

SCREW INCORE 3.5X54MM TI

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270688353
Hospital Revenue Code	278
Min. Negotiated Rate	$33.26
Max. Negotiated Rate	$690.00
Rate for Payer: Aetna Commercial	$524.40
Rate for Payer: Aetna Medicare Advantage	$414.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$351.90
Rate for Payer: Cigna Commercial	$690.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$303.60
Rate for Payer: Qualcare PPO/HMO/WC	$207.00
Rate for Payer: UnitedHealthcare Community & State	$33.26
Rate for Payer: Wellpoint Medicaid Managed Care	$36.57

SCREW INCORE 3.5X54MM TI

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270688353
Hospital Revenue Code	278
Min. Negotiated Rate	$207.00
Max. Negotiated Rate	$333.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$303.60
Rate for Payer: Qualcare PPO/HMO/WC	$207.00

SCREW INCORE LAPIDUS 5.9MMX 28

Facility

$24,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270688763
Hospital Revenue Code	278
Min. Negotiated Rate	$3,607.50
Max. Negotiated Rate	$5,820.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,810.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,820.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,291.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,607.50

SCREW INCORE LAPIDUS 5.9MMX 28

Facility

$24,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270688763
Hospital Revenue Code	278
Min. Negotiated Rate	$579.61
Max. Negotiated Rate	$12,025.00
Rate for Payer: Aetna Commercial	$9,139.00
Rate for Payer: Aetna Medicare Advantage	$7,215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,132.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,132.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,132.75
Rate for Payer: Cigna Commercial	$12,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,820.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,291.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,607.50
Rate for Payer: UnitedHealthcare Community & State	$579.61
Rate for Payer: Wellpoint Medicaid Managed Care	$637.33

SCREW INFINITY OCP 3.5X12MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270699634
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

SCREW INFINITY OCP 3.5X12MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270699634
Hospital Revenue Code	278
Min. Negotiated Rate	$210.88
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$210.88
Rate for Payer: Wellpoint Medicaid Managed Care	$231.88

SCREW INFINITY OCP 4.0X12MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270699633
Hospital Revenue Code	278
Min. Negotiated Rate	$210.88
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$210.88
Rate for Payer: Wellpoint Medicaid Managed Care	$231.88

Know your out-of-pocket cost for care.

All Charges