Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW INFINITY OCP 4.0X12MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270699633
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 INFL IN-FAST BONE

Facility

$1,724.85

Hospital Charge Code	270607866
Hospital Revenue Code	278
Min. Negotiated Rate	$258.73
Max. Negotiated Rate	$417.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$344.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$379.47
Rate for Payer: Qualcare PPO/HMO/WC	$258.73

SCREW INFL IN-FAST BONE

Facility

$1,724.85

Hospital Charge Code	270607866
Hospital Revenue Code	278
Min. Negotiated Rate	$41.57
Max. Negotiated Rate	$862.42
Rate for Payer: Aetna Commercial	$655.44
Rate for Payer: Aetna Medicare Advantage	$517.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$344.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.84
Rate for Payer: Cigna Commercial	$862.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$379.47
Rate for Payer: Qualcare PPO/HMO/WC	$258.73
Rate for Payer: UnitedHealthcare Community & State	$41.57
Rate for Payer: Wellpoint Medicaid Managed Care	$45.71

SCREW INHX CAP 5.0x40 71642240

Facility

$778.75

Hospital Charge Code	270633373
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 INHX CAP 5.0x40 71642240

Facility

$778.75

Hospital Charge Code	270633373
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 INHX CAP 5.0x55 71642255

Facility

$778.75

Hospital Charge Code	270633374
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 INHX CAP 5.0x55 71642255

Facility

$778.75

Hospital Charge Code	270633374
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 INNER MNTR

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270663778
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 INNER MNTR

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270663778
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 INNER MNTR H/H X-CONN

Facility

$785.00

Service Code	HCPCS C1713
Hospital Charge Code	270663777
Hospital Revenue Code	278
Min. Negotiated Rate	$117.75
Max. Negotiated Rate	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$172.70
Rate for Payer: Qualcare PPO/HMO/WC	$117.75

SCREW INNER MNTR H/H X-CONN

Facility

$785.00

Service Code	HCPCS C1713
Hospital Charge Code	270663777
Hospital Revenue Code	278
Min. Negotiated Rate	$18.92
Max. Negotiated Rate	$392.50
Rate for Payer: Aetna Commercial	$298.30
Rate for Payer: Aetna Medicare Advantage	$235.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.18
Rate for Payer: Cigna Commercial	$392.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$172.70
Rate for Payer: Qualcare PPO/HMO/WC	$117.75
Rate for Payer: UnitedHealthcare Community & State	$18.92
Rate for Payer: Wellpoint Medicaid Managed Care	$20.80

SCREW INNER OC

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270687896
Hospital Revenue Code	278
Min. Negotiated Rate	$16.03
Max. Negotiated Rate	$332.50
Rate for Payer: Aetna Commercial	$252.70
Rate for Payer: Aetna Medicare Advantage	$199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.57
Rate for Payer: Cigna Commercial	$332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75
Rate for Payer: UnitedHealthcare Community & State	$16.03
Rate for Payer: Wellpoint Medicaid Managed Care	$17.62

SCREW INNER OC

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270687896
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$160.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75

SCREW INTEGRAD LAPIPASTY 4.0 M

Facility

$2,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270697757
Hospital Revenue Code	278
Min. Negotiated Rate	$65.67
Max. Negotiated Rate	$1,362.50
Rate for Payer: Aetna Commercial	$1,035.50
Rate for Payer: Aetna Medicare Advantage	$817.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$694.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$694.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$545.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$694.88
Rate for Payer: Cigna Commercial	$1,362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$599.50
Rate for Payer: Qualcare PPO/HMO/WC	$408.75
Rate for Payer: UnitedHealthcare Community & State	$65.67
Rate for Payer: Wellpoint Medicaid Managed Care	$72.21

SCREW INTEGRAD LAPIPASTY 4.0 M

Facility

$2,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270697757
Hospital Revenue Code	278
Min. Negotiated Rate	$408.75
Max. Negotiated Rate	$659.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$545.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$599.50
Rate for Payer: Qualcare PPO/HMO/WC	$408.75

SCREW INTERENCE 10MM X30 MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684909
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 INTERENCE 10MM X30 MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684909
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 INTERENCE 10 X 30 MM

Facility

$1,519.25

Hospital Charge Code	270684908
Hospital Revenue Code	278
Min. Negotiated Rate	$227.89
Max. Negotiated Rate	$367.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$303.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$367.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$334.24
Rate for Payer: Qualcare PPO/HMO/WC	$227.89

SCREW INTERENCE 10 X 30 MM

Facility

$1,519.25

Hospital Charge Code	270684908
Hospital Revenue Code	278
Min. Negotiated Rate	$36.61
Max. Negotiated Rate	$759.62
Rate for Payer: Aetna Commercial	$577.32
Rate for Payer: Aetna Medicare Advantage	$455.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$387.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$387.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$303.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$387.41
Rate for Payer: Cigna Commercial	$759.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$367.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$334.24
Rate for Payer: Qualcare PPO/HMO/WC	$227.89
Rate for Payer: UnitedHealthcare Community & State	$36.61
Rate for Payer: Wellpoint Medicaid Managed Care	$40.26

SCREW INTERFERENCE 10x23MM

Facility

$1,250.00

Hospital Charge Code	270675571
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 INTERFERENCE 10x23MM

Facility

$1,250.00

Hospital Charge Code	270675571
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 INTERFERENCE 11X88MM

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270655963
Hospital Revenue Code	278
Min. Negotiated Rate	$28.32
Max. Negotiated Rate	$587.50
Rate for Payer: Aetna Commercial	$446.50
Rate for Payer: Aetna Medicare Advantage	$352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.62
Rate for Payer: Cigna Commercial	$587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$258.50
Rate for Payer: Qualcare PPO/HMO/WC	$176.25
Rate for Payer: UnitedHealthcare Community & State	$28.32
Rate for Payer: Wellpoint Medicaid Managed Care	$31.14

SCREW INTERFERENCE 11X88MM

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270655963
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$284.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$258.50
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

SCREW INTERFERENCE 8x23MM

Facility

$1,250.00

Hospital Charge Code	270675569
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 INTERFERENCE 8x23MM

Facility

$1,250.00

Hospital Charge Code	270675569
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

Know your out-of-pocket cost for care.

All Charges