Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW INTERFERENCE 9x23MM

Facility

$1,250.00

Hospital Charge Code	270675570
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 9x23MM

Facility

$1,250.00

Hospital Charge Code	270675570
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 RD 10x28MM

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270655961
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 RD 10x28MM

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270655961
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 INTERFRAG 3.5x30MM

Facility

$1,335.00

Service Code	HCPCS C1713
Hospital Charge Code	270679881
Hospital Revenue Code	278
Min. Negotiated Rate	$200.25
Max. Negotiated Rate	$323.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$267.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$323.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$293.70
Rate for Payer: Qualcare PPO/HMO/WC	$200.25

SCREW INTERFRAG 3.5x30MM

Facility

$1,335.00

Service Code	HCPCS C1713
Hospital Charge Code	270679881
Hospital Revenue Code	278
Min. Negotiated Rate	$32.17
Max. Negotiated Rate	$667.50
Rate for Payer: Aetna Commercial	$507.30
Rate for Payer: Aetna Medicare Advantage	$400.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$340.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$340.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$340.43
Rate for Payer: Cigna Commercial	$667.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$323.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$293.70
Rate for Payer: Qualcare PPO/HMO/WC	$200.25
Rate for Payer: UnitedHealthcare Community & State	$32.17
Rate for Payer: Wellpoint Medicaid Managed Care	$35.38

SCREW INTERFX SD DL 3.5X14

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270698832
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SCREW INTERFX SD DL 3.5X14

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270698832
Hospital Revenue Code	278
Min. Negotiated Rate	$25.30
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$399.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50
Rate for Payer: UnitedHealthcare Community & State	$25.30
Rate for Payer: Wellpoint Medicaid Managed Care	$27.82

SCREW INTERLOCK IM 4.5mmD 40mm

Facility

$611.10

Hospital Charge Code	270636662
Hospital Revenue Code	278
Min. Negotiated Rate	$91.67
Max. Negotiated Rate	$147.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.44
Rate for Payer: Qualcare PPO/HMO/WC	$91.67

SCREW INTERLOCK IM 4.5mmD 40mm

Facility

$611.10

Hospital Charge Code	270636662
Hospital Revenue Code	278
Min. Negotiated Rate	$14.73
Max. Negotiated Rate	$305.55
Rate for Payer: Aetna Commercial	$232.22
Rate for Payer: Aetna Medicare Advantage	$183.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.83
Rate for Payer: Cigna Commercial	$305.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.44
Rate for Payer: Qualcare PPO/HMO/WC	$91.67
Rate for Payer: UnitedHealthcare Community & State	$14.73
Rate for Payer: Wellpoint Medicaid Managed Care	$16.19

SCREW INTLOCKG 4.5x45 22534545

Facility

$570.45

Hospital Charge Code	270632315
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 INTLOCKG 4.5x45 22534545

Facility

$570.45

Hospital Charge Code	270632315
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 INTLOCKG 4.5x60 22536045

Facility

$570.45

Hospital Charge Code	270632314
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 INTLOCKG 4.5x60 22536045

Facility

$570.45

Hospital Charge Code	270632314
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 INTRF 7x20MM DISP SHEATH

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270646569
Hospital Revenue Code	278
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$218.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$126.50
Rate for Payer: Qualcare PPO/HMO/WC	$86.25
Rate for Payer: UnitedHealthcare Community & State	$13.86
Rate for Payer: Wellpoint Medicaid Managed Care	$15.24

SCREW INTRF 7x20MM DISP SHEATH

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270646569
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$126.50
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

SCREW INTRF 7x25MM DISP SHEATH

Facility

$825.00

Hospital Charge Code	270662450
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW INTRF 7x25MM DISP SHEATH

Facility

$825.00

Hospital Charge Code	270662450
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW INTRF 8x20MM DISP SHEATH

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270661235
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW INTRF 8x20MM DISP SHEATH

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270661235
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW INTRF 8x25MM DISP SHEATH

Facility

$825.00

Hospital Charge Code	270662451
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW INTRF 8x25MM DISP SHEATH

Facility

$825.00

Hospital Charge Code	270662451
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW INTRF 9x20MM DISP SHEATH

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270633507
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$126.50
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

SCREW INTRF 9x20MM DISP SHEATH

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270633507
Hospital Revenue Code	278
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$218.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$126.50
Rate for Payer: Qualcare PPO/HMO/WC	$86.25
Rate for Payer: UnitedHealthcare Community & State	$13.86
Rate for Payer: Wellpoint Medicaid Managed Care	$15.24

SCREW INTRF 9x25MM DISP SHEATH

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270633508
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

Know your out-of-pocket cost for care.

All Charges