Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW INTRF 9x25MM DISP SHEATH

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270633508
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 INTRFRNCE 9x30mm 231825

Facility

$1,725.00

Hospital Charge Code	270642504
Hospital Revenue Code	278
Min. Negotiated Rate	$41.57
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$655.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$379.50
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Community & State	$41.57
Rate for Payer: Wellpoint Medicaid Managed Care	$45.71

SCREW INTRFRNCE 9x30mm 231825

Facility

$1,725.00

Hospital Charge Code	270642504
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$417.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$379.50
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SCREW INV REV CANC 4.5X36MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270695300
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 INV REV CANC 4.5X36MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270695300
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 INV REV CANC 4.5X42MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270695310
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 INV REV CANC 4.5X42MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270695310
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 IRIX-C ST 3.5X14MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692358
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

SCREW IRIX-C ST 3.5X14MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692358
Hospital Revenue Code	278
Min. Negotiated Rate	$162.68
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$162.68
Rate for Payer: Wellpoint Medicaid Managed Care	$178.88

SCREW IRIXC ST RESCUE 3.7X13MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697558
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

SCREW IRIXC ST RESCUE 3.7X13MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697558
Hospital Revenue Code	278
Min. Negotiated Rate	$162.68
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$162.68
Rate for Payer: Wellpoint Medicaid Managed Care	$178.88

SCREW IRIX SELF DRILL 3.5X14MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270698376
Hospital Revenue Code	278
Min. Negotiated Rate	$162.68
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$162.68
Rate for Payer: Wellpoint Medicaid Managed Care	$178.88

SCREW IRIX SELF DRILL 3.5X14MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270698376
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

SCREW JONES 4.5x40MM

Facility

$4,270.00

Hospital Charge Code	270656798
Hospital Revenue Code	278
Min. Negotiated Rate	$102.91
Max. Negotiated Rate	$2,135.00
Rate for Payer: Aetna Commercial	$1,622.60
Rate for Payer: Aetna Medicare Advantage	$1,281.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,088.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,088.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$854.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,088.85
Rate for Payer: Cigna Commercial	$2,135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,033.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$939.40
Rate for Payer: Qualcare PPO/HMO/WC	$640.50
Rate for Payer: UnitedHealthcare Community & State	$102.91
Rate for Payer: Wellpoint Medicaid Managed Care	$113.16

SCREW JONES 4.5x40MM

Facility

$4,270.00

Hospital Charge Code	270656798
Hospital Revenue Code	278
Min. Negotiated Rate	$640.50
Max. Negotiated Rate	$1,033.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$854.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,033.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$939.40
Rate for Payer: Qualcare PPO/HMO/WC	$640.50

SCREW JONES P/THD 4.5x55MM

Facility

$3,975.00

Hospital Charge Code	270673454
Hospital Revenue Code	278
Min. Negotiated Rate	$95.80
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,510.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$596.25
Rate for Payer: UnitedHealthcare Community & State	$95.80
Rate for Payer: Wellpoint Medicaid Managed Care	$105.34

SCREW JONES P/THD 4.5x55MM

Facility

$3,975.00

Hospital Charge Code	270673454
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

SCREW JONES SHORT TH 5.5X 56MM

Facility

$3,231.25

Service Code	HCPCS C1713
Hospital Charge Code	270701366
Hospital Revenue Code	278
Min. Negotiated Rate	$77.87
Max. Negotiated Rate	$1,615.62
Rate for Payer: Aetna Commercial	$1,227.88
Rate for Payer: Aetna Medicare Advantage	$969.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$823.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$823.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$646.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$823.97
Rate for Payer: Cigna Commercial	$1,615.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$781.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$710.88
Rate for Payer: Qualcare PPO/HMO/WC	$484.69
Rate for Payer: UnitedHealthcare Community & State	$77.87
Rate for Payer: Wellpoint Medicaid Managed Care	$85.63

SCREW JONES SHORT TH 5.5X 56MM

Facility

$3,231.25

Service Code	HCPCS C1713
Hospital Charge Code	270701366
Hospital Revenue Code	278
Min. Negotiated Rate	$484.69
Max. Negotiated Rate	$781.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$646.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$781.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$710.88
Rate for Payer: Qualcare PPO/HMO/WC	$484.69

SCREW KIT TORQUE DEFINING

Facility

$2,077.40

Service Code	HCPCS C1713
Hospital Charge Code	270668548
Hospital Revenue Code	278
Min. Negotiated Rate	$50.07
Max. Negotiated Rate	$1,038.70
Rate for Payer: Aetna Commercial	$789.41
Rate for Payer: Aetna Medicare Advantage	$623.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$529.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$529.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$415.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$529.74
Rate for Payer: Cigna Commercial	$1,038.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$502.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$457.03
Rate for Payer: Qualcare PPO/HMO/WC	$311.61
Rate for Payer: UnitedHealthcare Community & State	$50.07
Rate for Payer: Wellpoint Medicaid Managed Care	$55.05

SCREW KIT TORQUE DEFINING

Facility

$2,077.40

Service Code	HCPCS C1713
Hospital Charge Code	270668548
Hospital Revenue Code	278
Min. Negotiated Rate	$311.61
Max. Negotiated Rate	$502.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$415.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$502.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$457.03
Rate for Payer: Qualcare PPO/HMO/WC	$311.61

SCREW KIT TORQUE SQ DRIVE

Facility

$1,260.00

Hospital Charge Code	270669870
Hospital Revenue Code	272
Min. Negotiated Rate	$189.00
Max. Negotiated Rate	$189.00
Rate for Payer: Qualcare PPO/HMO/WC	$189.00

SCREW KIT TORQUE SQ DRIVE

Facility

$1,260.00

Hospital Charge Code	270669870
Hospital Revenue Code	272
Min. Negotiated Rate	$30.37
Max. Negotiated Rate	$630.00
Rate for Payer: Aetna Commercial	$478.80
Rate for Payer: Aetna Medicare Advantage	$378.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$321.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$321.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$321.30
Rate for Payer: Cigna Commercial	$630.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$378.00
Rate for Payer: Oxford Commercial	$252.00
Rate for Payer: Qualcare PPO/HMO/WC	$189.00
Rate for Payer: UnitedHealthcare Commercial	$252.00
Rate for Payer: UnitedHealthcare Community & State	$30.37
Rate for Payer: Wellpoint Medicaid Managed Care	$33.39

SCREW KMD 1.6 5MM 14-1S1-1605

Facility

$153.65

Hospital Charge Code	270607677
Hospital Revenue Code	278
Min. Negotiated Rate	$23.05
Max. Negotiated Rate	$37.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.80
Rate for Payer: Qualcare PPO/HMO/WC	$23.05

SCREW KMD 1.6 5MM 14-1S1-1605

Facility

$153.65

Hospital Charge Code	270607677
Hospital Revenue Code	278
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$76.83
Rate for Payer: Aetna Commercial	$58.39
Rate for Payer: Aetna Medicare Advantage	$46.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.18
Rate for Payer: Cigna Commercial	$76.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.80
Rate for Payer: Qualcare PPO/HMO/WC	$23.05
Rate for Payer: UnitedHealthcare Community & State	$3.70
Rate for Payer: Wellpoint Medicaid Managed Care	$4.07

Know your out-of-pocket cost for care.

All Charges