Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LAG SOLID FIXED 75MM

Facility

$2,725.00

Hospital Charge Code	270662052
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 LAG SOLID SLIDING 105mm

Facility

$2,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270680836
Hospital Revenue Code	278
Min. Negotiated Rate	$51.45
Max. Negotiated Rate	$1,067.50
Rate for Payer: Aetna Commercial	$811.30
Rate for Payer: Aetna Medicare Advantage	$640.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$544.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$544.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$427.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$544.42
Rate for Payer: Cigna Commercial	$1,067.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$516.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$469.70
Rate for Payer: Qualcare PPO/HMO/WC	$320.25
Rate for Payer: UnitedHealthcare Community & State	$51.45
Rate for Payer: Wellpoint Medicaid Managed Care	$56.58

SCREW LAG SOLID SLIDING 105mm

Facility

$2,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270680836
Hospital Revenue Code	278
Min. Negotiated Rate	$320.25
Max. Negotiated Rate	$516.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$427.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$516.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$469.70
Rate for Payer: Qualcare PPO/HMO/WC	$320.25

SCREW LAG SOLID SLIDING 80MM

Facility

$2,725.00

Hospital Charge Code	270664900
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 LAG SOLID SLIDING 80MM

Facility

$2,725.00

Hospital Charge Code	270664900
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 LAG SOLID SLIDING 90mm

Facility

$2,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270646649
Hospital Revenue Code	278
Min. Negotiated Rate	$348.75
Max. Negotiated Rate	$562.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$511.50
Rate for Payer: Qualcare PPO/HMO/WC	$348.75

SCREW LAG SOLID SLIDING 90mm

Facility

$2,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270646649
Hospital Revenue Code	278
Min. Negotiated Rate	$56.03
Max. Negotiated Rate	$1,162.50
Rate for Payer: Aetna Commercial	$883.50
Rate for Payer: Aetna Medicare Advantage	$697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.88
Rate for Payer: Cigna Commercial	$1,162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$511.50
Rate for Payer: Qualcare PPO/HMO/WC	$348.75
Rate for Payer: UnitedHealthcare Community & State	$56.03
Rate for Payer: Wellpoint Medicaid Managed Care	$61.61

SCREW LAG SOLID SLIDING 95mm

Facility

$2,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270639212
Hospital Revenue Code	278
Min. Negotiated Rate	$348.75
Max. Negotiated Rate	$562.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$511.50
Rate for Payer: Qualcare PPO/HMO/WC	$348.75

SCREW LAG SOLID SLIDING 95mm

Facility

$2,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270639212
Hospital Revenue Code	278
Min. Negotiated Rate	$56.03
Max. Negotiated Rate	$1,162.50
Rate for Payer: Aetna Commercial	$883.50
Rate for Payer: Aetna Medicare Advantage	$697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.88
Rate for Payer: Cigna Commercial	$1,162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$511.50
Rate for Payer: Qualcare PPO/HMO/WC	$348.75
Rate for Payer: UnitedHealthcare Community & State	$56.03
Rate for Payer: Wellpoint Medicaid Managed Care	$61.61

SCREW LAG STANDARD 85MM

Facility

$623.15

Hospital Charge Code	270654991
Hospital Revenue Code	278
Min. Negotiated Rate	$93.47
Max. Negotiated Rate	$150.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.09
Rate for Payer: Qualcare PPO/HMO/WC	$93.47

SCREW LAG STANDARD 85MM

Facility

$623.15

Hospital Charge Code	270654991
Hospital Revenue Code	278
Min. Negotiated Rate	$15.02
Max. Negotiated Rate	$311.57
Rate for Payer: Aetna Commercial	$236.80
Rate for Payer: Aetna Medicare Advantage	$186.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.90
Rate for Payer: Cigna Commercial	$311.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.09
Rate for Payer: Qualcare PPO/HMO/WC	$93.47
Rate for Payer: UnitedHealthcare Community & State	$15.02
Rate for Payer: Wellpoint Medicaid Managed Care	$16.51

SCREW LAG TI 10.5 X 85MM

Facility

$3,077.10

Service Code	HCPCS C1713
Hospital Charge Code	270645794
Hospital Revenue Code	278
Min. Negotiated Rate	$461.56
Max. Negotiated Rate	$744.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$615.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$744.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$676.96
Rate for Payer: Qualcare PPO/HMO/WC	$461.56

SCREW LAG TI 10.5 X 85MM

Facility

$3,077.10

Service Code	HCPCS C1713
Hospital Charge Code	270645794
Hospital Revenue Code	278
Min. Negotiated Rate	$74.16
Max. Negotiated Rate	$1,538.55
Rate for Payer: Aetna Commercial	$1,169.30
Rate for Payer: Aetna Medicare Advantage	$923.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$784.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$784.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$615.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$784.66
Rate for Payer: Cigna Commercial	$1,538.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$744.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$676.96
Rate for Payer: Qualcare PPO/HMO/WC	$461.56
Rate for Payer: UnitedHealthcare Community & State	$74.16
Rate for Payer: Wellpoint Medicaid Managed Care	$81.54

SCREW LAG TI 10.5 X 95 MM

Facility

$4,220.00

Service Code	HCPCS C1713
Hospital Charge Code	270662051
Hospital Revenue Code	278
Min. Negotiated Rate	$101.70
Max. Negotiated Rate	$2,110.00
Rate for Payer: Aetna Commercial	$1,603.60
Rate for Payer: Aetna Medicare Advantage	$1,266.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,076.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,076.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$844.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,076.10
Rate for Payer: Cigna Commercial	$2,110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,021.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$928.40
Rate for Payer: Qualcare PPO/HMO/WC	$633.00
Rate for Payer: UnitedHealthcare Community & State	$101.70
Rate for Payer: Wellpoint Medicaid Managed Care	$111.83

SCREW LAG TI 10.5 X 95 MM

Facility

$4,220.00

Service Code	HCPCS C1713
Hospital Charge Code	270662051
Hospital Revenue Code	278
Min. Negotiated Rate	$633.00
Max. Negotiated Rate	$1,021.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$844.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,021.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$928.40
Rate for Payer: Qualcare PPO/HMO/WC	$633.00

SCREW LAG TI 10.5x95mm

Facility

$3,077.10

Service Code	HCPCS C1713
Hospital Charge Code	270672768
Hospital Revenue Code	278
Min. Negotiated Rate	$461.56
Max. Negotiated Rate	$744.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$615.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$744.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$676.96
Rate for Payer: Qualcare PPO/HMO/WC	$461.56

SCREW LAG TI 10.5x95mm

Facility

$3,077.10

Service Code	HCPCS C1713
Hospital Charge Code	270672768
Hospital Revenue Code	278
Min. Negotiated Rate	$74.16
Max. Negotiated Rate	$1,538.55
Rate for Payer: Aetna Commercial	$1,169.30
Rate for Payer: Aetna Medicare Advantage	$923.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$784.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$784.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$615.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$784.66
Rate for Payer: Cigna Commercial	$1,538.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$744.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$676.96
Rate for Payer: Qualcare PPO/HMO/WC	$461.56
Rate for Payer: UnitedHealthcare Community & State	$74.16
Rate for Payer: Wellpoint Medicaid Managed Care	$81.54

SCREW LAG Z NAIL 10.5 X 90

Facility

$2,810.00

Hospital Charge Code	270666935
Hospital Revenue Code	278
Min. Negotiated Rate	$421.50
Max. Negotiated Rate	$680.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$562.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$680.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$618.20
Rate for Payer: Qualcare PPO/HMO/WC	$421.50

SCREW LAG Z NAIL 10.5 X 90

Facility

$2,810.00

Hospital Charge Code	270666935
Hospital Revenue Code	278
Min. Negotiated Rate	$67.72
Max. Negotiated Rate	$1,405.00
Rate for Payer: Aetna Commercial	$1,067.80
Rate for Payer: Aetna Medicare Advantage	$843.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$716.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$716.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$562.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$716.55
Rate for Payer: Cigna Commercial	$1,405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$680.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$618.20
Rate for Payer: Qualcare PPO/HMO/WC	$421.50
Rate for Payer: UnitedHealthcare Community & State	$67.72
Rate for Payer: Wellpoint Medicaid Managed Care	$74.47

SCREW LAPIP 2.0 MM SNAP OFF

Facility

$2,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270695086
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 LAPIP 2.0 MM SNAP OFF

Facility

$2,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270695086
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 LAPIPLASTY 4.0 FT32/36MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270699776
Hospital Revenue Code	278
Min. Negotiated Rate	$75.31
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$75.31
Rate for Payer: Wellpoint Medicaid Managed Care	$82.81

SCREW LAPIPLASTY 4.0 FT32/36MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270699776
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

SCREW LAPIPLASTY FT4.0 38/42MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270699902
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

SCREW LAPIPLASTY FT4.0 38/42MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270699902
Hospital Revenue Code	278
Min. Negotiated Rate	$75.31
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$75.31
Rate for Payer: Wellpoint Medicaid Managed Care	$82.81

Know your out-of-pocket cost for care.

All Charges