Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LAPIPLASTY HDLSS 2.5MM

Facility

$2,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270700186
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 HDLSS 2.5MM

Facility

$2,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270700186
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 LATERNAL 5X30MM

Facility

$2,800.00

Hospital Charge Code	270703552
Hospital Revenue Code	278
Min. Negotiated Rate	$67.48
Max. Negotiated Rate	$1,400.00
Rate for Payer: Aetna Commercial	$1,064.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$616.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Community & State	$67.48
Rate for Payer: Wellpoint Medicaid Managed Care	$74.20

SCREW LATERNAL 5X30MM

Facility

$2,800.00

Hospital Charge Code	270703552
Hospital Revenue Code	278
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$677.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$616.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

SCREW LCK 4.2 X 18

Facility

$687.50

Service Code	HCPCS C1713
Hospital Charge Code	270701483
Hospital Revenue Code	278
Min. Negotiated Rate	$103.12
Max. Negotiated Rate	$166.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$103.12

SCREW LCK 4.2 X 18

Facility

$687.50

Service Code	HCPCS C1713
Hospital Charge Code	270701483
Hospital Revenue Code	278
Min. Negotiated Rate	$16.57
Max. Negotiated Rate	$343.75
Rate for Payer: Aetna Commercial	$261.25
Rate for Payer: Aetna Medicare Advantage	$206.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.31
Rate for Payer: Cigna Commercial	$343.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$103.12
Rate for Payer: UnitedHealthcare Community & State	$16.57
Rate for Payer: Wellpoint Medicaid Managed Care	$18.22

SCREW LCK CAP KIT 4.5X18MM WHT

Facility

$675.00

Service Code	HCPCS C1713
Hospital Charge Code	270668556
Hospital Revenue Code	278
Min. Negotiated Rate	$101.25
Max. Negotiated Rate	$163.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.50
Rate for Payer: Qualcare PPO/HMO/WC	$101.25

SCREW LCK CAP KIT 4.5X18MM WHT

Facility

$675.00

Service Code	HCPCS C1713
Hospital Charge Code	270668556
Hospital Revenue Code	278
Min. Negotiated Rate	$16.27
Max. Negotiated Rate	$337.50
Rate for Payer: Aetna Commercial	$256.50
Rate for Payer: Aetna Medicare Advantage	$202.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.12
Rate for Payer: Cigna Commercial	$337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.50
Rate for Payer: Qualcare PPO/HMO/WC	$101.25
Rate for Payer: UnitedHealthcare Community & State	$16.27
Rate for Payer: Wellpoint Medicaid Managed Care	$17.89

SCREW LCK CAP KIT 4.5X26MM ORG

Facility

$601.60

Service Code	HCPCS C1713
Hospital Charge Code	270668551
Hospital Revenue Code	278
Min. Negotiated Rate	$14.50
Max. Negotiated Rate	$300.80
Rate for Payer: Aetna Commercial	$228.61
Rate for Payer: Aetna Medicare Advantage	$180.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.41
Rate for Payer: Cigna Commercial	$300.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.35
Rate for Payer: Qualcare PPO/HMO/WC	$90.24
Rate for Payer: UnitedHealthcare Community & State	$14.50
Rate for Payer: Wellpoint Medicaid Managed Care	$15.94

SCREW LCK CAP KIT 4.5X26MM ORG

Facility

$601.60

Service Code	HCPCS C1713
Hospital Charge Code	270668551
Hospital Revenue Code	278
Min. Negotiated Rate	$90.24
Max. Negotiated Rate	$145.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.35
Rate for Payer: Qualcare PPO/HMO/WC	$90.24

SCREW LCK CAP KIT 4.5X30MM BLU

Facility

$601.60

Service Code	HCPCS C1713
Hospital Charge Code	270668554
Hospital Revenue Code	278
Min. Negotiated Rate	$14.50
Max. Negotiated Rate	$300.80
Rate for Payer: Aetna Commercial	$228.61
Rate for Payer: Aetna Medicare Advantage	$180.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.41
Rate for Payer: Cigna Commercial	$300.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.35
Rate for Payer: Qualcare PPO/HMO/WC	$90.24
Rate for Payer: UnitedHealthcare Community & State	$14.50
Rate for Payer: Wellpoint Medicaid Managed Care	$15.94

SCREW LCK CAP KIT 4.5X30MM BLU

Facility

$601.60

Service Code	HCPCS C1713
Hospital Charge Code	270668554
Hospital Revenue Code	278
Min. Negotiated Rate	$90.24
Max. Negotiated Rate	$145.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.35
Rate for Payer: Qualcare PPO/HMO/WC	$90.24

SCREW LCKG 2.0 X 12

Facility

$512.20

Service Code	HCPCS C1713
Hospital Charge Code	270688181
Hospital Revenue Code	278
Min. Negotiated Rate	$12.34
Max. Negotiated Rate	$256.10
Rate for Payer: Aetna Commercial	$194.64
Rate for Payer: Aetna Medicare Advantage	$153.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.61
Rate for Payer: Cigna Commercial	$256.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$112.68
Rate for Payer: Qualcare PPO/HMO/WC	$76.83
Rate for Payer: UnitedHealthcare Community & State	$12.34
Rate for Payer: Wellpoint Medicaid Managed Care	$13.57

SCREW LCKG 2.0 X 12

Facility

$512.20

Service Code	HCPCS C1713
Hospital Charge Code	270688181
Hospital Revenue Code	278
Min. Negotiated Rate	$76.83
Max. Negotiated Rate	$123.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$112.68
Rate for Payer: Qualcare PPO/HMO/WC	$76.83

SCREW LCKG 2.0 X 14

Facility

$512.20

Service Code	HCPCS C1713
Hospital Charge Code	270688182
Hospital Revenue Code	278
Min. Negotiated Rate	$12.34
Max. Negotiated Rate	$256.10
Rate for Payer: Aetna Commercial	$194.64
Rate for Payer: Aetna Medicare Advantage	$153.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.61
Rate for Payer: Cigna Commercial	$256.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$112.68
Rate for Payer: Qualcare PPO/HMO/WC	$76.83
Rate for Payer: UnitedHealthcare Community & State	$12.34
Rate for Payer: Wellpoint Medicaid Managed Care	$13.57

SCREW LCKG 2.0 X 14

Facility

$512.20

Service Code	HCPCS C1713
Hospital Charge Code	270688182
Hospital Revenue Code	278
Min. Negotiated Rate	$76.83
Max. Negotiated Rate	$123.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$112.68
Rate for Payer: Qualcare PPO/HMO/WC	$76.83

SCREW LCKG 525 STR DRV 5x40MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270660156
Hospital Revenue Code	278
Min. Negotiated Rate	$147.04
Max. Negotiated Rate	$237.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$215.66
Rate for Payer: Qualcare PPO/HMO/WC	$147.04

SCREW LCKG 525 STR DRV 5x40MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270660156
Hospital Revenue Code	278
Min. Negotiated Rate	$23.62
Max. Negotiated Rate	$490.12
Rate for Payer: Aetna Commercial	$372.50
Rate for Payer: Aetna Medicare Advantage	$294.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.96
Rate for Payer: Cigna Commercial	$490.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$215.66
Rate for Payer: Qualcare PPO/HMO/WC	$147.04
Rate for Payer: UnitedHealthcare Community & State	$23.62
Rate for Payer: Wellpoint Medicaid Managed Care	$25.98

SCREW LCKG SLF-TAP T4 1.3x16M

Facility

$472.75

Service Code	HCPCS C1713
Hospital Charge Code	270683578
Hospital Revenue Code	278
Min. Negotiated Rate	$70.91
Max. Negotiated Rate	$114.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.91

SCREW LCKG SLF-TAP T4 1.3x16M

Facility

$472.75

Service Code	HCPCS C1713
Hospital Charge Code	270683578
Hospital Revenue Code	278
Min. Negotiated Rate	$11.39
Max. Negotiated Rate	$236.38
Rate for Payer: Aetna Commercial	$179.65
Rate for Payer: Aetna Medicare Advantage	$141.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.55
Rate for Payer: Cigna Commercial	$236.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.91
Rate for Payer: UnitedHealthcare Community & State	$11.39
Rate for Payer: Wellpoint Medicaid Managed Care	$12.53

SCREW LCKG SLF-TAP T4 1.3x18

Facility

$472.75

Service Code	HCPCS C1713
Hospital Charge Code	270683579
Hospital Revenue Code	278
Min. Negotiated Rate	$11.39
Max. Negotiated Rate	$236.38
Rate for Payer: Aetna Commercial	$179.65
Rate for Payer: Aetna Medicare Advantage	$141.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.55
Rate for Payer: Cigna Commercial	$236.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.91
Rate for Payer: UnitedHealthcare Community & State	$11.39
Rate for Payer: Wellpoint Medicaid Managed Care	$12.53

SCREW LCKG SLF-TAP T4 1.3x18

Facility

$472.75

Service Code	HCPCS C1713
Hospital Charge Code	270683579
Hospital Revenue Code	278
Min. Negotiated Rate	$70.91
Max. Negotiated Rate	$114.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.91

SCREW LCKG SLF TPNG

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	270660646
Hospital Revenue Code	278
Min. Negotiated Rate	$77.85
Max. Negotiated Rate	$125.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.18
Rate for Payer: Qualcare PPO/HMO/WC	$77.85

SCREW LCKG SLF TPNG

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	270660646
Hospital Revenue Code	278
Min. Negotiated Rate	$12.51
Max. Negotiated Rate	$259.50
Rate for Payer: Aetna Commercial	$197.22
Rate for Payer: Aetna Medicare Advantage	$155.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.34
Rate for Payer: Cigna Commercial	$259.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.18
Rate for Payer: Qualcare PPO/HMO/WC	$77.85
Rate for Payer: UnitedHealthcare Community & State	$12.51
Rate for Payer: Wellpoint Medicaid Managed Care	$13.75

SCREW LCKG S/TPNG 4.0x22MM

Facility

$611.80

Service Code	HCPCS C1713
Hospital Charge Code	270646169
Hospital Revenue Code	278
Min. Negotiated Rate	$14.74
Max. Negotiated Rate	$305.90
Rate for Payer: Aetna Commercial	$232.48
Rate for Payer: Aetna Medicare Advantage	$183.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.01
Rate for Payer: Cigna Commercial	$305.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.60
Rate for Payer: Qualcare PPO/HMO/WC	$91.77
Rate for Payer: UnitedHealthcare Community & State	$14.74
Rate for Payer: Wellpoint Medicaid Managed Care	$16.21

Know your out-of-pocket cost for care.

All Charges