Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LCKG S/TPNG 4.0x22MM

Facility

$611.80

Service Code	HCPCS C1713
Hospital Charge Code	270646169
Hospital Revenue Code	278
Min. Negotiated Rate	$91.77
Max. Negotiated Rate	$148.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.36
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

SCREW LCKG S/TPPNG 5.0x10MM

Facility

$902.30

Service Code	HCPCS C1713
Hospital Charge Code	270648922
Hospital Revenue Code	278
Min. Negotiated Rate	$135.34
Max. Negotiated Rate	$218.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.51
Rate for Payer: Qualcare PPO/HMO/WC	$135.34

SCREW LCKG S/TPPNG 5.0x10MM

Facility

$902.30

Service Code	HCPCS C1713
Hospital Charge Code	270648922
Hospital Revenue Code	278
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$451.15
Rate for Payer: Aetna Commercial	$342.87
Rate for Payer: Aetna Medicare Advantage	$270.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.09
Rate for Payer: Cigna Commercial	$451.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.51
Rate for Payer: Qualcare PPO/HMO/WC	$135.34
Rate for Payer: UnitedHealthcare Community & State	$21.75
Rate for Payer: Wellpoint Medicaid Managed Care	$23.91

SCREW LCKG S/TPPNG 5.0x12MM

Facility

$902.30

Service Code	HCPCS C1713
Hospital Charge Code	270648923
Hospital Revenue Code	278
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$451.15
Rate for Payer: Aetna Commercial	$342.87
Rate for Payer: Aetna Medicare Advantage	$270.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.09
Rate for Payer: Cigna Commercial	$451.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.51
Rate for Payer: Qualcare PPO/HMO/WC	$135.34
Rate for Payer: UnitedHealthcare Community & State	$21.75
Rate for Payer: Wellpoint Medicaid Managed Care	$23.91

SCREW LCKG S/TPPNG 5.0x12MM

Facility

$902.30

Service Code	HCPCS C1713
Hospital Charge Code	270648923
Hospital Revenue Code	278
Min. Negotiated Rate	$135.34
Max. Negotiated Rate	$218.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.51
Rate for Payer: Qualcare PPO/HMO/WC	$135.34

SCREW LCKG S/TPPNG 5.0x8MM

Facility

$902.30

Service Code	HCPCS C1713
Hospital Charge Code	270648921
Hospital Revenue Code	278
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$451.15
Rate for Payer: Aetna Commercial	$342.87
Rate for Payer: Aetna Medicare Advantage	$270.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.09
Rate for Payer: Cigna Commercial	$451.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.51
Rate for Payer: Qualcare PPO/HMO/WC	$135.34
Rate for Payer: UnitedHealthcare Community & State	$21.75
Rate for Payer: Wellpoint Medicaid Managed Care	$23.91

SCREW LCKG S/TPPNG 5.0x8MM

Facility

$902.30

Service Code	HCPCS C1713
Hospital Charge Code	270648921
Hospital Revenue Code	278
Min. Negotiated Rate	$135.34
Max. Negotiated Rate	$218.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.51
Rate for Payer: Qualcare PPO/HMO/WC	$135.34

SCREW LCKG T25 STR DRV 4x24MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270637803
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 T25 STR DRV 4x24MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270637803
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 T25 STR DRV 4x26MM

Facility

$747.80

Service Code	HCPCS C1713
Hospital Charge Code	270679776
Hospital Revenue Code	278
Min. Negotiated Rate	$112.17
Max. Negotiated Rate	$180.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$164.52
Rate for Payer: Qualcare PPO/HMO/WC	$112.17

SCREW LCKG T25 STR DRV 4x26MM

Facility

$747.80

Service Code	HCPCS C1713
Hospital Charge Code	270679776
Hospital Revenue Code	278
Min. Negotiated Rate	$18.02
Max. Negotiated Rate	$373.90
Rate for Payer: Aetna Commercial	$284.16
Rate for Payer: Aetna Medicare Advantage	$224.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$190.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$190.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$190.69
Rate for Payer: Cigna Commercial	$373.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$164.52
Rate for Payer: Qualcare PPO/HMO/WC	$112.17
Rate for Payer: UnitedHealthcare Community & State	$18.02
Rate for Payer: Wellpoint Medicaid Managed Care	$19.82

SCREW LCKG T25 STR DRV 4x28MM

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270637804
Hospital Revenue Code	278
Min. Negotiated Rate	$22.94
Max. Negotiated Rate	$475.85
Rate for Payer: Aetna Commercial	$361.65
Rate for Payer: Aetna Medicare Advantage	$285.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.68
Rate for Payer: Cigna Commercial	$475.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.37
Rate for Payer: Qualcare PPO/HMO/WC	$142.75
Rate for Payer: UnitedHealthcare Community & State	$22.94
Rate for Payer: Wellpoint Medicaid Managed Care	$25.22

SCREW LCKG T25 STR DRV 4x28MM

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270637804
Hospital Revenue Code	278
Min. Negotiated Rate	$142.75
Max. Negotiated Rate	$230.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.37
Rate for Payer: Qualcare PPO/HMO/WC	$142.75

SCREW LCKG T25 STR DRV 4x30MM

Facility

$747.80

Service Code	HCPCS C1713
Hospital Charge Code	270679775
Hospital Revenue Code	278
Min. Negotiated Rate	$18.02
Max. Negotiated Rate	$373.90
Rate for Payer: Aetna Commercial	$284.16
Rate for Payer: Aetna Medicare Advantage	$224.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$190.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$190.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$190.69
Rate for Payer: Cigna Commercial	$373.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$164.52
Rate for Payer: Qualcare PPO/HMO/WC	$112.17
Rate for Payer: UnitedHealthcare Community & State	$18.02
Rate for Payer: Wellpoint Medicaid Managed Care	$19.82

SCREW LCKG T25 STR DRV 4x30MM

Facility

$747.80

Service Code	HCPCS C1713
Hospital Charge Code	270679775
Hospital Revenue Code	278
Min. Negotiated Rate	$112.17
Max. Negotiated Rate	$180.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$164.52
Rate for Payer: Qualcare PPO/HMO/WC	$112.17

SCREW LCKG T25 STR DRV 4x30MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270650155
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 T25 STR DRV 4x30MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270650155
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 T25 STR DRV 4x32MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270647423
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 T25 STR DRV 4x32MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270647423
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 T25 STR DRV 4x34MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270659942
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 T25 STR DRV 4x34MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270659942
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 T25 STR DRV 4x44MM

Facility

$924.00

Service Code	HCPCS C1713
Hospital Charge Code	270647421
Hospital Revenue Code	278
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$223.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$203.28
Rate for Payer: Qualcare PPO/HMO/WC	$138.60

SCREW LCKG T25 STR DRV 4x44MM

Facility

$924.00

Service Code	HCPCS C1713
Hospital Charge Code	270647421
Hospital Revenue Code	278
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$462.00
Rate for Payer: Aetna Commercial	$351.12
Rate for Payer: Aetna Medicare Advantage	$277.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.62
Rate for Payer: Cigna Commercial	$462.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$203.28
Rate for Payer: Qualcare PPO/HMO/WC	$138.60
Rate for Payer: UnitedHealthcare Community & State	$22.27
Rate for Payer: Wellpoint Medicaid Managed Care	$24.49

SCREW LCKG T25 STR DRV 4x48MM

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270647422
Hospital Revenue Code	278
Min. Negotiated Rate	$22.94
Max. Negotiated Rate	$475.85
Rate for Payer: Aetna Commercial	$361.65
Rate for Payer: Aetna Medicare Advantage	$285.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.68
Rate for Payer: Cigna Commercial	$475.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.37
Rate for Payer: Qualcare PPO/HMO/WC	$142.75
Rate for Payer: UnitedHealthcare Community & State	$22.94
Rate for Payer: Wellpoint Medicaid Managed Care	$25.22

SCREW LCKG T25 STR DRV 4x48MM

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270647422
Hospital Revenue Code	278
Min. Negotiated Rate	$142.75
Max. Negotiated Rate	$230.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.37
Rate for Payer: Qualcare PPO/HMO/WC	$142.75

Know your out-of-pocket cost for care.

All Charges