Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LCKG T25 STR DRV 4x52MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270680672
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 4x52MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270680672
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 5x28MM

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270661555
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 5x28MM

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270661555
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 5x30MM

Facility

$726.00

Service Code	HCPCS C1713
Hospital Charge Code	270646673
Hospital Revenue Code	278
Min. Negotiated Rate	$108.90
Max. Negotiated Rate	$175.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.72
Rate for Payer: Qualcare PPO/HMO/WC	$108.90

SCREW LCKG T25 STR DRV 5x30MM

Facility

$726.00

Service Code	HCPCS C1713
Hospital Charge Code	270646673
Hospital Revenue Code	278
Min. Negotiated Rate	$17.50
Max. Negotiated Rate	$363.00
Rate for Payer: Aetna Commercial	$275.88
Rate for Payer: Aetna Medicare Advantage	$217.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.13
Rate for Payer: Cigna Commercial	$363.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.72
Rate for Payer: Qualcare PPO/HMO/WC	$108.90
Rate for Payer: UnitedHealthcare Community & State	$17.50
Rate for Payer: Wellpoint Medicaid Managed Care	$19.24

SCREW LCKG T25 STR DRV 5x32MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270646671
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 5x32MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270646671
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 5x36MM

Facility

$3,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270646672
Hospital Revenue Code	278
Min. Negotiated Rate	$80.13
Max. Negotiated Rate	$1,662.50
Rate for Payer: Aetna Commercial	$1,263.50
Rate for Payer: Aetna Medicare Advantage	$997.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$847.88
Rate for Payer: Cigna Commercial	$1,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$731.50
Rate for Payer: Qualcare PPO/HMO/WC	$498.75
Rate for Payer: UnitedHealthcare Community & State	$80.13
Rate for Payer: Wellpoint Medicaid Managed Care	$88.11

SCREW LCKG T25 STR DRV 5x36MM

Facility

$3,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270646672
Hospital Revenue Code	278
Min. Negotiated Rate	$498.75
Max. Negotiated Rate	$804.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$731.50
Rate for Payer: Qualcare PPO/HMO/WC	$498.75

SCREW LCKG T25 STR DRV 5x38MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270660153
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 5x38MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270660153
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 5x42MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270645685
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 5x42MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270645685
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 5X48MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270676404
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 5X48MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270676404
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 5x58MM

Facility

$924.00

Service Code	HCPCS C1713
Hospital Charge Code	270671811
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 5x58MM

Facility

$924.00

Service Code	HCPCS C1713
Hospital Charge Code	270671811
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 5x62MM

Facility

$924.00

Service Code	HCPCS C1713
Hospital Charge Code	270675113
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 5x62MM

Facility

$924.00

Service Code	HCPCS C1713
Hospital Charge Code	270675113
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 5x66MM

Facility

$965.85

Service Code	HCPCS C1713
Hospital Charge Code	270688214
Hospital Revenue Code	278
Min. Negotiated Rate	$23.28
Max. Negotiated Rate	$482.93
Rate for Payer: Aetna Commercial	$367.02
Rate for Payer: Aetna Medicare Advantage	$289.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$246.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$246.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$246.29
Rate for Payer: Cigna Commercial	$482.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$233.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$212.49
Rate for Payer: Qualcare PPO/HMO/WC	$144.88
Rate for Payer: UnitedHealthcare Community & State	$23.28
Rate for Payer: Wellpoint Medicaid Managed Care	$25.60

SCREW LCKG T25 STR DRV 5x66MM

Facility

$965.85

Service Code	HCPCS C1713
Hospital Charge Code	270688214
Hospital Revenue Code	278
Min. Negotiated Rate	$144.88
Max. Negotiated Rate	$233.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$233.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$212.49
Rate for Payer: Qualcare PPO/HMO/WC	$144.88

SCREW LCKG T25 STR DRV 5x72MM

Facility

$924.00

Hospital Charge Code	270677440
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 5x72MM

Facility

$924.00

Hospital Charge Code	270677440
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 5x85MM

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270680078
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

Know your out-of-pocket cost for care.

All Charges