Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LCKG T25 STR DRV 5x85MM

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270680078
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 LCKING 4.0MM TI ANGULAR

Facility

$1,340.00

Hospital Charge Code	270662824
Hospital Revenue Code	278
Min. Negotiated Rate	$32.29
Max. Negotiated Rate	$670.00
Rate for Payer: Aetna Commercial	$509.20
Rate for Payer: Aetna Medicare Advantage	$402.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$341.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$341.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$341.70
Rate for Payer: Cigna Commercial	$670.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$294.80
Rate for Payer: Qualcare PPO/HMO/WC	$201.00
Rate for Payer: UnitedHealthcare Community & State	$32.29
Rate for Payer: Wellpoint Medicaid Managed Care	$35.51

SCREW LCKING 4.0MM TI ANGULAR

Facility

$1,340.00

Hospital Charge Code	270662824
Hospital Revenue Code	278
Min. Negotiated Rate	$201.00
Max. Negotiated Rate	$324.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$294.80
Rate for Payer: Qualcare PPO/HMO/WC	$201.00

SCREW LCKNG CAP KIT 4.5x46MM P

Facility

$547.85

Service Code	HCPCS C1713
Hospital Charge Code	270684300
Hospital Revenue Code	278
Min. Negotiated Rate	$13.20
Max. Negotiated Rate	$273.93
Rate for Payer: Aetna Commercial	$208.18
Rate for Payer: Aetna Medicare Advantage	$164.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.70
Rate for Payer: Cigna Commercial	$273.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$120.53
Rate for Payer: Qualcare PPO/HMO/WC	$82.18
Rate for Payer: UnitedHealthcare Community & State	$13.20
Rate for Payer: Wellpoint Medicaid Managed Care	$14.52

SCREW LCKNG CAP KIT 4.5x46MM P

Facility

$547.85

Service Code	HCPCS C1713
Hospital Charge Code	270684300
Hospital Revenue Code	278
Min. Negotiated Rate	$82.18
Max. Negotiated Rate	$132.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$120.53
Rate for Payer: Qualcare PPO/HMO/WC	$82.18

SCREW LCKNG SLF TAP 2.7x10MM

Facility

$623.80

Service Code	HCPCS C1713
Hospital Charge Code	270648480
Hospital Revenue Code	278
Min. Negotiated Rate	$15.03
Max. Negotiated Rate	$311.90
Rate for Payer: Aetna Commercial	$237.04
Rate for Payer: Aetna Medicare Advantage	$187.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.07
Rate for Payer: Cigna Commercial	$311.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.24
Rate for Payer: Qualcare PPO/HMO/WC	$93.57
Rate for Payer: UnitedHealthcare Community & State	$15.03
Rate for Payer: Wellpoint Medicaid Managed Care	$16.53

SCREW LCKNG SLF TAP 2.7x10MM

Facility

$623.80

Service Code	HCPCS C1713
Hospital Charge Code	270648480
Hospital Revenue Code	278
Min. Negotiated Rate	$93.57
Max. Negotiated Rate	$150.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.24
Rate for Payer: Qualcare PPO/HMO/WC	$93.57

SCREW LCKNG SLF TAP 2.7x8MM

Facility

$605.65

Service Code	HCPCS C1713
Hospital Charge Code	270664150
Hospital Revenue Code	278
Min. Negotiated Rate	$90.85
Max. Negotiated Rate	$146.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$133.24
Rate for Payer: Qualcare PPO/HMO/WC	$90.85

SCREW LCKNG SLF TAP 2.7x8MM

Facility

$605.65

Service Code	HCPCS C1713
Hospital Charge Code	270664150
Hospital Revenue Code	278
Min. Negotiated Rate	$14.60
Max. Negotiated Rate	$302.82
Rate for Payer: Aetna Commercial	$230.15
Rate for Payer: Aetna Medicare Advantage	$181.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.44
Rate for Payer: Cigna Commercial	$302.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$133.24
Rate for Payer: Qualcare PPO/HMO/WC	$90.85
Rate for Payer: UnitedHealthcare Community & State	$14.60
Rate for Payer: Wellpoint Medicaid Managed Care	$16.05

SCREW LCKNG T25 34MM 4.OMMM TI

Facility

$1,340.00

Hospital Charge Code	270662826
Hospital Revenue Code	278
Min. Negotiated Rate	$32.29
Max. Negotiated Rate	$670.00
Rate for Payer: Aetna Commercial	$509.20
Rate for Payer: Aetna Medicare Advantage	$402.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$341.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$341.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$341.70
Rate for Payer: Cigna Commercial	$670.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$294.80
Rate for Payer: Qualcare PPO/HMO/WC	$201.00
Rate for Payer: UnitedHealthcare Community & State	$32.29
Rate for Payer: Wellpoint Medicaid Managed Care	$35.51

SCREW LCKNG T25 34MM 4.OMMM TI

Facility

$1,340.00

Hospital Charge Code	270662826
Hospital Revenue Code	278
Min. Negotiated Rate	$201.00
Max. Negotiated Rate	$324.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$294.80
Rate for Payer: Qualcare PPO/HMO/WC	$201.00

SCREW LCKNG T25 4.0x26mm TI

Facility

$888.00

Hospital Charge Code	270662827
Hospital Revenue Code	278
Min. Negotiated Rate	$133.20
Max. Negotiated Rate	$214.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$195.36
Rate for Payer: Qualcare PPO/HMO/WC	$133.20

SCREW LCKNG T25 4.0x26mm TI

Facility

$888.00

Hospital Charge Code	270662827
Hospital Revenue Code	278
Min. Negotiated Rate	$21.40
Max. Negotiated Rate	$444.00
Rate for Payer: Aetna Commercial	$337.44
Rate for Payer: Aetna Medicare Advantage	$266.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.44
Rate for Payer: Cigna Commercial	$444.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$195.36
Rate for Payer: Qualcare PPO/HMO/WC	$133.20
Rate for Payer: UnitedHealthcare Community & State	$21.40
Rate for Payer: Wellpoint Medicaid Managed Care	$23.53

SCREW LCKNG T25 4.0x40mm TI

Facility

$888.00

Hospital Charge Code	270662825
Hospital Revenue Code	278
Min. Negotiated Rate	$133.20
Max. Negotiated Rate	$214.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$195.36
Rate for Payer: Qualcare PPO/HMO/WC	$133.20

SCREW LCKNG T25 4.0x40mm TI

Facility

$888.00

Hospital Charge Code	270662825
Hospital Revenue Code	278
Min. Negotiated Rate	$21.40
Max. Negotiated Rate	$444.00
Rate for Payer: Aetna Commercial	$337.44
Rate for Payer: Aetna Medicare Advantage	$266.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.44
Rate for Payer: Cigna Commercial	$444.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$195.36
Rate for Payer: Qualcare PPO/HMO/WC	$133.20
Rate for Payer: UnitedHealthcare Community & State	$21.40
Rate for Payer: Wellpoint Medicaid Managed Care	$23.53

SCREW LCK SQR 2.7MMX 15MM

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	270699270
Hospital Revenue Code	278
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.60

SCREW LCK SQR 2.7MMX 15MM

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	270699270
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

SCREW LCK SQR 2.7MMX 20MM

Facility

$980.00

Service Code	HCPCS C1713
Hospital Charge Code	270699267
Hospital Revenue Code	278
Min. Negotiated Rate	$23.62
Max. Negotiated Rate	$490.00
Rate for Payer: Aetna Commercial	$372.40
Rate for Payer: Aetna Medicare Advantage	$294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.90
Rate for Payer: Cigna Commercial	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$215.60
Rate for Payer: Qualcare PPO/HMO/WC	$147.00
Rate for Payer: UnitedHealthcare Community & State	$23.62
Rate for Payer: Wellpoint Medicaid Managed Care	$25.97

SCREW LCK SQR 2.7MMX 20MM

Facility

$980.00

Service Code	HCPCS C1713
Hospital Charge Code	270699267
Hospital Revenue Code	278
Min. Negotiated Rate	$147.00
Max. Negotiated Rate	$237.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$215.60
Rate for Payer: Qualcare PPO/HMO/WC	$147.00

SCREW LCK SQU 2.7 MMX10 MM

Facility

$825.00

Hospital Charge Code	270702389
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 LCK SQU 2.7 MMX10 MM

Facility

$825.00

Hospital Charge Code	270702389
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
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
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW LCK SQUARE 2.7 X 11MM

Facility

$990.00

Service Code	HCPCS C1713
Hospital Charge Code	270702078
Hospital Revenue Code	278
Min. Negotiated Rate	$148.50
Max. Negotiated Rate	$239.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$148.50

SCREW LCK SQUARE 2.7 X 11MM

Facility

$990.00

Service Code	HCPCS C1713
Hospital Charge Code	270702078
Hospital Revenue Code	278
Min. Negotiated Rate	$23.86
Max. Negotiated Rate	$495.00
Rate for Payer: Aetna Commercial	$376.20
Rate for Payer: Aetna Medicare Advantage	$297.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.45
Rate for Payer: Cigna Commercial	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$148.50
Rate for Payer: UnitedHealthcare Community & State	$23.86
Rate for Payer: Wellpoint Medicaid Managed Care	$26.23

SCREW LEAD CORT TI 5.0X20MM

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270691840
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

SCREW LEAD CORT TI 5.0X20MM

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270691840
Hospital Revenue Code	278
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

Know your out-of-pocket cost for care.

All Charges