Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LKG FOR IM NAIL 5.0X86MM

Facility

$2,730.00

Service Code	HCPCS C1713
Hospital Charge Code	270699940
Hospital Revenue Code	278
Min. Negotiated Rate	$65.79
Max. Negotiated Rate	$1,365.00
Rate for Payer: Aetna Commercial	$1,037.40
Rate for Payer: Aetna Medicare Advantage	$819.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$696.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$696.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$546.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$696.15
Rate for Payer: Cigna Commercial	$1,365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$660.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$600.60
Rate for Payer: Qualcare PPO/HMO/WC	$409.50
Rate for Payer: UnitedHealthcare Community & State	$65.79
Rate for Payer: Wellpoint Medicaid Managed Care	$72.34

SCREW LKG FOR IM NAIL 5.0X86MM

Facility

$2,730.00

Service Code	HCPCS C1713
Hospital Charge Code	270699940
Hospital Revenue Code	278
Min. Negotiated Rate	$409.50
Max. Negotiated Rate	$660.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$546.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$660.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$600.60
Rate for Payer: Qualcare PPO/HMO/WC	$409.50

SCREW LKG FT T8 2.4X20MM

Facility

$1,242.30

Service Code	HCPCS C1713
Hospital Charge Code	270700528
Hospital Revenue Code	278
Min. Negotiated Rate	$186.34
Max. Negotiated Rate	$300.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.31
Rate for Payer: Qualcare PPO/HMO/WC	$186.34

SCREW LKG FT T8 2.4X20MM

Facility

$1,242.30

Service Code	HCPCS C1713
Hospital Charge Code	270700528
Hospital Revenue Code	278
Min. Negotiated Rate	$29.94
Max. Negotiated Rate	$621.15
Rate for Payer: Aetna Commercial	$472.07
Rate for Payer: Aetna Medicare Advantage	$372.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.79
Rate for Payer: Cigna Commercial	$621.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.31
Rate for Payer: Qualcare PPO/HMO/WC	$186.34
Rate for Payer: UnitedHealthcare Community & State	$29.94
Rate for Payer: Wellpoint Medicaid Managed Care	$32.92

SCREW LKG FT T8 2.7X12MM

Facility

$1,242.30

Service Code	HCPCS C1713
Hospital Charge Code	270700506
Hospital Revenue Code	278
Min. Negotiated Rate	$29.94
Max. Negotiated Rate	$621.15
Rate for Payer: Aetna Commercial	$472.07
Rate for Payer: Aetna Medicare Advantage	$372.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.79
Rate for Payer: Cigna Commercial	$621.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.31
Rate for Payer: Qualcare PPO/HMO/WC	$186.34
Rate for Payer: UnitedHealthcare Community & State	$29.94
Rate for Payer: Wellpoint Medicaid Managed Care	$32.92

SCREW LKG FT T8 2.7X12MM

Facility

$1,242.30

Service Code	HCPCS C1713
Hospital Charge Code	270700506
Hospital Revenue Code	278
Min. Negotiated Rate	$186.34
Max. Negotiated Rate	$300.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.31
Rate for Payer: Qualcare PPO/HMO/WC	$186.34

SCREW LKG HEXALOBE 3.5X16MM

Facility

$705.00

Service Code	HCPCS C1713
Hospital Charge Code	270659703
Hospital Revenue Code	278
Min. Negotiated Rate	$105.75
Max. Negotiated Rate	$170.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$155.10
Rate for Payer: Qualcare PPO/HMO/WC	$105.75

SCREW LKG HEXALOBE 3.5X16MM

Facility

$705.00

Service Code	HCPCS C1713
Hospital Charge Code	270659703
Hospital Revenue Code	278
Min. Negotiated Rate	$16.99
Max. Negotiated Rate	$352.50
Rate for Payer: Aetna Commercial	$267.90
Rate for Payer: Aetna Medicare Advantage	$211.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.78
Rate for Payer: Cigna Commercial	$352.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$155.10
Rate for Payer: Qualcare PPO/HMO/WC	$105.75
Rate for Payer: UnitedHealthcare Community & State	$16.99
Rate for Payer: Wellpoint Medicaid Managed Care	$18.68

SCREW LKG HEXALOBE 3.5X40MM

Facility

$1,080.00

Service Code	HCPCS C1713
Hospital Charge Code	270697232
Hospital Revenue Code	278
Min. Negotiated Rate	$162.00
Max. Negotiated Rate	$261.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$237.60
Rate for Payer: Qualcare PPO/HMO/WC	$162.00

SCREW LKG HEXALOBE 3.5X40MM

Facility

$1,080.00

Service Code	HCPCS C1713
Hospital Charge Code	270697232
Hospital Revenue Code	278
Min. Negotiated Rate	$26.03
Max. Negotiated Rate	$540.00
Rate for Payer: Aetna Commercial	$410.40
Rate for Payer: Aetna Medicare Advantage	$324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.40
Rate for Payer: Cigna Commercial	$540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$237.60
Rate for Payer: Qualcare PPO/HMO/WC	$162.00
Rate for Payer: UnitedHealthcare Community & State	$26.03
Rate for Payer: Wellpoint Medicaid Managed Care	$28.62

SCREW LKG IM NL 5 80 XL25

Facility

$1,259.50

Service Code	HCPCS C1713
Hospital Charge Code	270698103
Hospital Revenue Code	278
Min. Negotiated Rate	$30.35
Max. Negotiated Rate	$629.75
Rate for Payer: Aetna Commercial	$478.61
Rate for Payer: Aetna Medicare Advantage	$377.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$321.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$321.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$321.17
Rate for Payer: Cigna Commercial	$629.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$277.09
Rate for Payer: Qualcare PPO/HMO/WC	$188.93
Rate for Payer: UnitedHealthcare Community & State	$30.35
Rate for Payer: Wellpoint Medicaid Managed Care	$33.38

SCREW LKG IM NL 5 80 XL25

Facility

$1,259.50

Service Code	HCPCS C1713
Hospital Charge Code	270698103
Hospital Revenue Code	278
Min. Negotiated Rate	$188.93
Max. Negotiated Rate	$304.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$277.09
Rate for Payer: Qualcare PPO/HMO/WC	$188.93

SCREW LKG IM NL 5X38MM XL25

Facility

$888.30

Service Code	HCPCS C1713
Hospital Charge Code	270692606
Hospital Revenue Code	278
Min. Negotiated Rate	$133.25
Max. Negotiated Rate	$214.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$195.43
Rate for Payer: Qualcare PPO/HMO/WC	$133.25

SCREW LKG IM NL 5X38MM XL25

Facility

$888.30

Service Code	HCPCS C1713
Hospital Charge Code	270692606
Hospital Revenue Code	278
Min. Negotiated Rate	$21.41
Max. Negotiated Rate	$444.15
Rate for Payer: Aetna Commercial	$337.55
Rate for Payer: Aetna Medicare Advantage	$266.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.52
Rate for Payer: Cigna Commercial	$444.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$195.43
Rate for Payer: Qualcare PPO/HMO/WC	$133.25
Rate for Payer: UnitedHealthcare Community & State	$21.41
Rate for Payer: Wellpoint Medicaid Managed Care	$23.54

SCREW LKG IM NL 5X58MM XL25

Facility

$1,259.50

Service Code	HCPCS C1713
Hospital Charge Code	270698100
Hospital Revenue Code	278
Min. Negotiated Rate	$30.35
Max. Negotiated Rate	$629.75
Rate for Payer: Aetna Commercial	$478.61
Rate for Payer: Aetna Medicare Advantage	$377.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$321.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$321.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$321.17
Rate for Payer: Cigna Commercial	$629.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$277.09
Rate for Payer: Qualcare PPO/HMO/WC	$188.93
Rate for Payer: UnitedHealthcare Community & State	$30.35
Rate for Payer: Wellpoint Medicaid Managed Care	$33.38

SCREW LKG IM NL 5X58MM XL25

Facility

$1,259.50

Service Code	HCPCS C1713
Hospital Charge Code	270698100
Hospital Revenue Code	278
Min. Negotiated Rate	$188.93
Max. Negotiated Rate	$304.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$277.09
Rate for Payer: Qualcare PPO/HMO/WC	$188.93

SCREW LKG ORTHOLOC3DI 3.5X28MM

Facility

$1,050.60

Service Code	HCPCS C1713
Hospital Charge Code	270700374
Hospital Revenue Code	278
Min. Negotiated Rate	$25.32
Max. Negotiated Rate	$525.30
Rate for Payer: Aetna Commercial	$399.23
Rate for Payer: Aetna Medicare Advantage	$315.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.90
Rate for Payer: Cigna Commercial	$525.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.13
Rate for Payer: Qualcare PPO/HMO/WC	$157.59
Rate for Payer: UnitedHealthcare Community & State	$25.32
Rate for Payer: Wellpoint Medicaid Managed Care	$27.84

SCREW LKG ORTHOLOC3DI 3.5X28MM

Facility

$1,050.60

Service Code	HCPCS C1713
Hospital Charge Code	270700374
Hospital Revenue Code	278
Min. Negotiated Rate	$157.59
Max. Negotiated Rate	$254.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.13
Rate for Payer: Qualcare PPO/HMO/WC	$157.59

SCREW LKG PERIPH 5.5X16MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270699155
Hospital Revenue Code	278
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

SCREW LKG PERIPH 5.5X16MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270699155
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW LKG PERIPH 5.5X20MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270699156
Hospital Revenue Code	278
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

SCREW LKG PERIPH 5.5X20MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270699156
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW LKG PERIPH 5.5X40MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270699157
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW LKG PERIPH 5.5X40MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270699157
Hospital Revenue Code	278
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

SCREW LKG PT T2 SHAFT 5X35MM

Facility

$2,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270699231
Hospital Revenue Code	278
Min. Negotiated Rate	$372.00
Max. Negotiated Rate	$600.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$496.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$545.60
Rate for Payer: Qualcare PPO/HMO/WC	$372.00

Know your out-of-pocket cost for care.

All Charges