Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LKG VARIAX FT 3.5X12MM

Facility

$1,257.80

Service Code	HCPCS C1713
Hospital Charge Code	270696915
Hospital Revenue Code	278
Min. Negotiated Rate	$30.31
Max. Negotiated Rate	$628.90
Rate for Payer: Aetna Commercial	$477.96
Rate for Payer: Aetna Medicare Advantage	$377.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$320.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$320.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$320.74
Rate for Payer: Cigna Commercial	$628.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$276.72
Rate for Payer: Qualcare PPO/HMO/WC	$188.67
Rate for Payer: UnitedHealthcare Community & State	$30.31
Rate for Payer: Wellpoint Medicaid Managed Care	$33.33

SCREW LKG VARIAX FT 3.5X16MM

Facility

$1,307.80

Service Code	HCPCS C1713
Hospital Charge Code	270696916
Hospital Revenue Code	278
Min. Negotiated Rate	$196.17
Max. Negotiated Rate	$316.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$261.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$316.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$287.72
Rate for Payer: Qualcare PPO/HMO/WC	$196.17

SCREW LKG VARIAX FT 3.5X16MM

Facility

$1,307.80

Service Code	HCPCS C1713
Hospital Charge Code	270696916
Hospital Revenue Code	278
Min. Negotiated Rate	$31.52
Max. Negotiated Rate	$653.90
Rate for Payer: Aetna Commercial	$496.96
Rate for Payer: Aetna Medicare Advantage	$392.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$333.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$333.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$261.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$333.49
Rate for Payer: Cigna Commercial	$653.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$316.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$287.72
Rate for Payer: Qualcare PPO/HMO/WC	$196.17
Rate for Payer: UnitedHealthcare Community & State	$31.52
Rate for Payer: Wellpoint Medicaid Managed Care	$34.66

SCREW LKG XL25 5.0X40MM

Facility

$1,259.50

Service Code	HCPCS C1713
Hospital Charge Code	270697680
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 XL25 5.0X40MM

Facility

$1,259.50

Service Code	HCPCS C1713
Hospital Charge Code	270697680
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 LOC 2.4 X 20 MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270690142
Hospital Revenue Code	278
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

SCREW LOC 2.4 X 20 MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270690142
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

SCREW LOC 2.4 X 28 MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270690143
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

SCREW LOC 2.4 X 28 MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270690143
Hospital Revenue Code	278
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

SCREW LOCK 14MM x2.4MM

Facility

$1,085.00

Service Code	HCPCS C1713
Hospital Charge Code	270680994
Hospital Revenue Code	278
Min. Negotiated Rate	$162.75
Max. Negotiated Rate	$262.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$238.70
Rate for Payer: Qualcare PPO/HMO/WC	$162.75

SCREW LOCK 14MM x2.4MM

Facility

$1,085.00

Service Code	HCPCS C1713
Hospital Charge Code	270680994
Hospital Revenue Code	278
Min. Negotiated Rate	$26.15
Max. Negotiated Rate	$542.50
Rate for Payer: Aetna Commercial	$412.30
Rate for Payer: Aetna Medicare Advantage	$325.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$276.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$276.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$276.68
Rate for Payer: Cigna Commercial	$542.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$238.70
Rate for Payer: Qualcare PPO/HMO/WC	$162.75
Rate for Payer: UnitedHealthcare Community & State	$26.15
Rate for Payer: Wellpoint Medicaid Managed Care	$28.75

SCREW LOCK 2.3X11MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270691339
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$174.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.40
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

SCREW LOCK 2.3X11MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270691339
Hospital Revenue Code	278
Min. Negotiated Rate	$17.35
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$273.60
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.40
Rate for Payer: Qualcare PPO/HMO/WC	$108.00
Rate for Payer: UnitedHealthcare Community & State	$17.35
Rate for Payer: Wellpoint Medicaid Managed Care	$19.08

SCREW LOCK 2.3X12MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270691340
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$174.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.40
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

SCREW LOCK 2.3X12MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270691340
Hospital Revenue Code	278
Min. Negotiated Rate	$17.35
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$273.60
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.40
Rate for Payer: Qualcare PPO/HMO/WC	$108.00
Rate for Payer: UnitedHealthcare Community & State	$17.35
Rate for Payer: Wellpoint Medicaid Managed Care	$19.08

SCREW LOCK 2.3X14

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270691343
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$174.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.40
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

SCREW LOCK 2.3X14

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270691343
Hospital Revenue Code	278
Min. Negotiated Rate	$17.35
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$273.60
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.40
Rate for Payer: Qualcare PPO/HMO/WC	$108.00
Rate for Payer: UnitedHealthcare Community & State	$17.35
Rate for Payer: Wellpoint Medicaid Managed Care	$19.08

SCREW LOCK 2.3X18MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270691341
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$174.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.40
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

SCREW LOCK 2.3X18MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270691341
Hospital Revenue Code	278
Min. Negotiated Rate	$17.35
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$273.60
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.40
Rate for Payer: Qualcare PPO/HMO/WC	$108.00
Rate for Payer: UnitedHealthcare Community & State	$17.35
Rate for Payer: Wellpoint Medicaid Managed Care	$19.08

SCREW LOCK 2.7X10MM STRATUM

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270693323
Hospital Revenue Code	278
Min. Negotiated Rate	$18.80
Max. Negotiated Rate	$390.00
Rate for Payer: Aetna Commercial	$296.40
Rate for Payer: Aetna Medicare Advantage	$234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.90
Rate for Payer: Cigna Commercial	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$171.60
Rate for Payer: Qualcare PPO/HMO/WC	$117.00
Rate for Payer: UnitedHealthcare Community & State	$18.80
Rate for Payer: Wellpoint Medicaid Managed Care	$20.67

SCREW LOCK 2.7X10MM STRATUM

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270693323
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$188.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$171.60
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

SCREW LOCK 3.5mmX16m COL-3160

Facility

$350.00

Hospital Charge Code	370638668
Hospital Revenue Code	278
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$133.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$77.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Community & State	$8.44
Rate for Payer: Wellpoint Medicaid Managed Care	$9.28

SCREW LOCK 3.5mmX16m COL-3160

Facility

$350.00

Hospital Charge Code	370638668
Hospital Revenue Code	278
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$84.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$77.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

SCREW LOCK 3.5mmX16mm COL-3160

Facility

$350.00

Hospital Charge Code	270638668
Hospital Revenue Code	278
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$133.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$77.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Community & State	$8.44
Rate for Payer: Wellpoint Medicaid Managed Care	$9.28

SCREW LOCK 3.5mmX16mm COL-3160

Facility

$350.00

Hospital Charge Code	270638668
Hospital Revenue Code	278
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$84.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$77.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

Know your out-of-pocket cost for care.

All Charges