Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCK 4.5x14mm 27814

Facility

$610.00

Service Code	HCPCS C1713
Hospital Charge Code	270648676
Hospital Revenue Code	278
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$147.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.20
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

SCREW LOCK 5.5MM OPEN TULIP

Facility

$385.00

Service Code	HCPCS C1713
Hospital Charge Code	270691604
Hospital Revenue Code	278
Min. Negotiated Rate	$9.28
Max. Negotiated Rate	$192.50
Rate for Payer: Aetna Commercial	$146.30
Rate for Payer: Aetna Medicare Advantage	$115.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.17
Rate for Payer: Cigna Commercial	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$84.70
Rate for Payer: Qualcare PPO/HMO/WC	$57.75
Rate for Payer: UnitedHealthcare Community & State	$9.28
Rate for Payer: Wellpoint Medicaid Managed Care	$10.20

SCREW LOCK 5.5MM OPEN TULIP

Facility

$385.00

Service Code	HCPCS C1713
Hospital Charge Code	270691604
Hospital Revenue Code	278
Min. Negotiated Rate	$57.75
Max. Negotiated Rate	$93.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$84.70
Rate for Payer: Qualcare PPO/HMO/WC	$57.75

SCREW LOCK CANC 3.0X20 3730220

Facility

$695.00

Hospital Charge Code	270643379
Hospital Revenue Code	278
Min. Negotiated Rate	$16.75
Max. Negotiated Rate	$347.50
Rate for Payer: Aetna Commercial	$264.10
Rate for Payer: Aetna Medicare Advantage	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.22
Rate for Payer: Cigna Commercial	$347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$152.90
Rate for Payer: Qualcare PPO/HMO/WC	$104.25
Rate for Payer: UnitedHealthcare Community & State	$16.75
Rate for Payer: Wellpoint Medicaid Managed Care	$18.42

SCREW LOCK CANC 3.0X20 3730220

Facility

$695.00

Hospital Charge Code	270643379
Hospital Revenue Code	278
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$168.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$152.90
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

SCREW LOCK CANC 3.0X22 3730222

Facility

$695.00

Hospital Charge Code	270643380
Hospital Revenue Code	278
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$168.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$152.90
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

SCREW LOCK CANC 3.0X22 3730222

Facility

$695.00

Hospital Charge Code	270643380
Hospital Revenue Code	278
Min. Negotiated Rate	$16.75
Max. Negotiated Rate	$347.50
Rate for Payer: Aetna Commercial	$264.10
Rate for Payer: Aetna Medicare Advantage	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.22
Rate for Payer: Cigna Commercial	$347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$152.90
Rate for Payer: Qualcare PPO/HMO/WC	$104.25
Rate for Payer: UnitedHealthcare Community & State	$16.75
Rate for Payer: Wellpoint Medicaid Managed Care	$18.42

SCREW LOCK CANC 3.0X30 3730230

Facility

$695.00

Hospital Charge Code	270643381
Hospital Revenue Code	278
Min. Negotiated Rate	$16.75
Max. Negotiated Rate	$347.50
Rate for Payer: Aetna Commercial	$264.10
Rate for Payer: Aetna Medicare Advantage	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.22
Rate for Payer: Cigna Commercial	$347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$152.90
Rate for Payer: Qualcare PPO/HMO/WC	$104.25
Rate for Payer: UnitedHealthcare Community & State	$16.75
Rate for Payer: Wellpoint Medicaid Managed Care	$18.42

SCREW LOCK CANC 3.0X30 3730230

Facility

$695.00

Hospital Charge Code	270643381
Hospital Revenue Code	278
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$168.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$152.90
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

SCREW LOCK FASTP 2.7MM HIGHP

Facility

$2,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270693223
Hospital Revenue Code	278
Min. Negotiated Rate	$65.67
Max. Negotiated Rate	$1,362.50
Rate for Payer: Aetna Commercial	$1,035.50
Rate for Payer: Aetna Medicare Advantage	$817.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$694.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$694.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$545.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$694.88
Rate for Payer: Cigna Commercial	$1,362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$599.50
Rate for Payer: Qualcare PPO/HMO/WC	$408.75
Rate for Payer: UnitedHealthcare Community & State	$65.67
Rate for Payer: Wellpoint Medicaid Managed Care	$72.21

SCREW LOCK FASTP 2.7MM HIGHP

Facility

$2,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270693223
Hospital Revenue Code	278
Min. Negotiated Rate	$408.75
Max. Negotiated Rate	$659.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$545.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$599.50
Rate for Payer: Qualcare PPO/HMO/WC	$408.75

SCREW LOCK FOR IM 5MM32MMXL25

Facility

$888.30

Service Code	HCPCS C1713
Hospital Charge Code	270692415
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 LOCK FOR IM 5MM32MMXL25

Facility

$888.30

Service Code	HCPCS C1713
Hospital Charge Code	270692415
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 LOCK FULL THRD 5x42.5mm

Facility

$949.45

Hospital Charge Code	270673212
Hospital Revenue Code	278
Min. Negotiated Rate	$142.42
Max. Negotiated Rate	$229.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$208.88
Rate for Payer: Qualcare PPO/HMO/WC	$142.42

SCREW LOCK FULL THRD 5x42.5mm

Facility

$949.45

Hospital Charge Code	270673212
Hospital Revenue Code	278
Min. Negotiated Rate	$22.88
Max. Negotiated Rate	$474.73
Rate for Payer: Aetna Commercial	$360.79
Rate for Payer: Aetna Medicare Advantage	$284.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.11
Rate for Payer: Cigna Commercial	$474.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$208.88
Rate for Payer: Qualcare PPO/HMO/WC	$142.42
Rate for Payer: UnitedHealthcare Community & State	$22.88
Rate for Payer: Wellpoint Medicaid Managed Care	$25.16

SCREW LOCKG CANN 5.0X60 222542

Facility

$754.00

Hospital Charge Code	270633661
Hospital Revenue Code	278
Min. Negotiated Rate	$113.10
Max. Negotiated Rate	$182.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.88
Rate for Payer: Qualcare PPO/HMO/WC	$113.10

SCREW LOCKG CANN 5.0X60 222542

Facility

$754.00

Hospital Charge Code	270633661
Hospital Revenue Code	278
Min. Negotiated Rate	$18.17
Max. Negotiated Rate	$377.00
Rate for Payer: Aetna Commercial	$286.52
Rate for Payer: Aetna Medicare Advantage	$226.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.27
Rate for Payer: Cigna Commercial	$377.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.88
Rate for Payer: Qualcare PPO/HMO/WC	$113.10
Rate for Payer: UnitedHealthcare Community & State	$18.17
Rate for Payer: Wellpoint Medicaid Managed Care	$19.98

SCREW LOCKG CANN 5.0X85 222554

Facility

$754.00

Hospital Charge Code	270630780
Hospital Revenue Code	278
Min. Negotiated Rate	$18.17
Max. Negotiated Rate	$377.00
Rate for Payer: Aetna Commercial	$286.52
Rate for Payer: Aetna Medicare Advantage	$226.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.27
Rate for Payer: Cigna Commercial	$377.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.88
Rate for Payer: Qualcare PPO/HMO/WC	$113.10
Rate for Payer: UnitedHealthcare Community & State	$18.17
Rate for Payer: Wellpoint Medicaid Managed Care	$19.98

SCREW LOCKG CANN 5.0X85 222554

Facility

$754.00

Hospital Charge Code	270630780
Hospital Revenue Code	278
Min. Negotiated Rate	$113.10
Max. Negotiated Rate	$182.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.88
Rate for Payer: Qualcare PPO/HMO/WC	$113.10

SCREW LOCKG LO PRO 2.4MMX16MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270668415
Hospital Revenue Code	278
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

SCREW LOCKG LO PRO 2.4MMX16MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270668415
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

SCREW LOCK HEXALOBE 3.5X10MM

Facility

$710.00

Service Code	HCPCS C1713
Hospital Charge Code	270668127
Hospital Revenue Code	278
Min. Negotiated Rate	$17.11
Max. Negotiated Rate	$355.00
Rate for Payer: Aetna Commercial	$269.80
Rate for Payer: Aetna Medicare Advantage	$213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.05
Rate for Payer: Cigna Commercial	$355.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$156.20
Rate for Payer: Qualcare PPO/HMO/WC	$106.50
Rate for Payer: UnitedHealthcare Community & State	$17.11
Rate for Payer: Wellpoint Medicaid Managed Care	$18.82

SCREW LOCK HEXALOBE 3.5X10MM

Facility

$710.00

Service Code	HCPCS C1713
Hospital Charge Code	270668127
Hospital Revenue Code	278
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$171.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$156.20
Rate for Payer: Qualcare PPO/HMO/WC	$106.50

SCREW LOCKING 10 MM X 2.4 MM

Facility

$1,085.00

Service Code	HCPCS C1713
Hospital Charge Code	270683984
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 LOCKING 10 MM X 2.4 MM

Facility

$1,085.00

Service Code	HCPCS C1713
Hospital Charge Code	270683984
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

Know your out-of-pocket cost for care.

All Charges