Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING 2.7X 30 MM

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	270701532
Hospital Revenue Code	278
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$159.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

SCREW LOCKING 2.7X 30 MM

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	270701532
Hospital Revenue Code	278
Min. Negotiated Rate	$15.91
Max. Negotiated Rate	$330.00
Rate for Payer: Aetna Commercial	$250.80
Rate for Payer: Aetna Medicare Advantage	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.30
Rate for Payer: Cigna Commercial	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.00
Rate for Payer: UnitedHealthcare Community & State	$15.91
Rate for Payer: Wellpoint Medicaid Managed Care	$17.49

SCREW LOCKING 2.7x8mm

Facility

$503.65

Service Code	HCPCS C1713
Hospital Charge Code	270645184
Hospital Revenue Code	278
Min. Negotiated Rate	$75.55
Max. Negotiated Rate	$121.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.80
Rate for Payer: Qualcare PPO/HMO/WC	$75.55

SCREW LOCKING 2.7x8mm

Facility

$503.65

Service Code	HCPCS C1713
Hospital Charge Code	270645184
Hospital Revenue Code	278
Min. Negotiated Rate	$12.14
Max. Negotiated Rate	$251.82
Rate for Payer: Aetna Commercial	$191.39
Rate for Payer: Aetna Medicare Advantage	$151.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.43
Rate for Payer: Cigna Commercial	$251.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.80
Rate for Payer: Qualcare PPO/HMO/WC	$75.55
Rate for Payer: UnitedHealthcare Community & State	$12.14
Rate for Payer: Wellpoint Medicaid Managed Care	$13.35

SCREW LOCKING 2.7 X 9 MM

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	270701525
Hospital Revenue Code	278
Min. Negotiated Rate	$21.87
Max. Negotiated Rate	$453.75
Rate for Payer: Aetna Commercial	$344.85
Rate for Payer: Aetna Medicare Advantage	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.41
Rate for Payer: Cigna Commercial	$453.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$136.12
Rate for Payer: UnitedHealthcare Community & State	$21.87
Rate for Payer: Wellpoint Medicaid Managed Care	$24.05

SCREW LOCKING 2.7 X 9 MM

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	270701525
Hospital Revenue Code	278
Min. Negotiated Rate	$136.12
Max. Negotiated Rate	$219.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$136.12

SCREW LOCKING 28MM

Facility

$1,335.00

Service Code	HCPCS C1713
Hospital Charge Code	270683200
Hospital Revenue Code	278
Min. Negotiated Rate	$200.25
Max. Negotiated Rate	$323.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$267.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$323.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$293.70
Rate for Payer: Qualcare PPO/HMO/WC	$200.25

SCREW LOCKING 28MM

Facility

$1,335.00

Service Code	HCPCS C1713
Hospital Charge Code	270683200
Hospital Revenue Code	278
Min. Negotiated Rate	$32.17
Max. Negotiated Rate	$667.50
Rate for Payer: Aetna Commercial	$507.30
Rate for Payer: Aetna Medicare Advantage	$400.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$340.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$340.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$340.43
Rate for Payer: Cigna Commercial	$667.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$323.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$293.70
Rate for Payer: Qualcare PPO/HMO/WC	$200.25
Rate for Payer: UnitedHealthcare Community & State	$32.17
Rate for Payer: Wellpoint Medicaid Managed Care	$35.38

SCREW LOCKING 28mm 3705-28

Facility

$615.00

Hospital Charge Code	270640118
Hospital Revenue Code	278
Min. Negotiated Rate	$14.82
Max. Negotiated Rate	$307.50
Rate for Payer: Aetna Commercial	$233.70
Rate for Payer: Aetna Medicare Advantage	$184.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.82
Rate for Payer: Cigna Commercial	$307.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.30
Rate for Payer: Qualcare PPO/HMO/WC	$92.25
Rate for Payer: UnitedHealthcare Community & State	$14.82
Rate for Payer: Wellpoint Medicaid Managed Care	$16.30

SCREW LOCKING 28mm 3705-28

Facility

$615.00

Hospital Charge Code	270640118
Hospital Revenue Code	278
Min. Negotiated Rate	$92.25
Max. Negotiated Rate	$148.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.30
Rate for Payer: Qualcare PPO/HMO/WC	$92.25

SCREW LOCKING 2X18MM ORTHO

Facility

$1,085.00

Service Code	HCPCS C1713
Hospital Charge Code	270680983
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 2X18MM ORTHO

Facility

$1,085.00

Service Code	HCPCS C1713
Hospital Charge Code	270680983
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 LOCKING 3.0X10MM

Facility

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	270661004
Hospital Revenue Code	278
Min. Negotiated Rate	$207.75
Max. Negotiated Rate	$335.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$304.70
Rate for Payer: Qualcare PPO/HMO/WC	$207.75

SCREW LOCKING 3.0X10MM

Facility

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	270661004
Hospital Revenue Code	278
Min. Negotiated Rate	$33.38
Max. Negotiated Rate	$692.50
Rate for Payer: Aetna Commercial	$526.30
Rate for Payer: Aetna Medicare Advantage	$415.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$353.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$353.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$353.18
Rate for Payer: Cigna Commercial	$692.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$304.70
Rate for Payer: Qualcare PPO/HMO/WC	$207.75
Rate for Payer: UnitedHealthcare Community & State	$33.38
Rate for Payer: Wellpoint Medicaid Managed Care	$36.70

SCREW LOCKING 3.0X14MM

Facility

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	270661008
Hospital Revenue Code	278
Min. Negotiated Rate	$33.38
Max. Negotiated Rate	$692.50
Rate for Payer: Aetna Commercial	$526.30
Rate for Payer: Aetna Medicare Advantage	$415.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$353.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$353.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$353.18
Rate for Payer: Cigna Commercial	$692.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$304.70
Rate for Payer: Qualcare PPO/HMO/WC	$207.75
Rate for Payer: UnitedHealthcare Community & State	$33.38
Rate for Payer: Wellpoint Medicaid Managed Care	$36.70

SCREW LOCKING 3.0X14MM

Facility

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	270661008
Hospital Revenue Code	278
Min. Negotiated Rate	$207.75
Max. Negotiated Rate	$335.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$304.70
Rate for Payer: Qualcare PPO/HMO/WC	$207.75

SCREW LOCKING 3.0X16MM

Facility

$1,340.00

Service Code	HCPCS C1713
Hospital Charge Code	270661031
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 LOCKING 3.0X16MM

Facility

$1,340.00

Service Code	HCPCS C1713
Hospital Charge Code	270661031
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 LOCKING 3.0X16MM MINIBUN

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693517
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

SCREW LOCKING 3.0X16MM MINIBUN

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693517
Hospital Revenue Code	278
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

SCREW LOCKING 3.0X18MM

Facility

$1,340.00

Service Code	HCPCS C1713
Hospital Charge Code	270661032
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 LOCKING 3.0X18MM

Facility

$1,340.00

Service Code	HCPCS C1713
Hospital Charge Code	270661032
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 LOCKING 3.0X20MM

Facility

$1,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270661010
Hospital Revenue Code	278
Min. Negotiated Rate	$34.34
Max. Negotiated Rate	$712.50
Rate for Payer: Aetna Commercial	$541.50
Rate for Payer: Aetna Medicare Advantage	$427.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.38
Rate for Payer: Cigna Commercial	$712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$313.50
Rate for Payer: Qualcare PPO/HMO/WC	$213.75
Rate for Payer: UnitedHealthcare Community & State	$34.34
Rate for Payer: Wellpoint Medicaid Managed Care	$37.76

SCREW LOCKING 3.0X20MM

Facility

$1,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270661010
Hospital Revenue Code	278
Min. Negotiated Rate	$213.75
Max. Negotiated Rate	$344.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$285.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$313.50
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

SCREW LOCKING 3.0X20MM MINIBUN

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693518
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

Know your out-of-pocket cost for care.

All Charges