Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING 3.5X4.5X15MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270668579
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SCREW LOCKING 3.5X4.75X20MM

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270668578
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

SCREW LOCKING 3.5X4.75X20MM

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270668578
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 LOCKING 3.5 X 52 MM

Facility

$624.00

Service Code	HCPCS C1713
Hospital Charge Code	270659785
Hospital Revenue Code	278
Min. Negotiated Rate	$15.04
Max. Negotiated Rate	$312.00
Rate for Payer: Aetna Commercial	$237.12
Rate for Payer: Aetna Medicare Advantage	$187.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.12
Rate for Payer: Cigna Commercial	$312.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.28
Rate for Payer: Qualcare PPO/HMO/WC	$93.60
Rate for Payer: UnitedHealthcare Community & State	$15.04
Rate for Payer: Wellpoint Medicaid Managed Care	$16.54

SCREW LOCKING 3.5 X 52 MM

Facility

$624.00

Service Code	HCPCS C1713
Hospital Charge Code	270659785
Hospital Revenue Code	278
Min. Negotiated Rate	$93.60
Max. Negotiated Rate	$151.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.28
Rate for Payer: Qualcare PPO/HMO/WC	$93.60

SCREW LOCKING 3.5x52mm

Facility

$630.00

Hospital Charge Code	270670776
Hospital Revenue Code	278
Min. Negotiated Rate	$94.50
Max. Negotiated Rate	$152.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$138.60
Rate for Payer: Qualcare PPO/HMO/WC	$94.50

SCREW LOCKING 3.5x52mm

Facility

$630.00

Hospital Charge Code	270670776
Hospital Revenue Code	278
Min. Negotiated Rate	$15.18
Max. Negotiated Rate	$315.00
Rate for Payer: Aetna Commercial	$239.40
Rate for Payer: Aetna Medicare Advantage	$189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.65
Rate for Payer: Cigna Commercial	$315.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$138.60
Rate for Payer: Qualcare PPO/HMO/WC	$94.50
Rate for Payer: UnitedHealthcare Community & State	$15.18
Rate for Payer: Wellpoint Medicaid Managed Care	$16.70

SCREW LOCKING 3.5 X 65

Facility

$937.50

Service Code	HCPCS C1713
Hospital Charge Code	270664334
Hospital Revenue Code	278
Min. Negotiated Rate	$140.62
Max. Negotiated Rate	$226.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$206.25
Rate for Payer: Qualcare PPO/HMO/WC	$140.62

SCREW LOCKING 3.5 X 65

Facility

$937.50

Service Code	HCPCS C1713
Hospital Charge Code	270664334
Hospital Revenue Code	278
Min. Negotiated Rate	$22.59
Max. Negotiated Rate	$468.75
Rate for Payer: Aetna Commercial	$356.25
Rate for Payer: Aetna Medicare Advantage	$281.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$239.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$239.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$239.06
Rate for Payer: Cigna Commercial	$468.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$206.25
Rate for Payer: Qualcare PPO/HMO/WC	$140.62
Rate for Payer: UnitedHealthcare Community & State	$22.59
Rate for Payer: Wellpoint Medicaid Managed Care	$24.84

SCREW LOCKING 3.5 X 85

Facility

$937.50

Hospital Charge Code	270664333
Hospital Revenue Code	278
Min. Negotiated Rate	$140.62
Max. Negotiated Rate	$226.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$206.25
Rate for Payer: Qualcare PPO/HMO/WC	$140.62

SCREW LOCKING 3.5 X 85

Facility

$937.50

Hospital Charge Code	270664333
Hospital Revenue Code	278
Min. Negotiated Rate	$22.59
Max. Negotiated Rate	$468.75
Rate for Payer: Aetna Commercial	$356.25
Rate for Payer: Aetna Medicare Advantage	$281.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$239.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$239.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$239.06
Rate for Payer: Cigna Commercial	$468.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$206.25
Rate for Payer: Qualcare PPO/HMO/WC	$140.62
Rate for Payer: UnitedHealthcare Community & State	$22.59
Rate for Payer: Wellpoint Medicaid Managed Care	$24.84

SCREW LOCKING 3.5 X 8MM

Facility

$730.00

Hospital Charge Code	270667389
Hospital Revenue Code	278
Min. Negotiated Rate	$17.59
Max. Negotiated Rate	$365.00
Rate for Payer: Aetna Commercial	$277.40
Rate for Payer: Aetna Medicare Advantage	$219.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.15
Rate for Payer: Cigna Commercial	$365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$160.60
Rate for Payer: Qualcare PPO/HMO/WC	$109.50
Rate for Payer: UnitedHealthcare Community & State	$17.59
Rate for Payer: Wellpoint Medicaid Managed Care	$19.34

SCREW LOCKING 3.5 X 8MM

Facility

$730.00

Hospital Charge Code	270667389
Hospital Revenue Code	278
Min. Negotiated Rate	$109.50
Max. Negotiated Rate	$176.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$160.60
Rate for Payer: Qualcare PPO/HMO/WC	$109.50

SCREW LOCKING 36mm 3705-36

Facility

$615.00

Hospital Charge Code	270640112
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 36mm 3705-36

Facility

$615.00

Hospital Charge Code	270640112
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 38mm 3705-38

Facility

$615.00

Hospital Charge Code	270640113
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 38mm 3705-38

Facility

$615.00

Hospital Charge Code	270640113
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 3MMX12MM

Facility

$1,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270669554
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 3MMX12MM

Facility

$1,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270669554
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 4.0MM 26MM

Facility

$594.00

Hospital Charge Code	270660399
Hospital Revenue Code	278
Min. Negotiated Rate	$89.10
Max. Negotiated Rate	$143.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$130.68
Rate for Payer: Qualcare PPO/HMO/WC	$89.10

SCREW LOCKING 4.0MM 26MM

Facility

$594.00

Hospital Charge Code	270660399
Hospital Revenue Code	278
Min. Negotiated Rate	$14.32
Max. Negotiated Rate	$297.00
Rate for Payer: Aetna Commercial	$225.72
Rate for Payer: Aetna Medicare Advantage	$178.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.47
Rate for Payer: Cigna Commercial	$297.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$130.68
Rate for Payer: Qualcare PPO/HMO/WC	$89.10
Rate for Payer: UnitedHealthcare Community & State	$14.32
Rate for Payer: Wellpoint Medicaid Managed Care	$15.74

SCREW LOCKING 40mm 3705-40

Facility

$615.00

Hospital Charge Code	270640116
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 40mm 3705-40

Facility

$615.00

Hospital Charge Code	270640116
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 4.0MM X 36MM

Facility

$594.00

Hospital Charge Code	270666920
Hospital Revenue Code	278
Min. Negotiated Rate	$14.32
Max. Negotiated Rate	$297.00
Rate for Payer: Aetna Commercial	$225.72
Rate for Payer: Aetna Medicare Advantage	$178.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.47
Rate for Payer: Cigna Commercial	$297.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$130.68
Rate for Payer: Qualcare PPO/HMO/WC	$89.10
Rate for Payer: UnitedHealthcare Community & State	$14.32
Rate for Payer: Wellpoint Medicaid Managed Care	$15.74

SCREW LOCKING 4.0MM X 36MM

Facility

$594.00

Hospital Charge Code	270666920
Hospital Revenue Code	278
Min. Negotiated Rate	$89.10
Max. Negotiated Rate	$143.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$130.68
Rate for Payer: Qualcare PPO/HMO/WC	$89.10

Know your out-of-pocket cost for care.

All Charges