Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING 4.0 x 28mm370528

Facility

$560.00

Hospital Charge Code	270638774
Hospital Revenue Code	278
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$212.80
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$123.20
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: Wellpoint Medicaid Managed Care	$14.84

SCREW LOCKING 4.0x30 371530

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270648065
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SCREW LOCKING 4.0x30 371530

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270648065
Hospital Revenue Code	278
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

SCREW LOCKING 4.0x30mm

Facility

$611.80

Service Code	HCPCS C1713
Hospital Charge Code	270628202
Hospital Revenue Code	278
Min. Negotiated Rate	$91.77
Max. Negotiated Rate	$148.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.60
Rate for Payer: Qualcare PPO/HMO/WC	$91.77

SCREW LOCKING 4.0x30mm

Facility

$611.80

Service Code	HCPCS C1713
Hospital Charge Code	270628202
Hospital Revenue Code	278
Min. Negotiated Rate	$14.74
Max. Negotiated Rate	$305.90
Rate for Payer: Aetna Commercial	$232.48
Rate for Payer: Aetna Medicare Advantage	$183.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.01
Rate for Payer: Cigna Commercial	$305.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.60
Rate for Payer: Qualcare PPO/HMO/WC	$91.77
Rate for Payer: UnitedHealthcare Community & State	$14.74
Rate for Payer: Wellpoint Medicaid Managed Care	$16.21

SCREW LOCKING 4.0 x 30mm370530

Facility

$560.00

Hospital Charge Code	270638772
Hospital Revenue Code	278
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$135.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$123.20
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

SCREW LOCKING 4.0 x 30mm370530

Facility

$560.00

Hospital Charge Code	270638772
Hospital Revenue Code	278
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$212.80
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$123.20
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: Wellpoint Medicaid Managed Care	$14.84

SCREW LOCKING 4.0x34 371534

Facility

$875.00

Hospital Charge Code	270648066
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SCREW LOCKING 4.0x34 371534

Facility

$875.00

Hospital Charge Code	270648066
Hospital Revenue Code	278
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

SCREW LOCKING 4.0x34mm

Facility

$611.80

Service Code	HCPCS C1713
Hospital Charge Code	270633663
Hospital Revenue Code	278
Min. Negotiated Rate	$91.77
Max. Negotiated Rate	$148.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.60
Rate for Payer: Qualcare PPO/HMO/WC	$91.77

SCREW LOCKING 4.0x34mm

Facility

$611.80

Service Code	HCPCS C1713
Hospital Charge Code	270633663
Hospital Revenue Code	278
Min. Negotiated Rate	$14.74
Max. Negotiated Rate	$305.90
Rate for Payer: Aetna Commercial	$232.48
Rate for Payer: Aetna Medicare Advantage	$183.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.01
Rate for Payer: Cigna Commercial	$305.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.60
Rate for Payer: Qualcare PPO/HMO/WC	$91.77
Rate for Payer: UnitedHealthcare Community & State	$14.74
Rate for Payer: Wellpoint Medicaid Managed Care	$16.21

SCREW LOCKING 4.0x38mm

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270659943
Hospital Revenue Code	278
Min. Negotiated Rate	$147.04
Max. Negotiated Rate	$237.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$215.66
Rate for Payer: Qualcare PPO/HMO/WC	$147.04

SCREW LOCKING 4.0x38mm

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270659943
Hospital Revenue Code	278
Min. Negotiated Rate	$23.62
Max. Negotiated Rate	$490.12
Rate for Payer: Aetna Commercial	$372.50
Rate for Payer: Aetna Medicare Advantage	$294.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.96
Rate for Payer: Cigna Commercial	$490.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$215.66
Rate for Payer: Qualcare PPO/HMO/WC	$147.04
Rate for Payer: UnitedHealthcare Community & State	$23.62
Rate for Payer: Wellpoint Medicaid Managed Care	$25.98

SCREW LOCKING 4.0X38MM

Facility

$1,115.00

Service Code	HCPCS C1713
Hospital Charge Code	270664513
Hospital Revenue Code	278
Min. Negotiated Rate	$26.87
Max. Negotiated Rate	$557.50
Rate for Payer: Aetna Commercial	$423.70
Rate for Payer: Aetna Medicare Advantage	$334.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$284.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$284.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$223.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$284.32
Rate for Payer: Cigna Commercial	$557.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$269.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$245.30
Rate for Payer: Qualcare PPO/HMO/WC	$167.25
Rate for Payer: UnitedHealthcare Community & State	$26.87
Rate for Payer: Wellpoint Medicaid Managed Care	$29.55

SCREW LOCKING 4.0X38MM

Facility

$1,115.00

Service Code	HCPCS C1713
Hospital Charge Code	270664513
Hospital Revenue Code	278
Min. Negotiated Rate	$167.25
Max. Negotiated Rate	$269.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$223.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$269.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$245.30
Rate for Payer: Qualcare PPO/HMO/WC	$167.25

SCREW LOCKING 4.0X46 222589

Facility

$540.70

Hospital Charge Code	270634794
Hospital Revenue Code	278
Min. Negotiated Rate	$81.11
Max. Negotiated Rate	$130.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.95
Rate for Payer: Qualcare PPO/HMO/WC	$81.11

SCREW LOCKING 4.0X46 222589

Facility

$540.70

Hospital Charge Code	270634794
Hospital Revenue Code	278
Min. Negotiated Rate	$13.03
Max. Negotiated Rate	$270.35
Rate for Payer: Cigna Commercial	$270.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.95
Rate for Payer: Qualcare PPO/HMO/WC	$81.11
Rate for Payer: UnitedHealthcare Community & State	$13.03
Rate for Payer: Wellpoint Medicaid Managed Care	$14.33
Rate for Payer: Aetna Commercial	$205.47
Rate for Payer: Aetna Medicare Advantage	$162.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.88

SCREW LOCKING 4.0X50MM

Facility

$1,136.55

Service Code	HCPCS C1713
Hospital Charge Code	270692177
Hospital Revenue Code	278
Min. Negotiated Rate	$27.39
Max. Negotiated Rate	$568.27
Rate for Payer: Aetna Commercial	$431.89
Rate for Payer: Aetna Medicare Advantage	$340.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$289.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$289.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$289.82
Rate for Payer: Cigna Commercial	$568.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$250.04
Rate for Payer: Qualcare PPO/HMO/WC	$170.48
Rate for Payer: UnitedHealthcare Community & State	$27.39
Rate for Payer: Wellpoint Medicaid Managed Care	$30.12

SCREW LOCKING 4.0X50MM

Facility

$1,136.55

Service Code	HCPCS C1713
Hospital Charge Code	270692177
Hospital Revenue Code	278
Min. Negotiated Rate	$170.48
Max. Negotiated Rate	$275.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$250.04
Rate for Payer: Qualcare PPO/HMO/WC	$170.48

SCREW LOCKING 4.0X50MM

Facility

$924.00

Hospital Charge Code	270669918
Hospital Revenue Code	278
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$462.00
Rate for Payer: Aetna Commercial	$351.12
Rate for Payer: Aetna Medicare Advantage	$277.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.62
Rate for Payer: Cigna Commercial	$462.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$203.28
Rate for Payer: Qualcare PPO/HMO/WC	$138.60
Rate for Payer: UnitedHealthcare Community & State	$22.27
Rate for Payer: Wellpoint Medicaid Managed Care	$24.49

SCREW LOCKING 4.0X50MM

Facility

$924.00

Hospital Charge Code	270669918
Hospital Revenue Code	278
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$223.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$203.28
Rate for Payer: Qualcare PPO/HMO/WC	$138.60

SCREW LOCKING 4.0x55 371555

Facility

$875.00

Hospital Charge Code	270648070
Hospital Revenue Code	278
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

SCREW LOCKING 4.0x55 371555

Facility

$875.00

Hospital Charge Code	270648070
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SCREW LOCKING 4.0x55 371555

Facility

$875.00

Hospital Charge Code	278648070
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SCREW LOCKING 4.0x55 371555

Facility

$875.00

Hospital Charge Code	278648070
Hospital Revenue Code	278
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

Know your out-of-pocket cost for care.

All Charges