Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING 5MM 44MM XL 25

Facility

$888.30

Service Code	HCPCS C1713
Hospital Charge Code	270692419
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 LOCKING 5MM 56MM XL 25

Facility

$888.30

Service Code	HCPCS C1713
Hospital Charge Code	270692417
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 LOCKING 5MM 56MM XL 25

Facility

$888.30

Service Code	HCPCS C1713
Hospital Charge Code	270692417
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 LOCKING 5MMX26MM

Facility

$885.00

Hospital Charge Code	270668423
Hospital Revenue Code	278
Min. Negotiated Rate	$21.33
Max. Negotiated Rate	$442.50
Rate for Payer: Aetna Commercial	$336.30
Rate for Payer: Aetna Medicare Advantage	$265.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$225.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$225.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$225.68
Rate for Payer: Cigna Commercial	$442.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$194.70
Rate for Payer: Qualcare PPO/HMO/WC	$132.75
Rate for Payer: UnitedHealthcare Community & State	$21.33
Rate for Payer: Wellpoint Medicaid Managed Care	$23.45

SCREW LOCKING 5MMX26MM

Facility

$885.00

Hospital Charge Code	270668423
Hospital Revenue Code	278
Min. Negotiated Rate	$132.75
Max. Negotiated Rate	$214.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$194.70
Rate for Payer: Qualcare PPO/HMO/WC	$132.75

SCREW LOCKING 5MMX40MM

Facility

$885.00

Hospital Charge Code	270668422
Hospital Revenue Code	278
Min. Negotiated Rate	$21.33
Max. Negotiated Rate	$442.50
Rate for Payer: Aetna Commercial	$336.30
Rate for Payer: Aetna Medicare Advantage	$265.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$225.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$225.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$225.68
Rate for Payer: Cigna Commercial	$442.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$194.70
Rate for Payer: Qualcare PPO/HMO/WC	$132.75
Rate for Payer: UnitedHealthcare Community & State	$21.33
Rate for Payer: Wellpoint Medicaid Managed Care	$23.45

SCREW LOCKING 5MMX40MM

Facility

$885.00

Hospital Charge Code	270668422
Hospital Revenue Code	278
Min. Negotiated Rate	$132.75
Max. Negotiated Rate	$214.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$194.70
Rate for Payer: Qualcare PPO/HMO/WC	$132.75

SCREW LOCKING 5MMx42MM

Facility

$973.35

Service Code	HCPCS C1713
Hospital Charge Code	270652422
Hospital Revenue Code	278
Min. Negotiated Rate	$146.00
Max. Negotiated Rate	$235.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.14
Rate for Payer: Qualcare PPO/HMO/WC	$146.00

SCREW LOCKING 5MMx42MM

Facility

$973.35

Service Code	HCPCS C1713
Hospital Charge Code	270652422
Hospital Revenue Code	278
Min. Negotiated Rate	$23.46
Max. Negotiated Rate	$486.68
Rate for Payer: Aetna Commercial	$369.87
Rate for Payer: Aetna Medicare Advantage	$292.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.20
Rate for Payer: Cigna Commercial	$486.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.14
Rate for Payer: Qualcare PPO/HMO/WC	$146.00
Rate for Payer: UnitedHealthcare Community & State	$23.46
Rate for Payer: Wellpoint Medicaid Managed Care	$25.79

SCREW LOCKING 5 x 32MM

Facility

$1,530.00

Service Code	HCPCS C1713
Hospital Charge Code	270701090
Hospital Revenue Code	278
Min. Negotiated Rate	$36.87
Max. Negotiated Rate	$765.00
Rate for Payer: Aetna Commercial	$581.40
Rate for Payer: Aetna Medicare Advantage	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$390.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$390.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$390.15
Rate for Payer: Cigna Commercial	$765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$336.60
Rate for Payer: Qualcare PPO/HMO/WC	$229.50
Rate for Payer: UnitedHealthcare Community & State	$36.87
Rate for Payer: Wellpoint Medicaid Managed Care	$40.55

SCREW LOCKING 5 x 32MM

Facility

$1,530.00

Service Code	HCPCS C1713
Hospital Charge Code	270701090
Hospital Revenue Code	278
Min. Negotiated Rate	$229.50
Max. Negotiated Rate	$370.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$336.60
Rate for Payer: Qualcare PPO/HMO/WC	$229.50

SCREW LOCKING 5 X 32 X 5 MM

Facility

$1,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270662869
Hospital Revenue Code	278
Min. Negotiated Rate	$33.74
Max. Negotiated Rate	$700.00
Rate for Payer: Aetna Commercial	$532.00
Rate for Payer: Aetna Medicare Advantage	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.00
Rate for Payer: Cigna Commercial	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$338.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$308.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.00
Rate for Payer: UnitedHealthcare Community & State	$33.74
Rate for Payer: Wellpoint Medicaid Managed Care	$37.10

SCREW LOCKING 5 X 32 X 5 MM

Facility

$1,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270662869
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$338.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$338.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$308.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.00

SCREW LOCKING 5X34MM XL 25

Facility

$888.30

Service Code	HCPCS C1713
Hospital Charge Code	270692728
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 LOCKING 5X34MM XL 25

Facility

$888.30

Service Code	HCPCS C1713
Hospital Charge Code	270692728
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 LOCKING 5X35mm 18965035S

Facility

$979.25

Service Code	HCPCS C1713
Hospital Charge Code	270645795
Hospital Revenue Code	278
Min. Negotiated Rate	$146.89
Max. Negotiated Rate	$236.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$215.44
Rate for Payer: Qualcare PPO/HMO/WC	$146.89

SCREW LOCKING 5X35mm 18965035S

Facility

$979.25

Service Code	HCPCS C1713
Hospital Charge Code	270645795
Hospital Revenue Code	278
Min. Negotiated Rate	$23.60
Max. Negotiated Rate	$489.62
Rate for Payer: Aetna Commercial	$372.12
Rate for Payer: Aetna Medicare Advantage	$293.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.71
Rate for Payer: Cigna Commercial	$489.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$215.44
Rate for Payer: Qualcare PPO/HMO/WC	$146.89
Rate for Payer: UnitedHealthcare Community & State	$23.60
Rate for Payer: Wellpoint Medicaid Managed Care	$25.95

SCREW LOCKING 5x36MM

Facility

$924.00

Hospital Charge Code	270665480
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 5x36MM

Facility

$924.00

Hospital Charge Code	270665480
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 5X36MM XL25

Facility

$888.30

Service Code	HCPCS C1713
Hospital Charge Code	270692729
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 LOCKING 5X36MM XL25

Facility

$888.30

Service Code	HCPCS C1713
Hospital Charge Code	270692729
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 LOCKING 5X50MM PART THD

Facility

$1,545.00

Hospital Charge Code	270670467
Hospital Revenue Code	278
Min. Negotiated Rate	$231.75
Max. Negotiated Rate	$373.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$309.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$373.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$339.90
Rate for Payer: Qualcare PPO/HMO/WC	$231.75

SCREW LOCKING 5X50MM PART THD

Facility

$1,545.00

Hospital Charge Code	270670467
Hospital Revenue Code	278
Min. Negotiated Rate	$37.23
Max. Negotiated Rate	$772.50
Rate for Payer: Aetna Commercial	$587.10
Rate for Payer: Aetna Medicare Advantage	$463.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$393.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$393.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$309.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$393.98
Rate for Payer: Cigna Commercial	$772.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$373.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$339.90
Rate for Payer: Qualcare PPO/HMO/WC	$231.75
Rate for Payer: UnitedHealthcare Community & State	$37.23
Rate for Payer: Wellpoint Medicaid Managed Care	$40.94

SCREW LOCKING 5x55 1896-5055S

Facility

$910.00

Service Code	HCPCS C1713
Hospital Charge Code	270638643
Hospital Revenue Code	278
Min. Negotiated Rate	$21.93
Max. Negotiated Rate	$455.00
Rate for Payer: Aetna Commercial	$345.80
Rate for Payer: Aetna Medicare Advantage	$273.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.05
Rate for Payer: Cigna Commercial	$455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.20
Rate for Payer: Qualcare PPO/HMO/WC	$136.50
Rate for Payer: UnitedHealthcare Community & State	$21.93
Rate for Payer: Wellpoint Medicaid Managed Care	$24.11

SCREW LOCKING 5x55 1896-5055S

Facility

$910.00

Service Code	HCPCS C1713
Hospital Charge Code	270638643
Hospital Revenue Code	278
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$220.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.20
Rate for Payer: Qualcare PPO/HMO/WC	$136.50

Know your out-of-pocket cost for care.

All Charges