Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING F/THRD 2.7x22mm

Facility

$670.00

Service Code	HCPCS C1713
Hospital Charge Code	270672346
Hospital Revenue Code	278
Min. Negotiated Rate	$16.15
Max. Negotiated Rate	$335.00
Rate for Payer: Aetna Commercial	$254.60
Rate for Payer: Aetna Medicare Advantage	$201.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.85
Rate for Payer: Cigna Commercial	$335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.40
Rate for Payer: Qualcare PPO/HMO/WC	$100.50
Rate for Payer: UnitedHealthcare Community & State	$16.15
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

SCREW LOCKING F/THRD 2.7x22mm

Facility

$670.00

Service Code	HCPCS C1713
Hospital Charge Code	270672346
Hospital Revenue Code	278
Min. Negotiated Rate	$100.50
Max. Negotiated Rate	$162.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.40
Rate for Payer: Qualcare PPO/HMO/WC	$100.50

SCREW LOCKING F/THRD 2.7x24mm

Facility

$670.00

Service Code	HCPCS C1713
Hospital Charge Code	270672347
Hospital Revenue Code	278
Min. Negotiated Rate	$100.50
Max. Negotiated Rate	$162.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.40
Rate for Payer: Qualcare PPO/HMO/WC	$100.50

SCREW LOCKING F/THRD 2.7x24mm

Facility

$670.00

Service Code	HCPCS C1713
Hospital Charge Code	270672347
Hospital Revenue Code	278
Min. Negotiated Rate	$16.15
Max. Negotiated Rate	$335.00
Rate for Payer: Aetna Commercial	$254.60
Rate for Payer: Aetna Medicare Advantage	$201.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.85
Rate for Payer: Cigna Commercial	$335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.40
Rate for Payer: Qualcare PPO/HMO/WC	$100.50
Rate for Payer: UnitedHealthcare Community & State	$16.15
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

SCREW LOCKING FULL THD 5x45MM

Facility

$979.45

Service Code	HCPCS C1713
Hospital Charge Code	270638644
Hospital Revenue Code	278
Min. Negotiated Rate	$146.92
Max. Negotiated Rate	$237.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$215.48
Rate for Payer: Qualcare PPO/HMO/WC	$146.92

SCREW LOCKING FULL THD 5x45MM

Facility

$979.45

Service Code	HCPCS C1713
Hospital Charge Code	270638644
Hospital Revenue Code	278
Min. Negotiated Rate	$23.60
Max. Negotiated Rate	$489.73
Rate for Payer: Aetna Commercial	$372.19
Rate for Payer: Aetna Medicare Advantage	$293.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.76
Rate for Payer: Cigna Commercial	$489.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$215.48
Rate for Payer: Qualcare PPO/HMO/WC	$146.92
Rate for Payer: UnitedHealthcare Community & State	$23.60
Rate for Payer: Wellpoint Medicaid Managed Care	$25.96

SCREW LOCKING FULLTHD 5x52.5MM

Facility

$1,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270651333
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 FULLTHD 5x52.5MM

Facility

$1,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270651333
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 FULL TREAD 5x50m

Facility

$1,470.00

Hospital Charge Code	270671130
Hospital Revenue Code	278
Min. Negotiated Rate	$220.50
Max. Negotiated Rate	$355.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$294.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$355.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$323.40
Rate for Payer: Qualcare PPO/HMO/WC	$220.50

SCREW LOCKING FULL TREAD 5x50m

Facility

$1,470.00

Hospital Charge Code	270671130
Hospital Revenue Code	278
Min. Negotiated Rate	$35.43
Max. Negotiated Rate	$735.00
Rate for Payer: Aetna Commercial	$558.60
Rate for Payer: Aetna Medicare Advantage	$441.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$374.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$374.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$374.85
Rate for Payer: Cigna Commercial	$735.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$355.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$323.40
Rate for Payer: Qualcare PPO/HMO/WC	$220.50
Rate for Payer: UnitedHealthcare Community & State	$35.43
Rate for Payer: Wellpoint Medicaid Managed Care	$38.95

SCREW LOCKING FULLY THD 5x30mm

Facility

$1,470.00

Service Code	HCPCS C1713
Hospital Charge Code	270673981
Hospital Revenue Code	278
Min. Negotiated Rate	$220.50
Max. Negotiated Rate	$355.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$294.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$355.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$323.40
Rate for Payer: Qualcare PPO/HMO/WC	$220.50

SCREW LOCKING FULLY THD 5x30mm

Facility

$1,470.00

Service Code	HCPCS C1713
Hospital Charge Code	270673981
Hospital Revenue Code	278
Min. Negotiated Rate	$35.43
Max. Negotiated Rate	$735.00
Rate for Payer: Aetna Commercial	$558.60
Rate for Payer: Aetna Medicare Advantage	$441.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$374.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$374.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$374.85
Rate for Payer: Cigna Commercial	$735.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$355.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$323.40
Rate for Payer: Qualcare PPO/HMO/WC	$220.50
Rate for Payer: UnitedHealthcare Community & State	$35.43
Rate for Payer: Wellpoint Medicaid Managed Care	$38.95

SCREW LOCKING FULLY THD 5X65MM

Facility

$1,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270669248
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 FULLY THD 5X65MM

Facility

$1,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270669248
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 FULLY THD 5x80MM

Facility

$1,970.00

Service Code	HCPCS C1713
Hospital Charge Code	270672000
Hospital Revenue Code	278
Min. Negotiated Rate	$47.48
Max. Negotiated Rate	$985.00
Rate for Payer: Aetna Commercial	$748.60
Rate for Payer: Aetna Medicare Advantage	$591.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$502.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$502.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$394.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$502.35
Rate for Payer: Cigna Commercial	$985.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$476.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$433.40
Rate for Payer: Qualcare PPO/HMO/WC	$295.50
Rate for Payer: UnitedHealthcare Community & State	$47.48
Rate for Payer: Wellpoint Medicaid Managed Care	$52.20

SCREW LOCKING FULLY THD 5x80MM

Facility

$1,970.00

Service Code	HCPCS C1713
Hospital Charge Code	270672000
Hospital Revenue Code	278
Min. Negotiated Rate	$295.50
Max. Negotiated Rate	$476.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$394.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$476.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$433.40
Rate for Payer: Qualcare PPO/HMO/WC	$295.50

SCREW LOCKING FULLY THD 5x90MM

Facility

$1,470.00

Service Code	HCPCS C1713
Hospital Charge Code	270674282
Hospital Revenue Code	278
Min. Negotiated Rate	$220.50
Max. Negotiated Rate	$355.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$294.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$355.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$323.40
Rate for Payer: Qualcare PPO/HMO/WC	$220.50

SCREW LOCKING FULLY THD 5x90MM

Facility

$1,470.00

Service Code	HCPCS C1713
Hospital Charge Code	270674282
Hospital Revenue Code	278
Min. Negotiated Rate	$35.43
Max. Negotiated Rate	$735.00
Rate for Payer: Aetna Commercial	$558.60
Rate for Payer: Aetna Medicare Advantage	$441.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$374.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$374.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$374.85
Rate for Payer: Cigna Commercial	$735.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$355.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$323.40
Rate for Payer: Qualcare PPO/HMO/WC	$220.50
Rate for Payer: UnitedHealthcare Community & State	$35.43
Rate for Payer: Wellpoint Medicaid Managed Care	$38.95

SCREW LOCKING FULLY THREADED

Facility

$979.45

Service Code	HCPCS C1713
Hospital Charge Code	270661245
Hospital Revenue Code	278
Min. Negotiated Rate	$23.60
Max. Negotiated Rate	$489.73
Rate for Payer: Aetna Commercial	$372.19
Rate for Payer: Aetna Medicare Advantage	$293.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.76
Rate for Payer: Cigna Commercial	$489.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$215.48
Rate for Payer: Qualcare PPO/HMO/WC	$146.92
Rate for Payer: UnitedHealthcare Community & State	$23.60
Rate for Payer: Wellpoint Medicaid Managed Care	$25.96

SCREW LOCKING FULLY THREADED

Facility

$979.45

Service Code	HCPCS C1713
Hospital Charge Code	270661245
Hospital Revenue Code	278
Min. Negotiated Rate	$146.92
Max. Negotiated Rate	$237.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$215.48
Rate for Payer: Qualcare PPO/HMO/WC	$146.92

SCREW LOCKING FULLY THREADED 5

Facility

$1,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270656558
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 FULLY THREADED 5

Facility

$1,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270656558
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 FUL THD 5X37.5MM

Facility

$979.45

Service Code	HCPCS C1713
Hospital Charge Code	270648352
Hospital Revenue Code	278
Min. Negotiated Rate	$23.60
Max. Negotiated Rate	$489.73
Rate for Payer: Aetna Commercial	$372.19
Rate for Payer: Aetna Medicare Advantage	$293.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.76
Rate for Payer: Cigna Commercial	$489.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$215.48
Rate for Payer: Qualcare PPO/HMO/WC	$146.92
Rate for Payer: UnitedHealthcare Community & State	$23.60
Rate for Payer: Wellpoint Medicaid Managed Care	$25.96

SCREW LOCKING FUL THD 5X37.5MM

Facility

$979.45

Service Code	HCPCS C1713
Hospital Charge Code	270648352
Hospital Revenue Code	278
Min. Negotiated Rate	$146.92
Max. Negotiated Rate	$237.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$215.48
Rate for Payer: Qualcare PPO/HMO/WC	$146.92

SCREW LOCKING GLENOSPHERE

Facility

$675.00

Service Code	HCPCS C1713
Hospital Charge Code	270668555
Hospital Revenue Code	278
Min. Negotiated Rate	$16.27
Max. Negotiated Rate	$337.50
Rate for Payer: Aetna Commercial	$256.50
Rate for Payer: Aetna Medicare Advantage	$202.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.12
Rate for Payer: Cigna Commercial	$337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.50
Rate for Payer: Qualcare PPO/HMO/WC	$101.25
Rate for Payer: UnitedHealthcare Community & State	$16.27
Rate for Payer: Wellpoint Medicaid Managed Care	$17.89

Know your out-of-pocket cost for care.

All Charges