Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING SLF/TAP 4.0x34mm

Facility

$630.15

Service Code	HCPCS C1713
Hospital Charge Code	270681477
Hospital Revenue Code	278
Min. Negotiated Rate	$15.19
Max. Negotiated Rate	$315.07
Rate for Payer: Aetna Commercial	$239.46
Rate for Payer: Aetna Medicare Advantage	$189.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.69
Rate for Payer: Cigna Commercial	$315.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$138.63
Rate for Payer: Qualcare PPO/HMO/WC	$94.52
Rate for Payer: UnitedHealthcare Community & State	$15.19
Rate for Payer: Wellpoint Medicaid Managed Care	$16.70

SCREW LOCKING SLF/TAP 4.0x34mm

Facility

$630.15

Service Code	HCPCS C1713
Hospital Charge Code	270681477
Hospital Revenue Code	278
Min. Negotiated Rate	$94.52
Max. Negotiated Rate	$152.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$138.63
Rate for Payer: Qualcare PPO/HMO/WC	$94.52

SCREW LOCKING SLF TAP 5x20MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270637797
Hospital Revenue Code	278
Min. Negotiated Rate	$14.97
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$14.97
Rate for Payer: Wellpoint Medicaid Managed Care	$16.46

SCREW LOCKING SLF TAP 5x20MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270637797
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

SCREW LOCKING SLF TAP 5x22MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270641544
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

SCREW LOCKING SLF TAP 5x22MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270641544
Hospital Revenue Code	278
Min. Negotiated Rate	$14.97
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$14.97
Rate for Payer: Wellpoint Medicaid Managed Care	$16.46

SCREW LOCKING SLF TAP 5x24MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270641543
Hospital Revenue Code	278
Min. Negotiated Rate	$14.97
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$14.97
Rate for Payer: Wellpoint Medicaid Managed Care	$16.46

SCREW LOCKING SLF TAP 5x24MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270641543
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

SCREW LOCKING SLF TAP 5x26MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270637795
Hospital Revenue Code	278
Min. Negotiated Rate	$14.97
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$14.97
Rate for Payer: Wellpoint Medicaid Managed Care	$16.46

SCREW LOCKING SLF TAP 5x26MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270637795
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

SCREW LOCKING SLF TAP 5x28MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270637794
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

SCREW LOCKING SLF TAP 5x28MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270637794
Hospital Revenue Code	278
Min. Negotiated Rate	$14.97
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$14.97
Rate for Payer: Wellpoint Medicaid Managed Care	$16.46

SCREW LOCKING SLF TAP 5x30MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270637875
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

SCREW LOCKING SLF TAP 5x30MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270637875
Hospital Revenue Code	278
Min. Negotiated Rate	$14.97
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$14.97
Rate for Payer: Wellpoint Medicaid Managed Care	$16.46

SCREW LOCKING SLF TAP 5x34MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270637874
Hospital Revenue Code	278
Min. Negotiated Rate	$14.97
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$14.97
Rate for Payer: Wellpoint Medicaid Managed Care	$16.46

SCREW LOCKING SLF TAP 5x34MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270637874
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

SCREW LOCKING SLF TAP 5x36MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270641549
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

SCREW LOCKING SLF TAP 5x36MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270641549
Hospital Revenue Code	278
Min. Negotiated Rate	$14.97
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$14.97
Rate for Payer: Wellpoint Medicaid Managed Care	$16.46

SCREW LOCKING SLF TAP 5x38MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270637793
Hospital Revenue Code	278
Min. Negotiated Rate	$14.97
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$14.97
Rate for Payer: Wellpoint Medicaid Managed Care	$16.46

SCREW LOCKING SLF TAP 5x38MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270637793
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

SCREW LOCKING SLF TAP 5x40MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270637876
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

SCREW LOCKING SLF TAP 5x40MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270637876
Hospital Revenue Code	278
Min. Negotiated Rate	$14.97
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$14.97
Rate for Payer: Wellpoint Medicaid Managed Care	$16.46

SCREW LOCKING SLF TAP 5x44MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270641548
Hospital Revenue Code	278
Min. Negotiated Rate	$14.97
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$14.97
Rate for Payer: Wellpoint Medicaid Managed Care	$16.46

SCREW LOCKING SLF TAP 5x44MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270641548
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

SCREW LOCKING SLF TAP 5x46MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270641545
Hospital Revenue Code	278
Min. Negotiated Rate	$14.97
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$14.97
Rate for Payer: Wellpoint Medicaid Managed Care	$16.46

Know your out-of-pocket cost for care.

All Charges