Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING STR DRV 5.0x30MM

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270674862
Hospital Revenue Code	278
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$376.50
Rate for Payer: Aetna Commercial	$286.14
Rate for Payer: Aetna Medicare Advantage	$225.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.01
Rate for Payer: Cigna Commercial	$376.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.66
Rate for Payer: Qualcare PPO/HMO/WC	$112.95
Rate for Payer: UnitedHealthcare Community & State	$18.15
Rate for Payer: Wellpoint Medicaid Managed Care	$19.95

SCREW LOCKING STR DRV 5.0x30MM

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270674862
Hospital Revenue Code	278
Min. Negotiated Rate	$112.95
Max. Negotiated Rate	$182.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.66
Rate for Payer: Qualcare PPO/HMO/WC	$112.95

SCREW LOCKING STR DRV 5x50MM

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270676133
Hospital Revenue Code	278
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$376.50
Rate for Payer: Aetna Commercial	$286.14
Rate for Payer: Aetna Medicare Advantage	$225.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.01
Rate for Payer: Cigna Commercial	$376.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.66
Rate for Payer: Qualcare PPO/HMO/WC	$112.95
Rate for Payer: UnitedHealthcare Community & State	$18.15
Rate for Payer: Wellpoint Medicaid Managed Care	$19.95

SCREW LOCKING STR DRV 5x50MM

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270676133
Hospital Revenue Code	278
Min. Negotiated Rate	$112.95
Max. Negotiated Rate	$182.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.66
Rate for Payer: Qualcare PPO/HMO/WC	$112.95

SCREW LOCKING STR DRV 5x80MM

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270675717
Hospital Revenue Code	278
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$376.50
Rate for Payer: Aetna Commercial	$286.14
Rate for Payer: Aetna Medicare Advantage	$225.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.01
Rate for Payer: Cigna Commercial	$376.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.66
Rate for Payer: Qualcare PPO/HMO/WC	$112.95
Rate for Payer: UnitedHealthcare Community & State	$18.15
Rate for Payer: Wellpoint Medicaid Managed Care	$19.95

SCREW LOCKING STR DRV 5x80MM

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270675717
Hospital Revenue Code	278
Min. Negotiated Rate	$112.95
Max. Negotiated Rate	$182.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.66
Rate for Payer: Qualcare PPO/HMO/WC	$112.95

SCREW LOCKING STR DRV 5x85MM

Facility

$753.00

Hospital Charge Code	270675846
Hospital Revenue Code	278
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$376.50
Rate for Payer: Aetna Commercial	$286.14
Rate for Payer: Aetna Medicare Advantage	$225.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.01
Rate for Payer: Cigna Commercial	$376.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.66
Rate for Payer: Qualcare PPO/HMO/WC	$112.95
Rate for Payer: UnitedHealthcare Community & State	$18.15
Rate for Payer: Wellpoint Medicaid Managed Care	$19.95

SCREW LOCKING STR DRV 5x85MM

Facility

$753.00

Hospital Charge Code	270675846
Hospital Revenue Code	278
Min. Negotiated Rate	$112.95
Max. Negotiated Rate	$182.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.66
Rate for Payer: Qualcare PPO/HMO/WC	$112.95

SCREW LOCKING T10 3.5MM/L20MM

Facility

$703.25

Service Code	HCPCS C1713
Hospital Charge Code	270657320
Hospital Revenue Code	278
Min. Negotiated Rate	$16.95
Max. Negotiated Rate	$351.62
Rate for Payer: Aetna Commercial	$267.24
Rate for Payer: Aetna Medicare Advantage	$210.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.33
Rate for Payer: Cigna Commercial	$351.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.72
Rate for Payer: Qualcare PPO/HMO/WC	$105.49
Rate for Payer: UnitedHealthcare Community & State	$16.95
Rate for Payer: Wellpoint Medicaid Managed Care	$18.64

SCREW LOCKING T10 3.5MM/L20MM

Facility

$703.25

Service Code	HCPCS C1713
Hospital Charge Code	270657320
Hospital Revenue Code	278
Min. Negotiated Rate	$105.49
Max. Negotiated Rate	$170.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.72
Rate for Payer: Qualcare PPO/HMO/WC	$105.49

SCREW LOCKING T10 3.5x50MM

Facility

$799.50

Hospital Charge Code	270674953
Hospital Revenue Code	278
Min. Negotiated Rate	$119.92
Max. Negotiated Rate	$193.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$175.89
Rate for Payer: Qualcare PPO/HMO/WC	$119.92

SCREW LOCKING T10 3.5x50MM

Facility

$799.50

Hospital Charge Code	270674953
Hospital Revenue Code	278
Min. Negotiated Rate	$19.27
Max. Negotiated Rate	$399.75
Rate for Payer: Aetna Commercial	$303.81
Rate for Payer: Aetna Medicare Advantage	$239.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$203.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$203.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$203.87
Rate for Payer: Cigna Commercial	$399.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$175.89
Rate for Payer: Qualcare PPO/HMO/WC	$119.92
Rate for Payer: UnitedHealthcare Community & State	$19.27
Rate for Payer: Wellpoint Medicaid Managed Care	$21.19

SCREW LOCKING T10 FT 3.5X10MM

Facility

$1,880.00

Service Code	HCPCS C1713
Hospital Charge Code	270694738
Hospital Revenue Code	278
Min. Negotiated Rate	$45.31
Max. Negotiated Rate	$940.00
Rate for Payer: Aetna Commercial	$714.40
Rate for Payer: Aetna Medicare Advantage	$564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$479.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$479.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$479.40
Rate for Payer: Cigna Commercial	$940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$454.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$413.60
Rate for Payer: Qualcare PPO/HMO/WC	$282.00
Rate for Payer: UnitedHealthcare Community & State	$45.31
Rate for Payer: Wellpoint Medicaid Managed Care	$49.82

SCREW LOCKING T10 FT 3.5X10MM

Facility

$1,880.00

Service Code	HCPCS C1713
Hospital Charge Code	270694738
Hospital Revenue Code	278
Min. Negotiated Rate	$282.00
Max. Negotiated Rate	$454.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$454.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$413.60
Rate for Payer: Qualcare PPO/HMO/WC	$282.00

SCREW LOCKING T10 FT 3.5X12MM

Facility

$1,880.00

Service Code	HCPCS C1713
Hospital Charge Code	270694739
Hospital Revenue Code	278
Min. Negotiated Rate	$282.00
Max. Negotiated Rate	$454.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$454.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$413.60
Rate for Payer: Qualcare PPO/HMO/WC	$282.00

SCREW LOCKING T10 FT 3.5X12MM

Facility

$1,880.00

Service Code	HCPCS C1713
Hospital Charge Code	270694739
Hospital Revenue Code	278
Min. Negotiated Rate	$45.31
Max. Negotiated Rate	$940.00
Rate for Payer: Aetna Commercial	$714.40
Rate for Payer: Aetna Medicare Advantage	$564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$479.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$479.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$479.40
Rate for Payer: Cigna Commercial	$940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$454.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$413.60
Rate for Payer: Qualcare PPO/HMO/WC	$282.00
Rate for Payer: UnitedHealthcare Community & State	$45.31
Rate for Payer: Wellpoint Medicaid Managed Care	$49.82

SCREW LOCKING T10 FT 3.5X14MM

Facility

$1,880.00

Service Code	HCPCS C1713
Hospital Charge Code	270694740
Hospital Revenue Code	278
Min. Negotiated Rate	$282.00
Max. Negotiated Rate	$454.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$454.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$413.60
Rate for Payer: Qualcare PPO/HMO/WC	$282.00

SCREW LOCKING T10 FT 3.5X14MM

Facility

$1,880.00

Service Code	HCPCS C1713
Hospital Charge Code	270694740
Hospital Revenue Code	278
Min. Negotiated Rate	$45.31
Max. Negotiated Rate	$940.00
Rate for Payer: Aetna Commercial	$714.40
Rate for Payer: Aetna Medicare Advantage	$564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$479.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$479.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$479.40
Rate for Payer: Cigna Commercial	$940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$454.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$413.60
Rate for Payer: Qualcare PPO/HMO/WC	$282.00
Rate for Payer: UnitedHealthcare Community & State	$45.31
Rate for Payer: Wellpoint Medicaid Managed Care	$49.82

SCREW LOCKING T10 FT 3.5X16MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270694741
Hospital Revenue Code	278
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$389.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$225.50
Rate for Payer: Qualcare PPO/HMO/WC	$153.75
Rate for Payer: UnitedHealthcare Community & State	$24.70
Rate for Payer: Wellpoint Medicaid Managed Care	$27.16

SCREW LOCKING T10 FT 3.5X16MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270694741
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$225.50
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

SCREW LOCKING T25 5x60MM STR

Facility

$924.00

Service Code	HCPCS C1713
Hospital Charge Code	270675687
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 T25 5x60MM STR

Facility

$924.00

Service Code	HCPCS C1713
Hospital Charge Code	270675687
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 T25 5x80MM

Facility

$924.00

Hospital Charge Code	270676888
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 T25 5x80MM

Facility

$924.00

Hospital Charge Code	270676887
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 T25 5x80MM

Facility

$924.00

Hospital Charge Code	270676888
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

Know your out-of-pocket cost for care.

All Charges