Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING T8 STAR 2.7X55MM

Facility

$489.00

Hospital Charge Code	270669933
Hospital Revenue Code	278
Min. Negotiated Rate	$73.35
Max. Negotiated Rate	$118.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$107.58
Rate for Payer: Qualcare PPO/HMO/WC	$73.35

SCREW LOCKING T8 STAR 2.7X55MM

Facility

$489.00

Hospital Charge Code	270669933
Hospital Revenue Code	278
Min. Negotiated Rate	$11.78
Max. Negotiated Rate	$244.50
Rate for Payer: Aetna Commercial	$185.82
Rate for Payer: Aetna Medicare Advantage	$146.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.69
Rate for Payer: Cigna Commercial	$244.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$107.58
Rate for Payer: Qualcare PPO/HMO/WC	$73.35
Rate for Payer: UnitedHealthcare Community & State	$11.78
Rate for Payer: Wellpoint Medicaid Managed Care	$12.96

SCREW LOCKING THREADED 5X60MM

Facility

$1,400.00

Hospital Charge Code	270668417
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 THREADED 5X60MM

Facility

$1,400.00

Hospital Charge Code	270668417
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 TI 3.5MM 28MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270686818
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW LOCKING TI 3.5MM 28MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270686818
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

SCREW LOCKING TI 3.5 X 40 MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270690978
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

SCREW LOCKING TI 3.5 X 40 MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270690978
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW LOCKING Ti 4.0 X 20 MM

Facility

$924.00

Hospital Charge Code	270667568
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 Ti 4.0 X 20 MM

Facility

$924.00

Hospital Charge Code	270667568
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 TI 4x40MM

Facility

$1,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270673951
Hospital Revenue Code	278
Min. Negotiated Rate	$30.25
Max. Negotiated Rate	$627.50
Rate for Payer: Aetna Commercial	$476.90
Rate for Payer: Aetna Medicare Advantage	$376.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$320.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$320.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$320.02
Rate for Payer: Cigna Commercial	$627.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$276.10
Rate for Payer: Qualcare PPO/HMO/WC	$188.25
Rate for Payer: UnitedHealthcare Community & State	$30.25
Rate for Payer: Wellpoint Medicaid Managed Care	$33.26

SCREW LOCKING TI 4x40MM

Facility

$1,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270673951
Hospital Revenue Code	278
Min. Negotiated Rate	$188.25
Max. Negotiated Rate	$303.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$276.10
Rate for Payer: Qualcare PPO/HMO/WC	$188.25

SCREW LOCKING TI 4x42MM

Facility

$1,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270673952
Hospital Revenue Code	278
Min. Negotiated Rate	$188.25
Max. Negotiated Rate	$303.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$276.10
Rate for Payer: Qualcare PPO/HMO/WC	$188.25

SCREW LOCKING TI 4x42MM

Facility

$1,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270673952
Hospital Revenue Code	278
Min. Negotiated Rate	$30.25
Max. Negotiated Rate	$627.50
Rate for Payer: Aetna Commercial	$476.90
Rate for Payer: Aetna Medicare Advantage	$376.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$320.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$320.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$320.02
Rate for Payer: Cigna Commercial	$627.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$276.10
Rate for Payer: Qualcare PPO/HMO/WC	$188.25
Rate for Payer: UnitedHealthcare Community & State	$30.25
Rate for Payer: Wellpoint Medicaid Managed Care	$33.26

SCREW LOCKING TI 4x60MM

Facility

$927.20

Service Code	HCPCS C1713
Hospital Charge Code	270674962
Hospital Revenue Code	278
Min. Negotiated Rate	$22.35
Max. Negotiated Rate	$463.60
Rate for Payer: Aetna Commercial	$352.34
Rate for Payer: Aetna Medicare Advantage	$278.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$236.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$236.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$236.44
Rate for Payer: Cigna Commercial	$463.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$203.98
Rate for Payer: Qualcare PPO/HMO/WC	$139.08
Rate for Payer: UnitedHealthcare Community & State	$22.35
Rate for Payer: Wellpoint Medicaid Managed Care	$24.57

SCREW LOCKING TI 4x60MM

Facility

$927.20

Service Code	HCPCS C1713
Hospital Charge Code	270674962
Hospital Revenue Code	278
Min. Negotiated Rate	$139.08
Max. Negotiated Rate	$224.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$203.98
Rate for Payer: Qualcare PPO/HMO/WC	$139.08

SCREW LOCKING TI 4x65MM

Facility

$927.20

Service Code	HCPCS C1713
Hospital Charge Code	270674961
Hospital Revenue Code	278
Min. Negotiated Rate	$22.35
Max. Negotiated Rate	$463.60
Rate for Payer: Aetna Commercial	$352.34
Rate for Payer: Aetna Medicare Advantage	$278.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$236.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$236.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$236.44
Rate for Payer: Cigna Commercial	$463.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$203.98
Rate for Payer: Qualcare PPO/HMO/WC	$139.08
Rate for Payer: UnitedHealthcare Community & State	$22.35
Rate for Payer: Wellpoint Medicaid Managed Care	$24.57

SCREW LOCKING TI 4x65MM

Facility

$927.20

Service Code	HCPCS C1713
Hospital Charge Code	270674961
Hospital Revenue Code	278
Min. Negotiated Rate	$139.08
Max. Negotiated Rate	$224.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$203.98
Rate for Payer: Qualcare PPO/HMO/WC	$139.08

SCREW LOCKING TI 4x70MM

Facility

$927.20

Service Code	HCPCS C1713
Hospital Charge Code	270674960
Hospital Revenue Code	278
Min. Negotiated Rate	$22.35
Max. Negotiated Rate	$463.60
Rate for Payer: Aetna Commercial	$352.34
Rate for Payer: Aetna Medicare Advantage	$278.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$236.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$236.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$236.44
Rate for Payer: Cigna Commercial	$463.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$203.98
Rate for Payer: Qualcare PPO/HMO/WC	$139.08
Rate for Payer: UnitedHealthcare Community & State	$22.35
Rate for Payer: Wellpoint Medicaid Managed Care	$24.57

SCREW LOCKING TI 4x70MM

Facility

$927.20

Service Code	HCPCS C1713
Hospital Charge Code	270674960
Hospital Revenue Code	278
Min. Negotiated Rate	$139.08
Max. Negotiated Rate	$224.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$203.98
Rate for Payer: Qualcare PPO/HMO/WC	$139.08

SCREW LOCKING TI 4x80MM

Facility

$1,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270673950
Hospital Revenue Code	278
Min. Negotiated Rate	$30.25
Max. Negotiated Rate	$627.50
Rate for Payer: Aetna Commercial	$476.90
Rate for Payer: Aetna Medicare Advantage	$376.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$320.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$320.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$320.02
Rate for Payer: Cigna Commercial	$627.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$276.10
Rate for Payer: Qualcare PPO/HMO/WC	$188.25
Rate for Payer: UnitedHealthcare Community & State	$30.25
Rate for Payer: Wellpoint Medicaid Managed Care	$33.26

SCREW LOCKING TI 4x80MM

Facility

$1,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270673950
Hospital Revenue Code	278
Min. Negotiated Rate	$188.25
Max. Negotiated Rate	$303.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$276.10
Rate for Payer: Qualcare PPO/HMO/WC	$188.25

SCREW LOCKING TI 4x85MM

Facility

$1,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270673949
Hospital Revenue Code	278
Min. Negotiated Rate	$30.25
Max. Negotiated Rate	$627.50
Rate for Payer: Aetna Commercial	$476.90
Rate for Payer: Aetna Medicare Advantage	$376.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$320.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$320.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$320.02
Rate for Payer: Cigna Commercial	$627.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$276.10
Rate for Payer: Qualcare PPO/HMO/WC	$188.25
Rate for Payer: UnitedHealthcare Community & State	$30.25
Rate for Payer: Wellpoint Medicaid Managed Care	$33.26

SCREW LOCKING TI 4x85MM

Facility

$1,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270673949
Hospital Revenue Code	278
Min. Negotiated Rate	$188.25
Max. Negotiated Rate	$303.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$276.10
Rate for Payer: Qualcare PPO/HMO/WC	$188.25

SCREW LOCKING TI 4x90MM

Facility

$1,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270673948
Hospital Revenue Code	278
Min. Negotiated Rate	$188.25
Max. Negotiated Rate	$303.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$276.10
Rate for Payer: Qualcare PPO/HMO/WC	$188.25

Know your out-of-pocket cost for care.

All Charges