Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCK MULTI DIR 3.5x38MM

Facility

$1,320.00

Service Code	HCPCS C1713
Hospital Charge Code	270673647
Hospital Revenue Code	278
Min. Negotiated Rate	$198.00
Max. Negotiated Rate	$319.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$290.40
Rate for Payer: Qualcare PPO/HMO/WC	$198.00

SCREW LOCK MULTI DIR 3.5x38MM

Facility

$1,320.00

Service Code	HCPCS C1713
Hospital Charge Code	270673647
Hospital Revenue Code	278
Min. Negotiated Rate	$31.81
Max. Negotiated Rate	$660.00
Rate for Payer: Aetna Commercial	$501.60
Rate for Payer: Aetna Medicare Advantage	$396.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$336.60
Rate for Payer: Cigna Commercial	$660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$290.40
Rate for Payer: Qualcare PPO/HMO/WC	$198.00
Rate for Payer: UnitedHealthcare Community & State	$31.81
Rate for Payer: Wellpoint Medicaid Managed Care	$34.98

SCREW LOCKNG CAN 5.0x50 222540

Facility

$644.85

Hospital Charge Code	270632185
Hospital Revenue Code	278
Min. Negotiated Rate	$96.73
Max. Negotiated Rate	$156.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.87
Rate for Payer: Qualcare PPO/HMO/WC	$96.73

SCREW LOCKNG CAN 5.0x50 222540

Facility

$644.85

Hospital Charge Code	270632185
Hospital Revenue Code	278
Min. Negotiated Rate	$15.54
Max. Negotiated Rate	$322.43
Rate for Payer: Aetna Commercial	$245.04
Rate for Payer: Aetna Medicare Advantage	$193.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.44
Rate for Payer: Cigna Commercial	$322.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.87
Rate for Payer: Qualcare PPO/HMO/WC	$96.73
Rate for Payer: UnitedHealthcare Community & State	$15.54
Rate for Payer: Wellpoint Medicaid Managed Care	$17.09

SCREW LOCKNG CAN 5.0x55 222541

Facility

$754.00

Hospital Charge Code	270634360
Hospital Revenue Code	278
Min. Negotiated Rate	$18.17
Max. Negotiated Rate	$377.00
Rate for Payer: Aetna Commercial	$286.52
Rate for Payer: Aetna Medicare Advantage	$226.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.27
Rate for Payer: Cigna Commercial	$377.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.88
Rate for Payer: Qualcare PPO/HMO/WC	$113.10
Rate for Payer: UnitedHealthcare Community & State	$18.17
Rate for Payer: Wellpoint Medicaid Managed Care	$19.98

SCREW LOCKNG CAN 5.0x55 222541

Facility

$754.00

Hospital Charge Code	270634360
Hospital Revenue Code	278
Min. Negotiated Rate	$113.10
Max. Negotiated Rate	$182.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.88
Rate for Payer: Qualcare PPO/HMO/WC	$113.10

SCREW LOCK OUT

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688389
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 LOCK OUT

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688389
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 LOCK SD 5.5X40MM

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694589
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

SCREW LOCK SD 5.5X40MM

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694589
Hospital Revenue Code	278
Min. Negotiated Rate	$66.28
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Community & State	$66.28
Rate for Payer: Wellpoint Medicaid Managed Care	$72.88

SCREW LOCK SQUARE 2.7MM X 14MM

Facility

$980.00

Hospital Charge Code	270663851
Hospital Revenue Code	278
Min. Negotiated Rate	$23.62
Max. Negotiated Rate	$490.00
Rate for Payer: Aetna Commercial	$372.40
Rate for Payer: Aetna Medicare Advantage	$294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.90
Rate for Payer: Cigna Commercial	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$215.60
Rate for Payer: Qualcare PPO/HMO/WC	$147.00
Rate for Payer: UnitedHealthcare Community & State	$23.62
Rate for Payer: Wellpoint Medicaid Managed Care	$25.97

SCREW LOCK SQUARE 2.7MM X 14MM

Facility

$980.00

Hospital Charge Code	270663851
Hospital Revenue Code	278
Min. Negotiated Rate	$147.00
Max. Negotiated Rate	$237.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$215.60
Rate for Payer: Qualcare PPO/HMO/WC	$147.00

SCREW LOCK T2 ALPHA 5.0X35MM

Facility

$1,443.75

Service Code	HCPCS C1713
Hospital Charge Code	270694563
Hospital Revenue Code	278
Min. Negotiated Rate	$216.56
Max. Negotiated Rate	$349.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$288.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$349.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$317.62
Rate for Payer: Qualcare PPO/HMO/WC	$216.56

SCREW LOCK T2 ALPHA 5.0X35MM

Facility

$1,443.75

Service Code	HCPCS C1713
Hospital Charge Code	270694563
Hospital Revenue Code	278
Min. Negotiated Rate	$34.79
Max. Negotiated Rate	$721.88
Rate for Payer: Aetna Commercial	$548.62
Rate for Payer: Aetna Medicare Advantage	$433.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$368.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$368.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$368.16
Rate for Payer: Cigna Commercial	$721.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$349.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$317.62
Rate for Payer: Qualcare PPO/HMO/WC	$216.56
Rate for Payer: UnitedHealthcare Community & State	$34.79
Rate for Payer: Wellpoint Medicaid Managed Care	$38.26

SCREW LOCK T2 ALPHA 5X30MM

Facility

$1,443.75

Service Code	HCPCS C1713
Hospital Charge Code	270694562
Hospital Revenue Code	278
Min. Negotiated Rate	$34.79
Max. Negotiated Rate	$721.88
Rate for Payer: Aetna Commercial	$548.62
Rate for Payer: Aetna Medicare Advantage	$433.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$368.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$368.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$368.16
Rate for Payer: Cigna Commercial	$721.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$349.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$317.62
Rate for Payer: Qualcare PPO/HMO/WC	$216.56
Rate for Payer: UnitedHealthcare Community & State	$34.79
Rate for Payer: Wellpoint Medicaid Managed Care	$38.26

SCREW LOCK T2 ALPHA 5X30MM

Facility

$1,443.75

Service Code	HCPCS C1713
Hospital Charge Code	270694562
Hospital Revenue Code	278
Min. Negotiated Rate	$216.56
Max. Negotiated Rate	$349.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$288.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$349.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$317.62
Rate for Payer: Qualcare PPO/HMO/WC	$216.56

SCREW LONG THREAD 6.7 X 60 MM

Facility

$1,250.00

Hospital Charge Code	270669798
Hospital Revenue Code	278
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

SCREW LONG THREAD 6.7 X 60 MM

Facility

$1,250.00

Hospital Charge Code	270669798
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW LO-PRO 3.5X12MM

Facility

$325.00

Service Code	HCPCS C1713
Hospital Charge Code	270699385
Hospital Revenue Code	278
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$78.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

SCREW LO-PRO 3.5X12MM

Facility

$325.00

Service Code	HCPCS C1713
Hospital Charge Code	270699385
Hospital Revenue Code	278
Min. Negotiated Rate	$7.83
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$123.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Community & State	$7.83
Rate for Payer: Wellpoint Medicaid Managed Care	$8.61

SCREW LO-PRO 6.5mm HEX 25mm

Facility

$309.80

Service Code	HCPCS C1713
Hospital Charge Code	270685520
Hospital Revenue Code	278
Min. Negotiated Rate	$7.47
Max. Negotiated Rate	$154.90
Rate for Payer: Aetna Commercial	$117.72
Rate for Payer: Aetna Medicare Advantage	$92.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.00
Rate for Payer: Cigna Commercial	$154.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$68.16
Rate for Payer: Qualcare PPO/HMO/WC	$46.47
Rate for Payer: UnitedHealthcare Community & State	$7.47
Rate for Payer: Wellpoint Medicaid Managed Care	$8.21

SCREW LO-PRO 6.5mm HEX 25mm

Facility

$309.80

Service Code	HCPCS C1713
Hospital Charge Code	270685520
Hospital Revenue Code	278
Min. Negotiated Rate	$46.47
Max. Negotiated Rate	$74.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$68.16
Rate for Payer: Qualcare PPO/HMO/WC	$46.47

SCREW LO PRO 6.7x65MM THD 18MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270674233
Hospital Revenue Code	278
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

SCREW LO PRO 6.7x65MM THD 18MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270674233
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW LO PRO 6.7x65MM THD 28MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270674232
Hospital Revenue Code	278
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

Know your out-of-pocket cost for care.

All Charges