Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOW-PROTI 4.0MMX 28MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270687064
Hospital Revenue Code	278
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

SCREW LOW PRO TI 4.5mm x 45mm

Facility

$975.00

Service Code	HCPCS C1713
Hospital Charge Code	270678700
Hospital Revenue Code	278
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$235.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

SCREW LOW PRO TI 4.5mm x 45mm

Facility

$975.00

Service Code	HCPCS C1713
Hospital Charge Code	270678700
Hospital Revenue Code	278
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

SCREW LOW P TI 4.5 mm x 30mm

Facility

$975.00

Service Code	HCPCS C1713
Hospital Charge Code	270678702
Hospital Revenue Code	278
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$235.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

SCREW LOW P TI 4.5 mm x 30mm

Facility

$975.00

Service Code	HCPCS C1713
Hospital Charge Code	270678702
Hospital Revenue Code	278
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

SCREW LOW P TI 4.5mm x50mm

Facility

$975.00

Service Code	HCPCS C1713
Hospital Charge Code	270678708
Hospital Revenue Code	278
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

SCREW LOW P TI 4.5mm x50mm

Facility

$975.00

Service Code	HCPCS C1713
Hospital Charge Code	270678708
Hospital Revenue Code	278
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$235.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

SCREW LP 2.3X18MM

Facility

$375.00

Hospital Charge Code	270661024
Hospital Revenue Code	278
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

SCREW LP 2.3X18MM

Facility

$375.00

Hospital Charge Code	270661024
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

SCREW LP 6.7 X 100MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270686757
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 LP 6.7 X 100MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270686757
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 LP 6.7 X 100MM CANN FT

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270686773
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 LP 6.7 X 100MM CANN FT

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270686773
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 LP CORT FT ST 3.5X16MM

Facility

$535.60

Service Code	HCPCS C1713
Hospital Charge Code	270700342
Hospital Revenue Code	278
Min. Negotiated Rate	$12.91
Max. Negotiated Rate	$267.80
Rate for Payer: Aetna Commercial	$203.53
Rate for Payer: Aetna Medicare Advantage	$160.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.58
Rate for Payer: Cigna Commercial	$267.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.83
Rate for Payer: Qualcare PPO/HMO/WC	$80.34
Rate for Payer: UnitedHealthcare Community & State	$12.91
Rate for Payer: Wellpoint Medicaid Managed Care	$14.19

SCREW LP CORT FT ST 3.5X16MM

Facility

$535.60

Service Code	HCPCS C1713
Hospital Charge Code	270700342
Hospital Revenue Code	278
Min. Negotiated Rate	$80.34
Max. Negotiated Rate	$129.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.83
Rate for Payer: Qualcare PPO/HMO/WC	$80.34

SCREW LP CORTICAL 1.6X6MM

Facility

$598.00

Service Code	HCPCS C1713
Hospital Charge Code	270699303
Hospital Revenue Code	278
Min. Negotiated Rate	$89.70
Max. Negotiated Rate	$144.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$131.56
Rate for Payer: Qualcare PPO/HMO/WC	$89.70

SCREW LP CORTICAL 1.6X6MM

Facility

$598.00

Service Code	HCPCS C1713
Hospital Charge Code	270699303
Hospital Revenue Code	278
Min. Negotiated Rate	$14.41
Max. Negotiated Rate	$299.00
Rate for Payer: Aetna Commercial	$227.24
Rate for Payer: Aetna Medicare Advantage	$179.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$152.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$152.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$152.49
Rate for Payer: Cigna Commercial	$299.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$131.56
Rate for Payer: Qualcare PPO/HMO/WC	$89.70
Rate for Payer: UnitedHealthcare Community & State	$14.41
Rate for Payer: Wellpoint Medicaid Managed Care	$15.85

SCREW LP CORTICAL 2.4X12MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270694871
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

SCREW LP CORTICAL 2.4X12MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270694871
Hospital Revenue Code	278
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

SCREW LP LOCKING 5X38MM XL25

Facility

$1,490.50

Service Code	HCPCS C1713
Hospital Charge Code	270695443
Hospital Revenue Code	278
Min. Negotiated Rate	$35.92
Max. Negotiated Rate	$745.25
Rate for Payer: Aetna Commercial	$566.39
Rate for Payer: Aetna Medicare Advantage	$447.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$380.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$380.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$380.08
Rate for Payer: Cigna Commercial	$745.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$327.91
Rate for Payer: Qualcare PPO/HMO/WC	$223.57
Rate for Payer: UnitedHealthcare Community & State	$35.92
Rate for Payer: Wellpoint Medicaid Managed Care	$39.50

SCREW LP LOCKING 5X38MM XL25

Facility

$1,490.50

Service Code	HCPCS C1713
Hospital Charge Code	270695443
Hospital Revenue Code	278
Min. Negotiated Rate	$223.57
Max. Negotiated Rate	$360.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$327.91
Rate for Payer: Qualcare PPO/HMO/WC	$223.57

SCREW LP LOCKING 5X44MM XL25

Facility

$1,490.50

Service Code	HCPCS C1713
Hospital Charge Code	270695444
Hospital Revenue Code	278
Min. Negotiated Rate	$223.57
Max. Negotiated Rate	$360.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$327.91
Rate for Payer: Qualcare PPO/HMO/WC	$223.57

SCREW LP LOCKING 5X44MM XL25

Facility

$1,490.50

Service Code	HCPCS C1713
Hospital Charge Code	270695444
Hospital Revenue Code	278
Min. Negotiated Rate	$35.92
Max. Negotiated Rate	$745.25
Rate for Payer: Aetna Commercial	$566.39
Rate for Payer: Aetna Medicare Advantage	$447.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$380.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$380.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$380.08
Rate for Payer: Cigna Commercial	$745.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$327.91
Rate for Payer: Qualcare PPO/HMO/WC	$223.57
Rate for Payer: UnitedHealthcare Community & State	$35.92
Rate for Payer: Wellpoint Medicaid Managed Care	$39.50

SCREW LP LOCKING 5X50MM XL25

Facility

$1,490.50

Service Code	HCPCS C1713
Hospital Charge Code	270695445
Hospital Revenue Code	278
Min. Negotiated Rate	$223.57
Max. Negotiated Rate	$360.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$327.91
Rate for Payer: Qualcare PPO/HMO/WC	$223.57

SCREW LP LOCKING 5X50MM XL25

Facility

$1,490.50

Service Code	HCPCS C1713
Hospital Charge Code	270695445
Hospital Revenue Code	278
Min. Negotiated Rate	$35.92
Max. Negotiated Rate	$745.25
Rate for Payer: Aetna Commercial	$566.39
Rate for Payer: Aetna Medicare Advantage	$447.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$380.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$380.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$380.08
Rate for Payer: Cigna Commercial	$745.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$327.91
Rate for Payer: Qualcare PPO/HMO/WC	$223.57
Rate for Payer: UnitedHealthcare Community & State	$35.92
Rate for Payer: Wellpoint Medicaid Managed Care	$39.50

Know your out-of-pocket cost for care.

All Charges