Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LP TI CORT MTP 3.0X18MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693499
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

SCREW LP TM SS CORTEX 2.7X32MM

Facility

$243.75

Service Code	HCPCS C1713
Hospital Charge Code	270699396
Hospital Revenue Code	278
Min. Negotiated Rate	$36.56
Max. Negotiated Rate	$58.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.62
Rate for Payer: Qualcare PPO/HMO/WC	$36.56

SCREW LP TM SS CORTEX 2.7X32MM

Facility

$243.75

Service Code	HCPCS C1713
Hospital Charge Code	270699396
Hospital Revenue Code	278
Min. Negotiated Rate	$5.87
Max. Negotiated Rate	$121.88
Rate for Payer: Aetna Commercial	$92.62
Rate for Payer: Aetna Medicare Advantage	$73.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.16
Rate for Payer: Cigna Commercial	$121.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.62
Rate for Payer: Qualcare PPO/HMO/WC	$36.56
Rate for Payer: UnitedHealthcare Community & State	$5.87
Rate for Payer: Wellpoint Medicaid Managed Care	$6.46

SCREW LP TRID II 6.5X40MM

Facility

$1,040.00

Service Code	HCPCS C1713
Hospital Charge Code	270695171
Hospital Revenue Code	278
Min. Negotiated Rate	$25.06
Max. Negotiated Rate	$520.00
Rate for Payer: Aetna Commercial	$395.20
Rate for Payer: Aetna Medicare Advantage	$312.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$265.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$265.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$208.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$265.20
Rate for Payer: Cigna Commercial	$520.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$251.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$228.80
Rate for Payer: Qualcare PPO/HMO/WC	$156.00
Rate for Payer: UnitedHealthcare Community & State	$25.06
Rate for Payer: Wellpoint Medicaid Managed Care	$27.56

SCREW LP TRID II 6.5X40MM

Facility

$1,040.00

Service Code	HCPCS C1713
Hospital Charge Code	270695171
Hospital Revenue Code	278
Min. Negotiated Rate	$156.00
Max. Negotiated Rate	$251.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$208.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$251.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$228.80
Rate for Payer: Qualcare PPO/HMO/WC	$156.00

SCREW L SOLID 115mm TITA 29262

Facility

$2,160.00

Hospital Charge Code	270644215
Hospital Revenue Code	278
Min. Negotiated Rate	$52.06
Max. Negotiated Rate	$1,080.00
Rate for Payer: Aetna Commercial	$820.80
Rate for Payer: Aetna Medicare Advantage	$648.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$550.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$550.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$432.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$550.80
Rate for Payer: Cigna Commercial	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$522.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$475.20
Rate for Payer: Qualcare PPO/HMO/WC	$324.00
Rate for Payer: UnitedHealthcare Community & State	$52.06
Rate for Payer: Wellpoint Medicaid Managed Care	$57.24

SCREW L SOLID 115mm TITA 29262

Facility

$2,160.00

Hospital Charge Code	270644215
Hospital Revenue Code	278
Min. Negotiated Rate	$324.00
Max. Negotiated Rate	$522.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$432.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$522.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$475.20
Rate for Payer: Qualcare PPO/HMO/WC	$324.00

SCREW LUMBAR 5.5X30MM

Facility

$2,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270693948
Hospital Revenue Code	278
Min. Negotiated Rate	$71.09
Max. Negotiated Rate	$1,475.00
Rate for Payer: Aetna Commercial	$1,121.00
Rate for Payer: Aetna Medicare Advantage	$885.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$752.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$752.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$590.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$752.25
Rate for Payer: Cigna Commercial	$1,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$713.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$649.00
Rate for Payer: Qualcare PPO/HMO/WC	$442.50
Rate for Payer: UnitedHealthcare Community & State	$71.09
Rate for Payer: Wellpoint Medicaid Managed Care	$78.17

SCREW LUMBAR 5.5X30MM

Facility

$2,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270693948
Hospital Revenue Code	278
Min. Negotiated Rate	$442.50
Max. Negotiated Rate	$713.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$713.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$649.00
Rate for Payer: Qualcare PPO/HMO/WC	$442.50

SCREW LUMBAR 5.5X35MM NEXXT

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270693628
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW LUMBAR 5.5X35MM NEXXT

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270693628
Hospital Revenue Code	278
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

SCREW LUMBAR LATERAL 35MM

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270695204
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$984.50
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

SCREW LUMBAR LATERAL 35MM

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270695204
Hospital Revenue Code	278
Min. Negotiated Rate	$107.85
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,700.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$984.50
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Community & State	$107.85
Rate for Payer: Wellpoint Medicaid Managed Care	$118.59

SCREW LX 5.5 X 50 MM

Facility

$9,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688580
Hospital Revenue Code	278
Min. Negotiated Rate	$234.97
Max. Negotiated Rate	$4,875.00
Rate for Payer: Aetna Commercial	$3,705.00
Rate for Payer: Aetna Medicare Advantage	$2,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,486.25
Rate for Payer: Cigna Commercial	$4,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,145.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50
Rate for Payer: UnitedHealthcare Community & State	$234.97
Rate for Payer: Wellpoint Medicaid Managed Care	$258.38

SCREW LX 5.5 X 50 MM

Facility

$9,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688580
Hospital Revenue Code	278
Min. Negotiated Rate	$1,462.50
Max. Negotiated Rate	$2,359.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,145.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50

SCREW LX 6.5 X 40 MM

Facility

$13,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688416
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$3,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

SCREW LX 6.5 X 40 MM

Facility

$13,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688416
Hospital Revenue Code	278
Min. Negotiated Rate	$331.38
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$5,225.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50
Rate for Payer: UnitedHealthcare Community & State	$331.38
Rate for Payer: Wellpoint Medicaid Managed Care	$364.38

SCREW LX 6.5 X 40MM

Facility

$9,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688578
Hospital Revenue Code	278
Min. Negotiated Rate	$1,462.50
Max. Negotiated Rate	$2,359.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,145.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50

SCREW LX 6.5 X 40MM

Facility

$9,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688578
Hospital Revenue Code	278
Min. Negotiated Rate	$234.97
Max. Negotiated Rate	$4,875.00
Rate for Payer: Aetna Commercial	$3,705.00
Rate for Payer: Aetna Medicare Advantage	$2,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,486.25
Rate for Payer: Cigna Commercial	$4,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,145.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50
Rate for Payer: UnitedHealthcare Community & State	$234.97
Rate for Payer: Wellpoint Medicaid Managed Care	$258.38

SCREW LX 6.5 X 45 MM

Facility

$13,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688415
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$3,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

SCREW LX 6.5 X 45 MM

Facility

$13,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688415
Hospital Revenue Code	278
Min. Negotiated Rate	$331.38
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$5,225.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50
Rate for Payer: UnitedHealthcare Community & State	$331.38
Rate for Payer: Wellpoint Medicaid Managed Care	$364.38

SCREW LX 7.5 X 40MM

Facility

$9,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688579
Hospital Revenue Code	278
Min. Negotiated Rate	$1,462.50
Max. Negotiated Rate	$2,359.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,145.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50

SCREW LX 7.5 X 40MM

Facility

$13,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688417
Hospital Revenue Code	278
Min. Negotiated Rate	$331.38
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$5,225.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50
Rate for Payer: UnitedHealthcare Community & State	$331.38
Rate for Payer: Wellpoint Medicaid Managed Care	$364.38

SCREW LX 7.5 X 40MM

Facility

$9,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688579
Hospital Revenue Code	278
Min. Negotiated Rate	$234.97
Max. Negotiated Rate	$4,875.00
Rate for Payer: Aetna Commercial	$3,705.00
Rate for Payer: Aetna Medicare Advantage	$2,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,486.25
Rate for Payer: Cigna Commercial	$4,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,145.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50
Rate for Payer: UnitedHealthcare Community & State	$234.97
Rate for Payer: Wellpoint Medicaid Managed Care	$258.38

SCREW LX 7.5 X 40MM

Facility

$13,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688417
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$3,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

Know your out-of-pocket cost for care.

All Charges