Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW MAS RELINE 5.5X40MM

Facility

$6,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270691368
Hospital Revenue Code	278
Min. Negotiated Rate	$1,031.25
Max. Negotiated Rate	$1,663.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,663.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,031.25

SCREW MATRIXNEURO TI SD 4MM

Facility

$690.00

Service Code	HCPCS C1713
Hospital Charge Code	270695274
Hospital Revenue Code	278
Min. Negotiated Rate	$103.50
Max. Negotiated Rate	$166.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$151.80
Rate for Payer: Qualcare PPO/HMO/WC	$103.50

SCREW MATRIXNEURO TI SD 4MM

Facility

$690.00

Service Code	HCPCS C1713
Hospital Charge Code	270695274
Hospital Revenue Code	278
Min. Negotiated Rate	$16.63
Max. Negotiated Rate	$345.00
Rate for Payer: Aetna Commercial	$262.20
Rate for Payer: Aetna Medicare Advantage	$207.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.95
Rate for Payer: Cigna Commercial	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$151.80
Rate for Payer: Qualcare PPO/HMO/WC	$103.50
Rate for Payer: UnitedHealthcare Community & State	$16.63
Rate for Payer: Wellpoint Medicaid Managed Care	$18.29

SCREW MAXCESS-C 12MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270667694
Hospital Revenue Code	278
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Community & State	$17.47
Rate for Payer: Wellpoint Medicaid Managed Care	$19.21

SCREW MAXCESS-C 12MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270667694
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW MAXTORQUE SD 4.0X35MM

Facility

$2,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270700667
Hospital Revenue Code	278
Min. Negotiated Rate	$59.77
Max. Negotiated Rate	$1,240.00
Rate for Payer: Aetna Commercial	$942.40
Rate for Payer: Aetna Medicare Advantage	$744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$632.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$632.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$496.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$632.40
Rate for Payer: Cigna Commercial	$1,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$545.60
Rate for Payer: Qualcare PPO/HMO/WC	$372.00
Rate for Payer: UnitedHealthcare Community & State	$59.77
Rate for Payer: Wellpoint Medicaid Managed Care	$65.72

SCREW MAXTORQUE SD 4.0X35MM

Facility

$2,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270700667
Hospital Revenue Code	278
Min. Negotiated Rate	$372.00
Max. Negotiated Rate	$600.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$496.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$545.60
Rate for Payer: Qualcare PPO/HMO/WC	$372.00

SCREW MAXTORQUE SD LT 4X37.5MM

Facility

$1,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270700710
Hospital Revenue Code	278
Min. Negotiated Rate	$25.67
Max. Negotiated Rate	$532.50
Rate for Payer: Aetna Commercial	$404.70
Rate for Payer: Aetna Medicare Advantage	$319.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$271.57
Rate for Payer: Cigna Commercial	$532.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$234.30
Rate for Payer: Qualcare PPO/HMO/WC	$159.75
Rate for Payer: UnitedHealthcare Community & State	$25.67
Rate for Payer: Wellpoint Medicaid Managed Care	$28.22

SCREW MAXTORQUE SD LT 4X37.5MM

Facility

$1,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270700710
Hospital Revenue Code	278
Min. Negotiated Rate	$159.75
Max. Negotiated Rate	$257.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$234.30
Rate for Payer: Qualcare PPO/HMO/WC	$159.75

SCREW MAXTORQUE SD LT 4X42.5MM

Facility

$1,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270700715
Hospital Revenue Code	278
Min. Negotiated Rate	$159.75
Max. Negotiated Rate	$257.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$234.30
Rate for Payer: Qualcare PPO/HMO/WC	$159.75

SCREW MAXTORQUE SD LT 4X42.5MM

Facility

$1,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270700715
Hospital Revenue Code	278
Min. Negotiated Rate	$25.67
Max. Negotiated Rate	$532.50
Rate for Payer: Aetna Commercial	$404.70
Rate for Payer: Aetna Medicare Advantage	$319.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$271.57
Rate for Payer: Cigna Commercial	$532.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$234.30
Rate for Payer: Qualcare PPO/HMO/WC	$159.75
Rate for Payer: UnitedHealthcare Community & State	$25.67
Rate for Payer: Wellpoint Medicaid Managed Care	$28.22

SCREW MD 2.7MMX24MM

Facility

$1,017.00

Hospital Charge Code	270703042
Hospital Revenue Code	278
Min. Negotiated Rate	$152.55
Max. Negotiated Rate	$246.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$223.74
Rate for Payer: Qualcare PPO/HMO/WC	$152.55

SCREW MD 2.7MMX24MM

Facility

$1,017.00

Hospital Charge Code	270703042
Hospital Revenue Code	278
Min. Negotiated Rate	$24.51
Max. Negotiated Rate	$508.50
Rate for Payer: Aetna Commercial	$386.46
Rate for Payer: Aetna Medicare Advantage	$305.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$259.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$259.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$259.33
Rate for Payer: Cigna Commercial	$508.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$223.74
Rate for Payer: Qualcare PPO/HMO/WC	$152.55
Rate for Payer: UnitedHealthcare Community & State	$24.51
Rate for Payer: Wellpoint Medicaid Managed Care	$26.95

SCREWMDS STRM 2.4 X 10MM RS ST

Facility

$1,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270692251
Hospital Revenue Code	278
Min. Negotiated Rate	$31.33
Max. Negotiated Rate	$650.00
Rate for Payer: Aetna Commercial	$494.00
Rate for Payer: Aetna Medicare Advantage	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$331.50
Rate for Payer: Cigna Commercial	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$286.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00
Rate for Payer: UnitedHealthcare Community & State	$31.33
Rate for Payer: Wellpoint Medicaid Managed Care	$34.45

SCREWMDS STRM 2.4 X 10MM RS ST

Facility

$1,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270692251
Hospital Revenue Code	278
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$314.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$286.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

SCREWMDS STRM 2.4 X 12MM RS ST

Facility

$1,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270692250
Hospital Revenue Code	278
Min. Negotiated Rate	$31.33
Max. Negotiated Rate	$650.00
Rate for Payer: Aetna Commercial	$494.00
Rate for Payer: Aetna Medicare Advantage	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$331.50
Rate for Payer: Cigna Commercial	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$286.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00
Rate for Payer: UnitedHealthcare Community & State	$31.33
Rate for Payer: Wellpoint Medicaid Managed Care	$34.45

SCREWMDS STRM 2.4 X 12MM RS ST

Facility

$1,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270692250
Hospital Revenue Code	278
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$314.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$286.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

SCREW METAGLIN LOCKNG 4.5X24MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270686443
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW METAGLIN LOCKNG 4.5X24MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270686443
Hospital Revenue Code	278
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

SCREW METAGLIN LOCKNG 4.5X36MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270686442
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW METAGLIN LOCKNG 4.5X36MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270686442
Hospital Revenue Code	278
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

SCREW METAGLIN NONLCK 4.5X18MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270686444
Hospital Revenue Code	278
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

SCREW METAGLIN NONLCK 4.5X18MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270686444
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW METAPHYEASL 2.7 MM X 32

Facility

$200.50

Service Code	HCPCS C1713
Hospital Charge Code	270677646
Hospital Revenue Code	278
Min. Negotiated Rate	$4.83
Max. Negotiated Rate	$100.25
Rate for Payer: Aetna Commercial	$76.19
Rate for Payer: Aetna Medicare Advantage	$60.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.13
Rate for Payer: Cigna Commercial	$100.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.11
Rate for Payer: Qualcare PPO/HMO/WC	$30.07
Rate for Payer: UnitedHealthcare Community & State	$4.83
Rate for Payer: Wellpoint Medicaid Managed Care	$5.31

SCREW METAPHYEASL 2.7 MM X 32

Facility

$200.50

Service Code	HCPCS C1713
Hospital Charge Code	270677646
Hospital Revenue Code	278
Min. Negotiated Rate	$30.07
Max. Negotiated Rate	$48.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.11
Rate for Payer: Qualcare PPO/HMO/WC	$30.07

Know your out-of-pocket cost for care.

All Charges