Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW MNTR F/A 3.5x16MM

Facility

$6,600.00

Hospital Charge Code	270664087
Hospital Revenue Code	278
Min. Negotiated Rate	$159.06
Max. Negotiated Rate	$3,300.00
Rate for Payer: Aetna Commercial	$2,508.00
Rate for Payer: Aetna Medicare Advantage	$1,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.00
Rate for Payer: Cigna Commercial	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.00
Rate for Payer: UnitedHealthcare Community & State	$159.06
Rate for Payer: Wellpoint Medicaid Managed Care	$174.90

SCREW MNTR F/A 3.5x16MM

Facility

$6,600.00

Hospital Charge Code	270664087
Hospital Revenue Code	278
Min. Negotiated Rate	$990.00
Max. Negotiated Rate	$1,597.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.00

SCREW MNTR M/L 3.5x14MM

Facility

$6,600.00

Hospital Charge Code	270663786
Hospital Revenue Code	278
Min. Negotiated Rate	$159.06
Max. Negotiated Rate	$3,300.00
Rate for Payer: Aetna Commercial	$2,508.00
Rate for Payer: Aetna Medicare Advantage	$1,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.00
Rate for Payer: Cigna Commercial	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.00
Rate for Payer: UnitedHealthcare Community & State	$159.06
Rate for Payer: Wellpoint Medicaid Managed Care	$174.90

SCREW MNTR M/L 3.5x14MM

Facility

$6,600.00

Hospital Charge Code	270663786
Hospital Revenue Code	278
Min. Negotiated Rate	$990.00
Max. Negotiated Rate	$1,597.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.00

SCREW MNTR M/L 3.5x16MM

Facility

$6,600.00

Hospital Charge Code	270663783
Hospital Revenue Code	278
Min. Negotiated Rate	$159.06
Max. Negotiated Rate	$3,300.00
Rate for Payer: Aetna Commercial	$2,508.00
Rate for Payer: Aetna Medicare Advantage	$1,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.00
Rate for Payer: Cigna Commercial	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.00
Rate for Payer: UnitedHealthcare Community & State	$159.06
Rate for Payer: Wellpoint Medicaid Managed Care	$174.90

SCREW MNTR M/L 3.5x16MM

Facility

$6,600.00

Hospital Charge Code	270663783
Hospital Revenue Code	278
Min. Negotiated Rate	$990.00
Max. Negotiated Rate	$1,597.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.00

SCREW MNTR M/L 3.5x18MM

Facility

$6,600.00

Hospital Charge Code	270663787
Hospital Revenue Code	278
Min. Negotiated Rate	$990.00
Max. Negotiated Rate	$1,597.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.00

SCREW MNTR M/L 3.5x18MM

Facility

$6,600.00

Hospital Charge Code	270663787
Hospital Revenue Code	278
Min. Negotiated Rate	$159.06
Max. Negotiated Rate	$3,300.00
Rate for Payer: Aetna Commercial	$2,508.00
Rate for Payer: Aetna Medicare Advantage	$1,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.00
Rate for Payer: Cigna Commercial	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.00
Rate for Payer: UnitedHealthcare Community & State	$159.06
Rate for Payer: Wellpoint Medicaid Managed Care	$174.90

SCREW MNTR OC 4.5x8MM

Facility

$1,505.00

Service Code	HCPCS C1713
Hospital Charge Code	270677389
Hospital Revenue Code	278
Min. Negotiated Rate	$36.27
Max. Negotiated Rate	$752.50
Rate for Payer: Aetna Commercial	$571.90
Rate for Payer: Aetna Medicare Advantage	$451.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$383.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$383.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$301.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$383.77
Rate for Payer: Cigna Commercial	$752.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$331.10
Rate for Payer: Qualcare PPO/HMO/WC	$225.75
Rate for Payer: UnitedHealthcare Community & State	$36.27
Rate for Payer: Wellpoint Medicaid Managed Care	$39.88

SCREW MNTR OC 4.5x8MM

Facility

$1,505.00

Service Code	HCPCS C1713
Hospital Charge Code	270677389
Hospital Revenue Code	278
Min. Negotiated Rate	$225.75
Max. Negotiated Rate	$364.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$301.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$331.10
Rate for Payer: Qualcare PPO/HMO/WC	$225.75

SCREW MNTR OC INNER

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270677390
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$160.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75

SCREW MNTR OC INNER

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270677390
Hospital Revenue Code	278
Min. Negotiated Rate	$16.03
Max. Negotiated Rate	$332.50
Rate for Payer: Aetna Commercial	$252.70
Rate for Payer: Aetna Medicare Advantage	$199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.57
Rate for Payer: Cigna Commercial	$332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75
Rate for Payer: UnitedHealthcare Community & State	$16.03
Rate for Payer: Wellpoint Medicaid Managed Care	$17.62

SCREW MOD 5.5 X 35 MM A 2C

Facility

$3,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270693097
Hospital Revenue Code	278
Min. Negotiated Rate	$453.75
Max. Negotiated Rate	$732.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$453.75

SCREW MOD 5.5 X 35 MM A 2C

Facility

$3,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270693097
Hospital Revenue Code	278
Min. Negotiated Rate	$72.90
Max. Negotiated Rate	$1,512.50
Rate for Payer: Aetna Commercial	$1,149.50
Rate for Payer: Aetna Medicare Advantage	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$771.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$771.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$771.38
Rate for Payer: Cigna Commercial	$1,512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$453.75
Rate for Payer: UnitedHealthcare Community & State	$72.90
Rate for Payer: Wellpoint Medicaid Managed Care	$80.16

SCREW MOD CANN 6.5X50MM

Facility

$13,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270697211
Hospital Revenue Code	278
Min. Negotiated Rate	$324.87
Max. Negotiated Rate	$6,740.00
Rate for Payer: Aetna Commercial	$5,122.40
Rate for Payer: Aetna Medicare Advantage	$4,044.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,437.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,437.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,696.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,437.40
Rate for Payer: Cigna Commercial	$6,740.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,262.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,965.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,022.00
Rate for Payer: UnitedHealthcare Community & State	$324.87
Rate for Payer: Wellpoint Medicaid Managed Care	$357.22

SCREW MOD CANN 6.5X50MM

Facility

$13,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270697211
Hospital Revenue Code	278
Min. Negotiated Rate	$2,022.00
Max. Negotiated Rate	$3,262.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,696.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,262.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,965.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,022.00

SCREW MOD CANN 7.5X45MM

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270695221
Hospital Revenue Code	278
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$877.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$797.50
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

SCREW MOD CANN 7.5X45MM

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270695221
Hospital Revenue Code	278
Min. Negotiated Rate	$87.36
Max. Negotiated Rate	$1,812.50
Rate for Payer: Aetna Commercial	$1,377.50
Rate for Payer: Aetna Medicare Advantage	$1,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$924.38
Rate for Payer: Cigna Commercial	$1,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$797.50
Rate for Payer: Qualcare PPO/HMO/WC	$543.75
Rate for Payer: UnitedHealthcare Community & State	$87.36
Rate for Payer: Wellpoint Medicaid Managed Care	$96.06

SCREW MOD CANN 7.5X50MM

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270695222
Hospital Revenue Code	278
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$877.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$797.50
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

SCREW MOD CANN 7.5X50MM

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270695222
Hospital Revenue Code	278
Min. Negotiated Rate	$87.36
Max. Negotiated Rate	$1,812.50
Rate for Payer: Aetna Commercial	$1,377.50
Rate for Payer: Aetna Medicare Advantage	$1,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$924.38
Rate for Payer: Cigna Commercial	$1,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$797.50
Rate for Payer: Qualcare PPO/HMO/WC	$543.75
Rate for Payer: UnitedHealthcare Community & State	$87.36
Rate for Payer: Wellpoint Medicaid Managed Care	$96.06

SCREW MOD ROBOTIC 7.5X45MM

Facility

$4,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270694878
Hospital Revenue Code	278
Min. Negotiated Rate	$104.83
Max. Negotiated Rate	$2,175.00
Rate for Payer: Aetna Commercial	$1,653.00
Rate for Payer: Aetna Medicare Advantage	$1,305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,109.25
Rate for Payer: Cigna Commercial	$2,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$957.00
Rate for Payer: Qualcare PPO/HMO/WC	$652.50
Rate for Payer: UnitedHealthcare Community & State	$104.83
Rate for Payer: Wellpoint Medicaid Managed Care	$115.28

SCREW MOD ROBOTIC 7.5X45MM

Facility

$4,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270694878
Hospital Revenue Code	278
Min. Negotiated Rate	$652.50
Max. Negotiated Rate	$1,052.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$957.00
Rate for Payer: Qualcare PPO/HMO/WC	$652.50

SCREW MOD ROBOTIC 7.5X50MM

Facility

$4,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270694879
Hospital Revenue Code	278
Min. Negotiated Rate	$652.50
Max. Negotiated Rate	$1,052.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$957.00
Rate for Payer: Qualcare PPO/HMO/WC	$652.50

SCREW MOD ROBOTIC 7.5X50MM

Facility

$4,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270694879
Hospital Revenue Code	278
Min. Negotiated Rate	$104.83
Max. Negotiated Rate	$2,175.00
Rate for Payer: Aetna Commercial	$1,653.00
Rate for Payer: Aetna Medicare Advantage	$1,305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,109.25
Rate for Payer: Cigna Commercial	$2,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$957.00
Rate for Payer: Qualcare PPO/HMO/WC	$652.50
Rate for Payer: UnitedHealthcare Community & State	$104.83
Rate for Payer: Wellpoint Medicaid Managed Care	$115.28

SCREW MOD SELFTAP CANN 7.5X45

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692293
Hospital Revenue Code	278
Min. Negotiated Rate	$120.50
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$120.50
Rate for Payer: Wellpoint Medicaid Managed Care	$132.50

Know your out-of-pocket cost for care.

All Charges