Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW MT LKG TI 3.5X14MM

Facility

$1,205.00

Service Code	HCPCS C1713
Hospital Charge Code	270698964
Hospital Revenue Code	278
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$291.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$265.10
Rate for Payer: Qualcare PPO/HMO/WC	$180.75

SCREW MT LKG TI 3.5X14MM

Facility

$1,205.00

Service Code	HCPCS C1713
Hospital Charge Code	270698964
Hospital Revenue Code	278
Min. Negotiated Rate	$29.04
Max. Negotiated Rate	$602.50
Rate for Payer: Aetna Commercial	$457.90
Rate for Payer: Aetna Medicare Advantage	$361.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.27
Rate for Payer: Cigna Commercial	$602.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$265.10
Rate for Payer: Qualcare PPO/HMO/WC	$180.75
Rate for Payer: UnitedHealthcare Community & State	$29.04
Rate for Payer: Wellpoint Medicaid Managed Care	$31.93

SCREW MT LKG TI 3.5X26MM

Facility

$1,205.00

Service Code	HCPCS C1713
Hospital Charge Code	270698962
Hospital Revenue Code	278
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$291.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$265.10
Rate for Payer: Qualcare PPO/HMO/WC	$180.75

SCREW MT LKG TI 3.5X26MM

Facility

$1,205.00

Service Code	HCPCS C1713
Hospital Charge Code	270698960
Hospital Revenue Code	278
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$291.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$265.10
Rate for Payer: Qualcare PPO/HMO/WC	$180.75

SCREW MT LKG TI 3.5X26MM

Facility

$1,205.00

Service Code	HCPCS C1713
Hospital Charge Code	270698960
Hospital Revenue Code	278
Min. Negotiated Rate	$29.04
Max. Negotiated Rate	$602.50
Rate for Payer: Aetna Commercial	$457.90
Rate for Payer: Aetna Medicare Advantage	$361.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.27
Rate for Payer: Cigna Commercial	$602.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$265.10
Rate for Payer: Qualcare PPO/HMO/WC	$180.75
Rate for Payer: UnitedHealthcare Community & State	$29.04
Rate for Payer: Wellpoint Medicaid Managed Care	$31.93

SCREW MT LKG TI 3.5X26MM

Facility

$1,205.00

Service Code	HCPCS C1713
Hospital Charge Code	270698962
Hospital Revenue Code	278
Min. Negotiated Rate	$29.04
Max. Negotiated Rate	$602.50
Rate for Payer: Aetna Commercial	$457.90
Rate for Payer: Aetna Medicare Advantage	$361.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.27
Rate for Payer: Cigna Commercial	$602.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$265.10
Rate for Payer: Qualcare PPO/HMO/WC	$180.75
Rate for Payer: UnitedHealthcare Community & State	$29.04
Rate for Payer: Wellpoint Medicaid Managed Care	$31.93

SCREW MT LKG TI 3.5X40MM

Facility

$1,205.00

Service Code	HCPCS C1713
Hospital Charge Code	270698957
Hospital Revenue Code	278
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$291.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$265.10
Rate for Payer: Qualcare PPO/HMO/WC	$180.75

SCREW MT LKG TI 3.5X40MM

Facility

$1,205.00

Service Code	HCPCS C1713
Hospital Charge Code	270698957
Hospital Revenue Code	278
Min. Negotiated Rate	$29.04
Max. Negotiated Rate	$602.50
Rate for Payer: Aetna Commercial	$457.90
Rate for Payer: Aetna Medicare Advantage	$361.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.27
Rate for Payer: Cigna Commercial	$602.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$265.10
Rate for Payer: Qualcare PPO/HMO/WC	$180.75
Rate for Payer: UnitedHealthcare Community & State	$29.04
Rate for Payer: Wellpoint Medicaid Managed Care	$31.93

SCREW MTP TI LP 3.0X14MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693497
Hospital Revenue Code	278
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
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
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

SCREW MTP TI LP 3.0X14MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693497
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 MT TI LOCKING 3.5X16MM

Facility

$975.00

Service Code	HCPCS C1713
Hospital Charge Code	270684109
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 MT TI LOCKING 3.5X16MM

Facility

$975.00

Service Code	HCPCS C1713
Hospital Charge Code	270684109
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 MUC 7.0 05

Facility

$115.00

Service Code	HCPCS C1713
Hospital Charge Code	270687136
Hospital Revenue Code	278
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$57.50
Rate for Payer: Aetna Commercial	$43.70
Rate for Payer: Aetna Medicare Advantage	$34.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.32
Rate for Payer: Cigna Commercial	$57.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.30
Rate for Payer: Qualcare PPO/HMO/WC	$17.25
Rate for Payer: UnitedHealthcare Community & State	$2.77
Rate for Payer: Wellpoint Medicaid Managed Care	$3.05

SCREW MUC 7.0 05

Facility

$115.00

Service Code	HCPCS C1713
Hospital Charge Code	270687136
Hospital Revenue Code	278
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$27.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.30
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

SCREW MULTIAX 6.5x40 8696540

Facility

$5,927.25

Hospital Charge Code	270630621
Hospital Revenue Code	278
Min. Negotiated Rate	$142.85
Max. Negotiated Rate	$2,963.62
Rate for Payer: Aetna Commercial	$2,252.36
Rate for Payer: Aetna Medicare Advantage	$1,778.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,511.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,511.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,185.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,511.45
Rate for Payer: Cigna Commercial	$2,963.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,434.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,303.99
Rate for Payer: Qualcare PPO/HMO/WC	$889.09
Rate for Payer: UnitedHealthcare Community & State	$142.85
Rate for Payer: Wellpoint Medicaid Managed Care	$157.07

SCREW MULTIAX 6.5x40 8696540

Facility

$5,927.25

Hospital Charge Code	270630621
Hospital Revenue Code	278
Min. Negotiated Rate	$889.09
Max. Negotiated Rate	$1,434.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,185.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,434.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,303.99
Rate for Payer: Qualcare PPO/HMO/WC	$889.09

SCREW MULTIAX 6.5x4.5 8696535

Facility

$5,927.25

Hospital Charge Code	270632352
Hospital Revenue Code	278
Min. Negotiated Rate	$889.09
Max. Negotiated Rate	$1,434.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,185.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,434.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,303.99
Rate for Payer: Qualcare PPO/HMO/WC	$889.09

SCREW MULTIAX 6.5x4.5 8696535

Facility

$5,927.25

Hospital Charge Code	270632352
Hospital Revenue Code	278
Min. Negotiated Rate	$142.85
Max. Negotiated Rate	$2,963.62
Rate for Payer: Aetna Commercial	$2,252.36
Rate for Payer: Aetna Medicare Advantage	$1,778.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,511.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,511.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,185.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,511.45
Rate for Payer: Cigna Commercial	$2,963.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,434.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,303.99
Rate for Payer: Qualcare PPO/HMO/WC	$889.09
Rate for Payer: UnitedHealthcare Community & State	$142.85
Rate for Payer: Wellpoint Medicaid Managed Care	$157.07

SCREW MULTIAXEL 6.5x45 8696545

Facility

$5,927.25

Hospital Charge Code	270630620
Hospital Revenue Code	278
Min. Negotiated Rate	$142.85
Max. Negotiated Rate	$2,963.62
Rate for Payer: Aetna Commercial	$2,252.36
Rate for Payer: Aetna Medicare Advantage	$1,778.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,511.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,511.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,185.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,511.45
Rate for Payer: Cigna Commercial	$2,963.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,434.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,303.99
Rate for Payer: Qualcare PPO/HMO/WC	$889.09
Rate for Payer: UnitedHealthcare Community & State	$142.85
Rate for Payer: Wellpoint Medicaid Managed Care	$157.07

SCREW MULTIAXEL 6.5x45 8696545

Facility

$5,927.25

Hospital Charge Code	270630620
Hospital Revenue Code	278
Min. Negotiated Rate	$889.09
Max. Negotiated Rate	$1,434.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,185.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,434.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,303.99
Rate for Payer: Qualcare PPO/HMO/WC	$889.09

SCREW MULTIAX SET 4PK

Facility

$20,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270698934
Hospital Revenue Code	278
Min. Negotiated Rate	$3,030.00
Max. Negotiated Rate	$4,888.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,040.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,888.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,444.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,030.00

SCREW MULTIAX SET 4PK

Facility

$20,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270698934
Hospital Revenue Code	278
Min. Negotiated Rate	$486.82
Max. Negotiated Rate	$10,100.00
Rate for Payer: Aetna Commercial	$7,676.00
Rate for Payer: Aetna Medicare Advantage	$6,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,151.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,151.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,151.00
Rate for Payer: Cigna Commercial	$10,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,888.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,444.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,030.00
Rate for Payer: UnitedHealthcare Community & State	$486.82
Rate for Payer: Wellpoint Medicaid Managed Care	$535.30

SCREW MULTI DIR. 2.7x18MM

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270673693
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

SCREW MULTI DIR. 2.7x18MM

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270673693
Hospital Revenue Code	278
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

SCREW MULTI DIR. 2.7x22MM

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270673614
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

Know your out-of-pocket cost for care.

All Charges