Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW NL 3X12MM

Facility

$950.00

Service Code	HCPCS C1713
Hospital Charge Code	270669409
Hospital Revenue Code	278
Min. Negotiated Rate	$22.89
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$361.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.00
Rate for Payer: Qualcare PPO/HMO/WC	$142.50
Rate for Payer: UnitedHealthcare Community & State	$22.89
Rate for Payer: Wellpoint Medicaid Managed Care	$25.18

SCREW NL 4.5 38

Facility

$545.00

Service Code	HCPCS C1713
Hospital Charge Code	270687140
Hospital Revenue Code	278
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$272.50
Rate for Payer: Aetna Commercial	$207.10
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.97
Rate for Payer: Cigna Commercial	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.90
Rate for Payer: Qualcare PPO/HMO/WC	$81.75
Rate for Payer: UnitedHealthcare Community & State	$13.13
Rate for Payer: Wellpoint Medicaid Managed Care	$14.44

SCREW NL 4.5 38

Facility

$545.00

Service Code	HCPCS C1713
Hospital Charge Code	270687140
Hospital Revenue Code	278
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$131.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.90
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

SCREW NL 4.5X28MM

Facility

$305.10

Service Code	HCPCS C1713
Hospital Charge Code	270700879
Hospital Revenue Code	278
Min. Negotiated Rate	$45.77
Max. Negotiated Rate	$73.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$67.12
Rate for Payer: Qualcare PPO/HMO/WC	$45.77

SCREW NL 4.5X28MM

Facility

$305.10

Service Code	HCPCS C1713
Hospital Charge Code	270700879
Hospital Revenue Code	278
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$152.55
Rate for Payer: Aetna Commercial	$115.94
Rate for Payer: Aetna Medicare Advantage	$91.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.80
Rate for Payer: Cigna Commercial	$152.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$67.12
Rate for Payer: Qualcare PPO/HMO/WC	$45.77
Rate for Payer: UnitedHealthcare Community & State	$7.35
Rate for Payer: Wellpoint Medicaid Managed Care	$8.09

SCREW NL 4.5X30MM

Facility

$305.10

Service Code	HCPCS C1713
Hospital Charge Code	270700880
Hospital Revenue Code	278
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$152.55
Rate for Payer: Aetna Commercial	$115.94
Rate for Payer: Aetna Medicare Advantage	$91.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.80
Rate for Payer: Cigna Commercial	$152.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$67.12
Rate for Payer: Qualcare PPO/HMO/WC	$45.77
Rate for Payer: UnitedHealthcare Community & State	$7.35
Rate for Payer: Wellpoint Medicaid Managed Care	$8.09

SCREW NL 4.5X30MM

Facility

$305.10

Service Code	HCPCS C1713
Hospital Charge Code	270700880
Hospital Revenue Code	278
Min. Negotiated Rate	$45.77
Max. Negotiated Rate	$73.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$67.12
Rate for Payer: Qualcare PPO/HMO/WC	$45.77

SCREW NL 4.5 X 60

Facility

$545.00

Service Code	HCPCS C1713
Hospital Charge Code	270687139
Hospital Revenue Code	278
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$272.50
Rate for Payer: Aetna Commercial	$207.10
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.97
Rate for Payer: Cigna Commercial	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.90
Rate for Payer: Qualcare PPO/HMO/WC	$81.75
Rate for Payer: UnitedHealthcare Community & State	$13.13
Rate for Payer: Wellpoint Medicaid Managed Care	$14.44

SCREW NL 4.5 X 60

Facility

$545.00

Service Code	HCPCS C1713
Hospital Charge Code	270687139
Hospital Revenue Code	278
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$131.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.90
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

SCREW NL 535 34

Facility

$545.00

Service Code	HCPCS C1713
Hospital Charge Code	270687134
Hospital Revenue Code	278
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$272.50
Rate for Payer: Aetna Commercial	$207.10
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.97
Rate for Payer: Cigna Commercial	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.90
Rate for Payer: Qualcare PPO/HMO/WC	$81.75
Rate for Payer: UnitedHealthcare Community & State	$13.13
Rate for Payer: Wellpoint Medicaid Managed Care	$14.44

SCREW NL 535 34

Facility

$545.00

Service Code	HCPCS C1713
Hospital Charge Code	270687134
Hospital Revenue Code	278
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$131.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.90
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

SCREW NL 5.5 50

Facility

$545.00

Service Code	HCPCS C1713
Hospital Charge Code	270687132
Hospital Revenue Code	278
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$272.50
Rate for Payer: Aetna Commercial	$207.10
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.97
Rate for Payer: Cigna Commercial	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.90
Rate for Payer: Qualcare PPO/HMO/WC	$81.75
Rate for Payer: UnitedHealthcare Community & State	$13.13
Rate for Payer: Wellpoint Medicaid Managed Care	$14.44

SCREW NL 5.5 50

Facility

$545.00

Service Code	HCPCS C1713
Hospital Charge Code	270687132
Hospital Revenue Code	278
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$131.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.90
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

SCREW NL 5.5 X 45

Facility

$545.00

Service Code	HCPCS C1713
Hospital Charge Code	270687133
Hospital Revenue Code	278
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$272.50
Rate for Payer: Aetna Commercial	$207.10
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.97
Rate for Payer: Cigna Commercial	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.90
Rate for Payer: Qualcare PPO/HMO/WC	$81.75
Rate for Payer: UnitedHealthcare Community & State	$13.13
Rate for Payer: Wellpoint Medicaid Managed Care	$14.44

SCREW NL 5.5 X 45

Facility

$545.00

Service Code	HCPCS C1713
Hospital Charge Code	270687133
Hospital Revenue Code	278
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$131.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.90
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

SCREW NL ANCHORAGE 3X10MM

Facility

$1,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270698993
Hospital Revenue Code	278
Min. Negotiated Rate	$35.67
Max. Negotiated Rate	$740.00
Rate for Payer: Aetna Commercial	$562.40
Rate for Payer: Aetna Medicare Advantage	$444.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$377.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$377.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$296.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$377.40
Rate for Payer: Cigna Commercial	$740.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$358.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$325.60
Rate for Payer: Qualcare PPO/HMO/WC	$222.00
Rate for Payer: UnitedHealthcare Community & State	$35.67
Rate for Payer: Wellpoint Medicaid Managed Care	$39.22

SCREW NL ANCHORAGE 3X10MM

Facility

$1,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270698993
Hospital Revenue Code	278
Min. Negotiated Rate	$222.00
Max. Negotiated Rate	$358.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$296.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$358.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$325.60
Rate for Payer: Qualcare PPO/HMO/WC	$222.00

SCREW NLKING PLT SCREW 3.5X10

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	270701418
Hospital Revenue Code	278
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$159.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

SCREW NLKING PLT SCREW 3.5X10

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	270701418
Hospital Revenue Code	278
Min. Negotiated Rate	$15.91
Max. Negotiated Rate	$330.00
Rate for Payer: Aetna Commercial	$250.80
Rate for Payer: Aetna Medicare Advantage	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.30
Rate for Payer: Cigna Commercial	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.00
Rate for Payer: UnitedHealthcare Community & State	$15.91
Rate for Payer: Wellpoint Medicaid Managed Care	$17.49

SCREW N/LOCKING 24MM

Facility

$540.00

Hospital Charge Code	270658035
Hospital Revenue Code	278
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$270.00
Rate for Payer: Aetna Commercial	$205.20
Rate for Payer: Aetna Medicare Advantage	$162.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.70
Rate for Payer: Cigna Commercial	$270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.80
Rate for Payer: Qualcare PPO/HMO/WC	$81.00
Rate for Payer: UnitedHealthcare Community & State	$13.01
Rate for Payer: Wellpoint Medicaid Managed Care	$14.31

SCREW N/LOCKING 24MM

Facility

$540.00

Hospital Charge Code	270658035
Hospital Revenue Code	278
Min. Negotiated Rate	$81.00
Max. Negotiated Rate	$130.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.80
Rate for Payer: Qualcare PPO/HMO/WC	$81.00

SCREW N-LOCKING 3.5X56MM

Facility

$660.00

Service Code	HCPCS C1716
Hospital Charge Code	270701409
Hospital Revenue Code	278
Min. Negotiated Rate	$15.91
Max. Negotiated Rate	$2,155.71
Rate for Payer: Aetna Commercial	$1,624.38
Rate for Payer: Aetna Medicare Advantage	$1,934.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,155.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,155.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$597.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,155.71
Rate for Payer: Cigna Commercial	$1,197.08
Rate for Payer: Cigna Medicare Advantage	$597.20
Rate for Payer: Clover Medicare Advantage	$567.34
Rate for Payer: EmblemHealth Commercial	$1,791.60
Rate for Payer: Humana Medicare Advantage	$615.12
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$597.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.00
Rate for Payer: UnitedHealthcare Community & State	$15.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$597.20
Rate for Payer: Wellcare Medicare Advantage	$597.20
Rate for Payer: Wellpoint Medicaid Managed Care	$17.49

SCREW N-LOCKING 3.5X56MM

Facility

$660.00

Service Code	HCPCS C1716
Hospital Charge Code	270701409
Hospital Revenue Code	278
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$159.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

SCREW N-LOCKING CANC LAG 4.x14

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	270672331
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$82.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$74.80
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

SCREW N-LOCKING CANC LAG 4.x14

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	270672331
Hospital Revenue Code	278
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$129.20
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$74.80
Rate for Payer: Qualcare PPO/HMO/WC	$51.00
Rate for Payer: UnitedHealthcare Community & State	$8.19
Rate for Payer: Wellpoint Medicaid Managed Care	$9.01

Know your out-of-pocket cost for care.

All Charges