Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW OPTILINK 5.0MM X 90 MM

Facility

$907.85

Service Code	HCPCS C1713
Hospital Charge Code	270691482
Hospital Revenue Code	278
Min. Negotiated Rate	$21.88
Max. Negotiated Rate	$453.93
Rate for Payer: Aetna Commercial	$344.98
Rate for Payer: Aetna Medicare Advantage	$272.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.50
Rate for Payer: Cigna Commercial	$453.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.73
Rate for Payer: Qualcare PPO/HMO/WC	$136.18
Rate for Payer: UnitedHealthcare Community & State	$21.88
Rate for Payer: Wellpoint Medicaid Managed Care	$24.06

SCREW OPTILINK ST SD 5.0X28MM

Facility

$907.85

Service Code	HCPCS C1713
Hospital Charge Code	270691214
Hospital Revenue Code	278
Min. Negotiated Rate	$21.88
Max. Negotiated Rate	$453.93
Rate for Payer: Aetna Commercial	$344.98
Rate for Payer: Aetna Medicare Advantage	$272.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.50
Rate for Payer: Cigna Commercial	$453.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.73
Rate for Payer: Qualcare PPO/HMO/WC	$136.18
Rate for Payer: UnitedHealthcare Community & State	$21.88
Rate for Payer: Wellpoint Medicaid Managed Care	$24.06

SCREW OPTILINK ST SD 5.0X28MM

Facility

$907.85

Service Code	HCPCS C1713
Hospital Charge Code	270691214
Hospital Revenue Code	278
Min. Negotiated Rate	$136.18
Max. Negotiated Rate	$219.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.73
Rate for Payer: Qualcare PPO/HMO/WC	$136.18

SCREW ORTHOLOC 3.5X36MM

Facility

$535.00

Service Code	HCPCS C1713
Hospital Charge Code	270700815
Hospital Revenue Code	278
Min. Negotiated Rate	$80.25
Max. Negotiated Rate	$129.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.70
Rate for Payer: Qualcare PPO/HMO/WC	$80.25

SCREW ORTHOLOC 3.5X36MM

Facility

$535.00

Service Code	HCPCS C1713
Hospital Charge Code	270700815
Hospital Revenue Code	278
Min. Negotiated Rate	$12.89
Max. Negotiated Rate	$267.50
Rate for Payer: Aetna Commercial	$203.30
Rate for Payer: Aetna Medicare Advantage	$160.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.43
Rate for Payer: Cigna Commercial	$267.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.70
Rate for Payer: Qualcare PPO/HMO/WC	$80.25
Rate for Payer: UnitedHealthcare Community & State	$12.89
Rate for Payer: Wellpoint Medicaid Managed Care	$14.18

SCREW ORTHOLOC 3DI 2.7X10MM

Facility

$1,050.60

Service Code	HCPCS C1713
Hospital Charge Code	270700378
Hospital Revenue Code	278
Min. Negotiated Rate	$25.32
Max. Negotiated Rate	$525.30
Rate for Payer: Aetna Commercial	$399.23
Rate for Payer: Aetna Medicare Advantage	$315.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.90
Rate for Payer: Cigna Commercial	$525.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.13
Rate for Payer: Qualcare PPO/HMO/WC	$157.59
Rate for Payer: UnitedHealthcare Community & State	$25.32
Rate for Payer: Wellpoint Medicaid Managed Care	$27.84

SCREW ORTHOLOC 3DI 2.7X10MM

Facility

$1,050.60

Service Code	HCPCS C1713
Hospital Charge Code	270700378
Hospital Revenue Code	278
Min. Negotiated Rate	$157.59
Max. Negotiated Rate	$254.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.13
Rate for Payer: Qualcare PPO/HMO/WC	$157.59

SCREW ORTHOLOC 3DI 3.5X10MM

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270700814
Hospital Revenue Code	278
Min. Negotiated Rate	$25.30
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$399.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50
Rate for Payer: UnitedHealthcare Community & State	$25.30
Rate for Payer: Wellpoint Medicaid Managed Care	$27.82

SCREW ORTHOLOC 3DI 3.5X10MM

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270700814
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SCREW ORTHOLOC NONLKG 3.5X50MM

Facility

$1,365.00

Service Code	HCPCS C1713
Hospital Charge Code	270700641
Hospital Revenue Code	278
Min. Negotiated Rate	$32.90
Max. Negotiated Rate	$682.50
Rate for Payer: Aetna Commercial	$518.70
Rate for Payer: Aetna Medicare Advantage	$409.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$348.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$348.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$273.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$348.07
Rate for Payer: Cigna Commercial	$682.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$300.30
Rate for Payer: Qualcare PPO/HMO/WC	$204.75
Rate for Payer: UnitedHealthcare Community & State	$32.90
Rate for Payer: Wellpoint Medicaid Managed Care	$36.17

SCREW ORTHOLOC NONLKG 3.5X50MM

Facility

$1,365.00

Service Code	HCPCS C1713
Hospital Charge Code	270700641
Hospital Revenue Code	278
Min. Negotiated Rate	$204.75
Max. Negotiated Rate	$330.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$273.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$300.30
Rate for Payer: Qualcare PPO/HMO/WC	$204.75

SCREW OSTEOPENIA 5.0MMx14MM

Facility

$372.75

Hospital Charge Code	270647951
Hospital Revenue Code	278
Min. Negotiated Rate	$8.98
Max. Negotiated Rate	$186.38
Rate for Payer: Aetna Commercial	$141.65
Rate for Payer: Aetna Medicare Advantage	$111.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.05
Rate for Payer: Cigna Commercial	$186.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.91
Rate for Payer: UnitedHealthcare Community & State	$8.98
Rate for Payer: Wellpoint Medicaid Managed Care	$9.88

SCREW OSTEOPENIA 5.0MMx14MM

Facility

$372.75

Hospital Charge Code	270647951
Hospital Revenue Code	278
Min. Negotiated Rate	$55.91
Max. Negotiated Rate	$90.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.91

SCREW OTPD CANN 2.2/120MM

Facility

$420.00

Hospital Charge Code	270606261
Hospital Revenue Code	278
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$101.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$92.40
Rate for Payer: Qualcare PPO/HMO/WC	$63.00

SCREW OTPD CANN 2.2/120MM

Facility

$420.00

Hospital Charge Code	270606261
Hospital Revenue Code	278
Min. Negotiated Rate	$10.12
Max. Negotiated Rate	$210.00
Rate for Payer: Aetna Commercial	$159.60
Rate for Payer: Aetna Medicare Advantage	$126.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.10
Rate for Payer: Cigna Commercial	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$92.40
Rate for Payer: Qualcare PPO/HMO/WC	$63.00
Rate for Payer: UnitedHealthcare Community & State	$10.12
Rate for Payer: Wellpoint Medicaid Managed Care	$11.13

SCREW OTPD CANN 2.2/12MM

Facility

$500.00

Hospital Charge Code	270606257
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW OTPD CANN 2.2/12MM

Facility

$500.00

Hospital Charge Code	270606257
Hospital Revenue Code	278
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

SCREW OTPD CANN 2.2/12MM

Facility

$382.45

Hospital Charge Code	270606264
Hospital Revenue Code	278
Min. Negotiated Rate	$57.37
Max. Negotiated Rate	$92.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$84.14
Rate for Payer: Qualcare PPO/HMO/WC	$57.37

SCREW OTPD CANN 2.2/12MM

Facility

$382.45

Hospital Charge Code	270606264
Hospital Revenue Code	278
Min. Negotiated Rate	$9.22
Max. Negotiated Rate	$191.22
Rate for Payer: Aetna Commercial	$145.33
Rate for Payer: Aetna Medicare Advantage	$114.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.52
Rate for Payer: Cigna Commercial	$191.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$84.14
Rate for Payer: Qualcare PPO/HMO/WC	$57.37
Rate for Payer: UnitedHealthcare Community & State	$9.22
Rate for Payer: Wellpoint Medicaid Managed Care	$10.13

SCREW OTPD CANN 2.2/14MM

Facility

$436.85

Hospital Charge Code	270606265
Hospital Revenue Code	278
Min. Negotiated Rate	$10.53
Max. Negotiated Rate	$218.43
Rate for Payer: Aetna Commercial	$166.00
Rate for Payer: Aetna Medicare Advantage	$131.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.40
Rate for Payer: Cigna Commercial	$218.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.11
Rate for Payer: Qualcare PPO/HMO/WC	$65.53
Rate for Payer: UnitedHealthcare Community & State	$10.53
Rate for Payer: Wellpoint Medicaid Managed Care	$11.58

SCREW OTPD CANN 2.2/14MM

Facility

$436.85

Hospital Charge Code	270606265
Hospital Revenue Code	278
Min. Negotiated Rate	$65.53
Max. Negotiated Rate	$105.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.11
Rate for Payer: Qualcare PPO/HMO/WC	$65.53

SCREW OTPD CANN 2.2/14MM

Facility

$484.00

Hospital Charge Code	270606258
Hospital Revenue Code	278
Min. Negotiated Rate	$11.66
Max. Negotiated Rate	$242.00
Rate for Payer: Aetna Commercial	$183.92
Rate for Payer: Aetna Medicare Advantage	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.42
Rate for Payer: Cigna Commercial	$242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$106.48
Rate for Payer: Qualcare PPO/HMO/WC	$72.60
Rate for Payer: UnitedHealthcare Community & State	$11.66
Rate for Payer: Wellpoint Medicaid Managed Care	$12.83

SCREW OTPD CANN 2.2/14MM

Facility

$484.00

Hospital Charge Code	270606258
Hospital Revenue Code	278
Min. Negotiated Rate	$72.60
Max. Negotiated Rate	$117.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$106.48
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

SCREW OTPD CANN 2.2/16MM

Facility

$420.00

Hospital Charge Code	270606259
Hospital Revenue Code	278
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$101.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$92.40
Rate for Payer: Qualcare PPO/HMO/WC	$63.00

SCREW OTPD CANN 2.2/16MM

Facility

$436.85

Hospital Charge Code	270606267
Hospital Revenue Code	278
Min. Negotiated Rate	$65.53
Max. Negotiated Rate	$105.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.11
Rate for Payer: Qualcare PPO/HMO/WC	$65.53

Know your out-of-pocket cost for care.

All Charges