Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW PEG 2.5x22MM PARTIAL THD

Facility

$585.00

Hospital Charge Code	270648153
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$141.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.70
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW PEG 2.5x22MM PARTIAL THD

Facility

$585.00

Hospital Charge Code	270648153
Hospital Revenue Code	278
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$222.30
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.70
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Community & State	$14.10
Rate for Payer: Wellpoint Medicaid Managed Care	$15.50

SCREW PEG 2.5x26MM PARTIAL THD

Facility

$585.00

Hospital Charge Code	270648155
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$141.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.70
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW PEG 2.5x26MM PARTIAL THD

Facility

$585.00

Hospital Charge Code	270648155
Hospital Revenue Code	278
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$222.30
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.70
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Community & State	$14.10
Rate for Payer: Wellpoint Medicaid Managed Care	$15.50

SCREW PEG 2.5x30MM PARTIAL THD

Facility

$585.00

Hospital Charge Code	270671104
Hospital Revenue Code	278
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$222.30
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.70
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Community & State	$14.10
Rate for Payer: Wellpoint Medicaid Managed Care	$15.50

SCREW PEG 2.5x30MM PARTIAL THD

Facility

$585.00

Hospital Charge Code	270671104
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$141.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.70
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW PEG NON LOCKING 2.5x14mm

Facility

$585.00

Hospital Charge Code	270671836
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$141.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.70
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW PEG NON LOCKING 2.5x14mm

Facility

$585.00

Hospital Charge Code	270671836
Hospital Revenue Code	278
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$222.30
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.70
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Community & State	$14.10
Rate for Payer: Wellpoint Medicaid Managed Care	$15.50

SCREW PEG NON LOCKING 2.5X26MM

Facility

$585.00

Hospital Charge Code	270671105
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$141.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.70
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW PEG NON LOCKING 2.5X26MM

Facility

$585.00

Hospital Charge Code	270671105
Hospital Revenue Code	278
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$222.30
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.70
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Community & State	$14.10
Rate for Payer: Wellpoint Medicaid Managed Care	$15.50

SCREW PELV CORTEX ST 3.5X75MM

Facility

$151.05

Service Code	HCPCS C1713
Hospital Charge Code	270696623
Hospital Revenue Code	278
Min. Negotiated Rate	$22.66
Max. Negotiated Rate	$36.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.23
Rate for Payer: Qualcare PPO/HMO/WC	$22.66

SCREW PELV CORTEX ST 3.5X75MM

Facility

$151.05

Service Code	HCPCS C1713
Hospital Charge Code	270696623
Hospital Revenue Code	278
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$75.53
Rate for Payer: Aetna Commercial	$57.40
Rate for Payer: Aetna Medicare Advantage	$45.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.52
Rate for Payer: Cigna Commercial	$75.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.23
Rate for Payer: Qualcare PPO/HMO/WC	$22.66
Rate for Payer: UnitedHealthcare Community & State	$3.64
Rate for Payer: Wellpoint Medicaid Managed Care	$4.00

SCREW PELV CORT S/TAP 3.5x70MM

Facility

$117.75

Service Code	HCPCS C1713
Hospital Charge Code	270665809
Hospital Revenue Code	278
Min. Negotiated Rate	$17.66
Max. Negotiated Rate	$28.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.91
Rate for Payer: Qualcare PPO/HMO/WC	$17.66

SCREW PELV CORT S/TAP 3.5x70MM

Facility

$117.75

Service Code	HCPCS C1713
Hospital Charge Code	270665809
Hospital Revenue Code	278
Min. Negotiated Rate	$2.84
Max. Negotiated Rate	$58.88
Rate for Payer: Aetna Commercial	$44.74
Rate for Payer: Aetna Medicare Advantage	$35.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.03
Rate for Payer: Cigna Commercial	$58.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.91
Rate for Payer: Qualcare PPO/HMO/WC	$17.66
Rate for Payer: UnitedHealthcare Community & State	$2.84
Rate for Payer: Wellpoint Medicaid Managed Care	$3.12

SCREW PELV CORT S/TAP 3.5x85MM

Facility

$121.30

Service Code	HCPCS C1713
Hospital Charge Code	270677980
Hospital Revenue Code	278
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$60.65
Rate for Payer: Aetna Commercial	$46.09
Rate for Payer: Aetna Medicare Advantage	$36.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.93
Rate for Payer: Cigna Commercial	$60.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.69
Rate for Payer: Qualcare PPO/HMO/WC	$18.20
Rate for Payer: UnitedHealthcare Community & State	$2.92
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

SCREW PELV CORT S/TAP 3.5x85MM

Facility

$121.30

Service Code	HCPCS C1713
Hospital Charge Code	270677980
Hospital Revenue Code	278
Min. Negotiated Rate	$18.20
Max. Negotiated Rate	$29.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.69
Rate for Payer: Qualcare PPO/HMO/WC	$18.20

SCREW PELVIC COTEX 3.5MM 80MM

Facility

$121.30

Service Code	HCPCS C1713
Hospital Charge Code	270678176
Hospital Revenue Code	278
Min. Negotiated Rate	$18.20
Max. Negotiated Rate	$29.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.69
Rate for Payer: Qualcare PPO/HMO/WC	$18.20

SCREW PELVIC COTEX 3.5MM 80MM

Facility

$121.30

Service Code	HCPCS C1713
Hospital Charge Code	270678176
Hospital Revenue Code	278
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$60.65
Rate for Payer: Aetna Commercial	$46.09
Rate for Payer: Aetna Medicare Advantage	$36.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.93
Rate for Payer: Cigna Commercial	$60.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.69
Rate for Payer: Qualcare PPO/HMO/WC	$18.20
Rate for Payer: UnitedHealthcare Community & State	$2.92
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

SCREW PELVIC G2

Facility

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	270681215
Hospital Revenue Code	278
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$75.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$68.20
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

SCREW PELVIC G2

Facility

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	270681215
Hospital Revenue Code	278
Min. Negotiated Rate	$7.47
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$117.80
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$68.20
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Community & State	$7.47
Rate for Payer: Wellpoint Medicaid Managed Care	$8.21

SCREW PELVIC LONG

Facility

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	270686371
Hospital Revenue Code	278
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$75.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$68.20
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

SCREW PELVIC LONG

Facility

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	270684591
Hospital Revenue Code	278
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$75.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$68.20
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

SCREW PELVIC LONG

Facility

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	270684558
Hospital Revenue Code	278
Min. Negotiated Rate	$7.47
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$117.80
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$68.20
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Community & State	$7.47
Rate for Payer: Wellpoint Medicaid Managed Care	$8.21

SCREW PELVIC LONG

Facility

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	270684558
Hospital Revenue Code	278
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$75.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$68.20
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

SCREW PELVIC LONG

Facility

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	270684591
Hospital Revenue Code	278
Min. Negotiated Rate	$7.47
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$117.80
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$68.20
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Community & State	$7.47
Rate for Payer: Wellpoint Medicaid Managed Care	$8.21

Know your out-of-pocket cost for care.

All Charges