Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW PELVIC LONG

Facility

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	270686371
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 STANDARD

Facility

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	270684557
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 STANDARD

Facility

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	270684557
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 PER 3.5x18x2.7 234801835

Facility

$122.25

Hospital Charge Code	270633305
Hospital Revenue Code	278
Min. Negotiated Rate	$18.34
Max. Negotiated Rate	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$18.34

SCREW PER 3.5x18x2.7 234801835

Facility

$122.25

Hospital Charge Code	270633305
Hospital Revenue Code	278
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$61.12
Rate for Payer: Aetna Commercial	$46.45
Rate for Payer: Aetna Medicare Advantage	$36.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.17
Rate for Payer: Cigna Commercial	$61.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$18.34
Rate for Payer: UnitedHealthcare Community & State	$2.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.24

SCREW PERACLR 3.5x18 234702018

Facility

$111.40

Hospital Charge Code	270637142
Hospital Revenue Code	278
Min. Negotiated Rate	$16.71
Max. Negotiated Rate	$26.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$24.51
Rate for Payer: Qualcare PPO/HMO/WC	$16.71

SCREW PERACLR 3.5x18 234702018

Facility

$111.40

Hospital Charge Code	270637142
Hospital Revenue Code	278
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$55.70
Rate for Payer: Aetna Commercial	$42.33
Rate for Payer: Aetna Medicare Advantage	$33.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.41
Rate for Payer: Cigna Commercial	$55.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$24.51
Rate for Payer: Qualcare PPO/HMO/WC	$16.71
Rate for Payer: UnitedHealthcare Community & State	$2.68
Rate for Payer: Wellpoint Medicaid Managed Care	$2.95

SCREW PERI 3.5MMX16MM W/2.7

Facility

$185.00

Service Code	HCPCS C1713
Hospital Charge Code	270661509
Hospital Revenue Code	278
Min. Negotiated Rate	$27.75
Max. Negotiated Rate	$44.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$40.70
Rate for Payer: Qualcare PPO/HMO/WC	$27.75

SCREW PERI 3.5MMX16MM W/2.7

Facility

$185.00

Service Code	HCPCS C1713
Hospital Charge Code	270661509
Hospital Revenue Code	278
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$92.50
Rate for Payer: Aetna Commercial	$70.30
Rate for Payer: Aetna Medicare Advantage	$55.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.17
Rate for Payer: Cigna Commercial	$92.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$40.70
Rate for Payer: Qualcare PPO/HMO/WC	$27.75
Rate for Payer: UnitedHealthcare Community & State	$4.46
Rate for Payer: Wellpoint Medicaid Managed Care	$4.90

SCREW PERI 3.5MMX22MM W/2.7

Facility

$185.00

Hospital Charge Code	270661510
Hospital Revenue Code	278
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$92.50
Rate for Payer: Aetna Commercial	$70.30
Rate for Payer: Aetna Medicare Advantage	$55.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.17
Rate for Payer: Cigna Commercial	$92.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$40.70
Rate for Payer: Qualcare PPO/HMO/WC	$27.75
Rate for Payer: UnitedHealthcare Community & State	$4.46
Rate for Payer: Wellpoint Medicaid Managed Care	$4.90

SCREW PERI 3.5MMX22MM W/2.7

Facility

$185.00

Hospital Charge Code	270661510
Hospital Revenue Code	278
Min. Negotiated Rate	$27.75
Max. Negotiated Rate	$44.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$40.70
Rate for Payer: Qualcare PPO/HMO/WC	$27.75

SCREW PERI 3.5mmx30mm 23483035

Facility

$122.25

Hospital Charge Code	270634819
Hospital Revenue Code	278
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$61.12
Rate for Payer: Aetna Commercial	$46.45
Rate for Payer: Aetna Medicare Advantage	$36.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.17
Rate for Payer: Cigna Commercial	$61.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$18.34
Rate for Payer: UnitedHealthcare Community & State	$2.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.24

SCREW PERI 3.5mmx30mm 23483035

Facility

$122.25

Hospital Charge Code	270634819
Hospital Revenue Code	278
Min. Negotiated Rate	$18.34
Max. Negotiated Rate	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$18.34

SCREW PERI 3.5mmx34m 23483435

Facility

$122.25

Hospital Charge Code	270634820
Hospital Revenue Code	278
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$61.12
Rate for Payer: Aetna Commercial	$46.45
Rate for Payer: Aetna Medicare Advantage	$36.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.17
Rate for Payer: Cigna Commercial	$61.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$18.34
Rate for Payer: UnitedHealthcare Community & State	$2.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.24

SCREW PERI 3.5mmx34m 23483435

Facility

$122.25

Hospital Charge Code	270634820
Hospital Revenue Code	278
Min. Negotiated Rate	$18.34
Max. Negotiated Rate	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$18.34

SCREW PERI 3.5mmx40mm 23484035

Facility

$122.25

Hospital Charge Code	270634821
Hospital Revenue Code	278
Min. Negotiated Rate	$18.34
Max. Negotiated Rate	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$18.34

SCREW PERI 3.5mmx40mm 23484035

Facility

$122.25

Hospital Charge Code	270634821
Hospital Revenue Code	278
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$61.12
Rate for Payer: Aetna Commercial	$46.45
Rate for Payer: Aetna Medicare Advantage	$36.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.17
Rate for Payer: Cigna Commercial	$61.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$18.34
Rate for Payer: UnitedHealthcare Community & State	$2.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.24

SCREW PERI 3.5mmx42mm 23484235

Facility

$122.25

Hospital Charge Code	270634822
Hospital Revenue Code	278
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$61.12
Rate for Payer: Aetna Commercial	$46.45
Rate for Payer: Aetna Medicare Advantage	$36.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.17
Rate for Payer: Cigna Commercial	$61.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$18.34
Rate for Payer: UnitedHealthcare Community & State	$2.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.24

SCREW PERI 3.5mmx42mm 23484235

Facility

$122.25

Hospital Charge Code	270634822
Hospital Revenue Code	278
Min. Negotiated Rate	$18.34
Max. Negotiated Rate	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$18.34

SCREW PERI 3.5mmx54mm 23485435

Facility

$122.25

Hospital Charge Code	270634823
Hospital Revenue Code	278
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$61.12
Rate for Payer: Aetna Commercial	$46.45
Rate for Payer: Aetna Medicare Advantage	$36.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.17
Rate for Payer: Cigna Commercial	$61.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$18.34
Rate for Payer: UnitedHealthcare Community & State	$2.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.24

SCREW PERI 3.5mmx54mm 23485435

Facility

$122.25

Hospital Charge Code	270634823
Hospital Revenue Code	278
Min. Negotiated Rate	$18.34
Max. Negotiated Rate	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$18.34

SCREW PERI 3.5x10 ST 23481035

Facility

$117.50

Hospital Charge Code	270632916
Hospital Revenue Code	278
Min. Negotiated Rate	$2.83
Max. Negotiated Rate	$58.75
Rate for Payer: Aetna Commercial	$44.65
Rate for Payer: Aetna Medicare Advantage	$35.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.96
Rate for Payer: Cigna Commercial	$58.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.85
Rate for Payer: Qualcare PPO/HMO/WC	$17.62
Rate for Payer: UnitedHealthcare Community & State	$2.83
Rate for Payer: Wellpoint Medicaid Managed Care	$3.11

SCREW PERI 3.5x10 ST 23481035

Facility

$117.50

Hospital Charge Code	270632916
Hospital Revenue Code	278
Min. Negotiated Rate	$17.62
Max. Negotiated Rate	$28.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.85
Rate for Payer: Qualcare PPO/HMO/WC	$17.62

SCREW PERI 3.5x12 ST 234801235

Facility

$122.45

Hospital Charge Code	270632917
Hospital Revenue Code	278
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$61.23
Rate for Payer: Aetna Commercial	$46.53
Rate for Payer: Aetna Medicare Advantage	$36.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.22
Rate for Payer: Cigna Commercial	$61.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.94
Rate for Payer: Qualcare PPO/HMO/WC	$18.37
Rate for Payer: UnitedHealthcare Community & State	$2.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.24

SCREW PERI 3.5x12 ST 234801235

Facility

$122.45

Hospital Charge Code	270632917
Hospital Revenue Code	278
Min. Negotiated Rate	$18.37
Max. Negotiated Rate	$29.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.94
Rate for Payer: Qualcare PPO/HMO/WC	$18.37

Know your out-of-pocket cost for care.

All Charges