Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW PERIARTL 4.0 38 23472238

Facility

$102.25

Hospital Charge Code	270634239
Hospital Revenue Code	278
Min. Negotiated Rate	$15.34
Max. Negotiated Rate	$24.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$15.34

SCREW PERIARTL 4.0 38 23472238

Facility

$102.25

Hospital Charge Code	270634239
Hospital Revenue Code	278
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$51.12
Rate for Payer: Aetna Commercial	$38.85
Rate for Payer: Aetna Medicare Advantage	$30.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.07
Rate for Payer: Cigna Commercial	$51.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$15.34
Rate for Payer: UnitedHealthcare Community & State	$2.46
Rate for Payer: Wellpoint Medicaid Managed Care	$2.71

SCREW PERIARTR 4.0 36 23472236

Facility

$102.25

Hospital Charge Code	270634238
Hospital Revenue Code	278
Min. Negotiated Rate	$15.34
Max. Negotiated Rate	$24.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$15.34

SCREW PERIARTR 4.0 36 23472236

Facility

$102.25

Hospital Charge Code	270634238
Hospital Revenue Code	278
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$51.12
Rate for Payer: Aetna Commercial	$38.85
Rate for Payer: Aetna Medicare Advantage	$30.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.07
Rate for Payer: Cigna Commercial	$51.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$15.34
Rate for Payer: UnitedHealthcare Community & State	$2.46
Rate for Payer: Wellpoint Medicaid Managed Care	$2.71

SCREW PERI CONICAL 2.7MM X 18M

Facility

$577.50

Service Code	HCPCS C1713
Hospital Charge Code	270702538
Hospital Revenue Code	278
Min. Negotiated Rate	$86.62
Max. Negotiated Rate	$139.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$86.62

SCREW PERI CONICAL 2.7MM X 18M

Facility

$577.50

Service Code	HCPCS C1713
Hospital Charge Code	270702538
Hospital Revenue Code	278
Min. Negotiated Rate	$13.92
Max. Negotiated Rate	$288.75
Rate for Payer: Aetna Commercial	$219.45
Rate for Payer: Aetna Medicare Advantage	$173.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.26
Rate for Payer: Cigna Commercial	$288.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$86.62
Rate for Payer: UnitedHealthcare Community & State	$13.92
Rate for Payer: Wellpoint Medicaid Managed Care	$15.30

SCREW PERIPHERAL 24MM

Facility

$600.00

Hospital Charge Code	270672419
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW PERIPHERAL 24MM

Facility

$600.00

Hospital Charge Code	270672419
Hospital Revenue Code	278
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

SCREW PERIPHERAL 30MM

Facility

$600.00

Hospital Charge Code	270672420
Hospital Revenue Code	278
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

SCREW PERIPHERAL 30MM

Facility

$600.00

Hospital Charge Code	270672420
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW PERIPHERAL 36MM

Facility

$600.00

Hospital Charge Code	270672421
Hospital Revenue Code	278
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

SCREW PERIPHERAL 36MM

Facility

$600.00

Hospital Charge Code	270672421
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW PERIPHERAL 42MM

Facility

$600.00

Hospital Charge Code	270672422
Hospital Revenue Code	278
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

SCREW PERIPHERAL 42MM

Facility

$600.00

Hospital Charge Code	270672422
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW PERIPHERAL 4.5x24MM

Facility

$650.00

Service Code	HCPCS C1713
Hospital Charge Code	270671581
Hospital Revenue Code	278
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

SCREW PERIPHERAL 4.5x24MM

Facility

$650.00

Service Code	HCPCS C1713
Hospital Charge Code	270671581
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

SCREW PERIPHERAL 4.5x28MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270671580
Hospital Revenue Code	278
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

SCREW PERIPHERAL 4.5x28MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270671580
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW PERIPHERAL 4.5x32MM

Facility

$650.00

Service Code	HCPCS C1713
Hospital Charge Code	270672126
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

SCREW PERIPHERAL 4.5x32MM

Facility

$650.00

Service Code	HCPCS C1713
Hospital Charge Code	270672126
Hospital Revenue Code	278
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

SCREW PERIPHERAL 48MM

Facility

$600.00

Hospital Charge Code	270672423
Hospital Revenue Code	278
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

SCREW PERIPHERAL 48MM

Facility

$600.00

Hospital Charge Code	270672423
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW PERIPR VAL OPTILINK 12MM

Facility

$1,569.50

Service Code	HCPCS C1713
Hospital Charge Code	270693771
Hospital Revenue Code	278
Min. Negotiated Rate	$235.43
Max. Negotiated Rate	$379.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$379.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$345.29
Rate for Payer: Qualcare PPO/HMO/WC	$235.43

SCREW PERIPR VAL OPTILINK 12MM

Facility

$1,569.50

Service Code	HCPCS C1713
Hospital Charge Code	270693771
Hospital Revenue Code	278
Min. Negotiated Rate	$37.82
Max. Negotiated Rate	$784.75
Rate for Payer: Aetna Commercial	$596.41
Rate for Payer: Aetna Medicare Advantage	$470.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$400.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$400.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$400.22
Rate for Payer: Cigna Commercial	$784.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$379.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$345.29
Rate for Payer: Qualcare PPO/HMO/WC	$235.43
Rate for Payer: UnitedHealthcare Community & State	$37.82
Rate for Payer: Wellpoint Medicaid Managed Care	$41.59

SCREW PERIPR VAL OPTILINK 5.0

Facility

$1,569.50

Service Code	HCPCS C1713
Hospital Charge Code	270693770
Hospital Revenue Code	278
Min. Negotiated Rate	$235.43
Max. Negotiated Rate	$379.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$379.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$345.29
Rate for Payer: Qualcare PPO/HMO/WC	$235.43

Know your out-of-pocket cost for care.

All Charges