Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW PERP AEQ PERF REV 5X34MM

Facility

$1,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270700521
Hospital Revenue Code	278
Min. Negotiated Rate	$43.38
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$684.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Community & State	$43.38
Rate for Payer: Wellpoint Medicaid Managed Care	$47.70

SCREW PERP AEQ PERF REV 5X34MM

Facility

$1,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270700521
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$435.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

SCREW PINNACLE CANC 6.5X35MM

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270700356
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 PINNACLE CANC 6.5X35MM

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270700356
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 PLATE COMPR 3.5x20MM

Facility

$934.80

Hospital Charge Code	270667923
Hospital Revenue Code	278
Min. Negotiated Rate	$22.53
Max. Negotiated Rate	$467.40
Rate for Payer: Aetna Commercial	$355.22
Rate for Payer: Aetna Medicare Advantage	$280.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.37
Rate for Payer: Cigna Commercial	$467.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$205.66
Rate for Payer: Qualcare PPO/HMO/WC	$140.22
Rate for Payer: UnitedHealthcare Community & State	$22.53
Rate for Payer: Wellpoint Medicaid Managed Care	$24.77

SCREW PLATE COMPR 3.5x20MM

Facility

$934.80

Hospital Charge Code	270667923
Hospital Revenue Code	278
Min. Negotiated Rate	$140.22
Max. Negotiated Rate	$226.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$205.66
Rate for Payer: Qualcare PPO/HMO/WC	$140.22

SCREW PLATE LOCKING 2.7x14MM

Facility

$1,068.50

Service Code	HCPCS C1713
Hospital Charge Code	270657185
Hospital Revenue Code	278
Min. Negotiated Rate	$160.28
Max. Negotiated Rate	$258.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.07
Rate for Payer: Qualcare PPO/HMO/WC	$160.28

SCREW PLATE LOCKING 2.7x14MM

Facility

$1,068.50

Service Code	HCPCS C1713
Hospital Charge Code	270657185
Hospital Revenue Code	278
Min. Negotiated Rate	$25.75
Max. Negotiated Rate	$534.25
Rate for Payer: Aetna Commercial	$406.03
Rate for Payer: Aetna Medicare Advantage	$320.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.47
Rate for Payer: Cigna Commercial	$534.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.07
Rate for Payer: Qualcare PPO/HMO/WC	$160.28
Rate for Payer: UnitedHealthcare Community & State	$25.75
Rate for Payer: Wellpoint Medicaid Managed Care	$28.32

SCREW PLATE LOCKING 2.7x16MM

Facility

$1,068.50

Service Code	HCPCS C1713
Hospital Charge Code	270657187
Hospital Revenue Code	278
Min. Negotiated Rate	$160.28
Max. Negotiated Rate	$258.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.07
Rate for Payer: Qualcare PPO/HMO/WC	$160.28

SCREW PLATE LOCKING 2.7x16MM

Facility

$1,068.50

Service Code	HCPCS C1713
Hospital Charge Code	270657187
Hospital Revenue Code	278
Min. Negotiated Rate	$25.75
Max. Negotiated Rate	$534.25
Rate for Payer: Aetna Commercial	$406.03
Rate for Payer: Aetna Medicare Advantage	$320.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.47
Rate for Payer: Cigna Commercial	$534.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.07
Rate for Payer: Qualcare PPO/HMO/WC	$160.28
Rate for Payer: UnitedHealthcare Community & State	$25.75
Rate for Payer: Wellpoint Medicaid Managed Care	$28.32

SCREW PLATE LOCKING 2.7x18MM

Facility

$1,068.50

Hospital Charge Code	270657188
Hospital Revenue Code	278
Min. Negotiated Rate	$160.28
Max. Negotiated Rate	$258.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.07
Rate for Payer: Qualcare PPO/HMO/WC	$160.28

SCREW PLATE LOCKING 2.7x18MM

Facility

$1,068.50

Hospital Charge Code	270657188
Hospital Revenue Code	278
Min. Negotiated Rate	$25.75
Max. Negotiated Rate	$534.25
Rate for Payer: Aetna Commercial	$406.03
Rate for Payer: Aetna Medicare Advantage	$320.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.47
Rate for Payer: Cigna Commercial	$534.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.07
Rate for Payer: Qualcare PPO/HMO/WC	$160.28
Rate for Payer: UnitedHealthcare Community & State	$25.75
Rate for Payer: Wellpoint Medicaid Managed Care	$28.32

SCREW PLATE LOCKING 2.7x20MM

Facility

$1,068.50

Hospital Charge Code	270657190
Hospital Revenue Code	278
Min. Negotiated Rate	$25.75
Max. Negotiated Rate	$534.25
Rate for Payer: Aetna Commercial	$406.03
Rate for Payer: Aetna Medicare Advantage	$320.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.47
Rate for Payer: Cigna Commercial	$534.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.07
Rate for Payer: Qualcare PPO/HMO/WC	$160.28
Rate for Payer: UnitedHealthcare Community & State	$25.75
Rate for Payer: Wellpoint Medicaid Managed Care	$28.32

SCREW PLATE LOCKING 2.7x20MM

Facility

$1,068.50

Hospital Charge Code	270657190
Hospital Revenue Code	278
Min. Negotiated Rate	$160.28
Max. Negotiated Rate	$258.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.07
Rate for Payer: Qualcare PPO/HMO/WC	$160.28

SCREW PLATE LOCKING 3.5x20MM

Facility

$1,283.30

Hospital Charge Code	270667924
Hospital Revenue Code	278
Min. Negotiated Rate	$30.93
Max. Negotiated Rate	$641.65
Rate for Payer: Aetna Commercial	$487.65
Rate for Payer: Aetna Medicare Advantage	$384.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$327.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$327.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$327.24
Rate for Payer: Cigna Commercial	$641.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$282.33
Rate for Payer: Qualcare PPO/HMO/WC	$192.50
Rate for Payer: UnitedHealthcare Community & State	$30.93
Rate for Payer: Wellpoint Medicaid Managed Care	$34.01

SCREW PLATE LOCKING 3.5x20MM

Facility

$1,283.30

Hospital Charge Code	270667924
Hospital Revenue Code	278
Min. Negotiated Rate	$192.50
Max. Negotiated Rate	$310.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$282.33
Rate for Payer: Qualcare PPO/HMO/WC	$192.50

SCREW PLATE LOCKING 3.5x26MM

Facility

$1,283.30

Hospital Charge Code	270667925
Hospital Revenue Code	278
Min. Negotiated Rate	$192.50
Max. Negotiated Rate	$310.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$282.33
Rate for Payer: Qualcare PPO/HMO/WC	$192.50

SCREW PLATE LOCKING 3.5x26MM

Facility

$1,283.30

Hospital Charge Code	270667925
Hospital Revenue Code	278
Min. Negotiated Rate	$30.93
Max. Negotiated Rate	$641.65
Rate for Payer: Aetna Commercial	$487.65
Rate for Payer: Aetna Medicare Advantage	$384.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$327.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$327.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$327.24
Rate for Payer: Cigna Commercial	$641.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$282.33
Rate for Payer: Qualcare PPO/HMO/WC	$192.50
Rate for Payer: UnitedHealthcare Community & State	$30.93
Rate for Payer: Wellpoint Medicaid Managed Care	$34.01

SCREW PLOY MESA 4.5X25MM

Facility

$6,250.00

Hospital Charge Code	270670238
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

SCREW PLOY MESA 4.5X25MM

Facility

$6,250.00

Hospital Charge Code	270670238
Hospital Revenue Code	278
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

SCREW PLOY MESA 4.5X30MM

Facility

$6,250.00

Hospital Charge Code	270670239
Hospital Revenue Code	278
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

SCREW PLOY MESA 4.5X30MM

Facility

$6,250.00

Hospital Charge Code	270670239
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

SCREW PLOY MESA 4.5X35MM

Facility

$6,250.00

Hospital Charge Code	270670240
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

SCREW PLOY MESA 4.5X35MM

Facility

$6,250.00

Hospital Charge Code	270670240
Hospital Revenue Code	278
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

SCREW PLOY MESA 4.5X40MM

Facility

$6,250.00

Hospital Charge Code	270670241
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

Know your out-of-pocket cost for care.

All Charges