Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW PLT 3.5X 30MM

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	201701289
Hospital Revenue Code	278
Min. Negotiated Rate	$21.87
Max. Negotiated Rate	$453.75
Rate for Payer: Aetna Commercial	$344.85
Rate for Payer: Aetna Medicare Advantage	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.41
Rate for Payer: Cigna Commercial	$453.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$136.12
Rate for Payer: UnitedHealthcare Community & State	$21.87
Rate for Payer: Wellpoint Medicaid Managed Care	$24.05

SCREW PLT 3.5X 30MM

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	201701289
Hospital Revenue Code	278
Min. Negotiated Rate	$136.12
Max. Negotiated Rate	$219.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$136.12

SCREW PLT 3.5X 30MM

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	701289
Hospital Revenue Code	278
Min. Negotiated Rate	$21.87
Max. Negotiated Rate	$453.75
Rate for Payer: Aetna Commercial	$344.85
Rate for Payer: Aetna Medicare Advantage	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.41
Rate for Payer: Cigna Commercial	$453.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$136.12
Rate for Payer: UnitedHealthcare Community & State	$21.87
Rate for Payer: Wellpoint Medicaid Managed Care	$24.05

SCREW PLT LKNG R3CON 3.5X 28 M

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	270701286
Hospital Revenue Code	278
Min. Negotiated Rate	$136.12
Max. Negotiated Rate	$219.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$136.12

SCREW PLT LKNG R3CON 3.5X 28 M

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	270701286
Hospital Revenue Code	278
Min. Negotiated Rate	$21.87
Max. Negotiated Rate	$453.75
Rate for Payer: Aetna Commercial	$344.85
Rate for Payer: Aetna Medicare Advantage	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.41
Rate for Payer: Cigna Commercial	$453.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$136.12
Rate for Payer: UnitedHealthcare Community & State	$21.87
Rate for Payer: Wellpoint Medicaid Managed Care	$24.05

SCREW PLT R2CON 2.7X 26 MM

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	270701293
Hospital Revenue Code	278
Min. Negotiated Rate	$21.87
Max. Negotiated Rate	$453.75
Rate for Payer: Aetna Commercial	$344.85
Rate for Payer: Aetna Medicare Advantage	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.41
Rate for Payer: Cigna Commercial	$453.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$136.12
Rate for Payer: UnitedHealthcare Community & State	$21.87
Rate for Payer: Wellpoint Medicaid Managed Care	$24.05

SCREW PLT R2CON 2.7X 26 MM

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	270701293
Hospital Revenue Code	278
Min. Negotiated Rate	$136.12
Max. Negotiated Rate	$219.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$136.12

SCREW PLT R2CON 2.7X 36MM

Facility

$907.50

Service Code	HCPCS C1718
Hospital Charge Code	270701291
Hospital Revenue Code	278
Min. Negotiated Rate	$136.12
Max. Negotiated Rate	$219.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$136.12

SCREW PLT R2CON 2.7X 36MM

Facility

$907.50

Service Code	HCPCS C1718
Hospital Charge Code	270701291
Hospital Revenue Code	278
Min. Negotiated Rate	$21.87
Max. Negotiated Rate	$453.75
Rate for Payer: Aetna Commercial	$344.85
Rate for Payer: Aetna Medicare Advantage	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.41
Rate for Payer: Cigna Commercial	$453.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$136.12
Rate for Payer: UnitedHealthcare Community & State	$21.87
Rate for Payer: Wellpoint Medicaid Managed Care	$24.05

SCREW PLT R2CON 3.5MMX36 MM

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	270701288
Hospital Revenue Code	278
Min. Negotiated Rate	$21.87
Max. Negotiated Rate	$453.75
Rate for Payer: Aetna Commercial	$344.85
Rate for Payer: Aetna Medicare Advantage	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.41
Rate for Payer: Cigna Commercial	$453.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$136.12
Rate for Payer: UnitedHealthcare Community & State	$21.87
Rate for Payer: Wellpoint Medicaid Managed Care	$24.05

SCREW PLT R2CON 3.5MMX36 MM

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	270701288
Hospital Revenue Code	278
Min. Negotiated Rate	$136.12
Max. Negotiated Rate	$219.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$136.12

SCREW PLT R2CON 3.5X 20 MM

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	270701290
Hospital Revenue Code	278
Min. Negotiated Rate	$21.87
Max. Negotiated Rate	$453.75
Rate for Payer: Aetna Commercial	$344.85
Rate for Payer: Aetna Medicare Advantage	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.41
Rate for Payer: Cigna Commercial	$453.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$136.12
Rate for Payer: UnitedHealthcare Community & State	$21.87
Rate for Payer: Wellpoint Medicaid Managed Care	$24.05

SCREW PLT R2CON 3.5X 20 MM

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	270701290
Hospital Revenue Code	278
Min. Negotiated Rate	$136.12
Max. Negotiated Rate	$219.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$136.12

SCREW PLT R2CON 3.5X 24 MM

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	270701295
Hospital Revenue Code	278
Min. Negotiated Rate	$15.91
Max. Negotiated Rate	$330.00
Rate for Payer: Aetna Commercial	$250.80
Rate for Payer: Aetna Medicare Advantage	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.30
Rate for Payer: Cigna Commercial	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.00
Rate for Payer: UnitedHealthcare Community & State	$15.91
Rate for Payer: Wellpoint Medicaid Managed Care	$17.49

SCREW PLT R2CON 3.5X 24 MM

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	270701295
Hospital Revenue Code	278
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$159.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

SCREW PLT R3CON 3.5 X 24 MM

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	270701287
Hospital Revenue Code	278
Min. Negotiated Rate	$21.87
Max. Negotiated Rate	$453.75
Rate for Payer: Aetna Commercial	$344.85
Rate for Payer: Aetna Medicare Advantage	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.41
Rate for Payer: Cigna Commercial	$453.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$136.12
Rate for Payer: UnitedHealthcare Community & State	$21.87
Rate for Payer: Wellpoint Medicaid Managed Care	$24.05

SCREW PLT R3CON 3.5 X 24 MM

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	270701287
Hospital Revenue Code	278
Min. Negotiated Rate	$136.12
Max. Negotiated Rate	$219.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$136.12

SCREW PLT R3CON 3.5X32 MM

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	270701294
Hospital Revenue Code	278
Min. Negotiated Rate	$136.12
Max. Negotiated Rate	$219.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$136.12

SCREW PLT R3CON 3.5X32 MM

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	270701294
Hospital Revenue Code	278
Min. Negotiated Rate	$21.87
Max. Negotiated Rate	$453.75
Rate for Payer: Aetna Commercial	$344.85
Rate for Payer: Aetna Medicare Advantage	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.41
Rate for Payer: Cigna Commercial	$453.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$136.12
Rate for Payer: UnitedHealthcare Community & State	$21.87
Rate for Payer: Wellpoint Medicaid Managed Care	$24.05

SCREW PLUG INCORE

Facility

$1,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270688018
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 PLUG INCORE

Facility

$1,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270688018
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 PLUG POST INCORE

Facility

$1,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270687068
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 PLUG POST INCORE

Facility

$1,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270687068
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 PLUSDRIVE 2.0 X 8 MM

Facility

$395.00

Hospital Charge Code	270666269
Hospital Revenue Code	278
Min. Negotiated Rate	$9.52
Max. Negotiated Rate	$197.50
Rate for Payer: Aetna Commercial	$150.10
Rate for Payer: Aetna Medicare Advantage	$118.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.72
Rate for Payer: Cigna Commercial	$197.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$86.90
Rate for Payer: Qualcare PPO/HMO/WC	$59.25
Rate for Payer: UnitedHealthcare Community & State	$9.52
Rate for Payer: Wellpoint Medicaid Managed Care	$10.47

SCREW PLUSDRIVE 2.0 X 8 MM

Facility

$395.00

Hospital Charge Code	270666269
Hospital Revenue Code	278
Min. Negotiated Rate	$59.25
Max. Negotiated Rate	$95.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$86.90
Rate for Payer: Qualcare PPO/HMO/WC	$59.25

Know your out-of-pocket cost for care.

All Charges