Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW POLY EVEREST 8.5X80MM

Facility

$6,000.00

Hospital Charge Code	270670236
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

SCREW POLY EVEREST 8.5X80MM

Facility

$6,000.00

Hospital Charge Code	270670236
Hospital Revenue Code	278
Min. Negotiated Rate	$144.60
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$159.00

SCREW POLY EVEREST 8.5X85MM

Facility

$6,000.00

Hospital Charge Code	270670237
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

SCREW POLY EVEREST 8.5X85MM

Facility

$6,000.00

Hospital Charge Code	270670237
Hospital Revenue Code	278
Min. Negotiated Rate	$144.60
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$159.00

SCREWPOLYEXTOVERWATCH6.5X50MM

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694125
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,155.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

SCREWPOLYEXTOVERWATCH6.5X50MM

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694125
Hospital Revenue Code	278
Min. Negotiated Rate	$126.53
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,995.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,155.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Community & State	$126.53
Rate for Payer: Wellpoint Medicaid Managed Care	$139.12

SCREW POLY TAB EXT 6.5X45MM

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692625
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,155.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

SCREW POLY TAB EXT 6.5X45MM

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692625
Hospital Revenue Code	278
Min. Negotiated Rate	$126.53
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,995.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,155.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Community & State	$126.53
Rate for Payer: Wellpoint Medicaid Managed Care	$139.12

SCREW POST ARTHROSCOPY CANCELL

Facility

$445.00

Hospital Charge Code	270655967
Hospital Revenue Code	278
Min. Negotiated Rate	$66.75
Max. Negotiated Rate	$107.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$89.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$97.90
Rate for Payer: Qualcare PPO/HMO/WC	$66.75

SCREW POST ARTHROSCOPY CANCELL

Facility

$445.00

Hospital Charge Code	270655967
Hospital Revenue Code	278
Min. Negotiated Rate	$10.72
Max. Negotiated Rate	$222.50
Rate for Payer: Aetna Commercial	$169.10
Rate for Payer: Aetna Medicare Advantage	$133.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$89.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.47
Rate for Payer: Cigna Commercial	$222.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$97.90
Rate for Payer: Qualcare PPO/HMO/WC	$66.75
Rate for Payer: UnitedHealthcare Community & State	$10.72
Rate for Payer: Wellpoint Medicaid Managed Care	$11.79

SCREW POST PLUG

Facility

$1,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270686980
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 POST PLUG

Facility

$1,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270686980
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 PP LKG ST T6 SD 5.0X14MM

Facility

$3,385.00

Service Code	HCPCS C1713
Hospital Charge Code	270700476
Hospital Revenue Code	278
Min. Negotiated Rate	$81.58
Max. Negotiated Rate	$1,692.50
Rate for Payer: Aetna Commercial	$1,286.30
Rate for Payer: Aetna Medicare Advantage	$1,015.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$863.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$863.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$677.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$863.17
Rate for Payer: Cigna Commercial	$1,692.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$819.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$744.70
Rate for Payer: Qualcare PPO/HMO/WC	$507.75
Rate for Payer: UnitedHealthcare Community & State	$81.58
Rate for Payer: Wellpoint Medicaid Managed Care	$89.70

SCREW PP LKG ST T6 SD 5.0X14MM

Facility

$3,385.00

Service Code	HCPCS C1713
Hospital Charge Code	270700476
Hospital Revenue Code	278
Min. Negotiated Rate	$507.75
Max. Negotiated Rate	$819.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$677.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$819.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$744.70
Rate for Payer: Qualcare PPO/HMO/WC	$507.75

SCREW PRARCLR 3.5x26 234702026

Facility

$111.40

Hospital Charge Code	270639268
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 PRARCLR 3.5x26 234702026

Facility

$111.40

Hospital Charge Code	270639268
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 PRARTLR 3.5x24 234702024

Facility

$111.40

Hospital Charge Code	270639267
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 PRARTLR 3.5x24 234702024

Facility

$111.40

Hospital Charge Code	270639267
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 PRECEPT - 6.5X45MM

Facility

$10,285.00

Hospital Charge Code	270657319
Hospital Revenue Code	278
Min. Negotiated Rate	$1,542.75
Max. Negotiated Rate	$2,488.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,057.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,488.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,262.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,542.75

SCREW PRECEPT - 6.5X45MM

Facility

$10,285.00

Hospital Charge Code	270657319
Hospital Revenue Code	278
Min. Negotiated Rate	$247.87
Max. Negotiated Rate	$5,142.50
Rate for Payer: Aetna Commercial	$3,908.30
Rate for Payer: Aetna Medicare Advantage	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,622.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,622.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,622.68
Rate for Payer: Cigna Commercial	$5,142.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,488.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,262.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,542.75
Rate for Payer: UnitedHealthcare Community & State	$247.87
Rate for Payer: Wellpoint Medicaid Managed Care	$272.55

SCREW PROFILE 8x25MM

Facility

$1,460.00

Service Code	HCPCS C1713
Hospital Charge Code	270673366
Hospital Revenue Code	278
Min. Negotiated Rate	$219.00
Max. Negotiated Rate	$353.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$353.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$321.20
Rate for Payer: Qualcare PPO/HMO/WC	$219.00

SCREW PROFILE 8x25MM

Facility

$1,460.00

Service Code	HCPCS C1713
Hospital Charge Code	270673366
Hospital Revenue Code	278
Min. Negotiated Rate	$35.19
Max. Negotiated Rate	$730.00
Rate for Payer: Aetna Commercial	$554.80
Rate for Payer: Aetna Medicare Advantage	$438.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$372.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$372.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$372.30
Rate for Payer: Cigna Commercial	$730.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$353.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$321.20
Rate for Payer: Qualcare PPO/HMO/WC	$219.00
Rate for Payer: UnitedHealthcare Community & State	$35.19
Rate for Payer: Wellpoint Medicaid Managed Care	$38.69

SCREW PRRTCLR 3.5x28 234702028

Facility

$111.40

Hospital Charge Code	270639269
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 PRRTCLR 3.5x28 234702028

Facility

$111.40

Hospital Charge Code	270639269
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 PT 4X40MM

Facility

$931.50

Service Code	HCPCS C1713
Hospital Charge Code	270701133
Hospital Revenue Code	278
Min. Negotiated Rate	$22.45
Max. Negotiated Rate	$465.75
Rate for Payer: Aetna Commercial	$353.97
Rate for Payer: Aetna Medicare Advantage	$279.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.53
Rate for Payer: Cigna Commercial	$465.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$204.93
Rate for Payer: Qualcare PPO/HMO/WC	$139.72
Rate for Payer: UnitedHealthcare Community & State	$22.45
Rate for Payer: Wellpoint Medicaid Managed Care	$24.68

Know your out-of-pocket cost for care.

All Charges