Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW PT 4X40MM

Facility

$931.50

Service Code	HCPCS C1713
Hospital Charge Code	270701133
Hospital Revenue Code	278
Min. Negotiated Rate	$139.72
Max. Negotiated Rate	$225.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.30
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

SCREW PT 5.0x60 325460S

Facility

$1,315.00

Hospital Charge Code	270648762
Hospital Revenue Code	278
Min. Negotiated Rate	$197.25
Max. Negotiated Rate	$318.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$289.30
Rate for Payer: Qualcare PPO/HMO/WC	$197.25

SCREW PT 5.0x60 325460S

Facility

$1,315.00

Hospital Charge Code	270648762
Hospital Revenue Code	278
Min. Negotiated Rate	$31.69
Max. Negotiated Rate	$657.50
Rate for Payer: Aetna Commercial	$499.70
Rate for Payer: Aetna Medicare Advantage	$394.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.32
Rate for Payer: Cigna Commercial	$657.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$289.30
Rate for Payer: Qualcare PPO/HMO/WC	$197.25
Rate for Payer: UnitedHealthcare Community & State	$31.69
Rate for Payer: Wellpoint Medicaid Managed Care	$34.85

SCREW PT CANCELLOUS 4X30MM

Facility

$1,452.30

Service Code	HCPCS C1713
Hospital Charge Code	270705010
Hospital Revenue Code	278
Min. Negotiated Rate	$217.84
Max. Negotiated Rate	$351.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$351.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$319.51
Rate for Payer: Qualcare PPO/HMO/WC	$217.84

SCREW PT CANCELLOUS 4X30MM

Facility

$1,452.30

Service Code	HCPCS C1713
Hospital Charge Code	270705010
Hospital Revenue Code	278
Min. Negotiated Rate	$35.00
Max. Negotiated Rate	$726.15
Rate for Payer: Aetna Commercial	$551.87
Rate for Payer: Aetna Medicare Advantage	$435.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$370.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$370.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$370.34
Rate for Payer: Cigna Commercial	$726.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$351.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$319.51
Rate for Payer: Qualcare PPO/HMO/WC	$217.84
Rate for Payer: UnitedHealthcare Community & State	$35.00
Rate for Payer: Wellpoint Medicaid Managed Care	$38.49

SCREW PTLY THRD TI 4.5X45MM

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693761
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

SCREW PTLY THRD TI 4.5X45MM

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693761
Hospital Revenue Code	278
Min. Negotiated Rate	$95.80
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,510.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$596.25
Rate for Payer: UnitedHealthcare Community & State	$95.80
Rate for Payer: Wellpoint Medicaid Managed Care	$105.34

SCREW PT THR C PANTA2 5.0X65MM

Facility

$4,895.00

Service Code	HCPCS C1713
Hospital Charge Code	270699960
Hospital Revenue Code	278
Min. Negotiated Rate	$734.25
Max. Negotiated Rate	$1,184.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$979.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,184.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,076.90
Rate for Payer: Qualcare PPO/HMO/WC	$734.25

SCREW PT THR C PANTA2 5.0X65MM

Facility

$4,895.00

Service Code	HCPCS C1713
Hospital Charge Code	270699960
Hospital Revenue Code	278
Min. Negotiated Rate	$117.97
Max. Negotiated Rate	$2,447.50
Rate for Payer: Aetna Commercial	$1,860.10
Rate for Payer: Aetna Medicare Advantage	$1,468.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,248.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,248.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$979.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,248.22
Rate for Payer: Cigna Commercial	$2,447.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,184.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,076.90
Rate for Payer: Qualcare PPO/HMO/WC	$734.25
Rate for Payer: UnitedHealthcare Community & State	$117.97
Rate for Payer: Wellpoint Medicaid Managed Care	$129.72

SCREW PT THREAD 4.5 X 55 MM

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270669797
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SCREW PT THREAD 4.5 X 55 MM

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270669797
Hospital Revenue Code	278
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

SCREW P VAL OPTILINK SD 5X14MM

Facility

$3,990.00

Service Code	HCPCS C1713
Hospital Charge Code	270699687
Hospital Revenue Code	278
Min. Negotiated Rate	$598.50
Max. Negotiated Rate	$965.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$798.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$965.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$877.80
Rate for Payer: Qualcare PPO/HMO/WC	$598.50

SCREW P VAL OPTILINK SD 5X14MM

Facility

$3,990.00

Service Code	HCPCS C1713
Hospital Charge Code	270699687
Hospital Revenue Code	278
Min. Negotiated Rate	$96.16
Max. Negotiated Rate	$1,995.00
Rate for Payer: Aetna Commercial	$1,516.20
Rate for Payer: Aetna Medicare Advantage	$1,197.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,017.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,017.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$798.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,017.45
Rate for Payer: Cigna Commercial	$1,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$965.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$877.80
Rate for Payer: Qualcare PPO/HMO/WC	$598.50
Rate for Payer: UnitedHealthcare Community & State	$96.16
Rate for Payer: Wellpoint Medicaid Managed Care	$105.73

SCREW P VAL OPTILINK SD 5X16MM

Facility

$3,990.00

Service Code	HCPCS C1713
Hospital Charge Code	270699688
Hospital Revenue Code	278
Min. Negotiated Rate	$96.16
Max. Negotiated Rate	$1,995.00
Rate for Payer: Aetna Commercial	$1,516.20
Rate for Payer: Aetna Medicare Advantage	$1,197.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,017.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,017.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$798.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,017.45
Rate for Payer: Cigna Commercial	$1,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$965.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$877.80
Rate for Payer: Qualcare PPO/HMO/WC	$598.50
Rate for Payer: UnitedHealthcare Community & State	$96.16
Rate for Payer: Wellpoint Medicaid Managed Care	$105.73

SCREW P VAL OPTILINK SD 5X16MM

Facility

$3,990.00

Service Code	HCPCS C1713
Hospital Charge Code	270699688
Hospital Revenue Code	278
Min. Negotiated Rate	$598.50
Max. Negotiated Rate	$965.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$798.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$965.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$877.80
Rate for Payer: Qualcare PPO/HMO/WC	$598.50

SCREW PYRENEES 2 LV MONO 44MM

Facility

$6,520.00

Service Code	HCPCS C1713
Hospital Charge Code	270691702
Hospital Revenue Code	278
Min. Negotiated Rate	$157.13
Max. Negotiated Rate	$3,260.00
Rate for Payer: Aetna Commercial	$2,477.60
Rate for Payer: Aetna Medicare Advantage	$1,956.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,662.60
Rate for Payer: Cigna Commercial	$3,260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,434.40
Rate for Payer: Qualcare PPO/HMO/WC	$978.00
Rate for Payer: UnitedHealthcare Community & State	$157.13
Rate for Payer: Wellpoint Medicaid Managed Care	$172.78

SCREW PYRENEES 2 LV MONO 44MM

Facility

$6,520.00

Service Code	HCPCS C1713
Hospital Charge Code	270691702
Hospital Revenue Code	278
Min. Negotiated Rate	$978.00
Max. Negotiated Rate	$1,577.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,434.40
Rate for Payer: Qualcare PPO/HMO/WC	$978.00

SCREW PYRENEES SLF STRT 4X12MM

Facility

$1,565.00

Hospital Charge Code	270670333
Hospital Revenue Code	278
Min. Negotiated Rate	$37.72
Max. Negotiated Rate	$782.50
Rate for Payer: Aetna Commercial	$594.70
Rate for Payer: Aetna Medicare Advantage	$469.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$399.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$399.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$399.07
Rate for Payer: Cigna Commercial	$782.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$378.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$344.30
Rate for Payer: Qualcare PPO/HMO/WC	$234.75
Rate for Payer: UnitedHealthcare Community & State	$37.72
Rate for Payer: Wellpoint Medicaid Managed Care	$41.47

SCREW PYRENEES SLF STRT 4X12MM

Facility

$1,565.00

Hospital Charge Code	270670333
Hospital Revenue Code	278
Min. Negotiated Rate	$234.75
Max. Negotiated Rate	$378.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$378.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$344.30
Rate for Payer: Qualcare PPO/HMO/WC	$234.75

SCREW PYRENEES SLF STRT 4X14MM

Facility

$1,565.00

Service Code	HCPCS C1713
Hospital Charge Code	270670335
Hospital Revenue Code	278
Min. Negotiated Rate	$37.72
Max. Negotiated Rate	$782.50
Rate for Payer: Aetna Commercial	$594.70
Rate for Payer: Aetna Medicare Advantage	$469.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$399.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$399.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$399.07
Rate for Payer: Cigna Commercial	$782.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$378.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$344.30
Rate for Payer: Qualcare PPO/HMO/WC	$234.75
Rate for Payer: UnitedHealthcare Community & State	$37.72
Rate for Payer: Wellpoint Medicaid Managed Care	$41.47

SCREW PYRENEES SLF STRT 4X14MM

Facility

$1,565.00

Service Code	HCPCS C1713
Hospital Charge Code	270670335
Hospital Revenue Code	278
Min. Negotiated Rate	$234.75
Max. Negotiated Rate	$378.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$378.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$344.30
Rate for Payer: Qualcare PPO/HMO/WC	$234.75

SCREW PYRENEES SLF STRT 4X16MM

Facility

$1,565.00

Service Code	HCPCS C1713
Hospital Charge Code	270670337
Hospital Revenue Code	278
Min. Negotiated Rate	$37.72
Max. Negotiated Rate	$782.50
Rate for Payer: Aetna Commercial	$594.70
Rate for Payer: Aetna Medicare Advantage	$469.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$399.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$399.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$399.07
Rate for Payer: Cigna Commercial	$782.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$378.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$344.30
Rate for Payer: Qualcare PPO/HMO/WC	$234.75
Rate for Payer: UnitedHealthcare Community & State	$37.72
Rate for Payer: Wellpoint Medicaid Managed Care	$41.47

SCREW PYRENEES SLF STRT 4X16MM

Facility

$1,565.00

Service Code	HCPCS C1713
Hospital Charge Code	270670337
Hospital Revenue Code	278
Min. Negotiated Rate	$234.75
Max. Negotiated Rate	$378.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$378.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$344.30
Rate for Payer: Qualcare PPO/HMO/WC	$234.75

SCREW PYRENEES SLF STRT 4X18MM

Facility

$1,565.00

Hospital Charge Code	270670339
Hospital Revenue Code	278
Min. Negotiated Rate	$37.72
Max. Negotiated Rate	$782.50
Rate for Payer: Aetna Commercial	$594.70
Rate for Payer: Aetna Medicare Advantage	$469.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$399.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$399.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$399.07
Rate for Payer: Cigna Commercial	$782.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$378.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$344.30
Rate for Payer: Qualcare PPO/HMO/WC	$234.75
Rate for Payer: UnitedHealthcare Community & State	$37.72
Rate for Payer: Wellpoint Medicaid Managed Care	$41.47

SCREW PYRENEES SLF STRT 4X18MM

Facility

$1,565.00

Hospital Charge Code	270670339
Hospital Revenue Code	278
Min. Negotiated Rate	$234.75
Max. Negotiated Rate	$378.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$378.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$344.30
Rate for Payer: Qualcare PPO/HMO/WC	$234.75

Know your out-of-pocket cost for care.

All Charges