Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW RESCUE VARIABLE 4.5X12MM

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270699100
Hospital Revenue Code	278
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

SCREW RETAINER 3.5MMX12MM

Facility

$917.50

Service Code	HCPCS C1713
Hospital Charge Code	270692983
Hospital Revenue Code	278
Min. Negotiated Rate	$137.62
Max. Negotiated Rate	$222.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$183.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$201.85
Rate for Payer: Qualcare PPO/HMO/WC	$137.62

SCREW RETAINER 3.5MMX12MM

Facility

$917.50

Service Code	HCPCS C1713
Hospital Charge Code	270692983
Hospital Revenue Code	278
Min. Negotiated Rate	$22.11
Max. Negotiated Rate	$458.75
Rate for Payer: Aetna Commercial	$348.65
Rate for Payer: Aetna Medicare Advantage	$275.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$233.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$233.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$183.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$233.96
Rate for Payer: Cigna Commercial	$458.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$201.85
Rate for Payer: Qualcare PPO/HMO/WC	$137.62
Rate for Payer: UnitedHealthcare Community & State	$22.11
Rate for Payer: Wellpoint Medicaid Managed Care	$24.31

SCREW RETAINER 3.5X14MM

Facility

$917.50

Service Code	HCPCS C1713
Hospital Charge Code	270692631
Hospital Revenue Code	278
Min. Negotiated Rate	$137.62
Max. Negotiated Rate	$222.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$183.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$201.85
Rate for Payer: Qualcare PPO/HMO/WC	$137.62

SCREW RETAINER 3.5X14MM

Facility

$917.50

Service Code	HCPCS C1713
Hospital Charge Code	270692631
Hospital Revenue Code	278
Min. Negotiated Rate	$22.11
Max. Negotiated Rate	$458.75
Rate for Payer: Aetna Commercial	$348.65
Rate for Payer: Aetna Medicare Advantage	$275.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$233.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$233.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$183.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$233.96
Rate for Payer: Cigna Commercial	$458.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$201.85
Rate for Payer: Qualcare PPO/HMO/WC	$137.62
Rate for Payer: UnitedHealthcare Community & State	$22.11
Rate for Payer: Wellpoint Medicaid Managed Care	$24.31

SCREW REUNION CTRPERI 6.5X24MM

Facility

$2,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270700594
Hospital Revenue Code	278
Min. Negotiated Rate	$51.45
Max. Negotiated Rate	$1,067.50
Rate for Payer: Aetna Commercial	$811.30
Rate for Payer: Aetna Medicare Advantage	$640.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$544.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$544.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$427.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$544.42
Rate for Payer: Cigna Commercial	$1,067.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$516.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$469.70
Rate for Payer: Qualcare PPO/HMO/WC	$320.25
Rate for Payer: UnitedHealthcare Community & State	$51.45
Rate for Payer: Wellpoint Medicaid Managed Care	$56.58

SCREW REUNION CTRPERI 6.5X24MM

Facility

$2,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270700594
Hospital Revenue Code	278
Min. Negotiated Rate	$320.25
Max. Negotiated Rate	$516.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$427.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$516.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$469.70
Rate for Payer: Qualcare PPO/HMO/WC	$320.25

SCREW REUNION PERIPH 4.5X36MM

Facility

$2,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270700593
Hospital Revenue Code	278
Min. Negotiated Rate	$320.25
Max. Negotiated Rate	$516.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$427.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$516.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$469.70
Rate for Payer: Qualcare PPO/HMO/WC	$320.25

SCREW REUNION PERIPH 4.5X36MM

Facility

$2,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270700593
Hospital Revenue Code	278
Min. Negotiated Rate	$51.45
Max. Negotiated Rate	$1,067.50
Rate for Payer: Aetna Commercial	$811.30
Rate for Payer: Aetna Medicare Advantage	$640.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$544.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$544.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$427.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$544.42
Rate for Payer: Cigna Commercial	$1,067.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$516.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$469.70
Rate for Payer: Qualcare PPO/HMO/WC	$320.25
Rate for Payer: UnitedHealthcare Community & State	$51.45
Rate for Payer: Wellpoint Medicaid Managed Care	$56.58

SCREW RND TAPERED INTF 8X28MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270675573
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 RND TAPERED INTF 8X28MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270675573
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 RSS 4.5X30 MM CAP

Facility

$984.75

Service Code	HCPCS C1713
Hospital Charge Code	270689634
Hospital Revenue Code	278
Min. Negotiated Rate	$147.71
Max. Negotiated Rate	$238.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$216.65
Rate for Payer: Qualcare PPO/HMO/WC	$147.71

SCREW RSS 4.5X30 MM CAP

Facility

$984.75

Service Code	HCPCS C1713
Hospital Charge Code	270689634
Hospital Revenue Code	278
Min. Negotiated Rate	$23.73
Max. Negotiated Rate	$492.38
Rate for Payer: Aetna Commercial	$374.20
Rate for Payer: Aetna Medicare Advantage	$295.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.11
Rate for Payer: Cigna Commercial	$492.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$216.65
Rate for Payer: Qualcare PPO/HMO/WC	$147.71
Rate for Payer: UnitedHealthcare Community & State	$23.73
Rate for Payer: Wellpoint Medicaid Managed Care	$26.10

SCREW RVRS GLENOID 6.5X25MM

Facility

$6,045.00

Service Code	HCPCS C1713
Hospital Charge Code	270700530
Hospital Revenue Code	278
Min. Negotiated Rate	$145.68
Max. Negotiated Rate	$3,022.50
Rate for Payer: Aetna Commercial	$2,297.10
Rate for Payer: Aetna Medicare Advantage	$1,813.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,541.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,541.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,209.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,541.47
Rate for Payer: Cigna Commercial	$3,022.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,462.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,329.90
Rate for Payer: Qualcare PPO/HMO/WC	$906.75
Rate for Payer: UnitedHealthcare Community & State	$145.68
Rate for Payer: Wellpoint Medicaid Managed Care	$160.19

SCREW RVRS GLENOID 6.5X25MM

Facility

$6,045.00

Service Code	HCPCS C1713
Hospital Charge Code	270700530
Hospital Revenue Code	278
Min. Negotiated Rate	$906.75
Max. Negotiated Rate	$1,462.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,209.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,462.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,329.90
Rate for Payer: Qualcare PPO/HMO/WC	$906.75

SCREWS 5.5 X 40 MM

Facility

$2,200.00

Hospital Charge Code	270702852
Hospital Revenue Code	278
Min. Negotiated Rate	$53.02
Max. Negotiated Rate	$1,100.00
Rate for Payer: Aetna Commercial	$836.00
Rate for Payer: Aetna Medicare Advantage	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$561.00
Rate for Payer: Cigna Commercial	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$330.00
Rate for Payer: UnitedHealthcare Community & State	$53.02
Rate for Payer: Wellpoint Medicaid Managed Care	$58.30

SCREWS 5.5 X 40 MM

Facility

$2,200.00

Hospital Charge Code	270702852
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$532.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$330.00

SCREWS 6.5 X 40MM

Facility

$4,365.00

Hospital Charge Code	270657289
Hospital Revenue Code	278
Min. Negotiated Rate	$105.20
Max. Negotiated Rate	$2,182.50
Rate for Payer: Aetna Commercial	$1,658.70
Rate for Payer: Aetna Medicare Advantage	$1,309.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,113.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,113.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$873.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,113.08
Rate for Payer: Cigna Commercial	$2,182.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,056.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$960.30
Rate for Payer: Qualcare PPO/HMO/WC	$654.75
Rate for Payer: UnitedHealthcare Community & State	$105.20
Rate for Payer: Wellpoint Medicaid Managed Care	$115.67

SCREWS 6.5 X 40MM

Facility

$4,365.00

Hospital Charge Code	270657289
Hospital Revenue Code	278
Min. Negotiated Rate	$654.75
Max. Negotiated Rate	$1,056.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$873.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,056.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$960.30
Rate for Payer: Qualcare PPO/HMO/WC	$654.75

SCREWS 6.5 X 45MM

Facility

$4,365.00

Hospital Charge Code	270657290
Hospital Revenue Code	278
Min. Negotiated Rate	$654.75
Max. Negotiated Rate	$1,056.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$873.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,056.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$960.30
Rate for Payer: Qualcare PPO/HMO/WC	$654.75

SCREWS 6.5 X 45MM

Facility

$4,365.00

Hospital Charge Code	270657290
Hospital Revenue Code	278
Min. Negotiated Rate	$105.20
Max. Negotiated Rate	$2,182.50
Rate for Payer: Aetna Commercial	$1,658.70
Rate for Payer: Aetna Medicare Advantage	$1,309.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,113.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,113.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$873.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,113.08
Rate for Payer: Cigna Commercial	$2,182.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,056.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$960.30
Rate for Payer: Qualcare PPO/HMO/WC	$654.75
Rate for Payer: UnitedHealthcare Community & State	$105.20
Rate for Payer: Wellpoint Medicaid Managed Care	$115.67

SCREW SAVANNAH T 6.5x35MM

Facility

$12,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270674911
Hospital Revenue Code	278
Min. Negotiated Rate	$1,815.00
Max. Negotiated Rate	$2,928.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00

SCREW SAVANNAH T 6.5x35MM

Facility

$12,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270674911
Hospital Revenue Code	278
Min. Negotiated Rate	$291.61
Max. Negotiated Rate	$6,050.00
Rate for Payer: Aetna Commercial	$4,598.00
Rate for Payer: Aetna Medicare Advantage	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,085.50
Rate for Payer: Cigna Commercial	$6,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00
Rate for Payer: UnitedHealthcare Community & State	$291.61
Rate for Payer: Wellpoint Medicaid Managed Care	$320.65

SCREW SAVANNAH T 6.5x45MM

Facility

$12,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270674912
Hospital Revenue Code	278
Min. Negotiated Rate	$291.61
Max. Negotiated Rate	$6,050.00
Rate for Payer: Aetna Commercial	$4,598.00
Rate for Payer: Aetna Medicare Advantage	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,085.50
Rate for Payer: Cigna Commercial	$6,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00
Rate for Payer: UnitedHealthcare Community & State	$291.61
Rate for Payer: Wellpoint Medicaid Managed Care	$320.65

SCREW SAVANNAH T 6.5x45MM

Facility

$12,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270674912
Hospital Revenue Code	278
Min. Negotiated Rate	$1,815.00
Max. Negotiated Rate	$2,928.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00

Know your out-of-pocket cost for care.

All Charges