Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW SD SCARLET AC-T 3.5X12MM

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697643
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
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

SCREW SD SCARLET AC-T 3.5X12MM

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697643
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 SD SCHANZ 5.0MM/125MM

Facility

$806.50

Service Code	HCPCS C1713
Hospital Charge Code	270678523
Hospital Revenue Code	278
Min. Negotiated Rate	$120.97
Max. Negotiated Rate	$195.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$161.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$177.43
Rate for Payer: Qualcare PPO/HMO/WC	$120.97

SCREW SD SCHANZ 5.0MM/125MM

Facility

$806.50

Service Code	HCPCS C1713
Hospital Charge Code	270678523
Hospital Revenue Code	278
Min. Negotiated Rate	$19.44
Max. Negotiated Rate	$403.25
Rate for Payer: Aetna Commercial	$306.47
Rate for Payer: Aetna Medicare Advantage	$241.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$205.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$205.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$161.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$205.66
Rate for Payer: Cigna Commercial	$403.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$177.43
Rate for Payer: Qualcare PPO/HMO/WC	$120.97
Rate for Payer: UnitedHealthcare Community & State	$19.44
Rate for Payer: Wellpoint Medicaid Managed Care	$21.37

SCREW SDV 4.0X12MM 65DV4012

Facility

$2,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270694346
Hospital Revenue Code	278
Min. Negotiated Rate	$50.61
Max. Negotiated Rate	$1,050.00
Rate for Payer: Aetna Commercial	$798.00
Rate for Payer: Aetna Medicare Advantage	$630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$535.50
Rate for Payer: Cigna Commercial	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$462.00
Rate for Payer: Qualcare PPO/HMO/WC	$315.00
Rate for Payer: UnitedHealthcare Community & State	$50.61
Rate for Payer: Wellpoint Medicaid Managed Care	$55.65

SCREW SDV 4.0X12MM 65DV4012

Facility

$2,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270694346
Hospital Revenue Code	278
Min. Negotiated Rate	$315.00
Max. Negotiated Rate	$508.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$462.00
Rate for Payer: Qualcare PPO/HMO/WC	$315.00

SCREW SDV 4.0X14MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270695984
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

SCREW SDV 4.0X14MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270695984
Hospital Revenue Code	278
Min. Negotiated Rate	$48.20
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$48.20
Rate for Payer: Wellpoint Medicaid Managed Care	$53.00

SCREW SDV 4.5 X 12MM

Facility

$2,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270697530
Hospital Revenue Code	278
Min. Negotiated Rate	$50.61
Max. Negotiated Rate	$1,050.00
Rate for Payer: Aetna Commercial	$798.00
Rate for Payer: Aetna Medicare Advantage	$630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$535.50
Rate for Payer: Cigna Commercial	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$462.00
Rate for Payer: Qualcare PPO/HMO/WC	$315.00
Rate for Payer: UnitedHealthcare Community & State	$50.61
Rate for Payer: Wellpoint Medicaid Managed Care	$55.65

SCREW SDV 4.5 X 12MM

Facility

$2,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270697530
Hospital Revenue Code	278
Min. Negotiated Rate	$315.00
Max. Negotiated Rate	$508.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$462.00
Rate for Payer: Qualcare PPO/HMO/WC	$315.00

SCREW SDVA 4.5X14MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270697679
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 SDVA 4.5X14MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270697679
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 SD VAR 5X25MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705509
Hospital Revenue Code	278
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

SCREW SD VAR 5X25MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705509
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW SD VARIABLE 4.5X14MM

Facility

$9,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698830
Hospital Revenue Code	278
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$2,178.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,980.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00

SCREW SD VARIABLE 4.5X14MM

Facility

$9,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698830
Hospital Revenue Code	278
Min. Negotiated Rate	$216.90
Max. Negotiated Rate	$4,500.00
Rate for Payer: Aetna Commercial	$3,420.00
Rate for Payer: Aetna Medicare Advantage	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,295.00
Rate for Payer: Cigna Commercial	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,980.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00
Rate for Payer: UnitedHealthcare Community & State	$216.90
Rate for Payer: Wellpoint Medicaid Managed Care	$238.50

SCREW SELF DRILL 1.5x4m 916104

Facility

$243.10

Hospital Charge Code	270630557
Hospital Revenue Code	278
Min. Negotiated Rate	$5.86
Max. Negotiated Rate	$121.55
Rate for Payer: Aetna Commercial	$92.38
Rate for Payer: Aetna Medicare Advantage	$72.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.99
Rate for Payer: Cigna Commercial	$121.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.48
Rate for Payer: Qualcare PPO/HMO/WC	$36.47
Rate for Payer: UnitedHealthcare Community & State	$5.86
Rate for Payer: Wellpoint Medicaid Managed Care	$6.44

SCREW SELF DRILL 1.5x4m 916104

Facility

$243.10

Hospital Charge Code	270630557
Hospital Revenue Code	278
Min. Negotiated Rate	$36.47
Max. Negotiated Rate	$58.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$53.48
Rate for Payer: Qualcare PPO/HMO/WC	$36.47

SCREW SELF DRILL 3.5X14MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697217
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

SCREW SELF DRILL 3.5X14MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697217
Hospital Revenue Code	278
Min. Negotiated Rate	$162.68
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$162.68
Rate for Payer: Wellpoint Medicaid Managed Care	$178.88

SCREW SELF DRILL 4X12 MM VA

Facility

$1,975.00

Hospital Charge Code	270662534
Hospital Revenue Code	278
Min. Negotiated Rate	$47.60
Max. Negotiated Rate	$987.50
Rate for Payer: Aetna Commercial	$750.50
Rate for Payer: Aetna Medicare Advantage	$592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.62
Rate for Payer: Cigna Commercial	$987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$477.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$434.50
Rate for Payer: Qualcare PPO/HMO/WC	$296.25
Rate for Payer: UnitedHealthcare Community & State	$47.60
Rate for Payer: Wellpoint Medicaid Managed Care	$52.34

SCREW SELF DRILL 4X12 MM VA

Facility

$1,975.00

Hospital Charge Code	270662534
Hospital Revenue Code	278
Min. Negotiated Rate	$296.25
Max. Negotiated Rate	$477.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$477.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$434.50
Rate for Payer: Qualcare PPO/HMO/WC	$296.25

SCREW SELFDRILL 5.0x100 294782

Facility

$580.40

Hospital Charge Code	270633850
Hospital Revenue Code	278
Min. Negotiated Rate	$13.99
Max. Negotiated Rate	$290.20
Rate for Payer: Aetna Commercial	$220.55
Rate for Payer: Aetna Medicare Advantage	$174.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.00
Rate for Payer: Cigna Commercial	$290.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.69
Rate for Payer: Qualcare PPO/HMO/WC	$87.06
Rate for Payer: UnitedHealthcare Community & State	$13.99
Rate for Payer: Wellpoint Medicaid Managed Care	$15.38

SCREW SELFDRILL 5.0x100 294782

Facility

$580.40

Hospital Charge Code	270633850
Hospital Revenue Code	278
Min. Negotiated Rate	$87.06
Max. Negotiated Rate	$140.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.69
Rate for Payer: Qualcare PPO/HMO/WC	$87.06

SCREW SELF DRILL CANN 4X42.5MM

Facility

$1,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270700664
Hospital Revenue Code	278
Min. Negotiated Rate	$159.75
Max. Negotiated Rate	$257.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$234.30
Rate for Payer: Qualcare PPO/HMO/WC	$159.75

Know your out-of-pocket cost for care.

All Charges