Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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	$25.67
Max. Negotiated Rate	$532.50
Rate for Payer: Aetna Commercial	$404.70
Rate for Payer: Aetna Medicare Advantage	$319.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$271.57
Rate for Payer: Cigna Commercial	$532.50
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
Rate for Payer: UnitedHealthcare Community & State	$25.67
Rate for Payer: Wellpoint Medicaid Managed Care	$28.22

SCREW SELF DRILLING 2.0 X 8 MM

Facility

$670.00

Hospital Charge Code	270666926
Hospital Revenue Code	272
Min. Negotiated Rate	$100.50
Max. Negotiated Rate	$100.50
Rate for Payer: Qualcare PPO/HMO/WC	$100.50

SCREW SELF DRILLING 2.0 X 8 MM

Facility

$670.00

Hospital Charge Code	270666926
Hospital Revenue Code	272
Min. Negotiated Rate	$16.15
Max. Negotiated Rate	$335.00
Rate for Payer: Aetna Commercial	$254.60
Rate for Payer: Aetna Medicare Advantage	$201.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.85
Rate for Payer: Cigna Commercial	$335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.00
Rate for Payer: Oxford Commercial	$134.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.50
Rate for Payer: UnitedHealthcare Commercial	$134.00
Rate for Payer: UnitedHealthcare Community & State	$16.15
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

SCREW SELF DRILLING 4.0 X 1

Facility

$1,975.00

Hospital Charge Code	270659680
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 DRILLING 4.0 X 1

Facility

$1,975.00

Hospital Charge Code	270659680
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 SELF DRILLING 4.0X14

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692517
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 SELF DRILLING 4.0X14

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692517
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 SELF DRILLING 4.0 X 14 M

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688701
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW SELF DRILLING 4.0 X 14 M

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688701
Hospital Revenue Code	278
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

SCREW SELF DRILLING 4.0X 14 MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688700
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW SELF DRILLING 4.0X 14 MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688700
Hospital Revenue Code	278
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

SCREW SELF-DRILL VAR 4.0X14MM

Facility

$1,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270694189
Hospital Revenue Code	278
Min. Negotiated Rate	$38.56
Max. Negotiated Rate	$800.00
Rate for Payer: Aetna Commercial	$608.00
Rate for Payer: Aetna Medicare Advantage	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$408.00
Rate for Payer: Cigna Commercial	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$352.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00
Rate for Payer: UnitedHealthcare Community & State	$38.56
Rate for Payer: Wellpoint Medicaid Managed Care	$42.40

SCREW SELF-DRILL VAR 4.0X14MM

Facility

$1,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270694189
Hospital Revenue Code	278
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$387.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$352.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

SCREW SELF-DRILL VAR 4.5X14MM

Facility

$1,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270694190
Hospital Revenue Code	278
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$387.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$352.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

SCREW SELF-DRILL VAR 4.5X14MM

Facility

$1,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270694190
Hospital Revenue Code	278
Min. Negotiated Rate	$38.56
Max. Negotiated Rate	$800.00
Rate for Payer: Aetna Commercial	$608.00
Rate for Payer: Aetna Medicare Advantage	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$408.00
Rate for Payer: Cigna Commercial	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$352.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00
Rate for Payer: UnitedHealthcare Community & State	$38.56
Rate for Payer: Wellpoint Medicaid Managed Care	$42.40

SCREW SELF DRIL VA 17MM 4.5MM

Facility

$2,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270691796
Hospital Revenue Code	278
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$677.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$616.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

SCREW SELF DRIL VA 17MM 4.5MM

Facility

$2,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270691796
Hospital Revenue Code	278
Min. Negotiated Rate	$67.48
Max. Negotiated Rate	$1,400.00
Rate for Payer: Aetna Commercial	$1,064.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$616.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Community & State	$67.48
Rate for Payer: Wellpoint Medicaid Managed Care	$74.20

SCREW SELF DRIL VA 4.5MMX15MM

Facility

$2,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270691797
Hospital Revenue Code	278
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$677.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$616.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

SCREW SELF DRIL VA 4.5MMX15MM

Facility

$2,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270691797
Hospital Revenue Code	278
Min. Negotiated Rate	$67.48
Max. Negotiated Rate	$1,400.00
Rate for Payer: Aetna Commercial	$1,064.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$616.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Community & State	$67.48
Rate for Payer: Wellpoint Medicaid Managed Care	$74.20

SCREW SELFDRL VA14MM ATLANTIS

Facility

$2,515.00

Service Code	HCPCS C1713
Hospital Charge Code	270691794
Hospital Revenue Code	278
Min. Negotiated Rate	$60.61
Max. Negotiated Rate	$1,257.50
Rate for Payer: Aetna Commercial	$955.70
Rate for Payer: Aetna Medicare Advantage	$754.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$641.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$641.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$503.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$641.33
Rate for Payer: Cigna Commercial	$1,257.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$608.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$553.30
Rate for Payer: Qualcare PPO/HMO/WC	$377.25
Rate for Payer: UnitedHealthcare Community & State	$60.61
Rate for Payer: Wellpoint Medicaid Managed Care	$66.65

SCREW SELFDRL VA14MM ATLANTIS

Facility

$2,515.00

Service Code	HCPCS C1713
Hospital Charge Code	270691794
Hospital Revenue Code	278
Min. Negotiated Rate	$377.25
Max. Negotiated Rate	$608.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$503.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$608.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$553.30
Rate for Payer: Qualcare PPO/HMO/WC	$377.25

SCREW SELF STARTING 4.5X 12 MM

Facility

$2,930.00

Service Code	HCPCS C1713
Hospital Charge Code	270689799
Hospital Revenue Code	278
Min. Negotiated Rate	$439.50
Max. Negotiated Rate	$709.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$586.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$709.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$644.60
Rate for Payer: Qualcare PPO/HMO/WC	$439.50

SCREW SELF STARTING 4.5X 12 MM

Facility

$2,930.00

Service Code	HCPCS C1713
Hospital Charge Code	270689799
Hospital Revenue Code	278
Min. Negotiated Rate	$70.61
Max. Negotiated Rate	$1,465.00
Rate for Payer: Aetna Commercial	$1,113.40
Rate for Payer: Aetna Medicare Advantage	$879.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$747.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$747.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$586.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$747.15
Rate for Payer: Cigna Commercial	$1,465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$709.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$644.60
Rate for Payer: Qualcare PPO/HMO/WC	$439.50
Rate for Payer: UnitedHealthcare Community & State	$70.61
Rate for Payer: Wellpoint Medicaid Managed Care	$77.64

SCREW SELF-TAP 3.5X14 3235114

Facility

$240.00

Hospital Charge Code	270643382
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

SCREW SELF-TAP 3.5X14 3235114

Facility

$240.00

Hospital Charge Code	270643382
Hospital Revenue Code	278
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Community & State	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$6.36

Know your out-of-pocket cost for care.

All Charges