Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW SET

Facility

$2,900.00

Hospital Charge Code	270661266
Hospital Revenue Code	278
Min. Negotiated Rate	$69.89
Max. Negotiated Rate	$1,450.00
Rate for Payer: Aetna Commercial	$1,102.00
Rate for Payer: Aetna Medicare Advantage	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$739.50
Rate for Payer: Cigna Commercial	$1,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$638.00
Rate for Payer: Qualcare PPO/HMO/WC	$435.00
Rate for Payer: UnitedHealthcare Community & State	$69.89
Rate for Payer: Wellpoint Medicaid Managed Care	$76.85

SCREW SET 15100

Facility

$618.75

Service Code	HCPCS C1713
Hospital Charge Code	270698056
Hospital Revenue Code	278
Min. Negotiated Rate	$14.91
Max. Negotiated Rate	$309.38
Rate for Payer: Aetna Commercial	$235.12
Rate for Payer: Aetna Medicare Advantage	$185.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.78
Rate for Payer: Cigna Commercial	$309.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.12
Rate for Payer: Qualcare PPO/HMO/WC	$92.81
Rate for Payer: UnitedHealthcare Community & State	$14.91
Rate for Payer: Wellpoint Medicaid Managed Care	$16.40

SCREW SET 15100

Facility

$618.75

Service Code	HCPCS C1713
Hospital Charge Code	270698056
Hospital Revenue Code	278
Min. Negotiated Rate	$92.81
Max. Negotiated Rate	$149.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.12
Rate for Payer: Qualcare PPO/HMO/WC	$92.81

SCREW SET AR

Facility

$1,065.00

Hospital Charge Code	270657229
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

SCREW SET AR

Facility

$1,065.00

Hospital Charge Code	270657229
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 SET FIREBIRD

Facility

$495.00

Service Code	HCPCS C1713
Hospital Charge Code	270692300
Hospital Revenue Code	278
Min. Negotiated Rate	$11.93
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$188.10
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$74.25
Rate for Payer: UnitedHealthcare Community & State	$11.93
Rate for Payer: Wellpoint Medicaid Managed Care	$13.12

SCREW SET FIREBIRD

Facility

$495.00

Service Code	HCPCS C1713
Hospital Charge Code	270692300
Hospital Revenue Code	278
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$119.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

SCREW SET M10 9690855

Facility

$669.65

Hospital Charge Code	270630338
Hospital Revenue Code	278
Min. Negotiated Rate	$100.45
Max. Negotiated Rate	$162.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.32
Rate for Payer: Qualcare PPO/HMO/WC	$100.45

SCREW SET M10 9690855

Facility

$669.65

Hospital Charge Code	270630338
Hospital Revenue Code	278
Min. Negotiated Rate	$16.14
Max. Negotiated Rate	$334.82
Rate for Payer: Aetna Commercial	$254.47
Rate for Payer: Aetna Medicare Advantage	$200.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.76
Rate for Payer: Cigna Commercial	$334.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.32
Rate for Payer: Qualcare PPO/HMO/WC	$100.45
Rate for Payer: UnitedHealthcare Community & State	$16.14
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

SCREW SET MARINER 41-1010

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693229
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

SCREW SET MARINER 41-1010

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693229
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW SET OVERWATCH

Facility

$675.00

Service Code	HCPCS C1713
Hospital Charge Code	270692589
Hospital Revenue Code	278
Min. Negotiated Rate	$101.25
Max. Negotiated Rate	$163.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.50
Rate for Payer: Qualcare PPO/HMO/WC	$101.25

SCREW SET OVERWATCH

Facility

$675.00

Service Code	HCPCS C1713
Hospital Charge Code	270692589
Hospital Revenue Code	278
Min. Negotiated Rate	$16.27
Max. Negotiated Rate	$337.50
Rate for Payer: Aetna Commercial	$256.50
Rate for Payer: Aetna Medicare Advantage	$202.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.12
Rate for Payer: Cigna Commercial	$337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.50
Rate for Payer: Qualcare PPO/HMO/WC	$101.25
Rate for Payer: UnitedHealthcare Community & State	$16.27
Rate for Payer: Wellpoint Medicaid Managed Care	$17.89

SCREW SET PEDICLE

Facility

$1,750.00

Hospital Charge Code	270680079
Hospital Revenue Code	272
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$525.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$350.00
Rate for Payer: UnitedHealthcare Community & State	$42.17
Rate for Payer: Wellpoint Medicaid Managed Care	$46.38

SCREW SET PEDICLE

Facility

$1,750.00

Hospital Charge Code	270680079
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

SCREW SET SAVANNAH-T

Facility

$2,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270656140
Hospital Revenue Code	278
Min. Negotiated Rate	$57.36
Max. Negotiated Rate	$1,190.00
Rate for Payer: Aetna Commercial	$904.40
Rate for Payer: Aetna Medicare Advantage	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$606.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$606.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$476.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$606.90
Rate for Payer: Cigna Commercial	$1,190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$523.60
Rate for Payer: Qualcare PPO/HMO/WC	$357.00
Rate for Payer: UnitedHealthcare Community & State	$57.36
Rate for Payer: Wellpoint Medicaid Managed Care	$63.07

SCREW SET SAVANNAH-T

Facility

$2,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270656140
Hospital Revenue Code	278
Min. Negotiated Rate	$357.00
Max. Negotiated Rate	$575.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$476.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$523.60
Rate for Payer: Qualcare PPO/HMO/WC	$357.00

SCREW SET SINGLE INNER

Facility

$1,775.00

Hospital Charge Code	270665208
Hospital Revenue Code	278
Min. Negotiated Rate	$266.25
Max. Negotiated Rate	$429.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$355.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$390.50
Rate for Payer: Qualcare PPO/HMO/WC	$266.25

SCREW SET SINGLE INNER

Facility

$1,775.00

Hospital Charge Code	270665208
Hospital Revenue Code	278
Min. Negotiated Rate	$42.78
Max. Negotiated Rate	$887.50
Rate for Payer: Aetna Commercial	$674.50
Rate for Payer: Aetna Medicare Advantage	$532.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$452.62
Rate for Payer: Cigna Commercial	$887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$390.50
Rate for Payer: Qualcare PPO/HMO/WC	$266.25
Rate for Payer: UnitedHealthcare Community & State	$42.78
Rate for Payer: Wellpoint Medicaid Managed Care	$47.04

SCREW SET SPINE 4.75MM TI CAP

Facility

$1,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270696281
Hospital Revenue Code	278
Min. Negotiated Rate	$43.98
Max. Negotiated Rate	$912.50
Rate for Payer: Aetna Commercial	$693.50
Rate for Payer: Aetna Medicare Advantage	$547.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$365.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.38
Rate for Payer: Cigna Commercial	$912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$441.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$401.50
Rate for Payer: Qualcare PPO/HMO/WC	$273.75
Rate for Payer: UnitedHealthcare Community & State	$43.98
Rate for Payer: Wellpoint Medicaid Managed Care	$48.36

SCREW SET SPINE 4.75MM TI CAP

Facility

$1,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270696281
Hospital Revenue Code	278
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$441.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$441.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$401.50
Rate for Payer: Qualcare PPO/HMO/WC	$273.75

SCREW SET SYMPHONY

Facility

$1,045.50

Service Code	HCPCS C1713
Hospital Charge Code	270693341
Hospital Revenue Code	278
Min. Negotiated Rate	$156.82
Max. Negotiated Rate	$253.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$209.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$230.01
Rate for Payer: Qualcare PPO/HMO/WC	$156.82

SCREW SET SYMPHONY

Facility

$1,045.50

Service Code	HCPCS C1713
Hospital Charge Code	270693341
Hospital Revenue Code	278
Min. Negotiated Rate	$25.20
Max. Negotiated Rate	$522.75
Rate for Payer: Aetna Commercial	$397.29
Rate for Payer: Aetna Medicare Advantage	$313.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$266.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$266.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$266.60
Rate for Payer: Cigna Commercial	$522.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$230.01
Rate for Payer: Qualcare PPO/HMO/WC	$156.82
Rate for Payer: UnitedHealthcare Community & State	$25.20
Rate for Payer: Wellpoint Medicaid Managed Care	$27.71

SCREW SET T25 5.5/6.0 TULIP

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693913
Hospital Revenue Code	278
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

SCREW SET T25 5.5/6.0 TULIP

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693913
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

Know your out-of-pocket cost for care.

All Charges