Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW SKY VARIABLE SD 18MM

Facility

$1,375.00

Hospital Charge Code	270663493
Hospital Revenue Code	278
Min. Negotiated Rate	$33.14
Max. Negotiated Rate	$687.50
Rate for Payer: Aetna Commercial	$522.50
Rate for Payer: Aetna Medicare Advantage	$412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.62
Rate for Payer: Cigna Commercial	$687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$206.25
Rate for Payer: UnitedHealthcare Community & State	$33.14
Rate for Payer: Wellpoint Medicaid Managed Care	$36.44

SCREW SKY VARIABLE SD 18MM

Facility

$1,375.00

Hospital Charge Code	270663493
Hospital Revenue Code	278
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$332.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

SCREW SKY VARIABLE ST 14MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270677699
Hospital Revenue Code	278
Min. Negotiated Rate	$33.14
Max. Negotiated Rate	$687.50
Rate for Payer: Aetna Commercial	$522.50
Rate for Payer: Aetna Medicare Advantage	$412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.62
Rate for Payer: Cigna Commercial	$687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$206.25
Rate for Payer: UnitedHealthcare Community & State	$33.14
Rate for Payer: Wellpoint Medicaid Managed Care	$36.44

SCREW SKY VARIABLE ST 14MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270677699
Hospital Revenue Code	278
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$332.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

SCREW SKY VARIABLE ST 16MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270670920
Hospital Revenue Code	278
Min. Negotiated Rate	$33.14
Max. Negotiated Rate	$687.50
Rate for Payer: Aetna Commercial	$522.50
Rate for Payer: Aetna Medicare Advantage	$412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.62
Rate for Payer: Cigna Commercial	$687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$206.25
Rate for Payer: UnitedHealthcare Community & State	$33.14
Rate for Payer: Wellpoint Medicaid Managed Care	$36.44

SCREW SKY VARIABLE ST 16MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270670920
Hospital Revenue Code	278
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$332.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

SCREW SLF DRILL DIAMOND 4x14MM

Facility

$1,630.00

Hospital Charge Code	270659696
Hospital Revenue Code	278
Min. Negotiated Rate	$39.28
Max. Negotiated Rate	$815.00
Rate for Payer: Aetna Commercial	$619.40
Rate for Payer: Aetna Medicare Advantage	$489.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$415.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$415.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$326.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$415.65
Rate for Payer: Cigna Commercial	$815.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$394.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$358.60
Rate for Payer: Qualcare PPO/HMO/WC	$244.50
Rate for Payer: UnitedHealthcare Community & State	$39.28
Rate for Payer: Wellpoint Medicaid Managed Care	$43.20

SCREW SLF DRILL DIAMOND 4x14MM

Facility

$1,630.00

Hospital Charge Code	270659696
Hospital Revenue Code	278
Min. Negotiated Rate	$244.50
Max. Negotiated Rate	$394.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$326.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$394.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$358.60
Rate for Payer: Qualcare PPO/HMO/WC	$244.50

SCREW SLF DRILL DIAMOND 4x16MM

Facility

$1,630.00

Hospital Charge Code	270659674
Hospital Revenue Code	278
Min. Negotiated Rate	$244.50
Max. Negotiated Rate	$394.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$326.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$394.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$358.60
Rate for Payer: Qualcare PPO/HMO/WC	$244.50

SCREW SLF DRILL DIAMOND 4x16MM

Facility

$1,630.00

Hospital Charge Code	270659674
Hospital Revenue Code	278
Min. Negotiated Rate	$39.28
Max. Negotiated Rate	$815.00
Rate for Payer: Aetna Commercial	$619.40
Rate for Payer: Aetna Medicare Advantage	$489.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$415.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$415.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$326.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$415.65
Rate for Payer: Cigna Commercial	$815.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$394.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$358.60
Rate for Payer: Qualcare PPO/HMO/WC	$244.50
Rate for Payer: UnitedHealthcare Community & State	$39.28
Rate for Payer: Wellpoint Medicaid Managed Care	$43.20

SCREW SLF DRILL DMD 4.3x16MM

Facility

$2,045.00

Hospital Charge Code	270658063
Hospital Revenue Code	278
Min. Negotiated Rate	$49.28
Max. Negotiated Rate	$1,022.50
Rate for Payer: Aetna Commercial	$777.10
Rate for Payer: Aetna Medicare Advantage	$613.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$521.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$521.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$409.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$521.48
Rate for Payer: Cigna Commercial	$1,022.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$494.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$449.90
Rate for Payer: Qualcare PPO/HMO/WC	$306.75
Rate for Payer: UnitedHealthcare Community & State	$49.28
Rate for Payer: Wellpoint Medicaid Managed Care	$54.19

SCREW SLF DRILL DMD 4.3x16MM

Facility

$2,045.00

Hospital Charge Code	270658063
Hospital Revenue Code	278
Min. Negotiated Rate	$306.75
Max. Negotiated Rate	$494.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$409.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$494.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$449.90
Rate for Payer: Qualcare PPO/HMO/WC	$306.75

SCREW SLF DRILL UNIPLATE2 14MM

Facility

$2,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270665074
Hospital Revenue Code	278
Min. Negotiated Rate	$431.25
Max. Negotiated Rate	$695.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$632.50
Rate for Payer: Qualcare PPO/HMO/WC	$431.25

SCREW SLF DRILL UNIPLATE2 14MM

Facility

$2,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270665074
Hospital Revenue Code	278
Min. Negotiated Rate	$69.29
Max. Negotiated Rate	$1,437.50
Rate for Payer: Aetna Commercial	$1,092.50
Rate for Payer: Aetna Medicare Advantage	$862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$733.12
Rate for Payer: Cigna Commercial	$1,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$632.50
Rate for Payer: Qualcare PPO/HMO/WC	$431.25
Rate for Payer: UnitedHealthcare Community & State	$69.29
Rate for Payer: Wellpoint Medicaid Managed Care	$76.19

SCREW SLF DRILL VARIA 3.6X14MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270695412
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 SLF DRILL VARIA 3.6X14MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270695412
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

SCREW SLF-DRLG/VARIA ANG 16MM

Facility

$1,209.05

Service Code	HCPCS C1713
Hospital Charge Code	270670529
Hospital Revenue Code	278
Min. Negotiated Rate	$29.14
Max. Negotiated Rate	$604.52
Rate for Payer: Aetna Commercial	$459.44
Rate for Payer: Aetna Medicare Advantage	$362.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.31
Rate for Payer: Cigna Commercial	$604.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$265.99
Rate for Payer: Qualcare PPO/HMO/WC	$181.36
Rate for Payer: UnitedHealthcare Community & State	$29.14
Rate for Payer: Wellpoint Medicaid Managed Care	$32.04

SCREW SLF-DRLG/VARIA ANG 16MM

Facility

$1,209.05

Service Code	HCPCS C1713
Hospital Charge Code	270670529
Hospital Revenue Code	278
Min. Negotiated Rate	$181.36
Max. Negotiated Rate	$292.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$265.99
Rate for Payer: Qualcare PPO/HMO/WC	$181.36

SCREW SLF TAP DIAMOND 4x12MM

Facility

$1,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270657670
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 SLF TAP DIAMOND 4x12MM

Facility

$1,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270657670
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 SLF TAP DIAMOND 4x14MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270658059
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW SLF TAP DIAMOND 4x14MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270658059
Hospital Revenue Code	278
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

SCREW SLF TAP FIX ANG 4.0X14MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694263
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 SLF TAP FIX ANG 4.0X14MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694263
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 SLFTP CT 4.5 38 48453801

Facility

$66.80

Hospital Charge Code	270606034
Hospital Revenue Code	278
Min. Negotiated Rate	$10.02
Max. Negotiated Rate	$16.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.70
Rate for Payer: Qualcare PPO/HMO/WC	$10.02

Know your out-of-pocket cost for care.

All Charges