Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW SPINAL 30MM TULIPHDCREO

Facility

$5,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270693234
Hospital Revenue Code	278
Min. Negotiated Rate	$858.75
Max. Negotiated Rate	$1,385.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,385.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,259.50
Rate for Payer: Qualcare PPO/HMO/WC	$858.75

SCREW SPINAL 30MM TULIPHDCREO

Facility

$5,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270693234
Hospital Revenue Code	278
Min. Negotiated Rate	$137.97
Max. Negotiated Rate	$2,862.50
Rate for Payer: Aetna Commercial	$2,175.50
Rate for Payer: Aetna Medicare Advantage	$1,717.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,459.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,459.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,459.88
Rate for Payer: Cigna Commercial	$2,862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,385.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,259.50
Rate for Payer: Qualcare PPO/HMO/WC	$858.75
Rate for Payer: UnitedHealthcare Community & State	$137.97
Rate for Payer: Wellpoint Medicaid Managed Care	$151.71

SCREW SPINAL SDVA 4.0X18MM

Facility

$15,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697547
Hospital Revenue Code	278
Min. Negotiated Rate	$361.50
Max. Negotiated Rate	$7,500.00
Rate for Payer: Aetna Commercial	$5,700.00
Rate for Payer: Aetna Medicare Advantage	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,825.00
Rate for Payer: Cigna Commercial	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00
Rate for Payer: UnitedHealthcare Community & State	$361.50
Rate for Payer: Wellpoint Medicaid Managed Care	$397.50

SCREW SPINAL SDVA 4.0X18MM

Facility

$15,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697547
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

SCREW SPINAL SDVA 4X16MM

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697150
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 SPINAL SDVA 4X16MM

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697150
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 SPINAL STD TI 5.5X25MM7D

Facility

$9,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270696609
Hospital Revenue Code	278
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$2,413.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,194.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

SCREW SPINAL STD TI 5.5X25MM7D

Facility

$9,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270696609
Hospital Revenue Code	278
Min. Negotiated Rate	$240.40
Max. Negotiated Rate	$4,987.50
Rate for Payer: Aetna Commercial	$3,790.50
Rate for Payer: Aetna Medicare Advantage	$2,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,543.62
Rate for Payer: Cigna Commercial	$4,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,194.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25
Rate for Payer: UnitedHealthcare Community & State	$240.40
Rate for Payer: Wellpoint Medicaid Managed Care	$264.34

SCREW SPINAL STFA GRUVE 4X18MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270698921
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 SPINAL STFA GRUVE 4X18MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270698921
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 SPINAL TI ALLOY DTRAX

Facility

$7,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692494
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,540.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

SCREW SPINAL TI ALLOY DTRAX

Facility

$7,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692494
Hospital Revenue Code	278
Min. Negotiated Rate	$168.70
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,660.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,540.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00
Rate for Payer: UnitedHealthcare Community & State	$168.70
Rate for Payer: Wellpoint Medicaid Managed Care	$185.50

SCREW SPINAL VAR SD 3.5X12MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270694922
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 SPINAL VAR SD 3.5X12MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270694922
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 SPIN DIAM 2MM LG 12MM

Facility

$1,477.45

Hospital Charge Code	270660951
Hospital Revenue Code	278
Min. Negotiated Rate	$221.62
Max. Negotiated Rate	$357.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$357.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$325.04
Rate for Payer: Qualcare PPO/HMO/WC	$221.62

SCREW SPIN DIAM 2MM LG 12MM

Facility

$1,477.45

Hospital Charge Code	270660951
Hospital Revenue Code	278
Min. Negotiated Rate	$35.61
Max. Negotiated Rate	$738.73
Rate for Payer: Aetna Commercial	$561.43
Rate for Payer: Aetna Medicare Advantage	$443.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.75
Rate for Payer: Cigna Commercial	$738.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$357.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$325.04
Rate for Payer: Qualcare PPO/HMO/WC	$221.62
Rate for Payer: UnitedHealthcare Community & State	$35.61
Rate for Payer: Wellpoint Medicaid Managed Care	$39.15

SCREW SPIN DIAM 2MM LG 14MM

Facility

$1,477.45

Hospital Charge Code	270660950
Hospital Revenue Code	278
Min. Negotiated Rate	$35.61
Max. Negotiated Rate	$738.73
Rate for Payer: Aetna Commercial	$561.43
Rate for Payer: Aetna Medicare Advantage	$443.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.75
Rate for Payer: Cigna Commercial	$738.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$357.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$325.04
Rate for Payer: Qualcare PPO/HMO/WC	$221.62
Rate for Payer: UnitedHealthcare Community & State	$35.61
Rate for Payer: Wellpoint Medicaid Managed Care	$39.15

SCREW SPIN DIAM 2MM LG 14MM

Facility

$1,477.45

Hospital Charge Code	270660950
Hospital Revenue Code	278
Min. Negotiated Rate	$221.62
Max. Negotiated Rate	$357.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$357.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$325.04
Rate for Payer: Qualcare PPO/HMO/WC	$221.62

SCREW SPINE OC 4.5 X 6 MM

Facility

$1,505.00

Service Code	HCPCS C1713
Hospital Charge Code	270683736
Hospital Revenue Code	278
Min. Negotiated Rate	$36.27
Max. Negotiated Rate	$752.50
Rate for Payer: Aetna Commercial	$571.90
Rate for Payer: Aetna Medicare Advantage	$451.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$383.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$383.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$301.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$383.77
Rate for Payer: Cigna Commercial	$752.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$331.10
Rate for Payer: Qualcare PPO/HMO/WC	$225.75
Rate for Payer: UnitedHealthcare Community & State	$36.27
Rate for Payer: Wellpoint Medicaid Managed Care	$39.88

SCREW SPINE OC 4.5 X 6 MM

Facility

$1,505.00

Service Code	HCPCS C1713
Hospital Charge Code	270683736
Hospital Revenue Code	278
Min. Negotiated Rate	$225.75
Max. Negotiated Rate	$364.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$301.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$331.10
Rate for Payer: Qualcare PPO/HMO/WC	$225.75

SCREW SPINE OC 5.25 X 10 MM

Facility

$1,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270683738
Hospital Revenue Code	278
Min. Negotiated Rate	$38.80
Max. Negotiated Rate	$805.00
Rate for Payer: Aetna Commercial	$611.80
Rate for Payer: Aetna Medicare Advantage	$483.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$322.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.55
Rate for Payer: Cigna Commercial	$805.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$354.20
Rate for Payer: Qualcare PPO/HMO/WC	$241.50
Rate for Payer: UnitedHealthcare Community & State	$38.80
Rate for Payer: Wellpoint Medicaid Managed Care	$42.66

SCREW SPINE OC 5.25 X 10 MM

Facility

$1,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270683738
Hospital Revenue Code	278
Min. Negotiated Rate	$241.50
Max. Negotiated Rate	$389.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$322.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$354.20
Rate for Payer: Qualcare PPO/HMO/WC	$241.50

SCREW SPINE OC 5.25 X 8 MM

Facility

$1,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270683737
Hospital Revenue Code	278
Min. Negotiated Rate	$38.80
Max. Negotiated Rate	$805.00
Rate for Payer: Aetna Commercial	$611.80
Rate for Payer: Aetna Medicare Advantage	$483.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$322.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.55
Rate for Payer: Cigna Commercial	$805.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$354.20
Rate for Payer: Qualcare PPO/HMO/WC	$241.50
Rate for Payer: UnitedHealthcare Community & State	$38.80
Rate for Payer: Wellpoint Medicaid Managed Care	$42.66

SCREW SPINE OC 5.25 X 8 MM

Facility

$1,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270683737
Hospital Revenue Code	278
Min. Negotiated Rate	$241.50
Max. Negotiated Rate	$389.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$322.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$354.20
Rate for Payer: Qualcare PPO/HMO/WC	$241.50

SCREW SPIN TI CA SD 4.6X15MM

Facility

$1,365.90

Service Code	HCPCS C1713
Hospital Charge Code	270693878
Hospital Revenue Code	278
Min. Negotiated Rate	$204.88
Max. Negotiated Rate	$330.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$273.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$300.50
Rate for Payer: Qualcare PPO/HMO/WC	$204.88

Know your out-of-pocket cost for care.

All Charges