Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW STRM NL 2.4 X 12MM RS ST

Facility

$920.00

Service Code	HCPCS C1713
Hospital Charge Code	270692252
Hospital Revenue Code	278
Min. Negotiated Rate	$22.17
Max. Negotiated Rate	$460.00
Rate for Payer: Aetna Commercial	$349.60
Rate for Payer: Aetna Medicare Advantage	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.60
Rate for Payer: Cigna Commercial	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$202.40
Rate for Payer: Qualcare PPO/HMO/WC	$138.00
Rate for Payer: UnitedHealthcare Community & State	$22.17
Rate for Payer: Wellpoint Medicaid Managed Care	$24.38

SCREW STRM NL LP 2.7X14MM ST

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270693506
Hospital Revenue Code	278
Min. Negotiated Rate	$18.80
Max. Negotiated Rate	$390.00
Rate for Payer: Aetna Commercial	$296.40
Rate for Payer: Aetna Medicare Advantage	$234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.90
Rate for Payer: Cigna Commercial	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$171.60
Rate for Payer: Qualcare PPO/HMO/WC	$117.00
Rate for Payer: UnitedHealthcare Community & State	$18.80
Rate for Payer: Wellpoint Medicaid Managed Care	$20.67

SCREW STRM NL LP 2.7X14MM ST

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270693506
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$188.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$171.60
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

SCREW STRY BIOS 10 28 2004-06

Facility

$1,262.45

Hospital Charge Code	270626964
Hospital Revenue Code	278
Min. Negotiated Rate	$189.37
Max. Negotiated Rate	$305.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$252.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$305.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$277.74
Rate for Payer: Qualcare PPO/HMO/WC	$189.37

SCREW STRY BIOS 10 28 2004-06

Facility

$1,262.45

Hospital Charge Code	270626964
Hospital Revenue Code	278
Min. Negotiated Rate	$30.43
Max. Negotiated Rate	$631.23
Rate for Payer: Aetna Commercial	$479.73
Rate for Payer: Aetna Medicare Advantage	$378.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$321.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$321.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$252.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$321.92
Rate for Payer: Cigna Commercial	$631.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$305.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$277.74
Rate for Payer: Qualcare PPO/HMO/WC	$189.37
Rate for Payer: UnitedHealthcare Community & State	$30.43
Rate for Payer: Wellpoint Medicaid Managed Care	$33.45

SCREW ST T25STDR TI LOCK 5MM

Facility

$895.05

Service Code	HCPCS C1713
Hospital Charge Code	270693694
Hospital Revenue Code	278
Min. Negotiated Rate	$134.26
Max. Negotiated Rate	$216.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$196.91
Rate for Payer: Qualcare PPO/HMO/WC	$134.26

SCREW ST T25STDR TI LOCK 5MM

Facility

$895.05

Service Code	HCPCS C1713
Hospital Charge Code	270693694
Hospital Revenue Code	278
Min. Negotiated Rate	$21.57
Max. Negotiated Rate	$447.52
Rate for Payer: Aetna Commercial	$340.12
Rate for Payer: Aetna Medicare Advantage	$268.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$228.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$228.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$228.24
Rate for Payer: Cigna Commercial	$447.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$196.91
Rate for Payer: Qualcare PPO/HMO/WC	$134.26
Rate for Payer: UnitedHealthcare Community & State	$21.57
Rate for Payer: Wellpoint Medicaid Managed Care	$23.72

SCREW ST VAR 4.5X12MM

Facility

$4,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270695653
Hospital Revenue Code	278
Min. Negotiated Rate	$720.00
Max. Negotiated Rate	$1,161.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,161.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,056.00
Rate for Payer: Qualcare PPO/HMO/WC	$720.00

SCREW ST VAR 4.5X12MM

Facility

$4,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270695653
Hospital Revenue Code	278
Min. Negotiated Rate	$115.68
Max. Negotiated Rate	$2,400.00
Rate for Payer: Aetna Commercial	$1,824.00
Rate for Payer: Aetna Medicare Advantage	$1,440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,224.00
Rate for Payer: Cigna Commercial	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,161.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,056.00
Rate for Payer: Qualcare PPO/HMO/WC	$720.00
Rate for Payer: UnitedHealthcare Community & State	$115.68
Rate for Payer: Wellpoint Medicaid Managed Care	$127.20

SCREW SUPER LAG 55MM-140MM

Facility

$773.00

Hospital Charge Code	1605690
Hospital Revenue Code	274
Min. Negotiated Rate	$115.95
Max. Negotiated Rate	$187.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.06
Rate for Payer: Qualcare PPO/HMO/WC	$115.95

SCREW SUPER LAG 55MM-140MM

Facility

$773.00

Hospital Charge Code	1605690
Hospital Revenue Code	274
Min. Negotiated Rate	$18.63
Max. Negotiated Rate	$386.50
Rate for Payer: Aetna Commercial	$293.74
Rate for Payer: Aetna Medicare Advantage	$231.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.12
Rate for Payer: Cigna Commercial	$386.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.06
Rate for Payer: Qualcare PPO/HMO/WC	$115.95
Rate for Payer: UnitedHealthcare Community & State	$18.63
Rate for Payer: Wellpoint Medicaid Managed Care	$20.48

SCREW SYMPHONY 3.5X18MM

Facility

$8,911.70

Service Code	HCPCS C1713
Hospital Charge Code	270694480
Hospital Revenue Code	278
Min. Negotiated Rate	$214.77
Max. Negotiated Rate	$4,455.85
Rate for Payer: Aetna Commercial	$3,386.45
Rate for Payer: Aetna Medicare Advantage	$2,673.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,272.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,272.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,782.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,272.48
Rate for Payer: Cigna Commercial	$4,455.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,156.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,960.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,336.76
Rate for Payer: UnitedHealthcare Community & State	$214.77
Rate for Payer: Wellpoint Medicaid Managed Care	$236.16

SCREW SYMPHONY 3.5X18MM

Facility

$8,911.70

Service Code	HCPCS C1713
Hospital Charge Code	270694480
Hospital Revenue Code	278
Min. Negotiated Rate	$1,336.76
Max. Negotiated Rate	$2,156.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,782.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,156.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,960.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,336.76

SCREW SYMPHONY OCT SET TALL

Facility

$1,045.50

Service Code	HCPCS C1713
Hospital Charge Code	270693351
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 SYMPHONY OCT SET TALL

Facility

$1,045.50

Service Code	HCPCS C1713
Hospital Charge Code	270693351
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 SYN 1.0 4MM 400.504

Facility

$332.00

Hospital Charge Code	270607187
Hospital Revenue Code	278
Min. Negotiated Rate	$49.80
Max. Negotiated Rate	$80.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$73.04
Rate for Payer: Qualcare PPO/HMO/WC	$49.80

SCREW SYN 1.0 4MM 400.504

Facility

$332.00

Hospital Charge Code	270607187
Hospital Revenue Code	278
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$166.00
Rate for Payer: Aetna Commercial	$126.16
Rate for Payer: Aetna Medicare Advantage	$99.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.66
Rate for Payer: Cigna Commercial	$166.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$73.04
Rate for Payer: Qualcare PPO/HMO/WC	$49.80
Rate for Payer: UnitedHealthcare Community & State	$8.00
Rate for Payer: Wellpoint Medicaid Managed Care	$8.80

SCREW SYN CANC 4.0 100 206.100

Facility

$77.65

Hospital Charge Code	270604258
Hospital Revenue Code	278
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$38.83
Rate for Payer: Aetna Commercial	$29.51
Rate for Payer: Aetna Medicare Advantage	$23.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.80
Rate for Payer: Cigna Commercial	$38.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$17.08
Rate for Payer: Qualcare PPO/HMO/WC	$11.65
Rate for Payer: UnitedHealthcare Community & State	$1.87
Rate for Payer: Wellpoint Medicaid Managed Care	$2.06

SCREW SYN CANC 4.0 100 206.100

Facility

$77.65

Hospital Charge Code	270604258
Hospital Revenue Code	278
Min. Negotiated Rate	$11.65
Max. Negotiated Rate	$18.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$17.08
Rate for Payer: Qualcare PPO/HMO/WC	$11.65

SCREW SYN CANC 4.0 100 207.100

Facility

$76.85

Hospital Charge Code	270604287
Hospital Revenue Code	278
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$38.42
Rate for Payer: Aetna Commercial	$29.20
Rate for Payer: Aetna Medicare Advantage	$23.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.60
Rate for Payer: Cigna Commercial	$38.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.91
Rate for Payer: Qualcare PPO/HMO/WC	$11.53
Rate for Payer: UnitedHealthcare Community & State	$1.85
Rate for Payer: Wellpoint Medicaid Managed Care	$2.04

SCREW SYN CANC 4.0 100 207.100

Facility

$76.85

Hospital Charge Code	270604287
Hospital Revenue Code	278
Min. Negotiated Rate	$11.53
Max. Negotiated Rate	$18.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.91
Rate for Payer: Qualcare PPO/HMO/WC	$11.53

SCREW SYN CANC 4.0 10 404.010

Facility

$72.85

Hospital Charge Code	270601857
Hospital Revenue Code	274
Min. Negotiated Rate	$10.93
Max. Negotiated Rate	$17.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.03
Rate for Payer: Qualcare PPO/HMO/WC	$10.93

SCREW SYN CANC 4.0 10 404.010

Facility

$72.85

Hospital Charge Code	270601857
Hospital Revenue Code	274
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$36.42
Rate for Payer: Aetna Commercial	$27.68
Rate for Payer: Aetna Medicare Advantage	$21.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.58
Rate for Payer: Cigna Commercial	$36.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.03
Rate for Payer: Qualcare PPO/HMO/WC	$10.93
Rate for Payer: UnitedHealthcare Community & State	$1.76
Rate for Payer: Wellpoint Medicaid Managed Care	$1.93

SCREW SYN CANC 4.0 11 400.624

Facility

$341.65

Hospital Charge Code	270617336
Hospital Revenue Code	278
Min. Negotiated Rate	$51.25
Max. Negotiated Rate	$82.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$75.16
Rate for Payer: Qualcare PPO/HMO/WC	$51.25

SCREW SYN CANC 4.0 11 400.624

Facility

$341.65

Hospital Charge Code	270617336
Hospital Revenue Code	278
Min. Negotiated Rate	$8.23
Max. Negotiated Rate	$170.82
Rate for Payer: Aetna Commercial	$129.83
Rate for Payer: Aetna Medicare Advantage	$102.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.12
Rate for Payer: Cigna Commercial	$170.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$75.16
Rate for Payer: Qualcare PPO/HMO/WC	$51.25
Rate for Payer: UnitedHealthcare Community & State	$8.23
Rate for Payer: Wellpoint Medicaid Managed Care	$9.05

Know your out-of-pocket cost for care.

All Charges