Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW T15 LP CORT 3.5X26MM NS

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270680678
Hospital Revenue Code	278
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$6.63
Rate for Payer: Wellpoint Medicaid Managed Care	$7.29

SCREW T15 LP CORT 3.5X26MM NS

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270680678
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$66.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

SCREW T15 LP CORT 3.5X30MM NS

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270680677
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$66.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

SCREW T15 LP CORT 3.5X30MM NS

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270680677
Hospital Revenue Code	278
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$6.63
Rate for Payer: Wellpoint Medicaid Managed Care	$7.29

SCREW T15 LP CORT 3.5X32MM NS

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270686580
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$66.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

SCREW T15 LP CORT 3.5X32MM NS

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270686580
Hospital Revenue Code	278
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$6.63
Rate for Payer: Wellpoint Medicaid Managed Care	$7.29

SCREW T15 LP CORT 3.5X36MM NS

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270686581
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$66.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

SCREW T15 LP CORT 3.5X36MM NS

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270686581
Hospital Revenue Code	278
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$6.63
Rate for Payer: Wellpoint Medicaid Managed Care	$7.29

SCREW T15 LP CORT 3.5X46MM NS

Facility

$234.00

Service Code	HCPCS C1713
Hospital Charge Code	270680846
Hospital Revenue Code	278
Min. Negotiated Rate	$5.64
Max. Negotiated Rate	$117.00
Rate for Payer: Aetna Commercial	$88.92
Rate for Payer: Aetna Medicare Advantage	$70.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.67
Rate for Payer: Cigna Commercial	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$51.48
Rate for Payer: Qualcare PPO/HMO/WC	$35.10
Rate for Payer: UnitedHealthcare Community & State	$5.64
Rate for Payer: Wellpoint Medicaid Managed Care	$6.20

SCREW T15 LP CORT 3.5X46MM NS

Facility

$234.00

Service Code	HCPCS C1713
Hospital Charge Code	270680846
Hospital Revenue Code	278
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$56.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$51.48
Rate for Payer: Qualcare PPO/HMO/WC	$35.10

SCREW T15 LP CORT 3.5X52MM NS

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270686582
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$66.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

SCREW T15 LP CORT 3.5X52MM NS

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270686582
Hospital Revenue Code	278
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$6.63
Rate for Payer: Wellpoint Medicaid Managed Care	$7.29

SCREW T15 LP CPORT 3.5 X 12 MM

Facility

$700.00

Hospital Charge Code	270703584
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SCREW T15 LP CPORT 3.5 X 12 MM

Facility

$700.00

Hospital Charge Code	270703584
Hospital Revenue Code	278
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

SCREW T15 MD 3.5X34MM NS

Facility

$572.00

Service Code	HCPCS C1713
Hospital Charge Code	270680843
Hospital Revenue Code	278
Min. Negotiated Rate	$85.80
Max. Negotiated Rate	$138.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$85.80

SCREW T15 MD 3.5X34MM NS

Facility

$572.00

Service Code	HCPCS C1713
Hospital Charge Code	270680843
Hospital Revenue Code	278
Min. Negotiated Rate	$13.79
Max. Negotiated Rate	$286.00
Rate for Payer: Aetna Commercial	$217.36
Rate for Payer: Aetna Medicare Advantage	$171.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.86
Rate for Payer: Cigna Commercial	$286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$85.80
Rate for Payer: UnitedHealthcare Community & State	$13.79
Rate for Payer: Wellpoint Medicaid Managed Care	$15.16

SCREW T15 MD 3.5X36MM NS

Facility

$852.50

Service Code	HCPCS C1713
Hospital Charge Code	270693601
Hospital Revenue Code	278
Min. Negotiated Rate	$127.88
Max. Negotiated Rate	$206.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.55
Rate for Payer: Qualcare PPO/HMO/WC	$127.88

SCREW T15 MD 3.5X36MM NS

Facility

$852.50

Service Code	HCPCS C1713
Hospital Charge Code	270693601
Hospital Revenue Code	278
Min. Negotiated Rate	$20.55
Max. Negotiated Rate	$426.25
Rate for Payer: Aetna Commercial	$323.95
Rate for Payer: Aetna Medicare Advantage	$255.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$217.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$217.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$217.39
Rate for Payer: Cigna Commercial	$426.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.55
Rate for Payer: Qualcare PPO/HMO/WC	$127.88
Rate for Payer: UnitedHealthcare Community & State	$20.55
Rate for Payer: Wellpoint Medicaid Managed Care	$22.59

SCREW T15 MD 3.5X40MM NS

Facility

$852.50

Service Code	HCPCS C1713
Hospital Charge Code	270693602
Hospital Revenue Code	278
Min. Negotiated Rate	$20.55
Max. Negotiated Rate	$426.25
Rate for Payer: Aetna Commercial	$323.95
Rate for Payer: Aetna Medicare Advantage	$255.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$217.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$217.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$217.39
Rate for Payer: Cigna Commercial	$426.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.55
Rate for Payer: Qualcare PPO/HMO/WC	$127.88
Rate for Payer: UnitedHealthcare Community & State	$20.55
Rate for Payer: Wellpoint Medicaid Managed Care	$22.59

SCREW T15 MD 3.5X40MM NS

Facility

$852.50

Service Code	HCPCS C1713
Hospital Charge Code	270693602
Hospital Revenue Code	278
Min. Negotiated Rate	$127.88
Max. Negotiated Rate	$206.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.55
Rate for Payer: Qualcare PPO/HMO/WC	$127.88

SCREW T15 MD 3.5X42MM NS

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270680844
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 T15 MD 3.5X42MM NS

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270680844
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 T15 MD 3.5X44MM NS

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270680679
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 T15 MD 3.5X44MM NS

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270680679
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 T15 MD 3.5X50MM NS

Facility

$852.50

Service Code	HCPCS C1713
Hospital Charge Code	270680680
Hospital Revenue Code	278
Min. Negotiated Rate	$20.55
Max. Negotiated Rate	$426.25
Rate for Payer: Aetna Commercial	$323.95
Rate for Payer: Aetna Medicare Advantage	$255.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$217.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$217.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$217.39
Rate for Payer: Cigna Commercial	$426.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.55
Rate for Payer: Qualcare PPO/HMO/WC	$127.88
Rate for Payer: UnitedHealthcare Community & State	$20.55
Rate for Payer: Wellpoint Medicaid Managed Care	$22.59

Know your out-of-pocket cost for care.

All Charges