Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW TBOLT POLY 5.5X40MM

Facility

$4,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696794
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

SCREW TENO 5.5x8MM

Facility

$2,040.00

Service Code	HCPCS C1713
Hospital Charge Code	270676705
Hospital Revenue Code	278
Min. Negotiated Rate	$49.16
Max. Negotiated Rate	$1,020.00
Rate for Payer: Aetna Commercial	$775.20
Rate for Payer: Aetna Medicare Advantage	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$520.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$520.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$520.20
Rate for Payer: Cigna Commercial	$1,020.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$493.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$448.80
Rate for Payer: Qualcare PPO/HMO/WC	$306.00
Rate for Payer: UnitedHealthcare Community & State	$49.16
Rate for Payer: Wellpoint Medicaid Managed Care	$54.06

SCREW TENO 5.5x8MM

Facility

$2,040.00

Service Code	HCPCS C1713
Hospital Charge Code	270676705
Hospital Revenue Code	278
Min. Negotiated Rate	$306.00
Max. Negotiated Rate	$493.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$408.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$493.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$448.80
Rate for Payer: Qualcare PPO/HMO/WC	$306.00

SCREW TENODE BIO 9X23mAR-1590B

Facility

$1,463.25

Hospital Charge Code	270636061
Hospital Revenue Code	278
Min. Negotiated Rate	$35.26
Max. Negotiated Rate	$731.62
Rate for Payer: Aetna Commercial	$556.03
Rate for Payer: Aetna Medicare Advantage	$438.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.13
Rate for Payer: Cigna Commercial	$731.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$321.92
Rate for Payer: Qualcare PPO/HMO/WC	$219.49
Rate for Payer: UnitedHealthcare Community & State	$35.26
Rate for Payer: Wellpoint Medicaid Managed Care	$38.78

SCREW TENODE BIO 9X23mAR-1590B

Facility

$1,463.25

Hospital Charge Code	270636061
Hospital Revenue Code	278
Min. Negotiated Rate	$219.49
Max. Negotiated Rate	$354.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$321.92
Rate for Payer: Qualcare PPO/HMO/WC	$219.49

SCREW TENODESIS 4 X10

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270685594
Hospital Revenue Code	278
Min. Negotiated Rate	$41.57
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$655.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$379.50
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Community & State	$41.57
Rate for Payer: Wellpoint Medicaid Managed Care	$45.71

SCREW TENODESIS 4 X10

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270685594
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$417.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$379.50
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SCREW TENODESIS 4X10 MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270687615
Hospital Revenue Code	278
Min. Negotiated Rate	$41.57
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$655.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$379.50
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Community & State	$41.57
Rate for Payer: Wellpoint Medicaid Managed Care	$45.71

SCREW TENODESIS 4X10 MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270687615
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$417.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$379.50
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SCREW TENODESIS 5.5x15MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270675073
Hospital Revenue Code	278
Min. Negotiated Rate	$41.57
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$655.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$379.50
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Community & State	$41.57
Rate for Payer: Wellpoint Medicaid Managed Care	$45.71

SCREW TENODESIS 5.5x15MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270675073
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$417.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$379.50
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SCREW TENODESIS 6.25 X15 MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270688245
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

SCREW TENODESIS 6.25 X15 MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270688245
Hospital Revenue Code	278
Min. Negotiated Rate	$48.20
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$48.20
Rate for Payer: Wellpoint Medicaid Managed Care	$53.00

SCREW TENODESIS 8X12MM BIO-

Facility

$2,250.00

Hospital Charge Code	270664267
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 TENODESIS 8X12MM BIO-

Facility

$2,250.00

Hospital Charge Code	270664267
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 TENODESIS BIO 8X23mm

Facility

$1,463.25

Hospital Charge Code	270636060
Hospital Revenue Code	278
Min. Negotiated Rate	$219.49
Max. Negotiated Rate	$354.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$321.92
Rate for Payer: Qualcare PPO/HMO/WC	$219.49

SCREW TENODESIS BIO 8X23mm

Facility

$1,463.25

Hospital Charge Code	270636060
Hospital Revenue Code	278
Min. Negotiated Rate	$35.26
Max. Negotiated Rate	$731.62
Rate for Payer: Aetna Commercial	$556.03
Rate for Payer: Aetna Medicare Advantage	$438.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.13
Rate for Payer: Cigna Commercial	$731.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$321.92
Rate for Payer: Qualcare PPO/HMO/WC	$219.49
Rate for Payer: UnitedHealthcare Community & State	$35.26
Rate for Payer: Wellpoint Medicaid Managed Care	$38.78

SCREW TENODESIS DISP 2.5 X 6

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270691591
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 TENODESIS DISP 2.5 X 6

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270691591
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 TENODESIS PEEK

Facility

$2,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270691580
Hospital Revenue Code	278
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$514.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$467.50
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

SCREW TENODESIS PEEK

Facility

$2,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270691590
Hospital Revenue Code	278
Min. Negotiated Rate	$48.80
Max. Negotiated Rate	$1,012.50
Rate for Payer: Aetna Commercial	$769.50
Rate for Payer: Aetna Medicare Advantage	$607.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$516.38
Rate for Payer: Cigna Commercial	$1,012.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$445.50
Rate for Payer: Qualcare PPO/HMO/WC	$303.75
Rate for Payer: UnitedHealthcare Community & State	$48.80
Rate for Payer: Wellpoint Medicaid Managed Care	$53.66

SCREW TENODESIS PEEK

Facility

$2,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270691580
Hospital Revenue Code	278
Min. Negotiated Rate	$51.21
Max. Negotiated Rate	$1,062.50
Rate for Payer: Aetna Commercial	$807.50
Rate for Payer: Aetna Medicare Advantage	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$541.88
Rate for Payer: Cigna Commercial	$1,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$467.50
Rate for Payer: Qualcare PPO/HMO/WC	$318.75
Rate for Payer: UnitedHealthcare Community & State	$51.21
Rate for Payer: Wellpoint Medicaid Managed Care	$56.31

SCREW TENODESIS PEEK

Facility

$2,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270691590
Hospital Revenue Code	278
Min. Negotiated Rate	$303.75
Max. Negotiated Rate	$490.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$445.50
Rate for Payer: Qualcare PPO/HMO/WC	$303.75

SCREW TENODESIS W/DRIVER PK 5.

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270679968
Hospital Revenue Code	278
Min. Negotiated Rate	$66.28
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Community & State	$66.28
Rate for Payer: Wellpoint Medicaid Managed Care	$72.88

SCREW TENODESIS W/DRIVER PK 5.

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270679968
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

Know your out-of-pocket cost for care.

All Charges