Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW TI 3.0 X 26 MM VAL

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270691747
Hospital Revenue Code	278
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

SCREW TI 3.0 X 26 MM VAL

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270691747
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SCREW TI 3.0 X 28 MM VAL

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270691748
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SCREW TI 3.0 X 28 MM VAL

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270691748
Hospital Revenue Code	278
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

SCREW Ti 4.0 x 20MM 345264

Facility

$401.65

Hospital Charge Code	270612314
Hospital Revenue Code	278
Min. Negotiated Rate	$9.68
Max. Negotiated Rate	$200.82
Rate for Payer: Aetna Commercial	$152.63
Rate for Payer: Aetna Medicare Advantage	$120.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.42
Rate for Payer: Cigna Commercial	$200.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.36
Rate for Payer: Qualcare PPO/HMO/WC	$60.25
Rate for Payer: UnitedHealthcare Community & State	$9.68
Rate for Payer: Wellpoint Medicaid Managed Care	$10.64

SCREW Ti 4.0 x 20MM 345264

Facility

$401.65

Hospital Charge Code	270612314
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$97.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.36
Rate for Payer: Qualcare PPO/HMO/WC	$60.25

SCREW Ti 4.0 x 24MM 345268

Facility

$401.65

Hospital Charge Code	270612305
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$97.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.36
Rate for Payer: Qualcare PPO/HMO/WC	$60.25

SCREW Ti 4.0 x 24MM 345268

Facility

$401.65

Hospital Charge Code	270612305
Hospital Revenue Code	278
Min. Negotiated Rate	$9.68
Max. Negotiated Rate	$200.82
Rate for Payer: Aetna Commercial	$152.63
Rate for Payer: Aetna Medicare Advantage	$120.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.42
Rate for Payer: Cigna Commercial	$200.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.36
Rate for Payer: Qualcare PPO/HMO/WC	$60.25
Rate for Payer: UnitedHealthcare Community & State	$9.68
Rate for Payer: Wellpoint Medicaid Managed Care	$10.64

SCREW Ti 4.0 x 30MM 345274

Facility

$401.65

Hospital Charge Code	270612306
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$97.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.36
Rate for Payer: Qualcare PPO/HMO/WC	$60.25

SCREW Ti 4.0 x 30MM 345274

Facility

$401.65

Hospital Charge Code	270612306
Hospital Revenue Code	278
Min. Negotiated Rate	$9.68
Max. Negotiated Rate	$200.82
Rate for Payer: Aetna Commercial	$152.63
Rate for Payer: Aetna Medicare Advantage	$120.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.42
Rate for Payer: Cigna Commercial	$200.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.36
Rate for Payer: Qualcare PPO/HMO/WC	$60.25
Rate for Payer: UnitedHealthcare Community & State	$9.68
Rate for Payer: Wellpoint Medicaid Managed Care	$10.64

SCREW TI 4.5CANNCOMPHDLS LT 32

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270693422
Hospital Revenue Code	278
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$459.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$417.56
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

SCREW TI 4.5CANNCOMPHDLS LT 32

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270693422
Hospital Revenue Code	278
Min. Negotiated Rate	$45.74
Max. Negotiated Rate	$949.00
Rate for Payer: Aetna Commercial	$721.24
Rate for Payer: Aetna Medicare Advantage	$569.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$483.99
Rate for Payer: Cigna Commercial	$949.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$417.56
Rate for Payer: Qualcare PPO/HMO/WC	$284.70
Rate for Payer: UnitedHealthcare Community & State	$45.74
Rate for Payer: Wellpoint Medicaid Managed Care	$50.30

SCREW TI 4.5CANNCOMPHDLS LT 36

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270693423
Hospital Revenue Code	278
Min. Negotiated Rate	$45.74
Max. Negotiated Rate	$949.00
Rate for Payer: Aetna Commercial	$721.24
Rate for Payer: Aetna Medicare Advantage	$569.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$483.99
Rate for Payer: Cigna Commercial	$949.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$417.56
Rate for Payer: Qualcare PPO/HMO/WC	$284.70
Rate for Payer: UnitedHealthcare Community & State	$45.74
Rate for Payer: Wellpoint Medicaid Managed Care	$50.30

SCREW TI 4.5CANNCOMPHDLS LT 36

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270693423
Hospital Revenue Code	278
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$459.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$417.56
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

SCREW TI 4.5CANNCOMPHDLS LT 46

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270693424
Hospital Revenue Code	278
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$459.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$417.56
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

SCREW TI 4.5CANNCOMPHDLS LT 46

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270693424
Hospital Revenue Code	278
Min. Negotiated Rate	$45.74
Max. Negotiated Rate	$949.00
Rate for Payer: Aetna Commercial	$721.24
Rate for Payer: Aetna Medicare Advantage	$569.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$483.99
Rate for Payer: Cigna Commercial	$949.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$417.56
Rate for Payer: Qualcare PPO/HMO/WC	$284.70
Rate for Payer: UnitedHealthcare Community & State	$45.74
Rate for Payer: Wellpoint Medicaid Managed Care	$50.30

SCREW TI 4.5CANNCOMPHDLS ST 50

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270693421
Hospital Revenue Code	278
Min. Negotiated Rate	$45.74
Max. Negotiated Rate	$949.00
Rate for Payer: Aetna Commercial	$721.24
Rate for Payer: Aetna Medicare Advantage	$569.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$483.99
Rate for Payer: Cigna Commercial	$949.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$417.56
Rate for Payer: Qualcare PPO/HMO/WC	$284.70
Rate for Payer: UnitedHealthcare Community & State	$45.74
Rate for Payer: Wellpoint Medicaid Managed Care	$50.30

SCREW TI 4.5CANNCOMPHDLS ST 50

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270693421
Hospital Revenue Code	278
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$459.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$417.56
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

SCREW Ti 4.5 x 16MM 345316

Facility

$401.65

Hospital Charge Code	270612316
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$97.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.36
Rate for Payer: Qualcare PPO/HMO/WC	$60.25

SCREW Ti 4.5 x 16MM 345316

Facility

$401.65

Hospital Charge Code	270612316
Hospital Revenue Code	278
Min. Negotiated Rate	$9.68
Max. Negotiated Rate	$200.82
Rate for Payer: Aetna Commercial	$152.63
Rate for Payer: Aetna Medicare Advantage	$120.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.42
Rate for Payer: Cigna Commercial	$200.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.36
Rate for Payer: Qualcare PPO/HMO/WC	$60.25
Rate for Payer: UnitedHealthcare Community & State	$9.68
Rate for Payer: Wellpoint Medicaid Managed Care	$10.64

SCREW Ti 5.0X45mm 33-345428

Facility

$813.65

Hospital Charge Code	270612853
Hospital Revenue Code	278
Min. Negotiated Rate	$19.61
Max. Negotiated Rate	$406.82
Rate for Payer: Aetna Commercial	$309.19
Rate for Payer: Aetna Medicare Advantage	$244.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.48
Rate for Payer: Cigna Commercial	$406.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$179.00
Rate for Payer: Qualcare PPO/HMO/WC	$122.05
Rate for Payer: UnitedHealthcare Community & State	$19.61
Rate for Payer: Wellpoint Medicaid Managed Care	$21.56

SCREW Ti 5.0X45mm 33-345428

Facility

$813.65

Hospital Charge Code	270612853
Hospital Revenue Code	278
Min. Negotiated Rate	$122.05
Max. Negotiated Rate	$196.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$179.00
Rate for Payer: Qualcare PPO/HMO/WC	$122.05

SCREW TI 5.0x70mm

Facility

$675.00

Hospital Charge Code	270638904
Hospital Revenue Code	278
Min. Negotiated Rate	$101.25
Max. Negotiated Rate	$163.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.50
Rate for Payer: Qualcare PPO/HMO/WC	$101.25

SCREW TI 5.0x70mm

Facility

$675.00

Hospital Charge Code	270638904
Hospital Revenue Code	278
Min. Negotiated Rate	$16.27
Max. Negotiated Rate	$337.50
Rate for Payer: Aetna Commercial	$256.50
Rate for Payer: Aetna Medicare Advantage	$202.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.12
Rate for Payer: Cigna Commercial	$337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.50
Rate for Payer: Qualcare PPO/HMO/WC	$101.25
Rate for Payer: UnitedHealthcare Community & State	$16.27
Rate for Payer: Wellpoint Medicaid Managed Care	$17.89

SCREW Ti 6.5 x 20mm 103531

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270612161
Hospital Revenue Code	278
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

Know your out-of-pocket cost for care.

All Charges