Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW TI CANN ST 5X85MM

Facility

$1,809.50

Service Code	HCPCS C1713
Hospital Charge Code	270698491
Hospital Revenue Code	278
Min. Negotiated Rate	$43.61
Max. Negotiated Rate	$904.75
Rate for Payer: Aetna Commercial	$687.61
Rate for Payer: Aetna Medicare Advantage	$542.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$361.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.42
Rate for Payer: Cigna Commercial	$904.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$437.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$398.09
Rate for Payer: Qualcare PPO/HMO/WC	$271.43
Rate for Payer: UnitedHealthcare Community & State	$43.61
Rate for Payer: Wellpoint Medicaid Managed Care	$47.95

SCREW Ti CANNUL 70X115m 345738

Facility

$818.45

Hospital Charge Code	270630432
Hospital Revenue Code	278
Min. Negotiated Rate	$122.77
Max. Negotiated Rate	$198.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$180.06
Rate for Payer: Qualcare PPO/HMO/WC	$122.77

SCREW Ti CANNUL 70X115m 345738

Facility

$818.45

Hospital Charge Code	270630432
Hospital Revenue Code	278
Min. Negotiated Rate	$19.72
Max. Negotiated Rate	$409.23
Rate for Payer: Aetna Commercial	$311.01
Rate for Payer: Aetna Medicare Advantage	$245.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.70
Rate for Payer: Cigna Commercial	$409.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$180.06
Rate for Payer: Qualcare PPO/HMO/WC	$122.77
Rate for Payer: UnitedHealthcare Community & State	$19.72
Rate for Payer: Wellpoint Medicaid Managed Care	$21.69

SCREW TI CORTEX 1.5MM

Facility

$155.10

Service Code	HCPCS C1713
Hospital Charge Code	270689211
Hospital Revenue Code	278
Min. Negotiated Rate	$3.74
Max. Negotiated Rate	$77.55
Rate for Payer: Aetna Commercial	$58.94
Rate for Payer: Aetna Medicare Advantage	$46.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.55
Rate for Payer: Cigna Commercial	$77.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$34.12
Rate for Payer: Qualcare PPO/HMO/WC	$23.27
Rate for Payer: UnitedHealthcare Community & State	$3.74
Rate for Payer: Wellpoint Medicaid Managed Care	$4.11

SCREW TI CORTEX 1.5MM

Facility

$155.10

Service Code	HCPCS C1713
Hospital Charge Code	270689211
Hospital Revenue Code	278
Min. Negotiated Rate	$23.27
Max. Negotiated Rate	$37.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$34.12
Rate for Payer: Qualcare PPO/HMO/WC	$23.27

SCREW TI F ACDF 3.5X14MM 6D

Facility

$6,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270697117
Hospital Revenue Code	278
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

SCREW TI F ACDF 3.5X14MM 6D

Facility

$6,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270697117
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

SCREW TIGER HEADLESS 3MMX34

Facility

$1,375.00

Hospital Charge Code	270666766
Hospital Revenue Code	278
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$332.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

SCREW TIGER HEADLESS 3MMX34

Facility

$1,375.00

Hospital Charge Code	270666766
Hospital Revenue Code	278
Min. Negotiated Rate	$33.14
Max. Negotiated Rate	$687.50
Rate for Payer: Aetna Commercial	$522.50
Rate for Payer: Aetna Medicare Advantage	$412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.62
Rate for Payer: Cigna Commercial	$687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$206.25
Rate for Payer: UnitedHealthcare Community & State	$33.14
Rate for Payer: Wellpoint Medicaid Managed Care	$36.44

SCREW TI HDLS COMP 4.5X38MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700599
Hospital Revenue Code	278
Min. Negotiated Rate	$129.54
Max. Negotiated Rate	$2,687.50
Rate for Payer: Aetna Commercial	$2,042.50
Rate for Payer: Aetna Medicare Advantage	$1,612.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.62
Rate for Payer: Cigna Commercial	$2,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,182.50
Rate for Payer: Qualcare PPO/HMO/WC	$806.25
Rate for Payer: UnitedHealthcare Community & State	$129.54
Rate for Payer: Wellpoint Medicaid Managed Care	$142.44

SCREW TI HDLS COMP 4.5X38MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700599
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,182.50
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

SCREW TI INCORE 3.5 X 54MM

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270688019
Hospital Revenue Code	278
Min. Negotiated Rate	$33.26
Max. Negotiated Rate	$690.00
Rate for Payer: Aetna Commercial	$524.40
Rate for Payer: Aetna Medicare Advantage	$414.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$351.90
Rate for Payer: Cigna Commercial	$690.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$303.60
Rate for Payer: Qualcare PPO/HMO/WC	$207.00
Rate for Payer: UnitedHealthcare Community & State	$33.26
Rate for Payer: Wellpoint Medicaid Managed Care	$36.57

SCREW TI INCORE 3.5 X 54MM

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270688019
Hospital Revenue Code	278
Min. Negotiated Rate	$207.00
Max. Negotiated Rate	$333.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$303.60
Rate for Payer: Qualcare PPO/HMO/WC	$207.00

SCREW Ti LAG 010.5x75mm

Facility

$4,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270671132
Hospital Revenue Code	278
Min. Negotiated Rate	$106.76
Max. Negotiated Rate	$2,215.00
Rate for Payer: Aetna Commercial	$1,683.40
Rate for Payer: Aetna Medicare Advantage	$1,329.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,129.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,129.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$886.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,129.65
Rate for Payer: Cigna Commercial	$2,215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,072.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$974.60
Rate for Payer: Qualcare PPO/HMO/WC	$664.50
Rate for Payer: UnitedHealthcare Community & State	$106.76
Rate for Payer: Wellpoint Medicaid Managed Care	$117.39

SCREW Ti LAG 010.5x75mm

Facility

$4,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270671132
Hospital Revenue Code	278
Min. Negotiated Rate	$664.50
Max. Negotiated Rate	$1,072.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$886.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,072.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$974.60
Rate for Payer: Qualcare PPO/HMO/WC	$664.50

SCREW Ti LAG 010.5x75MM

Facility

$3,685.00

Hospital Charge Code	270648351
Hospital Revenue Code	278
Min. Negotiated Rate	$552.75
Max. Negotiated Rate	$891.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$737.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$891.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$810.70
Rate for Payer: Qualcare PPO/HMO/WC	$552.75

SCREW Ti LAG 010.5x75MM

Facility

$3,685.00

Hospital Charge Code	270648351
Hospital Revenue Code	278
Min. Negotiated Rate	$88.81
Max. Negotiated Rate	$1,842.50
Rate for Payer: Aetna Commercial	$1,400.30
Rate for Payer: Aetna Medicare Advantage	$1,105.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$939.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$939.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$737.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$939.67
Rate for Payer: Cigna Commercial	$1,842.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$891.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$810.70
Rate for Payer: Qualcare PPO/HMO/WC	$552.75
Rate for Payer: UnitedHealthcare Community & State	$88.81
Rate for Payer: Wellpoint Medicaid Managed Care	$97.65

SCREW TI LKG LP 3.5X12MM

Facility

$812.50

Service Code	HCPCS C1713
Hospital Charge Code	270688318
Hospital Revenue Code	278
Min. Negotiated Rate	$19.58
Max. Negotiated Rate	$406.25
Rate for Payer: Aetna Commercial	$308.75
Rate for Payer: Aetna Medicare Advantage	$243.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.19
Rate for Payer: Cigna Commercial	$406.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$178.75
Rate for Payer: Qualcare PPO/HMO/WC	$121.88
Rate for Payer: UnitedHealthcare Community & State	$19.58
Rate for Payer: Wellpoint Medicaid Managed Care	$21.53

SCREW TI LKG LP 3.5X12MM

Facility

$812.50

Service Code	HCPCS C1713
Hospital Charge Code	270688318
Hospital Revenue Code	278
Min. Negotiated Rate	$121.88
Max. Negotiated Rate	$196.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$178.75
Rate for Payer: Qualcare PPO/HMO/WC	$121.88

SCREW TI LOCKING 5.0x42 458942

Facility

$649.85

Hospital Charge Code	270633855
Hospital Revenue Code	278
Min. Negotiated Rate	$97.48
Max. Negotiated Rate	$157.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$129.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$142.97
Rate for Payer: Qualcare PPO/HMO/WC	$97.48

SCREW TI LOCKING 5.0x42 458942

Facility

$649.85

Hospital Charge Code	270633855
Hospital Revenue Code	278
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$324.93
Rate for Payer: Aetna Commercial	$246.94
Rate for Payer: Aetna Medicare Advantage	$194.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$129.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.71
Rate for Payer: Cigna Commercial	$324.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$142.97
Rate for Payer: Qualcare PPO/HMO/WC	$97.48
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.22

SCREW TI LOCKING 5.0x44 458944

Facility

$649.85

Hospital Charge Code	270633688
Hospital Revenue Code	278
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$324.93
Rate for Payer: Aetna Commercial	$246.94
Rate for Payer: Aetna Medicare Advantage	$194.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$129.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.71
Rate for Payer: Cigna Commercial	$324.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$142.97
Rate for Payer: Qualcare PPO/HMO/WC	$97.48
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.22

SCREW TI LOCKING 5.0x44 458944

Facility

$649.85

Hospital Charge Code	270633688
Hospital Revenue Code	278
Min. Negotiated Rate	$97.48
Max. Negotiated Rate	$157.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$129.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$142.97
Rate for Payer: Qualcare PPO/HMO/WC	$97.48

SCREW TI LOCKING 5X50MM

Facility

$945.00

Service Code	HCPCS C1713
Hospital Charge Code	270645391
Hospital Revenue Code	278
Min. Negotiated Rate	$141.75
Max. Negotiated Rate	$228.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$207.90
Rate for Payer: Qualcare PPO/HMO/WC	$141.75

SCREW TI LOCKING 5X50MM

Facility

$945.00

Service Code	HCPCS C1713
Hospital Charge Code	270645391
Hospital Revenue Code	278
Min. Negotiated Rate	$22.77
Max. Negotiated Rate	$472.50
Rate for Payer: Aetna Commercial	$359.10
Rate for Payer: Aetna Medicare Advantage	$283.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.97
Rate for Payer: Cigna Commercial	$472.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$207.90
Rate for Payer: Qualcare PPO/HMO/WC	$141.75
Rate for Payer: UnitedHealthcare Community & State	$22.77
Rate for Payer: Wellpoint Medicaid Managed Care	$25.04

Know your out-of-pocket cost for care.

All Charges