Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW TI LOCKING 5X56MM

Facility

$945.00

Hospital Charge Code	270670733
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 5X56MM

Facility

$945.00

Hospital Charge Code	270670733
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

SCREW TILOCK SET

Facility

$804.75

Service Code	HCPCS C1713
Hospital Charge Code	270699239
Hospital Revenue Code	278
Min. Negotiated Rate	$120.71
Max. Negotiated Rate	$194.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$177.04
Rate for Payer: Qualcare PPO/HMO/WC	$120.71

SCREW TILOCK SET

Facility

$804.75

Service Code	HCPCS C1713
Hospital Charge Code	270699239
Hospital Revenue Code	278
Min. Negotiated Rate	$19.39
Max. Negotiated Rate	$402.38
Rate for Payer: Aetna Commercial	$305.81
Rate for Payer: Aetna Medicare Advantage	$241.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$205.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$205.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$205.21
Rate for Payer: Cigna Commercial	$402.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$177.04
Rate for Payer: Qualcare PPO/HMO/WC	$120.71
Rate for Payer: UnitedHealthcare Community & State	$19.39
Rate for Payer: Wellpoint Medicaid Managed Care	$21.33

SCREW TILOC WT25 STR DR 5X76MM

Facility

$747.80

Service Code	HCPCS C1713
Hospital Charge Code	270680163
Hospital Revenue Code	278
Min. Negotiated Rate	$112.17
Max. Negotiated Rate	$180.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$164.52
Rate for Payer: Qualcare PPO/HMO/WC	$112.17

SCREW TILOC WT25 STR DR 5X76MM

Facility

$747.80

Service Code	HCPCS C1713
Hospital Charge Code	270680163
Hospital Revenue Code	278
Min. Negotiated Rate	$18.02
Max. Negotiated Rate	$373.90
Rate for Payer: Aetna Commercial	$284.16
Rate for Payer: Aetna Medicare Advantage	$224.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$190.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$190.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$190.69
Rate for Payer: Cigna Commercial	$373.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$164.52
Rate for Payer: Qualcare PPO/HMO/WC	$112.17
Rate for Payer: UnitedHealthcare Community & State	$18.02
Rate for Payer: Wellpoint Medicaid Managed Care	$19.82

SCREW TI LOW PROFILE 4X24MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270677408
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SCREW TI LOW PROFILE 4X24MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270677408
Hospital Revenue Code	278
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

SCREW TI MATRIXNEURO SD 3MM

Facility

$690.00

Service Code	HCPCS C1713
Hospital Charge Code	270697090
Hospital Revenue Code	278
Min. Negotiated Rate	$16.63
Max. Negotiated Rate	$345.00
Rate for Payer: Aetna Commercial	$262.20
Rate for Payer: Aetna Medicare Advantage	$207.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.95
Rate for Payer: Cigna Commercial	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$151.80
Rate for Payer: Qualcare PPO/HMO/WC	$103.50
Rate for Payer: UnitedHealthcare Community & State	$16.63
Rate for Payer: Wellpoint Medicaid Managed Care	$18.29

SCREW TI MATRIXNEURO SD 3MM

Facility

$690.00

Service Code	HCPCS C1713
Hospital Charge Code	270697090
Hospital Revenue Code	278
Min. Negotiated Rate	$103.50
Max. Negotiated Rate	$166.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$151.80
Rate for Payer: Qualcare PPO/HMO/WC	$103.50

SCREW TI MOD CANN 8.5X50MM

Facility

$7,751.00

Service Code	HCPCS C1713
Hospital Charge Code	270695297
Hospital Revenue Code	278
Min. Negotiated Rate	$1,162.65
Max. Negotiated Rate	$1,875.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,705.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.65

SCREW TI MOD CANN 8.5X50MM

Facility

$7,751.00

Service Code	HCPCS C1713
Hospital Charge Code	270695297
Hospital Revenue Code	278
Min. Negotiated Rate	$186.80
Max. Negotiated Rate	$3,875.50
Rate for Payer: Aetna Commercial	$2,945.38
Rate for Payer: Aetna Medicare Advantage	$2,325.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,976.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,976.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,976.51
Rate for Payer: Cigna Commercial	$3,875.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,705.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.65
Rate for Payer: UnitedHealthcare Community & State	$186.80
Rate for Payer: Wellpoint Medicaid Managed Care	$205.40

SCREW TI MOD CANN 9.5X50MM

Facility

$5,751.00

Service Code	HCPCS C1713
Hospital Charge Code	270695298
Hospital Revenue Code	278
Min. Negotiated Rate	$862.65
Max. Negotiated Rate	$1,391.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,265.22
Rate for Payer: Qualcare PPO/HMO/WC	$862.65

SCREW TI MOD CANN 9.5X50MM

Facility

$5,751.00

Service Code	HCPCS C1713
Hospital Charge Code	270695298
Hospital Revenue Code	278
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$2,875.50
Rate for Payer: Aetna Commercial	$2,185.38
Rate for Payer: Aetna Medicare Advantage	$1,725.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.51
Rate for Payer: Cigna Commercial	$2,875.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,265.22
Rate for Payer: Qualcare PPO/HMO/WC	$862.65
Rate for Payer: UnitedHealthcare Community & State	$138.60
Rate for Payer: Wellpoint Medicaid Managed Care	$152.40

SCREW TI MOD MIS CANN 7.5X40MM

Facility

$6,990.00

Service Code	HCPCS C1713
Hospital Charge Code	270695962
Hospital Revenue Code	278
Min. Negotiated Rate	$1,048.50
Max. Negotiated Rate	$1,691.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,398.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,691.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,537.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,048.50

SCREW TI MOD MIS CANN 7.5X40MM

Facility

$6,990.00

Service Code	HCPCS C1713
Hospital Charge Code	270695962
Hospital Revenue Code	278
Min. Negotiated Rate	$168.46
Max. Negotiated Rate	$3,495.00
Rate for Payer: Aetna Commercial	$2,656.20
Rate for Payer: Aetna Medicare Advantage	$2,097.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,782.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,782.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,398.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,782.45
Rate for Payer: Cigna Commercial	$3,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,691.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,537.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,048.50
Rate for Payer: UnitedHealthcare Community & State	$168.46
Rate for Payer: Wellpoint Medicaid Managed Care	$185.24

SCREW TI MODULAR GRN 6.5X50MM

Facility

$6,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270699662
Hospital Revenue Code	278
Min. Negotiated Rate	$166.29
Max. Negotiated Rate	$3,450.00
Rate for Payer: Aetna Commercial	$2,622.00
Rate for Payer: Aetna Medicare Advantage	$2,070.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,759.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,759.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,380.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,759.50
Rate for Payer: Cigna Commercial	$3,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,669.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,518.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,035.00
Rate for Payer: UnitedHealthcare Community & State	$166.29
Rate for Payer: Wellpoint Medicaid Managed Care	$182.85

SCREW TI MODULAR GRN 6.5X50MM

Facility

$6,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270699662
Hospital Revenue Code	278
Min. Negotiated Rate	$1,035.00
Max. Negotiated Rate	$1,669.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,380.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,669.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,518.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,035.00

SCREW TI PEDICLE POLY 6.5X40MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270694184
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$1,631.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,482.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

SCREW TI PEDICLE POLY 6.5X40MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270694184
Hospital Revenue Code	278
Min. Negotiated Rate	$162.43
Max. Negotiated Rate	$3,370.00
Rate for Payer: Aetna Commercial	$2,561.20
Rate for Payer: Aetna Medicare Advantage	$2,022.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,718.70
Rate for Payer: Cigna Commercial	$3,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,482.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00
Rate for Payer: UnitedHealthcare Community & State	$162.43
Rate for Payer: Wellpoint Medicaid Managed Care	$178.61

SCREW TI PEDICLE POLY 8.5X40MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270694812
Hospital Revenue Code	278
Min. Negotiated Rate	$162.43
Max. Negotiated Rate	$3,370.00
Rate for Payer: Aetna Commercial	$2,561.20
Rate for Payer: Aetna Medicare Advantage	$2,022.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,718.70
Rate for Payer: Cigna Commercial	$3,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,482.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00
Rate for Payer: UnitedHealthcare Community & State	$162.43
Rate for Payer: Wellpoint Medicaid Managed Care	$178.61

SCREW TI PEDICLE POLY 8.5X40MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270694812
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$1,631.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,482.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

SCREW TI POLYAX 8.5X35MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270695705
Hospital Revenue Code	278
Min. Negotiated Rate	$162.43
Max. Negotiated Rate	$3,370.00
Rate for Payer: Aetna Commercial	$2,561.20
Rate for Payer: Aetna Medicare Advantage	$2,022.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,718.70
Rate for Payer: Cigna Commercial	$3,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,482.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00
Rate for Payer: UnitedHealthcare Community & State	$162.43
Rate for Payer: Wellpoint Medicaid Managed Care	$178.61

SCREW TI POLYAX 8.5X35MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270695705
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$1,631.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,482.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

SCREW TI SD MAXTORQUE 4X45MM

Facility

$1,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270700602
Hospital Revenue Code	278
Min. Negotiated Rate	$25.67
Max. Negotiated Rate	$532.50
Rate for Payer: Aetna Commercial	$404.70
Rate for Payer: Aetna Medicare Advantage	$319.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$271.57
Rate for Payer: Cigna Commercial	$532.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$234.30
Rate for Payer: Qualcare PPO/HMO/WC	$159.75
Rate for Payer: UnitedHealthcare Community & State	$25.67
Rate for Payer: Wellpoint Medicaid Managed Care	$28.22

Know your out-of-pocket cost for care.

All Charges