Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW TI SD MAXTORQUE 4X45MM

Facility

$1,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270700602
Hospital Revenue Code	278
Min. Negotiated Rate	$159.75
Max. Negotiated Rate	$257.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
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

SCREW TI SD VA 4.0X14MM

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697204
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

SCREW TI SD VA 4.0X14MM

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697204
Hospital Revenue Code	278
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

SCREW TI SELFTAP 4.5MMX14MM

Facility

$1,465.00

Service Code	HCPCS C1713
Hospital Charge Code	270693705
Hospital Revenue Code	278
Min. Negotiated Rate	$219.75
Max. Negotiated Rate	$354.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$293.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$322.30
Rate for Payer: Qualcare PPO/HMO/WC	$219.75

SCREW TI SELFTAP 4.5MMX14MM

Facility

$1,465.00

Service Code	HCPCS C1713
Hospital Charge Code	270693705
Hospital Revenue Code	278
Min. Negotiated Rate	$35.31
Max. Negotiated Rate	$732.50
Rate for Payer: Aetna Commercial	$556.70
Rate for Payer: Aetna Medicare Advantage	$439.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$293.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.57
Rate for Payer: Cigna Commercial	$732.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$322.30
Rate for Payer: Qualcare PPO/HMO/WC	$219.75
Rate for Payer: UnitedHealthcare Community & State	$35.31
Rate for Payer: Wellpoint Medicaid Managed Care	$38.82

SCREW TI SNAP OFF 2.75X16MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270699707
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

SCREW TI SNAP OFF 2.75X16MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270699707
Hospital Revenue Code	278
Min. Negotiated Rate	$75.31
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$75.31
Rate for Payer: Wellpoint Medicaid Managed Care	$82.81

SCREW TI SNAP OFF 2.75X18MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270699706
Hospital Revenue Code	278
Min. Negotiated Rate	$75.31
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$75.31
Rate for Payer: Wellpoint Medicaid Managed Care	$82.81

SCREW TI SNAP OFF 2.75X18MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270699706
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

SCREW TITANIUM 18mm 3.5****

Facility

$48.00

Hospital Charge Code	27060146
Hospital Revenue Code	279
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$24.00
Rate for Payer: Aetna Commercial	$18.24
Rate for Payer: Aetna Medicare Advantage	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.24
Rate for Payer: Cigna Commercial	$24.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.40
Rate for Payer: Oxford Commercial	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$7.20
Rate for Payer: UnitedHealthcare Commercial	$9.60
Rate for Payer: UnitedHealthcare Community & State	$1.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.27

SCREW TITANIUM 18mm 3.5****

Facility

$48.00

Hospital Charge Code	27060146
Hospital Revenue Code	279
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

SCREW TITANIUM 2.0X 13MM

Facility

$1,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270684052
Hospital Revenue Code	278
Min. Negotiated Rate	$34.34
Max. Negotiated Rate	$712.50
Rate for Payer: Aetna Commercial	$541.50
Rate for Payer: Aetna Medicare Advantage	$427.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.38
Rate for Payer: Cigna Commercial	$712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$313.50
Rate for Payer: Qualcare PPO/HMO/WC	$213.75
Rate for Payer: UnitedHealthcare Community & State	$34.34
Rate for Payer: Wellpoint Medicaid Managed Care	$37.76

SCREW TITANIUM 2.0X 13MM

Facility

$1,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270684052
Hospital Revenue Code	278
Min. Negotiated Rate	$213.75
Max. Negotiated Rate	$344.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$285.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$313.50
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

SCREW TIT LOK 3.5MM X 34M

Facility

$750.02

Service Code	HCPCS C1713
Hospital Charge Code	270687869
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW TIT LOK 3.5MM X 34M

Facility

$750.02

Service Code	HCPCS C1713
Hospital Charge Code	270687869
Hospital Revenue Code	278
Min. Negotiated Rate	$18.08
Max. Negotiated Rate	$375.01
Rate for Payer: Aetna Commercial	$285.01
Rate for Payer: Aetna Medicare Advantage	$225.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.26
Rate for Payer: Cigna Commercial	$375.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.08
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

SCREW TI VAL 3.0X22MM

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270692861
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 VAL 3.0X22MM

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270692861
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 W/PIL 4 0x46m 345846

Facility

$530.75

Hospital Charge Code	270630434
Hospital Revenue Code	278
Min. Negotiated Rate	$12.79
Max. Negotiated Rate	$265.38
Rate for Payer: Aetna Commercial	$201.69
Rate for Payer: Aetna Medicare Advantage	$159.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.34
Rate for Payer: Cigna Commercial	$265.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.77
Rate for Payer: Qualcare PPO/HMO/WC	$79.61
Rate for Payer: UnitedHealthcare Community & State	$12.79
Rate for Payer: Wellpoint Medicaid Managed Care	$14.06

SCREW Ti W/PIL 4 0x46m 345846

Facility

$530.75

Hospital Charge Code	270630434
Hospital Revenue Code	278
Min. Negotiated Rate	$79.61
Max. Negotiated Rate	$128.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.77
Rate for Payer: Qualcare PPO/HMO/WC	$79.61

SCREW TI W/PILOT THRD 4mmX38mm

Facility

$496.00

Hospital Charge Code	270627444
Hospital Revenue Code	278
Min. Negotiated Rate	$74.40
Max. Negotiated Rate	$120.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$109.12
Rate for Payer: Qualcare PPO/HMO/WC	$74.40

SCREW TI W/PILOT THRD 4mmX38mm

Facility

$496.00

Hospital Charge Code	270627444
Hospital Revenue Code	278
Min. Negotiated Rate	$11.95
Max. Negotiated Rate	$248.00
Rate for Payer: Aetna Commercial	$188.48
Rate for Payer: Aetna Medicare Advantage	$148.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.48
Rate for Payer: Cigna Commercial	$248.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$109.12
Rate for Payer: Qualcare PPO/HMO/WC	$74.40
Rate for Payer: UnitedHealthcare Community & State	$11.95
Rate for Payer: Wellpoint Medicaid Managed Care	$13.14

SCREW Ti WPIL TH 4.0x68 345868

Facility

$575.45

Hospital Charge Code	270634724
Hospital Revenue Code	278
Min. Negotiated Rate	$13.87
Max. Negotiated Rate	$287.73
Rate for Payer: Aetna Commercial	$218.67
Rate for Payer: Aetna Medicare Advantage	$172.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.74
Rate for Payer: Cigna Commercial	$287.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$126.60
Rate for Payer: Qualcare PPO/HMO/WC	$86.32
Rate for Payer: UnitedHealthcare Community & State	$13.87
Rate for Payer: Wellpoint Medicaid Managed Care	$15.25

SCREW Ti WPIL TH 4.0x68 345868

Facility

$575.45

Hospital Charge Code	270634724
Hospital Revenue Code	278
Min. Negotiated Rate	$86.32
Max. Negotiated Rate	$139.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$126.60
Rate for Payer: Qualcare PPO/HMO/WC	$86.32

SCREW Ti W/PL TD 4.0x72 345872

Facility

$565.50

Hospital Charge Code	270633333
Hospital Revenue Code	278
Min. Negotiated Rate	$13.63
Max. Negotiated Rate	$282.75
Rate for Payer: Aetna Commercial	$214.89
Rate for Payer: Aetna Medicare Advantage	$169.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.20
Rate for Payer: Cigna Commercial	$282.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$124.41
Rate for Payer: Qualcare PPO/HMO/WC	$84.83
Rate for Payer: UnitedHealthcare Community & State	$13.63
Rate for Payer: Wellpoint Medicaid Managed Care	$14.99

SCREW Ti W/PL TD 4.0x72 345872

Facility

$565.50

Hospital Charge Code	270633333
Hospital Revenue Code	278
Min. Negotiated Rate	$84.83
Max. Negotiated Rate	$136.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$124.41
Rate for Payer: Qualcare PPO/HMO/WC	$84.83

Know your out-of-pocket cost for care.

All Charges