Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW TM CORT ST 6.5X50MM

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270697049
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

SCREW TM CORT ST 6.5X50MM

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270697049
Hospital Revenue Code	278
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

SCREW TNFA-ADVANCE 85 MM

Facility

$3,559.30

Service Code	HCPCS C1713
Hospital Charge Code	270698687
Hospital Revenue Code	278
Min. Negotiated Rate	$533.89
Max. Negotiated Rate	$861.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$711.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$861.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$783.05
Rate for Payer: Qualcare PPO/HMO/WC	$533.89

SCREW TNFA-ADVANCE 85 MM

Facility

$3,559.30

Service Code	HCPCS C1713
Hospital Charge Code	270698687
Hospital Revenue Code	278
Min. Negotiated Rate	$85.78
Max. Negotiated Rate	$1,779.65
Rate for Payer: Aetna Commercial	$1,352.53
Rate for Payer: Aetna Medicare Advantage	$1,067.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$907.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$907.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$711.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$907.62
Rate for Payer: Cigna Commercial	$1,779.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$861.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$783.05
Rate for Payer: Qualcare PPO/HMO/WC	$533.89
Rate for Payer: UnitedHealthcare Community & State	$85.78
Rate for Payer: Wellpoint Medicaid Managed Care	$94.32

SCREW TOWER T25 6.5

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692799
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW TOWER T25 6.5

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692799
Hospital Revenue Code	278
Min. Negotiated Rate	$259.07
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$4,085.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50
Rate for Payer: UnitedHealthcare Community & State	$259.07
Rate for Payer: Wellpoint Medicaid Managed Care	$284.88

SCREW TRANSFIXING 6mm 14285

Facility

$830.00

Service Code	HCPCS C1713
Hospital Charge Code	270637343
Hospital Revenue Code	278
Min. Negotiated Rate	$20.00
Max. Negotiated Rate	$415.00
Rate for Payer: Aetna Commercial	$315.40
Rate for Payer: Aetna Medicare Advantage	$249.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.65
Rate for Payer: Cigna Commercial	$415.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$182.60
Rate for Payer: Qualcare PPO/HMO/WC	$124.50
Rate for Payer: UnitedHealthcare Community & State	$20.00
Rate for Payer: Wellpoint Medicaid Managed Care	$22.00

SCREW TRANSFIXING 6mm 14285

Facility

$830.00

Service Code	HCPCS C1713
Hospital Charge Code	270637343
Hospital Revenue Code	278
Min. Negotiated Rate	$124.50
Max. Negotiated Rate	$200.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$182.60
Rate for Payer: Qualcare PPO/HMO/WC	$124.50

SCREW TREP ATT 9.5MM

Facility

$1,483.75

Service Code	HCPCS C1713
Hospital Charge Code	270691898
Hospital Revenue Code	278
Min. Negotiated Rate	$35.76
Max. Negotiated Rate	$741.88
Rate for Payer: Aetna Commercial	$563.83
Rate for Payer: Aetna Medicare Advantage	$445.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$378.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$378.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$296.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$378.36
Rate for Payer: Cigna Commercial	$741.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$359.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$326.43
Rate for Payer: Qualcare PPO/HMO/WC	$222.56
Rate for Payer: UnitedHealthcare Community & State	$35.76
Rate for Payer: Wellpoint Medicaid Managed Care	$39.32

SCREW TREP ATT 9.5MM

Facility

$1,483.75

Service Code	HCPCS C1713
Hospital Charge Code	270691898
Hospital Revenue Code	278
Min. Negotiated Rate	$222.56
Max. Negotiated Rate	$359.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$296.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$359.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$326.43
Rate for Payer: Qualcare PPO/HMO/WC	$222.56

SCREW TRIO 35MM VERSAFIT CUP

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	270684304
Hospital Revenue Code	278
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

SCREW TRIO 35MM VERSAFIT CUP

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	270684304
Hospital Revenue Code	278
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

SCREW TRIO 40MM VERSAFITCUP

Facility

$3,290.85

Service Code	HCPCS C1713
Hospital Charge Code	270684246
Hospital Revenue Code	278
Min. Negotiated Rate	$79.31
Max. Negotiated Rate	$1,645.42
Rate for Payer: Aetna Commercial	$1,250.52
Rate for Payer: Aetna Medicare Advantage	$987.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$658.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$839.17
Rate for Payer: Cigna Commercial	$1,645.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$796.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$723.99
Rate for Payer: Qualcare PPO/HMO/WC	$493.63
Rate for Payer: UnitedHealthcare Community & State	$79.31
Rate for Payer: Wellpoint Medicaid Managed Care	$87.21

SCREW TRIO 40MM VERSAFITCUP

Facility

$3,290.85

Service Code	HCPCS C1713
Hospital Charge Code	270684246
Hospital Revenue Code	278
Min. Negotiated Rate	$493.63
Max. Negotiated Rate	$796.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$658.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$796.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$723.99
Rate for Payer: Qualcare PPO/HMO/WC	$493.63

SCREW TRITON 12X40

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696331
Hospital Revenue Code	278
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$5,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,950.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

SCREW TRITON 12X40

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696331
Hospital Revenue Code	278
Min. Negotiated Rate	$542.25
Max. Negotiated Rate	$11,250.00
Rate for Payer: Aetna Commercial	$8,550.00
Rate for Payer: Aetna Medicare Advantage	$6,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,737.50
Rate for Payer: Cigna Commercial	$11,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,950.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00
Rate for Payer: UnitedHealthcare Community & State	$542.25
Rate for Payer: Wellpoint Medicaid Managed Care	$596.25

SCREW TRITON 12X55MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270695039
Hospital Revenue Code	278
Min. Negotiated Rate	$542.25
Max. Negotiated Rate	$11,250.00
Rate for Payer: Aetna Commercial	$8,550.00
Rate for Payer: Aetna Medicare Advantage	$6,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,737.50
Rate for Payer: Cigna Commercial	$11,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,950.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00
Rate for Payer: UnitedHealthcare Community & State	$542.25
Rate for Payer: Wellpoint Medicaid Managed Care	$596.25

SCREW TRITON 12X55MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270695039
Hospital Revenue Code	278
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$5,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,950.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

SCREW TRITON 12X60

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696330
Hospital Revenue Code	278
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$5,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,950.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

SCREW TRITON 12X60

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696330
Hospital Revenue Code	278
Min. Negotiated Rate	$542.25
Max. Negotiated Rate	$11,250.00
Rate for Payer: Aetna Commercial	$8,550.00
Rate for Payer: Aetna Medicare Advantage	$6,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,737.50
Rate for Payer: Cigna Commercial	$11,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,950.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00
Rate for Payer: UnitedHealthcare Community & State	$542.25
Rate for Payer: Wellpoint Medicaid Managed Care	$596.25

SCREW TRITON S 12X45MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270699823
Hospital Revenue Code	278
Min. Negotiated Rate	$542.25
Max. Negotiated Rate	$11,250.00
Rate for Payer: Aetna Commercial	$8,550.00
Rate for Payer: Aetna Medicare Advantage	$6,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,737.50
Rate for Payer: Cigna Commercial	$11,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,950.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00
Rate for Payer: UnitedHealthcare Community & State	$542.25
Rate for Payer: Wellpoint Medicaid Managed Care	$596.25

SCREW TRITON S 12X45MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270699823
Hospital Revenue Code	278
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$5,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,950.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

SCREW TRITON S 8X40MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270699824
Hospital Revenue Code	278
Min. Negotiated Rate	$542.25
Max. Negotiated Rate	$11,250.00
Rate for Payer: Aetna Commercial	$8,550.00
Rate for Payer: Aetna Medicare Advantage	$6,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,737.50
Rate for Payer: Cigna Commercial	$11,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,950.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00
Rate for Payer: UnitedHealthcare Community & State	$542.25
Rate for Payer: Wellpoint Medicaid Managed Care	$596.25

SCREW TRITON S 8X40MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270699824
Hospital Revenue Code	278
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$5,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,950.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

SCREW TULIP MODUL MIS 30MM

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693890
Hospital Revenue Code	278
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$877.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$797.50
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

Know your out-of-pocket cost for care.

All Charges