Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW TULIP MODUL MIS 30MM

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693890
Hospital Revenue Code	278
Min. Negotiated Rate	$87.36
Max. Negotiated Rate	$1,812.50
Rate for Payer: Aetna Commercial	$1,377.50
Rate for Payer: Aetna Medicare Advantage	$1,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$924.38
Rate for Payer: Cigna Commercial	$1,812.50
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
Rate for Payer: UnitedHealthcare Community & State	$87.36
Rate for Payer: Wellpoint Medicaid Managed Care	$96.06

SCREW TWIST 2.7MMX12MM

Facility

$1,560.00

Service Code	HCPCS C1713
Hospital Charge Code	270694776
Hospital Revenue Code	278
Min. Negotiated Rate	$234.00
Max. Negotiated Rate	$377.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$312.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$377.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$343.20
Rate for Payer: Qualcare PPO/HMO/WC	$234.00

SCREW TWIST 2.7MMX12MM

Facility

$1,560.00

Service Code	HCPCS C1713
Hospital Charge Code	270694776
Hospital Revenue Code	278
Min. Negotiated Rate	$37.60
Max. Negotiated Rate	$780.00
Rate for Payer: Aetna Commercial	$592.80
Rate for Payer: Aetna Medicare Advantage	$468.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$397.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$397.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$312.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$397.80
Rate for Payer: Cigna Commercial	$780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$377.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$343.20
Rate for Payer: Qualcare PPO/HMO/WC	$234.00
Rate for Payer: UnitedHealthcare Community & State	$37.60
Rate for Payer: Wellpoint Medicaid Managed Care	$41.34

SCREW TWIST OFF 2.0 X 11

Facility

$1,560.00

Service Code	HCPCS C1713
Hospital Charge Code	270688766
Hospital Revenue Code	278
Min. Negotiated Rate	$234.00
Max. Negotiated Rate	$377.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$312.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$377.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$343.20
Rate for Payer: Qualcare PPO/HMO/WC	$234.00

SCREW TWIST OFF 2.0 X 11

Facility

$1,560.00

Service Code	HCPCS C1713
Hospital Charge Code	270688766
Hospital Revenue Code	278
Min. Negotiated Rate	$37.60
Max. Negotiated Rate	$780.00
Rate for Payer: Aetna Commercial	$592.80
Rate for Payer: Aetna Medicare Advantage	$468.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$397.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$397.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$312.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$397.80
Rate for Payer: Cigna Commercial	$780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$377.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$343.20
Rate for Payer: Qualcare PPO/HMO/WC	$234.00
Rate for Payer: UnitedHealthcare Community & State	$37.60
Rate for Payer: Wellpoint Medicaid Managed Care	$41.34

SCREW TWIST OFF 2X12MM

Facility

$3,910.00

Service Code	HCPCS C1713
Hospital Charge Code	270694568
Hospital Revenue Code	278
Min. Negotiated Rate	$586.50
Max. Negotiated Rate	$946.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$782.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$946.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$860.20
Rate for Payer: Qualcare PPO/HMO/WC	$586.50

SCREW TWIST OFF 2X12MM

Facility

$3,910.00

Service Code	HCPCS C1713
Hospital Charge Code	270694568
Hospital Revenue Code	278
Min. Negotiated Rate	$94.23
Max. Negotiated Rate	$1,955.00
Rate for Payer: Aetna Commercial	$1,485.80
Rate for Payer: Aetna Medicare Advantage	$1,173.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$997.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$997.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$782.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$997.05
Rate for Payer: Cigna Commercial	$1,955.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$946.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$860.20
Rate for Payer: Qualcare PPO/HMO/WC	$586.50
Rate for Payer: UnitedHealthcare Community & State	$94.23
Rate for Payer: Wellpoint Medicaid Managed Care	$103.61

SCREW TYPHOON FACET 4.5X23MM

Facility

$7,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270696187
Hospital Revenue Code	278
Min. Negotiated Rate	$1,196.25
Max. Negotiated Rate	$1,929.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,754.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25

SCREW TYPHOON FACET 4.5X23MM

Facility

$7,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270696187
Hospital Revenue Code	278
Min. Negotiated Rate	$192.20
Max. Negotiated Rate	$3,987.50
Rate for Payer: Aetna Commercial	$3,030.50
Rate for Payer: Aetna Medicare Advantage	$2,392.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,033.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,033.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,033.62
Rate for Payer: Cigna Commercial	$3,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,754.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25
Rate for Payer: UnitedHealthcare Community & State	$192.20
Rate for Payer: Wellpoint Medicaid Managed Care	$211.34

SCREW UNICORTICAL 5.0X18MM

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270699606
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 UNICORTICAL 5.0X18MM

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270699606
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 UNIPL ANT CERV 4.6X15MM

Facility

$1,365.90

Service Code	HCPCS C1713
Hospital Charge Code	270693870
Hospital Revenue Code	278
Min. Negotiated Rate	$32.92
Max. Negotiated Rate	$682.95
Rate for Payer: Aetna Commercial	$519.04
Rate for Payer: Aetna Medicare Advantage	$409.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$348.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$348.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$273.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$348.30
Rate for Payer: Cigna Commercial	$682.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$300.50
Rate for Payer: Qualcare PPO/HMO/WC	$204.88
Rate for Payer: UnitedHealthcare Community & State	$32.92
Rate for Payer: Wellpoint Medicaid Managed Care	$36.20

SCREW UNIPL ANT CERV 4.6X15MM

Facility

$1,365.90

Service Code	HCPCS C1713
Hospital Charge Code	270693870
Hospital Revenue Code	278
Min. Negotiated Rate	$204.88
Max. Negotiated Rate	$330.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$273.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$300.50
Rate for Payer: Qualcare PPO/HMO/WC	$204.88

SCREW UNIPLATE 2SELF DRILL 16m

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270663295
Hospital Revenue Code	278
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$474.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$431.20
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

SCREW UNIPLATE 2SELF DRILL 16m

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270663295
Hospital Revenue Code	278
Min. Negotiated Rate	$47.24
Max. Negotiated Rate	$980.00
Rate for Payer: Aetna Commercial	$744.80
Rate for Payer: Aetna Medicare Advantage	$588.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$499.80
Rate for Payer: Cigna Commercial	$980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$431.20
Rate for Payer: Qualcare PPO/HMO/WC	$294.00
Rate for Payer: UnitedHealthcare Community & State	$47.24
Rate for Payer: Wellpoint Medicaid Managed Care	$51.94

SCREW UNIPLATE SELF DRILL 12MM

Facility

$1,870.00

Service Code	HCPCS C1713
Hospital Charge Code	270687813
Hospital Revenue Code	278
Min. Negotiated Rate	$280.50
Max. Negotiated Rate	$452.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$452.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$411.40
Rate for Payer: Qualcare PPO/HMO/WC	$280.50

SCREW UNIPLATE SELF DRILL 12MM

Facility

$1,870.00

Service Code	HCPCS C1713
Hospital Charge Code	270687813
Hospital Revenue Code	278
Min. Negotiated Rate	$45.07
Max. Negotiated Rate	$935.00
Rate for Payer: Aetna Commercial	$710.60
Rate for Payer: Aetna Medicare Advantage	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$476.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$476.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$374.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$476.85
Rate for Payer: Cigna Commercial	$935.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$452.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$411.40
Rate for Payer: Qualcare PPO/HMO/WC	$280.50
Rate for Payer: UnitedHealthcare Community & State	$45.07
Rate for Payer: Wellpoint Medicaid Managed Care	$49.55

SCREW UNIPLATE SELF DRILL 12MM

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270676851
Hospital Revenue Code	278
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$474.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$431.20
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

SCREW UNIPLATE SELF DRILL 12MM

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270676851
Hospital Revenue Code	278
Min. Negotiated Rate	$47.24
Max. Negotiated Rate	$980.00
Rate for Payer: Aetna Commercial	$744.80
Rate for Payer: Aetna Medicare Advantage	$588.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$499.80
Rate for Payer: Cigna Commercial	$980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$431.20
Rate for Payer: Qualcare PPO/HMO/WC	$294.00
Rate for Payer: UnitedHealthcare Community & State	$47.24
Rate for Payer: Wellpoint Medicaid Managed Care	$51.94

SCREW UNIPLATE SELF DRILL 14MM

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270671112
Hospital Revenue Code	278
Min. Negotiated Rate	$47.24
Max. Negotiated Rate	$980.00
Rate for Payer: Aetna Commercial	$744.80
Rate for Payer: Aetna Medicare Advantage	$588.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$499.80
Rate for Payer: Cigna Commercial	$980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$431.20
Rate for Payer: Qualcare PPO/HMO/WC	$294.00
Rate for Payer: UnitedHealthcare Community & State	$47.24
Rate for Payer: Wellpoint Medicaid Managed Care	$51.94

SCREW UNIPLATE SELF DRILL 14MM

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270671112
Hospital Revenue Code	278
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$474.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$431.20
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

SCREW UNIPLATE SELF DRILL 16MM

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270663104
Hospital Revenue Code	278
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$474.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$431.20
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

SCREW UNIPLATE SELF DRILL 16MM

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270663104
Hospital Revenue Code	278
Min. Negotiated Rate	$47.24
Max. Negotiated Rate	$980.00
Rate for Payer: Aetna Commercial	$744.80
Rate for Payer: Aetna Medicare Advantage	$588.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$499.80
Rate for Payer: Cigna Commercial	$980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$431.20
Rate for Payer: Qualcare PPO/HMO/WC	$294.00
Rate for Payer: UnitedHealthcare Community & State	$47.24
Rate for Payer: Wellpoint Medicaid Managed Care	$51.94

SCREW UNIPLATE SELF DRILL 16MM

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270677698
Hospital Revenue Code	278
Min. Negotiated Rate	$47.24
Max. Negotiated Rate	$980.00
Rate for Payer: Aetna Commercial	$744.80
Rate for Payer: Aetna Medicare Advantage	$588.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$499.80
Rate for Payer: Cigna Commercial	$980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$431.20
Rate for Payer: Qualcare PPO/HMO/WC	$294.00
Rate for Payer: UnitedHealthcare Community & State	$47.24
Rate for Payer: Wellpoint Medicaid Managed Care	$51.94

SCREW UNIPLATE SELF DRILL 16MM

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270677698
Hospital Revenue Code	278
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$474.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$431.20
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

Know your out-of-pocket cost for care.

All Charges