Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW UNIPLATE SELF DRILL 18MM

Facility

$1,960.00

Hospital Charge Code	270676536
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 18MM

Facility

$1,960.00

Hospital Charge Code	270676536
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 VA 2.3X14MM

Facility

$765.00

Hospital Charge Code	270668129
Hospital Revenue Code	278
Min. Negotiated Rate	$18.44
Max. Negotiated Rate	$382.50
Rate for Payer: Aetna Commercial	$290.70
Rate for Payer: Aetna Medicare Advantage	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.07
Rate for Payer: Cigna Commercial	$382.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$168.30
Rate for Payer: Qualcare PPO/HMO/WC	$114.75
Rate for Payer: UnitedHealthcare Community & State	$18.44
Rate for Payer: Wellpoint Medicaid Managed Care	$20.27

SCREW VA 2.3X14MM

Facility

$765.00

Hospital Charge Code	270668129
Hospital Revenue Code	278
Min. Negotiated Rate	$114.75
Max. Negotiated Rate	$185.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$168.30
Rate for Payer: Qualcare PPO/HMO/WC	$114.75

SCREW VA 4X16MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270704156
Hospital Revenue Code	278
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

SCREW VA 4X16MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270704156
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

SCREW VAL 2.0 X 10MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270689899
Hospital Revenue Code	278
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

SCREW VAL 2.0 X 10MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270689899
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SCREW VAL 2.0 X 8MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270689900
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SCREW VAL 2.0 X 8MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270689900
Hospital Revenue Code	278
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

SCREW VAL 2.4X12MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270693610
Hospital Revenue Code	278
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

SCREW VAL 2.4X12MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270693610
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SCREW VAL 5.0 LOCKING STSD14MM

Facility

$2,165.00

Service Code	HCPCS C1713
Hospital Charge Code	270697335
Hospital Revenue Code	278
Min. Negotiated Rate	$324.75
Max. Negotiated Rate	$523.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$433.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$523.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$476.30
Rate for Payer: Qualcare PPO/HMO/WC	$324.75

SCREW VAL 5.0 LOCKING STSD14MM

Facility

$2,165.00

Service Code	HCPCS C1713
Hospital Charge Code	270697335
Hospital Revenue Code	278
Min. Negotiated Rate	$52.18
Max. Negotiated Rate	$1,082.50
Rate for Payer: Aetna Commercial	$822.70
Rate for Payer: Aetna Medicare Advantage	$649.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$552.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$552.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$433.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$552.08
Rate for Payer: Cigna Commercial	$1,082.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$523.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$476.30
Rate for Payer: Qualcare PPO/HMO/WC	$324.75
Rate for Payer: UnitedHealthcare Community & State	$52.18
Rate for Payer: Wellpoint Medicaid Managed Care	$57.37

SCREW VAL 5.0 LOCKING STSD18MM

Facility

$2,165.00

Service Code	HCPCS C1713
Hospital Charge Code	270697334
Hospital Revenue Code	278
Min. Negotiated Rate	$52.18
Max. Negotiated Rate	$1,082.50
Rate for Payer: Aetna Commercial	$822.70
Rate for Payer: Aetna Medicare Advantage	$649.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$552.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$552.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$433.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$552.08
Rate for Payer: Cigna Commercial	$1,082.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$523.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$476.30
Rate for Payer: Qualcare PPO/HMO/WC	$324.75
Rate for Payer: UnitedHealthcare Community & State	$52.18
Rate for Payer: Wellpoint Medicaid Managed Care	$57.37

SCREW VAL 5.0 LOCKING STSD18MM

Facility

$2,165.00

Service Code	HCPCS C1713
Hospital Charge Code	270697334
Hospital Revenue Code	278
Min. Negotiated Rate	$324.75
Max. Negotiated Rate	$523.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$433.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$523.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$476.30
Rate for Payer: Qualcare PPO/HMO/WC	$324.75

SCREW VA LCKG 2.0x10MM

Facility

$543.85

Service Code	HCPCS C1713
Hospital Charge Code	270677812
Hospital Revenue Code	278
Min. Negotiated Rate	$13.11
Max. Negotiated Rate	$271.93
Rate for Payer: Aetna Commercial	$206.66
Rate for Payer: Aetna Medicare Advantage	$163.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.68
Rate for Payer: Cigna Commercial	$271.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.65
Rate for Payer: Qualcare PPO/HMO/WC	$81.58
Rate for Payer: UnitedHealthcare Community & State	$13.11
Rate for Payer: Wellpoint Medicaid Managed Care	$14.41

SCREW VA LCKG 2.0x10MM

Facility

$543.85

Service Code	HCPCS C1713
Hospital Charge Code	270677812
Hospital Revenue Code	278
Min. Negotiated Rate	$81.58
Max. Negotiated Rate	$131.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.65
Rate for Payer: Qualcare PPO/HMO/WC	$81.58

SCREW VA LCKG 2.0x12MM

Facility

$543.85

Service Code	HCPCS C1713
Hospital Charge Code	270677813
Hospital Revenue Code	278
Min. Negotiated Rate	$81.58
Max. Negotiated Rate	$131.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.65
Rate for Payer: Qualcare PPO/HMO/WC	$81.58

SCREW VA LCKG 2.0x12MM

Facility

$543.85

Service Code	HCPCS C1713
Hospital Charge Code	270677813
Hospital Revenue Code	278
Min. Negotiated Rate	$13.11
Max. Negotiated Rate	$271.93
Rate for Payer: Aetna Commercial	$206.66
Rate for Payer: Aetna Medicare Advantage	$163.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.68
Rate for Payer: Cigna Commercial	$271.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.65
Rate for Payer: Qualcare PPO/HMO/WC	$81.58
Rate for Payer: UnitedHealthcare Community & State	$13.11
Rate for Payer: Wellpoint Medicaid Managed Care	$14.41

SCREW VA LCKG 2.0x14MM

Facility

$543.85

Service Code	HCPCS C1713
Hospital Charge Code	270677814
Hospital Revenue Code	278
Min. Negotiated Rate	$81.58
Max. Negotiated Rate	$131.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.65
Rate for Payer: Qualcare PPO/HMO/WC	$81.58

SCREW VA LCKG 2.0x14MM

Facility

$543.85

Service Code	HCPCS C1713
Hospital Charge Code	270677814
Hospital Revenue Code	278
Min. Negotiated Rate	$13.11
Max. Negotiated Rate	$271.93
Rate for Payer: Aetna Commercial	$206.66
Rate for Payer: Aetna Medicare Advantage	$163.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.68
Rate for Payer: Cigna Commercial	$271.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.65
Rate for Payer: Qualcare PPO/HMO/WC	$81.58
Rate for Payer: UnitedHealthcare Community & State	$13.11
Rate for Payer: Wellpoint Medicaid Managed Care	$14.41

SCREW VA LCKG 2.0x16MM

Facility

$543.85

Service Code	HCPCS C1713
Hospital Charge Code	270677815
Hospital Revenue Code	278
Min. Negotiated Rate	$13.11
Max. Negotiated Rate	$271.93
Rate for Payer: Aetna Commercial	$206.66
Rate for Payer: Aetna Medicare Advantage	$163.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.68
Rate for Payer: Cigna Commercial	$271.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.65
Rate for Payer: Qualcare PPO/HMO/WC	$81.58
Rate for Payer: UnitedHealthcare Community & State	$13.11
Rate for Payer: Wellpoint Medicaid Managed Care	$14.41

SCREW VA LCKG 2.0x16MM

Facility

$543.85

Service Code	HCPCS C1713
Hospital Charge Code	270677815
Hospital Revenue Code	278
Min. Negotiated Rate	$81.58
Max. Negotiated Rate	$131.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.65
Rate for Payer: Qualcare PPO/HMO/WC	$81.58

SCREW VA LCKG 2.0x18MM

Facility

$543.85

Service Code	HCPCS C1713
Hospital Charge Code	270680076
Hospital Revenue Code	278
Min. Negotiated Rate	$81.58
Max. Negotiated Rate	$131.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.65
Rate for Payer: Qualcare PPO/HMO/WC	$81.58

Know your out-of-pocket cost for care.

All Charges