Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW VARIAX T8 FT 2.7X12MM

Facility

$727.20

Service Code	HCPCS C1713
Hospital Charge Code	270700620
Hospital Revenue Code	278
Min. Negotiated Rate	$17.53
Max. Negotiated Rate	$363.60
Rate for Payer: Aetna Commercial	$276.34
Rate for Payer: Aetna Medicare Advantage	$218.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.44
Rate for Payer: Cigna Commercial	$363.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.98
Rate for Payer: Qualcare PPO/HMO/WC	$109.08
Rate for Payer: UnitedHealthcare Community & State	$17.53
Rate for Payer: Wellpoint Medicaid Managed Care	$19.27

SCREW VARIAX T8 FT 2.7X12MM

Facility

$727.20

Service Code	HCPCS C1713
Hospital Charge Code	270700620
Hospital Revenue Code	278
Min. Negotiated Rate	$109.08
Max. Negotiated Rate	$175.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.98
Rate for Payer: Qualcare PPO/HMO/WC	$109.08

SCREW VARIAX T8 FT 2.7X40MM

Facility

$727.20

Service Code	HCPCS C1713
Hospital Charge Code	270699832
Hospital Revenue Code	278
Min. Negotiated Rate	$109.08
Max. Negotiated Rate	$175.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.98
Rate for Payer: Qualcare PPO/HMO/WC	$109.08

SCREW VARIAX T8 FT 2.7X40MM

Facility

$727.20

Service Code	HCPCS C1713
Hospital Charge Code	270699832
Hospital Revenue Code	278
Min. Negotiated Rate	$17.53
Max. Negotiated Rate	$363.60
Rate for Payer: Aetna Commercial	$276.34
Rate for Payer: Aetna Medicare Advantage	$218.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.44
Rate for Payer: Cigna Commercial	$363.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.98
Rate for Payer: Qualcare PPO/HMO/WC	$109.08
Rate for Payer: UnitedHealthcare Community & State	$17.53
Rate for Payer: Wellpoint Medicaid Managed Care	$19.27

SCREW VARIAX T8 FT LKG2.7X40MM

Facility

$1,242.30

Service Code	HCPCS C1713
Hospital Charge Code	270699828
Hospital Revenue Code	278
Min. Negotiated Rate	$29.94
Max. Negotiated Rate	$621.15
Rate for Payer: Aetna Commercial	$472.07
Rate for Payer: Aetna Medicare Advantage	$372.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.79
Rate for Payer: Cigna Commercial	$621.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.31
Rate for Payer: Qualcare PPO/HMO/WC	$186.34
Rate for Payer: UnitedHealthcare Community & State	$29.94
Rate for Payer: Wellpoint Medicaid Managed Care	$32.92

SCREW VARIAX T8 FT LKG2.7X40MM

Facility

$1,242.30

Service Code	HCPCS C1713
Hospital Charge Code	270699828
Hospital Revenue Code	278
Min. Negotiated Rate	$186.34
Max. Negotiated Rate	$300.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.31
Rate for Payer: Qualcare PPO/HMO/WC	$186.34

SCREW VARI S/TAPPING 4.0x12MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270677683
Hospital Revenue Code	278
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

SCREW VARI S/TAPPING 4.0x12MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270677683
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW VAR LOCKING TI 3.0X12MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270696249
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW VAR LOCKING TI 3.0X12MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270696249
Hospital Revenue Code	278
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

SCREW VAR LOCKING TI 3.0X14MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270696250
Hospital Revenue Code	278
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

SCREW VAR LOCKING TI 3.0X14MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270696250
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW VAR LOCKING TI 3X10MM

Facility

$1,519.00

Hospital Charge Code	270696508
Hospital Revenue Code	278
Min. Negotiated Rate	$227.85
Max. Negotiated Rate	$367.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$303.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$367.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$334.18
Rate for Payer: Qualcare PPO/HMO/WC	$227.85

SCREW VAR LOCKING TI 3X10MM

Facility

$1,519.00

Hospital Charge Code	270696508
Hospital Revenue Code	278
Min. Negotiated Rate	$36.61
Max. Negotiated Rate	$759.50
Rate for Payer: Aetna Commercial	$577.22
Rate for Payer: Aetna Medicare Advantage	$455.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$387.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$387.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$303.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$387.35
Rate for Payer: Cigna Commercial	$759.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$367.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$334.18
Rate for Payer: Qualcare PPO/HMO/WC	$227.85
Rate for Payer: UnitedHealthcare Community & State	$36.61
Rate for Payer: Wellpoint Medicaid Managed Care	$40.25

SCREW VAR SD 4.0X14MM

Facility

$2,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270695716
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$60.25
Rate for Payer: Wellpoint Medicaid Managed Care	$66.25

SCREW VAR SD 4.0X14MM

Facility

$2,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270695716
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

SCREW VAR SELF DRILL 3.5X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270694367
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW VAR SELF DRILL 3.5X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270694367
Hospital Revenue Code	278
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

SCREW VAR SELF DRILL 4.0 X 16M

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692487
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW VAR SELF DRILL 4.0 X 16M

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692487
Hospital Revenue Code	278
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

SCREW VAR SELFTAPPING 4.0X14MM

Facility

$1,000.00

Hospital Charge Code	270694704
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW VAR SELFTAPPING 4.0X14MM

Facility

$1,000.00

Hospital Charge Code	270694704
Hospital Revenue Code	272
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$200.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

SCREWVENTED 07X20MM BC

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270687903
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREWVENTED 07X20MM BC

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270687903
Hospital Revenue Code	278
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

SCREW VENTED 8 MM X 20 MM BC

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688546
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

Know your out-of-pocket cost for care.

All Charges