Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW WEDGE 8x25MM

Facility

$955.00

Hospital Charge Code	270676063
Hospital Revenue Code	278
Min. Negotiated Rate	$23.02
Max. Negotiated Rate	$477.50
Rate for Payer: Aetna Commercial	$362.90
Rate for Payer: Aetna Medicare Advantage	$286.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$243.53
Rate for Payer: Cigna Commercial	$477.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$210.10
Rate for Payer: Qualcare PPO/HMO/WC	$143.25
Rate for Payer: UnitedHealthcare Community & State	$23.02
Rate for Payer: Wellpoint Medicaid Managed Care	$25.31

SCREW WEDGE 8x25MM UNIVERSAL

Facility

$955.00

Service Code	HCPCS C1713
Hospital Charge Code	270673447
Hospital Revenue Code	278
Min. Negotiated Rate	$23.02
Max. Negotiated Rate	$477.50
Rate for Payer: Aetna Commercial	$362.90
Rate for Payer: Aetna Medicare Advantage	$286.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$243.53
Rate for Payer: Cigna Commercial	$477.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$210.10
Rate for Payer: Qualcare PPO/HMO/WC	$143.25
Rate for Payer: UnitedHealthcare Community & State	$23.02
Rate for Payer: Wellpoint Medicaid Managed Care	$25.31

SCREW WEDGE 8x25MM UNIVERSAL

Facility

$955.00

Service Code	HCPCS C1713
Hospital Charge Code	270673447
Hospital Revenue Code	278
Min. Negotiated Rate	$143.25
Max. Negotiated Rate	$231.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$210.10
Rate for Payer: Qualcare PPO/HMO/WC	$143.25

SCREW WEDGE 9x20MM UNIVERSAL

Facility

$955.00

Service Code	HCPCS C1713
Hospital Charge Code	270673448
Hospital Revenue Code	278
Min. Negotiated Rate	$143.25
Max. Negotiated Rate	$231.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$210.10
Rate for Payer: Qualcare PPO/HMO/WC	$143.25

SCREW WEDGE 9x20MM UNIVERSAL

Facility

$955.00

Service Code	HCPCS C1713
Hospital Charge Code	270673448
Hospital Revenue Code	278
Min. Negotiated Rate	$23.02
Max. Negotiated Rate	$477.50
Rate for Payer: Aetna Commercial	$362.90
Rate for Payer: Aetna Medicare Advantage	$286.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$243.53
Rate for Payer: Cigna Commercial	$477.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$210.10
Rate for Payer: Qualcare PPO/HMO/WC	$143.25
Rate for Payer: UnitedHealthcare Community & State	$23.02
Rate for Payer: Wellpoint Medicaid Managed Care	$25.31

SCREW WEDGE 9X25MM UNIVERSAL

Facility

$955.00

Hospital Charge Code	270670501
Hospital Revenue Code	278
Min. Negotiated Rate	$23.02
Max. Negotiated Rate	$477.50
Rate for Payer: Aetna Commercial	$362.90
Rate for Payer: Aetna Medicare Advantage	$286.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$243.53
Rate for Payer: Cigna Commercial	$477.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$210.10
Rate for Payer: Qualcare PPO/HMO/WC	$143.25
Rate for Payer: UnitedHealthcare Community & State	$23.02
Rate for Payer: Wellpoint Medicaid Managed Care	$25.31

SCREW WEDGE 9X25MM UNIVERSAL

Facility

$955.00

Hospital Charge Code	270670501
Hospital Revenue Code	278
Min. Negotiated Rate	$143.25
Max. Negotiated Rate	$231.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$210.10
Rate for Payer: Qualcare PPO/HMO/WC	$143.25

SCREW WHEAD COMP 4.3MM X 34

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270688009
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

SCREW WHEAD COMP 4.3MM X 34

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270688009
Hospital Revenue Code	278
Min. Negotiated Rate	$45.19
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$712.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$49.69

SCREW WLZ 10 999880

Facility

$159.25

Hospital Charge Code	270610840
Hospital Revenue Code	278
Min. Negotiated Rate	$23.89
Max. Negotiated Rate	$38.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$35.03
Rate for Payer: Qualcare PPO/HMO/WC	$23.89

SCREW WLZ 10 999880

Facility

$159.25

Hospital Charge Code	270610840
Hospital Revenue Code	278
Min. Negotiated Rate	$3.84
Max. Negotiated Rate	$79.62
Rate for Payer: Aetna Commercial	$60.52
Rate for Payer: Aetna Medicare Advantage	$47.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.61
Rate for Payer: Cigna Commercial	$79.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$35.03
Rate for Payer: Qualcare PPO/HMO/WC	$23.89
Rate for Payer: UnitedHealthcare Community & State	$3.84
Rate for Payer: Wellpoint Medicaid Managed Care	$4.22

SCREW WLZ 12 999882

Facility

$161.65

Hospital Charge Code	270610841
Hospital Revenue Code	278
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$80.83
Rate for Payer: Aetna Commercial	$61.43
Rate for Payer: Aetna Medicare Advantage	$48.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.22
Rate for Payer: Cigna Commercial	$80.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$35.56
Rate for Payer: Qualcare PPO/HMO/WC	$24.25
Rate for Payer: UnitedHealthcare Community & State	$3.90
Rate for Payer: Wellpoint Medicaid Managed Care	$4.28

SCREW WLZ 12 999882

Facility

$161.65

Hospital Charge Code	270610841
Hospital Revenue Code	278
Min. Negotiated Rate	$24.25
Max. Negotiated Rate	$39.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$35.56
Rate for Payer: Qualcare PPO/HMO/WC	$24.25

SCREW WLZ 2.3 5MM 91-2305

Facility

$254.45

Hospital Charge Code	270620855
Hospital Revenue Code	278
Min. Negotiated Rate	$6.13
Max. Negotiated Rate	$127.22
Rate for Payer: Aetna Commercial	$96.69
Rate for Payer: Aetna Medicare Advantage	$76.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.88
Rate for Payer: Cigna Commercial	$127.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.98
Rate for Payer: Qualcare PPO/HMO/WC	$38.17
Rate for Payer: UnitedHealthcare Community & State	$6.13
Rate for Payer: Wellpoint Medicaid Managed Care	$6.74

SCREW WLZ 2.3 5MM 91-2305

Facility

$254.45

Hospital Charge Code	270620855
Hospital Revenue Code	278
Min. Negotiated Rate	$38.17
Max. Negotiated Rate	$61.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.98
Rate for Payer: Qualcare PPO/HMO/WC	$38.17

SCREW WLZ 2.7 15 999816

Facility

$300.85

Hospital Charge Code	270612242
Hospital Revenue Code	278
Min. Negotiated Rate	$7.25
Max. Negotiated Rate	$150.43
Rate for Payer: Aetna Commercial	$114.32
Rate for Payer: Aetna Medicare Advantage	$90.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.72
Rate for Payer: Cigna Commercial	$150.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$66.19
Rate for Payer: Qualcare PPO/HMO/WC	$45.13
Rate for Payer: UnitedHealthcare Community & State	$7.25
Rate for Payer: Wellpoint Medicaid Managed Care	$7.97

SCREW WLZ 2.7 15 999816

Facility

$300.85

Hospital Charge Code	270612242
Hospital Revenue Code	278
Min. Negotiated Rate	$45.13
Max. Negotiated Rate	$72.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$66.19
Rate for Payer: Qualcare PPO/HMO/WC	$45.13

SCREW WLZ 2.7 18 999818

Facility

$315.25

Hospital Charge Code	270612243
Hospital Revenue Code	278
Min. Negotiated Rate	$47.29
Max. Negotiated Rate	$76.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$69.36
Rate for Payer: Qualcare PPO/HMO/WC	$47.29

SCREW WLZ 2.7 18 999818

Facility

$315.25

Hospital Charge Code	270612243
Hospital Revenue Code	278
Min. Negotiated Rate	$7.60
Max. Negotiated Rate	$157.62
Rate for Payer: Aetna Commercial	$119.80
Rate for Payer: Aetna Medicare Advantage	$94.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.39
Rate for Payer: Cigna Commercial	$157.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$69.36
Rate for Payer: Qualcare PPO/HMO/WC	$47.29
Rate for Payer: UnitedHealthcare Community & State	$7.60
Rate for Payer: Wellpoint Medicaid Managed Care	$8.35

SCREW WLZ 2.O 5 999481

Facility

$161.65

Hospital Charge Code	270612240
Hospital Revenue Code	278
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$80.83
Rate for Payer: Aetna Commercial	$61.43
Rate for Payer: Aetna Medicare Advantage	$48.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.22
Rate for Payer: Cigna Commercial	$80.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$35.56
Rate for Payer: Qualcare PPO/HMO/WC	$24.25
Rate for Payer: UnitedHealthcare Community & State	$3.90
Rate for Payer: Wellpoint Medicaid Managed Care	$4.28

SCREW WLZ 2.O 5 999481

Facility

$161.65

Hospital Charge Code	270612240
Hospital Revenue Code	278
Min. Negotiated Rate	$24.25
Max. Negotiated Rate	$39.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$35.56
Rate for Payer: Qualcare PPO/HMO/WC	$24.25

SCREW WLZ CTR DR 2.0 15 019485

Facility

$116.00

Hospital Charge Code	270610966
Hospital Revenue Code	278
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$58.00
Rate for Payer: Aetna Commercial	$44.08
Rate for Payer: Aetna Medicare Advantage	$34.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.58
Rate for Payer: Cigna Commercial	$58.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.52
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Community & State	$2.80
Rate for Payer: Wellpoint Medicaid Managed Care	$3.07

SCREW WLZ CTR DR 2.0 15 019485

Facility

$116.00

Hospital Charge Code	270610966
Hospital Revenue Code	278
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$28.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.52
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

SCREW WLZ CTR DR 2.0 17 019487

Facility

$121.65

Hospital Charge Code	270610967
Hospital Revenue Code	278
Min. Negotiated Rate	$18.25
Max. Negotiated Rate	$29.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.76
Rate for Payer: Qualcare PPO/HMO/WC	$18.25

SCREW WLZ CTR DR 2.0 17 019487

Facility

$121.65

Hospital Charge Code	270610967
Hospital Revenue Code	278
Min. Negotiated Rate	$2.93
Max. Negotiated Rate	$60.83
Rate for Payer: Aetna Commercial	$46.23
Rate for Payer: Aetna Medicare Advantage	$36.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.02
Rate for Payer: Cigna Commercial	$60.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26.76
Rate for Payer: Qualcare PPO/HMO/WC	$18.25
Rate for Payer: UnitedHealthcare Community & State	$2.93
Rate for Payer: Wellpoint Medicaid Managed Care	$3.22

Know your out-of-pocket cost for care.

All Charges