Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

5.0 SCREW 38

Facility

$1,314.45

Service Code	HCPCS C1713
Hospital Charge Code	270656660
Hospital Revenue Code	278
Min. Negotiated Rate	$31.68
Max. Negotiated Rate	$657.23
Rate for Payer: Aetna Commercial	$499.49
Rate for Payer: Aetna Medicare Advantage	$394.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$262.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.18
Rate for Payer: Cigna Commercial	$657.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$289.18
Rate for Payer: Qualcare PPO/HMO/WC	$197.17
Rate for Payer: UnitedHealthcare Community & State	$31.68
Rate for Payer: Wellpoint Medicaid Managed Care	$34.83

5.0 SCREW 40 IN

Facility

$1,314.45

Hospital Charge Code	270656661
Hospital Revenue Code	278
Min. Negotiated Rate	$197.17
Max. Negotiated Rate	$318.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$262.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$289.18
Rate for Payer: Qualcare PPO/HMO/WC	$197.17

5.0 SCREW 40 IN

Facility

$1,314.45

Hospital Charge Code	270656661
Hospital Revenue Code	278
Min. Negotiated Rate	$31.68
Max. Negotiated Rate	$657.23
Rate for Payer: Aetna Commercial	$499.49
Rate for Payer: Aetna Medicare Advantage	$394.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$262.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.18
Rate for Payer: Cigna Commercial	$657.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$289.18
Rate for Payer: Qualcare PPO/HMO/WC	$197.17
Rate for Payer: UnitedHealthcare Community & State	$31.68
Rate for Payer: Wellpoint Medicaid Managed Care	$34.83

5.0X25MM SCREW

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270705950
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

5.0X25MM SCREW

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270705950
Hospital Revenue Code	278
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

5.0X30MM SCREW

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270705951
Hospital Revenue Code	278
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

5.0X30MM SCREW

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270705951
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

5.0 X 50MM SCREW

Facility

$920.50

Hospital Charge Code	270656454
Hospital Revenue Code	278
Min. Negotiated Rate	$22.18
Max. Negotiated Rate	$460.25
Rate for Payer: Aetna Commercial	$349.79
Rate for Payer: Aetna Medicare Advantage	$276.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.73
Rate for Payer: Cigna Commercial	$460.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$202.51
Rate for Payer: Qualcare PPO/HMO/WC	$138.07
Rate for Payer: UnitedHealthcare Community & State	$22.18
Rate for Payer: Wellpoint Medicaid Managed Care	$24.39

5.0 X 50MM SCREW

Facility

$920.50

Hospital Charge Code	270656454
Hospital Revenue Code	278
Min. Negotiated Rate	$138.07
Max. Negotiated Rate	$222.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$202.51
Rate for Payer: Qualcare PPO/HMO/WC	$138.07

5.0 X 70MM SCREW

Facility

$920.50

Hospital Charge Code	270656456
Hospital Revenue Code	278
Min. Negotiated Rate	$22.18
Max. Negotiated Rate	$460.25
Rate for Payer: Aetna Commercial	$349.79
Rate for Payer: Aetna Medicare Advantage	$276.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.73
Rate for Payer: Cigna Commercial	$460.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$202.51
Rate for Payer: Qualcare PPO/HMO/WC	$138.07
Rate for Payer: UnitedHealthcare Community & State	$22.18
Rate for Payer: Wellpoint Medicaid Managed Care	$24.39

5.0 X 70MM SCREW

Facility

$920.50

Hospital Charge Code	270656456
Hospital Revenue Code	278
Min. Negotiated Rate	$138.07
Max. Negotiated Rate	$222.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$202.51
Rate for Payer: Qualcare PPO/HMO/WC	$138.07

51MM 3HOLE ANTERIOR RETACTOR

Facility

$11,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270704090
Hospital Revenue Code	278
Min. Negotiated Rate	$271.12
Max. Negotiated Rate	$5,625.00
Rate for Payer: Aetna Commercial	$4,275.00
Rate for Payer: Aetna Medicare Advantage	$3,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,868.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,868.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,868.75
Rate for Payer: Cigna Commercial	$5,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,722.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,475.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,687.50
Rate for Payer: UnitedHealthcare Community & State	$271.12
Rate for Payer: Wellpoint Medicaid Managed Care	$298.12

51MM 3HOLE ANTERIOR RETACTOR

Facility

$11,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270704090
Hospital Revenue Code	278
Min. Negotiated Rate	$1,687.50
Max. Negotiated Rate	$2,722.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,722.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,475.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,687.50

51MM PATELLA REAMER

Facility

$876.65

Hospital Charge Code	270656914
Hospital Revenue Code	272
Min. Negotiated Rate	$21.13
Max. Negotiated Rate	$438.32
Rate for Payer: Aetna Commercial	$333.13
Rate for Payer: Aetna Medicare Advantage	$263.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.55
Rate for Payer: Cigna Commercial	$438.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$263.00
Rate for Payer: Oxford Commercial	$175.33
Rate for Payer: Qualcare PPO/HMO/WC	$131.50
Rate for Payer: UnitedHealthcare Commercial	$175.33
Rate for Payer: UnitedHealthcare Community & State	$21.13
Rate for Payer: Wellpoint Medicaid Managed Care	$23.23

51MM PATELLA REAMER

Facility

$876.65

Hospital Charge Code	270656914
Hospital Revenue Code	272
Min. Negotiated Rate	$131.50
Max. Negotiated Rate	$131.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.50

5.25MMX6MM BOLT

Facility

$1,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270687817
Hospital Revenue Code	278
Min. Negotiated Rate	$38.80
Max. Negotiated Rate	$805.00
Rate for Payer: Aetna Commercial	$611.80
Rate for Payer: Aetna Medicare Advantage	$483.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$322.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.55
Rate for Payer: Cigna Commercial	$805.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$354.20
Rate for Payer: Qualcare PPO/HMO/WC	$241.50
Rate for Payer: UnitedHealthcare Community & State	$38.80
Rate for Payer: Wellpoint Medicaid Managed Care	$42.66

5.25MMX6MM BOLT

Facility

$1,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270687817
Hospital Revenue Code	278
Min. Negotiated Rate	$241.50
Max. Negotiated Rate	$389.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$322.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$354.20
Rate for Payer: Qualcare PPO/HMO/WC	$241.50

52MM TM MULTI-HOLE

Facility

$8,660.65

Hospital Charge Code	270656915
Hospital Revenue Code	278
Min. Negotiated Rate	$208.72
Max. Negotiated Rate	$4,330.32
Rate for Payer: Aetna Commercial	$3,291.05
Rate for Payer: Aetna Medicare Advantage	$2,598.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,208.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,208.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,732.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,208.47
Rate for Payer: Cigna Commercial	$4,330.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,095.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,905.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,299.10
Rate for Payer: UnitedHealthcare Community & State	$208.72
Rate for Payer: Wellpoint Medicaid Managed Care	$229.51

52MM TM MULTI-HOLE

Facility

$8,660.65

Hospital Charge Code	270656915
Hospital Revenue Code	278
Min. Negotiated Rate	$1,299.10
Max. Negotiated Rate	$2,095.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,732.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,095.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,905.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,299.10

5.5MM BONE TAP

Facility

$2,767.50

Hospital Charge Code	270704177
Hospital Revenue Code	279
Min. Negotiated Rate	$66.70
Max. Negotiated Rate	$1,383.75
Rate for Payer: Aetna Commercial	$1,051.65
Rate for Payer: Aetna Medicare Advantage	$830.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$705.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$705.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$705.71
Rate for Payer: Cigna Commercial	$1,383.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$830.25
Rate for Payer: Oxford Commercial	$553.50
Rate for Payer: Qualcare PPO/HMO/WC	$415.12
Rate for Payer: UnitedHealthcare Commercial	$553.50
Rate for Payer: UnitedHealthcare Community & State	$66.70
Rate for Payer: Wellpoint Medicaid Managed Care	$73.34

5.5MM BONE TAP

Facility

$2,767.50

Hospital Charge Code	270704177
Hospital Revenue Code	279
Min. Negotiated Rate	$415.12
Max. Negotiated Rate	$415.12
Rate for Payer: Qualcare PPO/HMO/WC	$415.12

5.5MM PERCUTANEOUS ROD/PREBENT

Facility

$1,250.00

Hospital Charge Code	270701733
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

5.5MM PERCUTANEOUS ROD/PREBENT

Facility

$1,250.00

Hospital Charge Code	270701733
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

5.5MM SET SCREW

Facility

$450.00

Service Code	HCPCS C1713
Hospital Charge Code	270704176
Hospital Revenue Code	278
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Community & State	$10.85
Rate for Payer: Wellpoint Medicaid Managed Care	$11.93

5.5MM SET SCREW

Facility

$450.00

Service Code	HCPCS C1713
Hospital Charge Code	270704176
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$108.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

Know your out-of-pocket cost for care.

All Charges