Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW 4.0mm TITAN CANCEL 24mm

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270603202
Hospital Revenue Code	278
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$37.08
Rate for Payer: Aetna Commercial	$28.18
Rate for Payer: Aetna Medicare Advantage	$22.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.91
Rate for Payer: Cigna Commercial	$37.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.31
Rate for Payer: Qualcare PPO/HMO/WC	$11.12
Rate for Payer: UnitedHealthcare Community & State	$1.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1.96

SCREW 4.0mm TITAN CANCEL 24mm

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270603318
Hospital Revenue Code	278
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$35.15
Rate for Payer: Aetna Commercial	$26.71
Rate for Payer: Aetna Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.93
Rate for Payer: Cigna Commercial	$35.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.47
Rate for Payer: Qualcare PPO/HMO/WC	$10.54
Rate for Payer: UnitedHealthcare Community & State	$1.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1.86

SCREW 4.0mm TITAN CANCEL 24mm

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270603202
Hospital Revenue Code	278
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$17.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.31
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

SCREW 4.0mm TITAN CANCEL 24mm

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270603318
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$17.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.47
Rate for Payer: Qualcare PPO/HMO/WC	$10.54

SCREW 4.0mm TITAN CANCEL 26mm

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270603319
Hospital Revenue Code	278
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$35.15
Rate for Payer: Aetna Commercial	$26.71
Rate for Payer: Aetna Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.93
Rate for Payer: Cigna Commercial	$35.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.47
Rate for Payer: Qualcare PPO/HMO/WC	$10.54
Rate for Payer: UnitedHealthcare Community & State	$1.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1.86

SCREW 4.0mm TITAN CANCEL 26mm

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270603319
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$17.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.47
Rate for Payer: Qualcare PPO/HMO/WC	$10.54

SCREW 4.0mm TITAN CANCEL 28mm

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270603320
Hospital Revenue Code	278
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$35.15
Rate for Payer: Aetna Commercial	$26.71
Rate for Payer: Aetna Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.93
Rate for Payer: Cigna Commercial	$35.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.47
Rate for Payer: Qualcare PPO/HMO/WC	$10.54
Rate for Payer: UnitedHealthcare Community & State	$1.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1.86

SCREW 4.0mm TITAN CANCEL 28mm

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270603320
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$17.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.47
Rate for Payer: Qualcare PPO/HMO/WC	$10.54

SCREW 4.0mm TITAN CANCEL 30mm

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270603206
Hospital Revenue Code	278
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$37.08
Rate for Payer: Aetna Commercial	$28.18
Rate for Payer: Aetna Medicare Advantage	$22.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.91
Rate for Payer: Cigna Commercial	$37.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.31
Rate for Payer: Qualcare PPO/HMO/WC	$11.12
Rate for Payer: UnitedHealthcare Community & State	$1.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1.96

SCREW 4.0mm TITAN CANCEL 30mm

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270603206
Hospital Revenue Code	278
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$17.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.31
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

SCREW 4.0mm TITAN CANCEL 35mm

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270603322
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$17.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.47
Rate for Payer: Qualcare PPO/HMO/WC	$10.54

SCREW 4.0mm TITAN CANCEL 35mm

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270603322
Hospital Revenue Code	278
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$35.15
Rate for Payer: Aetna Commercial	$26.71
Rate for Payer: Aetna Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.93
Rate for Payer: Cigna Commercial	$35.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.47
Rate for Payer: Qualcare PPO/HMO/WC	$10.54
Rate for Payer: UnitedHealthcare Community & State	$1.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1.86

SCREW4.0mmTITN CANC100mm*****

Facility

$38.00

Hospital Charge Code	27060336
Hospital Revenue Code	279
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$5.70

SCREW4.0mmTITN CANC100mm*****

Facility

$38.00

Hospital Charge Code	27060336
Hospital Revenue Code	279
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$19.00
Rate for Payer: Aetna Commercial	$14.44
Rate for Payer: Aetna Medicare Advantage	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.69
Rate for Payer: Cigna Commercial	$19.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.40
Rate for Payer: Oxford Commercial	$7.60
Rate for Payer: Qualcare PPO/HMO/WC	$5.70
Rate for Payer: UnitedHealthcare Commercial	$7.60
Rate for Payer: UnitedHealthcare Community & State	$0.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1.01

SCREW 4.0 MMX 10MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692745
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 4.0 MMX 10MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692745
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 4.0M X 10MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692744
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 4.0M X 10MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692744
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 4.0M X 12MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692714
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 4.0M X 12MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692714
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 4.0M X 14MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692743
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 4.0M X 14MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692743
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 4.0 POLY SYMPH 3.5X12MM

Facility

$7,836.15

Service Code	HCPCS C1713
Hospital Charge Code	270693348
Hospital Revenue Code	278
Min. Negotiated Rate	$188.85
Max. Negotiated Rate	$3,918.07
Rate for Payer: Aetna Commercial	$2,977.74
Rate for Payer: Aetna Medicare Advantage	$2,350.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,998.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,998.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,567.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,998.22
Rate for Payer: Cigna Commercial	$3,918.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,896.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,723.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,175.42
Rate for Payer: UnitedHealthcare Community & State	$188.85
Rate for Payer: Wellpoint Medicaid Managed Care	$207.66

SCREW 4.0 POLY SYMPH 3.5X12MM

Facility

$7,836.15

Service Code	HCPCS C1713
Hospital Charge Code	270693348
Hospital Revenue Code	278
Min. Negotiated Rate	$1,175.42
Max. Negotiated Rate	$1,896.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,567.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,896.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,723.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,175.42

SCREW 4.0 POLY SYMPH 3.5X14MM

Facility

$7,836.15

Service Code	HCPCS C1713
Hospital Charge Code	270693353
Hospital Revenue Code	278
Min. Negotiated Rate	$1,175.42
Max. Negotiated Rate	$1,896.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,567.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,896.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,723.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,175.42

Know your out-of-pocket cost for care.

All Charges