Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE CANN P/THD 4x22MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604269
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 BONE CANN P/THD 4x24MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604270
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 BONE CANN P/THD 4x24MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604270
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 BONE CANN P/THD 4x28MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604272
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 BONE CANN P/THD 4x28MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604272
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 BONE CANN P/THD 4x30MM

Facility

$68.25

Service Code	HCPCS C1713
Hospital Charge Code	270604273
Hospital Revenue Code	278
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$34.12
Rate for Payer: Aetna Commercial	$25.93
Rate for Payer: Aetna Medicare Advantage	$20.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.40
Rate for Payer: Cigna Commercial	$34.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.02
Rate for Payer: Qualcare PPO/HMO/WC	$10.24
Rate for Payer: UnitedHealthcare Community & State	$1.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1.81

SCREW BONE CANN P/THD 4x30MM

Facility

$68.25

Service Code	HCPCS C1713
Hospital Charge Code	270604273
Hospital Revenue Code	278
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$16.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.02
Rate for Payer: Qualcare PPO/HMO/WC	$10.24

SCREW BONE CANN P/THD 4x35MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604274
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 BONE CANN P/THD 4x35MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604274
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 BONE CANN P/THD 4x40MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604275
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 BONE CANN P/THD 4x40MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604275
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 BONE CANN P/THD 4x45MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604276
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 BONE CANN P/THD 4x45MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604276
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 BONE CANN P/THD 4x50MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604277
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 BONE CANN P/THD 4x50MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604277
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 BONE CANN P/THD 4x55MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604278
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 BONE CANN P/THD 4x55MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604278
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 BONE CANN P/THD 4x60MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604279
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 BONE CANN P/THD 4x60MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604279
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 BONE CORTICAL 4.5X26MM

Facility

$220.00

Service Code	HCPCS C1713
Hospital Charge Code	270694690
Hospital Revenue Code	278
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$53.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$48.40
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

SCREW BONE CORTICAL 4.5X26MM

Facility

$220.00

Service Code	HCPCS C1713
Hospital Charge Code	270694690
Hospital Revenue Code	278
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$83.60
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$48.40
Rate for Payer: Qualcare PPO/HMO/WC	$33.00
Rate for Payer: UnitedHealthcare Community & State	$5.30
Rate for Payer: Wellpoint Medicaid Managed Care	$5.83

SCREW BONE CORTICAL 4.5X28MM

Facility

$220.00

Service Code	HCPCS C1713
Hospital Charge Code	270694692
Hospital Revenue Code	278
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$53.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$48.40
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

SCREW BONE CORTICAL 4.5X28MM

Facility

$220.00

Service Code	HCPCS C1713
Hospital Charge Code	270694692
Hospital Revenue Code	278
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$83.60
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$48.40
Rate for Payer: Qualcare PPO/HMO/WC	$33.00
Rate for Payer: UnitedHealthcare Community & State	$5.30
Rate for Payer: Wellpoint Medicaid Managed Care	$5.83

SCREW BONE CORTICAL 5.0MMX38

Facility

$1,320.00

Service Code	HCPCS C1713
Hospital Charge Code	270702721
Hospital Revenue Code	278
Min. Negotiated Rate	$198.00
Max. Negotiated Rate	$319.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$290.40
Rate for Payer: Qualcare PPO/HMO/WC	$198.00

SCREW BONE CORTICAL 5.0MMX38

Facility

$1,320.00

Service Code	HCPCS C1713
Hospital Charge Code	270702721
Hospital Revenue Code	278
Min. Negotiated Rate	$31.81
Max. Negotiated Rate	$660.00
Rate for Payer: Aetna Commercial	$501.60
Rate for Payer: Aetna Medicare Advantage	$396.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$336.60
Rate for Payer: Cigna Commercial	$660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$290.40
Rate for Payer: Qualcare PPO/HMO/WC	$198.00
Rate for Payer: UnitedHealthcare Community & State	$31.81
Rate for Payer: Wellpoint Medicaid Managed Care	$34.98

Know your out-of-pocket cost for care.

All Charges