Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANC F/THRD 3.5x14MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655875
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$199.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.51
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x16MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655876
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.52
Rate for Payer: Aetna Commercial	$313.52
Rate for Payer: Aetna Medicare Advantage	$247.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.39
Rate for Payer: Cigna Commercial	$412.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.51
Rate for Payer: Qualcare PPO/HMO/WC	$123.76
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW CANC F/THRD 3.5x16MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655876
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$199.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.51
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x18MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655880
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.52
Rate for Payer: Aetna Commercial	$313.52
Rate for Payer: Aetna Medicare Advantage	$247.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.39
Rate for Payer: Cigna Commercial	$412.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.51
Rate for Payer: Qualcare PPO/HMO/WC	$123.76
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW CANC F/THRD 3.5x18MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655880
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$199.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.51
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x20MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270652239
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$199.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.51
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x20MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270652239
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.52
Rate for Payer: Aetna Commercial	$313.52
Rate for Payer: Aetna Medicare Advantage	$247.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.39
Rate for Payer: Cigna Commercial	$412.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.51
Rate for Payer: Qualcare PPO/HMO/WC	$123.76
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW CANC F/THRD 3.5x22MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655882
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$199.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.51
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x22MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655882
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.52
Rate for Payer: Aetna Commercial	$313.52
Rate for Payer: Aetna Medicare Advantage	$247.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.39
Rate for Payer: Cigna Commercial	$412.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.51
Rate for Payer: Qualcare PPO/HMO/WC	$123.76
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW CANC F/THRD 3.5x24MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655883
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.52
Rate for Payer: Aetna Commercial	$313.52
Rate for Payer: Aetna Medicare Advantage	$247.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.39
Rate for Payer: Cigna Commercial	$412.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.51
Rate for Payer: Qualcare PPO/HMO/WC	$123.76
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW CANC F/THRD 3.5x24MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655883
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$199.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.51
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x26MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655887
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$199.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.51
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x26MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655887
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.52
Rate for Payer: Aetna Commercial	$313.52
Rate for Payer: Aetna Medicare Advantage	$247.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.39
Rate for Payer: Cigna Commercial	$412.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.51
Rate for Payer: Qualcare PPO/HMO/WC	$123.76
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW CANC F/THRD 3.5x28MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655889
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$199.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.51
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x28MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655889
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.52
Rate for Payer: Aetna Commercial	$313.52
Rate for Payer: Aetna Medicare Advantage	$247.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.39
Rate for Payer: Cigna Commercial	$412.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.51
Rate for Payer: Qualcare PPO/HMO/WC	$123.76
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW CANC F/THRD 3.5x30MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270652242
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$199.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.51
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x30MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270652242
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.52
Rate for Payer: Aetna Commercial	$313.52
Rate for Payer: Aetna Medicare Advantage	$247.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.39
Rate for Payer: Cigna Commercial	$412.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.51
Rate for Payer: Qualcare PPO/HMO/WC	$123.76
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW CANC F/THRD 3.5x32MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655891
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$199.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.51
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x32MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655891
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.52
Rate for Payer: Aetna Commercial	$313.52
Rate for Payer: Aetna Medicare Advantage	$247.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.39
Rate for Payer: Cigna Commercial	$412.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.51
Rate for Payer: Qualcare PPO/HMO/WC	$123.76
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW CANC F/THRD 3.5x34MM

Facility

$801.00

Service Code	HCPCS C1713
Hospital Charge Code	270655893
Hospital Revenue Code	278
Min. Negotiated Rate	$19.30
Max. Negotiated Rate	$400.50
Rate for Payer: Aetna Commercial	$304.38
Rate for Payer: Aetna Medicare Advantage	$240.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.25
Rate for Payer: Cigna Commercial	$400.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.22
Rate for Payer: Qualcare PPO/HMO/WC	$120.15
Rate for Payer: UnitedHealthcare Community & State	$19.30
Rate for Payer: Wellpoint Medicaid Managed Care	$21.23

SCREW CANC F/THRD 3.5x34MM

Facility

$801.00

Service Code	HCPCS C1713
Hospital Charge Code	270655893
Hospital Revenue Code	278
Min. Negotiated Rate	$120.15
Max. Negotiated Rate	$193.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.22
Rate for Payer: Qualcare PPO/HMO/WC	$120.15

SCREW CANC F/THRD 3.5x36MM

Facility

$801.00

Service Code	HCPCS C1713
Hospital Charge Code	270655894
Hospital Revenue Code	278
Min. Negotiated Rate	$19.30
Max. Negotiated Rate	$400.50
Rate for Payer: Aetna Commercial	$304.38
Rate for Payer: Aetna Medicare Advantage	$240.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.25
Rate for Payer: Cigna Commercial	$400.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.22
Rate for Payer: Qualcare PPO/HMO/WC	$120.15
Rate for Payer: UnitedHealthcare Community & State	$19.30
Rate for Payer: Wellpoint Medicaid Managed Care	$21.23

SCREW CANC F/THRD 3.5x36MM

Facility

$801.00

Service Code	HCPCS C1713
Hospital Charge Code	270655894
Hospital Revenue Code	278
Min. Negotiated Rate	$120.15
Max. Negotiated Rate	$193.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.22
Rate for Payer: Qualcare PPO/HMO/WC	$120.15

SCREW CANC F/THRD 3.5x38MM

Facility

$801.00

Service Code	HCPCS C1713
Hospital Charge Code	270655895
Hospital Revenue Code	278
Min. Negotiated Rate	$120.15
Max. Negotiated Rate	$193.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.22
Rate for Payer: Qualcare PPO/HMO/WC	$120.15

SCREW CANC F/THRD 3.5x38MM

Facility

$801.00

Service Code	HCPCS C1713
Hospital Charge Code	270655895
Hospital Revenue Code	278
Min. Negotiated Rate	$19.30
Max. Negotiated Rate	$400.50
Rate for Payer: Aetna Commercial	$304.38
Rate for Payer: Aetna Medicare Advantage	$240.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.25
Rate for Payer: Cigna Commercial	$400.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.22
Rate for Payer: Qualcare PPO/HMO/WC	$120.15
Rate for Payer: UnitedHealthcare Community & State	$19.30
Rate for Payer: Wellpoint Medicaid Managed Care	$21.23

Know your out-of-pocket cost for care.

All Charges