Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANC F/THRD 3.5x40MM

Facility

$801.00

Service Code	HCPCS C1713
Hospital Charge Code	270655897
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 3.5x40MM

Facility

$801.00

Service Code	HCPCS C1713
Hospital Charge Code	270655897
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 3.5x42MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655898
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 3.5x42MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655898
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 3.5x44MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655900
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 3.5x44MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655900
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 3.5x48MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655903
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 3.5x48MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655903
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 3.5x50MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655904
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 3.5x50MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655904
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 6.5x60MM

Facility

$135.00

Hospital Charge Code	270676303
Hospital Revenue Code	278
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$51.30
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.42
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.25
Rate for Payer: UnitedHealthcare Community & State	$3.25
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

SCREW CANC F/THRD 6.5x60MM

Facility

$135.00

Hospital Charge Code	270676303
Hospital Revenue Code	278
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$32.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

SCREW CANC INV REVER 4.5X36MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270696095
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

SCREW CANC INV REVER 4.5X36MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270696095
Hospital Revenue Code	278
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$180.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Community & State	$11.45
Rate for Payer: Wellpoint Medicaid Managed Care	$12.59

SCREW CANCL 6.5 16x50 16235250

Facility

$238.15

Hospital Charge Code	270633935
Hospital Revenue Code	278
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$57.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.39
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

SCREW CANCL 6.5 16x50 16235250

Facility

$238.15

Hospital Charge Code	270633935
Hospital Revenue Code	278
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$119.08
Rate for Payer: Aetna Commercial	$90.50
Rate for Payer: Aetna Medicare Advantage	$71.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.73
Rate for Payer: Cigna Commercial	$119.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.39
Rate for Payer: Qualcare PPO/HMO/WC	$35.72
Rate for Payer: UnitedHealthcare Community & State	$5.74
Rate for Payer: Wellpoint Medicaid Managed Care	$6.31

SCREW CANC LAG 5.5x90mm

Facility

$405.00

Service Code	HCPCS C1713
Hospital Charge Code	270671595
Hospital Revenue Code	278
Min. Negotiated Rate	$9.76
Max. Negotiated Rate	$202.50
Rate for Payer: Aetna Commercial	$153.90
Rate for Payer: Aetna Medicare Advantage	$121.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$103.28
Rate for Payer: Cigna Commercial	$202.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$89.10
Rate for Payer: Qualcare PPO/HMO/WC	$60.75
Rate for Payer: UnitedHealthcare Community & State	$9.76
Rate for Payer: Wellpoint Medicaid Managed Care	$10.73

SCREW CANC LAG 5.5x90mm

Facility

$405.00

Service Code	HCPCS C1713
Hospital Charge Code	270671595
Hospital Revenue Code	278
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$98.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$89.10
Rate for Payer: Qualcare PPO/HMO/WC	$60.75

SCREW CANC LOCK 4.2x36 3742236

Facility

$945.00

Hospital Charge Code	270643577
Hospital Revenue Code	278
Min. Negotiated Rate	$22.77
Max. Negotiated Rate	$472.50
Rate for Payer: Aetna Commercial	$359.10
Rate for Payer: Aetna Medicare Advantage	$283.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.97
Rate for Payer: Cigna Commercial	$472.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$207.90
Rate for Payer: Qualcare PPO/HMO/WC	$141.75
Rate for Payer: UnitedHealthcare Community & State	$22.77
Rate for Payer: Wellpoint Medicaid Managed Care	$25.04

SCREW CANC LOCK 4.2x36 3742236

Facility

$945.00

Hospital Charge Code	270643577
Hospital Revenue Code	278
Min. Negotiated Rate	$141.75
Max. Negotiated Rate	$228.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$207.90
Rate for Payer: Qualcare PPO/HMO/WC	$141.75

SCREW CANC LOCK 4.2x40 3742240

Facility

$945.00

Hospital Charge Code	270643576
Hospital Revenue Code	278
Min. Negotiated Rate	$22.77
Max. Negotiated Rate	$472.50
Rate for Payer: Aetna Commercial	$359.10
Rate for Payer: Aetna Medicare Advantage	$283.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.97
Rate for Payer: Cigna Commercial	$472.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$207.90
Rate for Payer: Qualcare PPO/HMO/WC	$141.75
Rate for Payer: UnitedHealthcare Community & State	$22.77
Rate for Payer: Wellpoint Medicaid Managed Care	$25.04

SCREW CANC LOCK 4.2x40 3742240

Facility

$945.00

Hospital Charge Code	270643576
Hospital Revenue Code	278
Min. Negotiated Rate	$141.75
Max. Negotiated Rate	$228.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$207.90
Rate for Payer: Qualcare PPO/HMO/WC	$141.75

SCREW CANC LOCK 4.2x50 3742250

Facility

$945.00

Hospital Charge Code	270643575
Hospital Revenue Code	278
Min. Negotiated Rate	$22.77
Max. Negotiated Rate	$472.50
Rate for Payer: Aetna Commercial	$359.10
Rate for Payer: Aetna Medicare Advantage	$283.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.97
Rate for Payer: Cigna Commercial	$472.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$207.90
Rate for Payer: Qualcare PPO/HMO/WC	$141.75
Rate for Payer: UnitedHealthcare Community & State	$22.77
Rate for Payer: Wellpoint Medicaid Managed Care	$25.04

SCREW CANC LOCK 4.2x50 3742250

Facility

$945.00

Hospital Charge Code	270643575
Hospital Revenue Code	278
Min. Negotiated Rate	$141.75
Max. Negotiated Rate	$228.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$207.90
Rate for Payer: Qualcare PPO/HMO/WC	$141.75

SCREW CANC LOCK 44MM

Facility

$1,155.00

Hospital Charge Code	270702010
Hospital Revenue Code	278
Min. Negotiated Rate	$173.25
Max. Negotiated Rate	$279.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$231.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$173.25

Know your out-of-pocket cost for care.

All Charges