Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CAN COMP HDLS TI4.5 40MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700658
Hospital Revenue Code	278
Min. Negotiated Rate	$129.54
Max. Negotiated Rate	$2,687.50
Rate for Payer: Aetna Commercial	$2,042.50
Rate for Payer: Aetna Medicare Advantage	$1,612.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.62
Rate for Payer: Cigna Commercial	$2,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,182.50
Rate for Payer: Qualcare PPO/HMO/WC	$806.25
Rate for Payer: UnitedHealthcare Community & State	$129.54
Rate for Payer: Wellpoint Medicaid Managed Care	$142.44

SCREW CAN COMP HDLS TI4.5 40MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700658
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,182.50
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

SCREW CAN COMP HDLS TI4.5 44MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700657
Hospital Revenue Code	278
Min. Negotiated Rate	$129.54
Max. Negotiated Rate	$2,687.50
Rate for Payer: Aetna Commercial	$2,042.50
Rate for Payer: Aetna Medicare Advantage	$1,612.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.62
Rate for Payer: Cigna Commercial	$2,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,182.50
Rate for Payer: Qualcare PPO/HMO/WC	$806.25
Rate for Payer: UnitedHealthcare Community & State	$129.54
Rate for Payer: Wellpoint Medicaid Managed Care	$142.44

SCREW CAN COMP HDLS TI4.5 44MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700657
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,182.50
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

SCREW CAN CONICL 5.0x55 222557

Facility

$664.70

Hospital Charge Code	270634362
Hospital Revenue Code	278
Min. Negotiated Rate	$16.02
Max. Negotiated Rate	$332.35
Rate for Payer: Aetna Commercial	$252.59
Rate for Payer: Aetna Medicare Advantage	$199.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.50
Rate for Payer: Cigna Commercial	$332.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.23
Rate for Payer: Qualcare PPO/HMO/WC	$99.70
Rate for Payer: UnitedHealthcare Community & State	$16.02
Rate for Payer: Wellpoint Medicaid Managed Care	$17.61

SCREW CAN CONICL 5.0x55 222557

Facility

$664.70

Hospital Charge Code	270634362
Hospital Revenue Code	278
Min. Negotiated Rate	$99.70
Max. Negotiated Rate	$160.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.23
Rate for Payer: Qualcare PPO/HMO/WC	$99.70

SCREW CAN CONICL 7.3x80 222607

Facility

$1,002.00

Hospital Charge Code	270634364
Hospital Revenue Code	278
Min. Negotiated Rate	$24.15
Max. Negotiated Rate	$501.00
Rate for Payer: Aetna Commercial	$380.76
Rate for Payer: Aetna Medicare Advantage	$300.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.51
Rate for Payer: Cigna Commercial	$501.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.44
Rate for Payer: Qualcare PPO/HMO/WC	$150.30
Rate for Payer: UnitedHealthcare Community & State	$24.15
Rate for Payer: Wellpoint Medicaid Managed Care	$26.55

SCREW CAN CONICL 7.3x80 222607

Facility

$1,002.00

Hospital Charge Code	270634364
Hospital Revenue Code	278
Min. Negotiated Rate	$150.30
Max. Negotiated Rate	$242.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.44
Rate for Payer: Qualcare PPO/HMO/WC	$150.30

SCREW CANC P/THRD 3.5x10MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270648934
Hospital Revenue Code	278
Min. Negotiated Rate	$19.36
Max. Negotiated Rate	$401.70
Rate for Payer: Aetna Commercial	$305.29
Rate for Payer: Aetna Medicare Advantage	$241.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.87
Rate for Payer: Cigna Commercial	$401.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.51
Rate for Payer: UnitedHealthcare Community & State	$19.36
Rate for Payer: Wellpoint Medicaid Managed Care	$21.29

SCREW CANC P/THRD 3.5x10MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270648934
Hospital Revenue Code	278
Min. Negotiated Rate	$120.51
Max. Negotiated Rate	$194.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.51

SCREW CANC P/THRD 3.5x12MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270655857
Hospital Revenue Code	278
Min. Negotiated Rate	$19.36
Max. Negotiated Rate	$401.70
Rate for Payer: Aetna Commercial	$305.29
Rate for Payer: Aetna Medicare Advantage	$241.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.87
Rate for Payer: Cigna Commercial	$401.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.51
Rate for Payer: UnitedHealthcare Community & State	$19.36
Rate for Payer: Wellpoint Medicaid Managed Care	$21.29

SCREW CANC P/THRD 3.5x12MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270655857
Hospital Revenue Code	278
Min. Negotiated Rate	$120.51
Max. Negotiated Rate	$194.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.51

SCREW CANC P/THRD 3.5x14MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270655858
Hospital Revenue Code	278
Min. Negotiated Rate	$120.51
Max. Negotiated Rate	$194.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.51

SCREW CANC P/THRD 3.5x14MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270655858
Hospital Revenue Code	278
Min. Negotiated Rate	$19.36
Max. Negotiated Rate	$401.70
Rate for Payer: Aetna Commercial	$305.29
Rate for Payer: Aetna Medicare Advantage	$241.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.87
Rate for Payer: Cigna Commercial	$401.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.51
Rate for Payer: UnitedHealthcare Community & State	$19.36
Rate for Payer: Wellpoint Medicaid Managed Care	$21.29

SCREW CANC P/THRD 3.5x16MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270655859
Hospital Revenue Code	278
Min. Negotiated Rate	$19.36
Max. Negotiated Rate	$401.70
Rate for Payer: Aetna Commercial	$305.29
Rate for Payer: Aetna Medicare Advantage	$241.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.87
Rate for Payer: Cigna Commercial	$401.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.51
Rate for Payer: UnitedHealthcare Community & State	$19.36
Rate for Payer: Wellpoint Medicaid Managed Care	$21.29

SCREW CANC P/THRD 3.5x16MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270655859
Hospital Revenue Code	278
Min. Negotiated Rate	$120.51
Max. Negotiated Rate	$194.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.51

SCREW CANC P/THRD 3.5x20MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270655860
Hospital Revenue Code	278
Min. Negotiated Rate	$19.36
Max. Negotiated Rate	$401.70
Rate for Payer: Aetna Commercial	$305.29
Rate for Payer: Aetna Medicare Advantage	$241.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.87
Rate for Payer: Cigna Commercial	$401.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.51
Rate for Payer: UnitedHealthcare Community & State	$19.36
Rate for Payer: Wellpoint Medicaid Managed Care	$21.29

SCREW CANC P/THRD 3.5x20MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270655860
Hospital Revenue Code	278
Min. Negotiated Rate	$120.51
Max. Negotiated Rate	$194.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.51

SCREW CANC P/THRD 3.5x22MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270655861
Hospital Revenue Code	278
Min. Negotiated Rate	$120.51
Max. Negotiated Rate	$194.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.51

SCREW CANC P/THRD 3.5x22MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270655861
Hospital Revenue Code	278
Min. Negotiated Rate	$19.36
Max. Negotiated Rate	$401.70
Rate for Payer: Aetna Commercial	$305.29
Rate for Payer: Aetna Medicare Advantage	$241.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.87
Rate for Payer: Cigna Commercial	$401.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.51
Rate for Payer: UnitedHealthcare Community & State	$19.36
Rate for Payer: Wellpoint Medicaid Managed Care	$21.29

SCREW CANC P/THRD 3.5x24MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270652238
Hospital Revenue Code	278
Min. Negotiated Rate	$120.51
Max. Negotiated Rate	$194.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.51

SCREW CANC P/THRD 3.5x24MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270652238
Hospital Revenue Code	278
Min. Negotiated Rate	$19.36
Max. Negotiated Rate	$401.70
Rate for Payer: Aetna Commercial	$305.29
Rate for Payer: Aetna Medicare Advantage	$241.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.87
Rate for Payer: Cigna Commercial	$401.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.51
Rate for Payer: UnitedHealthcare Community & State	$19.36
Rate for Payer: Wellpoint Medicaid Managed Care	$21.29

SCREW CANC P/THRD 3.5x26MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270655862
Hospital Revenue Code	278
Min. Negotiated Rate	$19.36
Max. Negotiated Rate	$401.70
Rate for Payer: Aetna Commercial	$305.29
Rate for Payer: Aetna Medicare Advantage	$241.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.87
Rate for Payer: Cigna Commercial	$401.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.51
Rate for Payer: UnitedHealthcare Community & State	$19.36
Rate for Payer: Wellpoint Medicaid Managed Care	$21.29

SCREW CANC P/THRD 3.5x26MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270655862
Hospital Revenue Code	278
Min. Negotiated Rate	$120.51
Max. Negotiated Rate	$194.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.51

SCREW CANC P/THRD 3.5x28MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270655863
Hospital Revenue Code	278
Min. Negotiated Rate	$120.51
Max. Negotiated Rate	$194.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.51

Know your out-of-pocket cost for care.

All Charges