Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANC P/THRD 3.5x28MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270655863
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 3.5x36MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270632482
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 3.5x36MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270632482
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 3.5x38MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270655864
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 3.5x38MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270655864
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 3.5x40MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270655865
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 3.5x40MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270655865
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 3.5x42MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270652244
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 3.5x42MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270652244
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 3.5x44MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270629207
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 3.5x44MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270629207
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 3.5x46MM

Facility

$827.50

Service Code	HCPCS C1713
Hospital Charge Code	270655866
Hospital Revenue Code	278
Min. Negotiated Rate	$124.12
Max. Negotiated Rate	$200.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$182.05
Rate for Payer: Qualcare PPO/HMO/WC	$124.12

SCREW CANC P/THRD 3.5x46MM

Facility

$827.50

Service Code	HCPCS C1713
Hospital Charge Code	270655866
Hospital Revenue Code	278
Min. Negotiated Rate	$19.94
Max. Negotiated Rate	$413.75
Rate for Payer: Aetna Commercial	$314.45
Rate for Payer: Aetna Medicare Advantage	$248.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.01
Rate for Payer: Cigna Commercial	$413.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$182.05
Rate for Payer: Qualcare PPO/HMO/WC	$124.12
Rate for Payer: UnitedHealthcare Community & State	$19.94
Rate for Payer: Wellpoint Medicaid Managed Care	$21.93

SCREW CANC P/THRD 3.5x48MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270655868
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 3.5x48MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270655868
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 3.5x50MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270648935
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 3.5x50MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270648935
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 PT THD4x40 24804040

Facility

$200.50

Hospital Charge Code	270639427
Hospital Revenue Code	278
Min. Negotiated Rate	$4.83
Max. Negotiated Rate	$100.25
Rate for Payer: Aetna Commercial	$76.19
Rate for Payer: Aetna Medicare Advantage	$60.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.13
Rate for Payer: Cigna Commercial	$100.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.11
Rate for Payer: Qualcare PPO/HMO/WC	$30.07
Rate for Payer: UnitedHealthcare Community & State	$4.83
Rate for Payer: Wellpoint Medicaid Managed Care	$5.31

SCREW CANC PT THD4x40 24804040

Facility

$200.50

Hospital Charge Code	270639427
Hospital Revenue Code	278
Min. Negotiated Rate	$30.07
Max. Negotiated Rate	$48.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$44.11
Rate for Payer: Qualcare PPO/HMO/WC	$30.07

SCREW CANC Q/FIX P/THD 3x30MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270679308
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW CANC Q/FIX P/THD 3x30MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270679308
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

SCREW CANC Q/FIX P/THD 3x32MM

Facility

$930.00

Service Code	HCPCS C1713
Hospital Charge Code	270648824
Hospital Revenue Code	278
Min. Negotiated Rate	$22.41
Max. Negotiated Rate	$465.00
Rate for Payer: Aetna Commercial	$353.40
Rate for Payer: Aetna Medicare Advantage	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.15
Rate for Payer: Cigna Commercial	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$204.60
Rate for Payer: Qualcare PPO/HMO/WC	$139.50
Rate for Payer: UnitedHealthcare Community & State	$22.41
Rate for Payer: Wellpoint Medicaid Managed Care	$24.64

SCREW CANC Q/FIX P/THD 3x32MM

Facility

$930.00

Service Code	HCPCS C1713
Hospital Charge Code	270648824
Hospital Revenue Code	278
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$225.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$204.60
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

SCREW CANC Q/FIX P/THD 3x40MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270676999
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

SCREW CANC Q/FIX P/THD 3x40MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270676999
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

Know your out-of-pocket cost for care.

All Charges