Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANC TL 7.3x16mm 95mm

Facility

$1,128.35

Service Code	HCPCS C1713
Hospital Charge Code	270605032
Hospital Revenue Code	278
Min. Negotiated Rate	$27.19
Max. Negotiated Rate	$564.17
Rate for Payer: Aetna Commercial	$428.77
Rate for Payer: Aetna Medicare Advantage	$338.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$287.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$287.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$287.73
Rate for Payer: Cigna Commercial	$564.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$273.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$248.24
Rate for Payer: Qualcare PPO/HMO/WC	$169.25
Rate for Payer: UnitedHealthcare Community & State	$27.19
Rate for Payer: Wellpoint Medicaid Managed Care	$29.90

SCREW CANC TL 7.3x16mm 95mm

Facility

$1,128.35

Service Code	HCPCS C1713
Hospital Charge Code	270605032
Hospital Revenue Code	278
Min. Negotiated Rate	$169.25
Max. Negotiated Rate	$273.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$273.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$248.24
Rate for Payer: Qualcare PPO/HMO/WC	$169.25

SCREW CANC TTN 4/95MM

Facility

$38.00

Hospital Charge Code	27060335
Hospital Revenue Code	279
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$19.00
Rate for Payer: Aetna Commercial	$14.44
Rate for Payer: Aetna Medicare Advantage	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.69
Rate for Payer: Cigna Commercial	$19.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.40
Rate for Payer: Oxford Commercial	$7.60
Rate for Payer: Qualcare PPO/HMO/WC	$5.70
Rate for Payer: UnitedHealthcare Commercial	$7.60
Rate for Payer: UnitedHealthcare Community & State	$0.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1.01

SCREW CANC TTN 4/95MM

Facility

$38.00

Hospital Charge Code	27060335
Hospital Revenue Code	279
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$5.70

SCREW CAN FL THR 4x65 11424065

Facility

$426.65

Hospital Charge Code	270625287
Hospital Revenue Code	278
Min. Negotiated Rate	$10.28
Max. Negotiated Rate	$213.32
Rate for Payer: Aetna Commercial	$162.13
Rate for Payer: Aetna Medicare Advantage	$128.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.80
Rate for Payer: Cigna Commercial	$213.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.86
Rate for Payer: Qualcare PPO/HMO/WC	$64.00
Rate for Payer: UnitedHealthcare Community & State	$10.28
Rate for Payer: Wellpoint Medicaid Managed Care	$11.31

SCREW CAN FL THR 4x65 11424065

Facility

$426.65

Hospital Charge Code	270625287
Hospital Revenue Code	278
Min. Negotiated Rate	$64.00
Max. Negotiated Rate	$103.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.86
Rate for Payer: Qualcare PPO/HMO/WC	$64.00

SCREW CAN FUL 5X36 1142-50-36

Facility

$568.60

Hospital Charge Code	270635051
Hospital Revenue Code	278
Min. Negotiated Rate	$13.70
Max. Negotiated Rate	$284.30
Rate for Payer: Aetna Commercial	$216.07
Rate for Payer: Aetna Medicare Advantage	$170.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.99
Rate for Payer: Cigna Commercial	$284.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.09
Rate for Payer: Qualcare PPO/HMO/WC	$85.29
Rate for Payer: UnitedHealthcare Community & State	$13.70
Rate for Payer: Wellpoint Medicaid Managed Care	$15.07

SCREW CAN FUL 5X36 1142-50-36

Facility

$568.60

Hospital Charge Code	270635051
Hospital Revenue Code	278
Min. Negotiated Rate	$85.29
Max. Negotiated Rate	$137.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.09
Rate for Payer: Qualcare PPO/HMO/WC	$85.29

SCREW CAN FULL THRD HD 3X20MM

Facility

$962.50

Hospital Charge Code	270702430
Hospital Revenue Code	278
Min. Negotiated Rate	$23.20
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$365.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$144.38
Rate for Payer: UnitedHealthcare Community & State	$23.20
Rate for Payer: Wellpoint Medicaid Managed Care	$25.51

SCREW CAN FULL THRD HD 3X20MM

Facility

$962.50

Hospital Charge Code	270702430
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW CAN FULL THRD HD 3X36MM

Facility

$962.00

Hospital Charge Code	270702431
Hospital Revenue Code	278
Min. Negotiated Rate	$23.18
Max. Negotiated Rate	$481.00
Rate for Payer: Aetna Commercial	$365.56
Rate for Payer: Aetna Medicare Advantage	$288.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.31
Rate for Payer: Cigna Commercial	$481.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.64
Rate for Payer: Qualcare PPO/HMO/WC	$144.30
Rate for Payer: UnitedHealthcare Community & State	$23.18
Rate for Payer: Wellpoint Medicaid Managed Care	$25.49

SCREW CAN FULL THRD HD 3X36MM

Facility

$962.00

Hospital Charge Code	270702431
Hospital Revenue Code	278
Min. Negotiated Rate	$144.30
Max. Negotiated Rate	$232.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.64
Rate for Payer: Qualcare PPO/HMO/WC	$144.30

SCREW CAN HD 3X14MM

Facility

$972.50

Service Code	HCPCS C1713
Hospital Charge Code	270701407
Hospital Revenue Code	278
Min. Negotiated Rate	$23.44
Max. Negotiated Rate	$486.25
Rate for Payer: Aetna Commercial	$369.55
Rate for Payer: Aetna Medicare Advantage	$291.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.99
Rate for Payer: Cigna Commercial	$486.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$213.95
Rate for Payer: Qualcare PPO/HMO/WC	$145.88
Rate for Payer: UnitedHealthcare Community & State	$23.44
Rate for Payer: Wellpoint Medicaid Managed Care	$25.77

SCREW CAN HD 3X14MM

Facility

$972.50

Service Code	HCPCS C1713
Hospital Charge Code	270701407
Hospital Revenue Code	278
Min. Negotiated Rate	$145.88
Max. Negotiated Rate	$235.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$213.95
Rate for Payer: Qualcare PPO/HMO/WC	$145.88

SCREW CAN HD 3X16MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701337
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW CAN HD 3X16MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701337
Hospital Revenue Code	278
Min. Negotiated Rate	$23.20
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$365.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$144.38
Rate for Payer: UnitedHealthcare Community & State	$23.20
Rate for Payer: Wellpoint Medicaid Managed Care	$25.51

SCREW CAN HD 3 X 20MM

Facility

$962.50

Hospital Charge Code	270701956
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW CAN HD 3 X 20MM

Facility

$962.50

Hospital Charge Code	270701956
Hospital Revenue Code	278
Min. Negotiated Rate	$23.20
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$365.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$144.38
Rate for Payer: UnitedHealthcare Community & State	$23.20
Rate for Payer: Wellpoint Medicaid Managed Care	$25.51

SCREW CAN HD 3 X 22MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701406
Hospital Revenue Code	278
Min. Negotiated Rate	$23.20
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$365.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$144.38
Rate for Payer: UnitedHealthcare Community & State	$23.20
Rate for Payer: Wellpoint Medicaid Managed Care	$25.51

SCREW CAN HD 3 X 22MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701406
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW CAN HD 3 X 26 MM

Facility

$962.50

Hospital Charge Code	270701880
Hospital Revenue Code	278
Min. Negotiated Rate	$23.20
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$365.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$144.38
Rate for Payer: UnitedHealthcare Community & State	$23.20
Rate for Payer: Wellpoint Medicaid Managed Care	$25.51

SCREW CAN HD 3 X 26 MM

Facility

$962.50

Hospital Charge Code	270701880
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW CAN HD 3X34MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701336
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW CAN HD 3X34MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701336
Hospital Revenue Code	278
Min. Negotiated Rate	$23.20
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$365.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$144.38
Rate for Payer: UnitedHealthcare Community & State	$23.20
Rate for Payer: Wellpoint Medicaid Managed Care	$25.51

SCREW CAN LOCKNG 7.3x80 222573

Facility

$1,121.00

Hospital Charge Code	270634363
Hospital Revenue Code	278
Min. Negotiated Rate	$168.15
Max. Negotiated Rate	$271.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$246.62
Rate for Payer: Qualcare PPO/HMO/WC	$168.15

Know your out-of-pocket cost for care.

All Charges