Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN 3.0X16MM

Facility

$941.50

Service Code	HCPCS C1713
Hospital Charge Code	270692676
Hospital Revenue Code	278
Min. Negotiated Rate	$22.69
Max. Negotiated Rate	$470.75
Rate for Payer: Aetna Commercial	$357.77
Rate for Payer: Aetna Medicare Advantage	$282.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$188.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.08
Rate for Payer: Cigna Commercial	$470.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$207.13
Rate for Payer: Qualcare PPO/HMO/WC	$141.22
Rate for Payer: UnitedHealthcare Community & State	$22.69
Rate for Payer: Wellpoint Medicaid Managed Care	$24.95

SCREW CANN 3.0X16MM

Facility

$941.50

Service Code	HCPCS C1713
Hospital Charge Code	270692676
Hospital Revenue Code	278
Min. Negotiated Rate	$141.22
Max. Negotiated Rate	$227.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$188.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$207.13
Rate for Payer: Qualcare PPO/HMO/WC	$141.22

SCREW CANN 30X 28MM

Facility

$865.00

Service Code	HCPCS C1713
Hospital Charge Code	270687364
Hospital Revenue Code	278
Min. Negotiated Rate	$129.75
Max. Negotiated Rate	$209.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$190.30
Rate for Payer: Qualcare PPO/HMO/WC	$129.75

SCREW CANN 30X 28MM

Facility

$865.00

Service Code	HCPCS C1713
Hospital Charge Code	270687364
Hospital Revenue Code	278
Min. Negotiated Rate	$20.85
Max. Negotiated Rate	$432.50
Rate for Payer: Aetna Commercial	$328.70
Rate for Payer: Aetna Medicare Advantage	$259.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$220.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$220.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$220.57
Rate for Payer: Cigna Commercial	$432.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$190.30
Rate for Payer: Qualcare PPO/HMO/WC	$129.75
Rate for Payer: UnitedHealthcare Community & State	$20.85
Rate for Payer: Wellpoint Medicaid Managed Care	$22.92

SCREW CANN 3.0 X 34mm

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270680165
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 CANN 3.0 X 34mm

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270680165
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 CANN 32MM THD 6.5x60MM

Facility

$1,071.00

Service Code	HCPCS C1713
Hospital Charge Code	270675803
Hospital Revenue Code	278
Min. Negotiated Rate	$160.65
Max. Negotiated Rate	$259.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.62
Rate for Payer: Qualcare PPO/HMO/WC	$160.65

SCREW CANN 32MM THD 6.5x60MM

Facility

$1,071.00

Service Code	HCPCS C1713
Hospital Charge Code	270675803
Hospital Revenue Code	278
Min. Negotiated Rate	$25.81
Max. Negotiated Rate	$535.50
Rate for Payer: Aetna Commercial	$406.98
Rate for Payer: Aetna Medicare Advantage	$321.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$273.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$273.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$273.11
Rate for Payer: Cigna Commercial	$535.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.62
Rate for Payer: Qualcare PPO/HMO/WC	$160.65
Rate for Payer: UnitedHealthcare Community & State	$25.81
Rate for Payer: Wellpoint Medicaid Managed Care	$28.38

SCREW CANN 32MM THD 6.5x70MM

Facility

$1,136.25

Service Code	HCPCS C1713
Hospital Charge Code	270675804
Hospital Revenue Code	278
Min. Negotiated Rate	$27.38
Max. Negotiated Rate	$568.12
Rate for Payer: Aetna Commercial	$431.77
Rate for Payer: Aetna Medicare Advantage	$340.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$289.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$289.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$289.74
Rate for Payer: Cigna Commercial	$568.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$249.97
Rate for Payer: Qualcare PPO/HMO/WC	$170.44
Rate for Payer: UnitedHealthcare Community & State	$27.38
Rate for Payer: Wellpoint Medicaid Managed Care	$30.11

SCREW CANN 32MM THD 6.5x70MM

Facility

$1,136.25

Service Code	HCPCS C1713
Hospital Charge Code	270675804
Hospital Revenue Code	278
Min. Negotiated Rate	$170.44
Max. Negotiated Rate	$274.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$249.97
Rate for Payer: Qualcare PPO/HMO/WC	$170.44

SCREW CANN 32MM THD 6.5x75MM

Facility

$1,136.25

Service Code	HCPCS C1713
Hospital Charge Code	270675805
Hospital Revenue Code	278
Min. Negotiated Rate	$27.38
Max. Negotiated Rate	$568.12
Rate for Payer: Aetna Commercial	$431.77
Rate for Payer: Aetna Medicare Advantage	$340.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$289.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$289.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$289.74
Rate for Payer: Cigna Commercial	$568.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$249.97
Rate for Payer: Qualcare PPO/HMO/WC	$170.44
Rate for Payer: UnitedHealthcare Community & State	$27.38
Rate for Payer: Wellpoint Medicaid Managed Care	$30.11

SCREW CANN 32MM THD 6.5x75MM

Facility

$1,136.25

Service Code	HCPCS C1713
Hospital Charge Code	270675805
Hospital Revenue Code	278
Min. Negotiated Rate	$170.44
Max. Negotiated Rate	$274.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$249.97
Rate for Payer: Qualcare PPO/HMO/WC	$170.44

SCREW CANN 32MM THRD 7.3x100MM

Facility

$1,129.85

Service Code	HCPCS C1713
Hospital Charge Code	270605058
Hospital Revenue Code	278
Min. Negotiated Rate	$169.48
Max. Negotiated Rate	$273.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$273.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$248.57
Rate for Payer: Qualcare PPO/HMO/WC	$169.48

SCREW CANN 32MM THRD 7.3x100MM

Facility

$1,129.85

Service Code	HCPCS C1713
Hospital Charge Code	270605058
Hospital Revenue Code	278
Min. Negotiated Rate	$27.23
Max. Negotiated Rate	$564.92
Rate for Payer: Aetna Commercial	$429.34
Rate for Payer: Aetna Medicare Advantage	$338.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$288.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$288.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$288.11
Rate for Payer: Cigna Commercial	$564.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$273.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$248.57
Rate for Payer: Qualcare PPO/HMO/WC	$169.48
Rate for Payer: UnitedHealthcare Community & State	$27.23
Rate for Payer: Wellpoint Medicaid Managed Care	$29.94

SCREW CANN 32MM THRD 7.3x105MM

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270605059
Hospital Revenue Code	278
Min. Negotiated Rate	$164.54
Max. Negotiated Rate	$265.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$265.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$164.54

SCREW CANN 32MM THRD 7.3x105MM

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270605059
Hospital Revenue Code	278
Min. Negotiated Rate	$26.44
Max. Negotiated Rate	$548.48
Rate for Payer: Aetna Commercial	$416.84
Rate for Payer: Aetna Medicare Advantage	$329.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$279.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$279.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$279.72
Rate for Payer: Cigna Commercial	$548.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$265.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$164.54
Rate for Payer: UnitedHealthcare Community & State	$26.44
Rate for Payer: Wellpoint Medicaid Managed Care	$29.07

SCREW CANN 32MM THRD 7.3x110MM

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605060
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$160.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75

SCREW CANN 32MM THRD 7.3x110MM

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605060
Hospital Revenue Code	278
Min. Negotiated Rate	$16.03
Max. Negotiated Rate	$332.50
Rate for Payer: Aetna Commercial	$252.70
Rate for Payer: Aetna Medicare Advantage	$199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.57
Rate for Payer: Cigna Commercial	$332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75
Rate for Payer: UnitedHealthcare Community & State	$16.03
Rate for Payer: Wellpoint Medicaid Managed Care	$17.62

SCREW CANN 32MM THRD 7.3x120MM

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605062
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$160.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75

SCREW CANN 32MM THRD 7.3x120MM

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605062
Hospital Revenue Code	278
Min. Negotiated Rate	$16.03
Max. Negotiated Rate	$332.50
Rate for Payer: Aetna Commercial	$252.70
Rate for Payer: Aetna Medicare Advantage	$199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.57
Rate for Payer: Cigna Commercial	$332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75
Rate for Payer: UnitedHealthcare Community & State	$16.03
Rate for Payer: Wellpoint Medicaid Managed Care	$17.62

SCREW CANN 32MM THRD 7.3x125MM

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605063
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$160.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75

SCREW CANN 32MM THRD 7.3x125MM

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605063
Hospital Revenue Code	278
Min. Negotiated Rate	$16.03
Max. Negotiated Rate	$332.50
Rate for Payer: Aetna Commercial	$252.70
Rate for Payer: Aetna Medicare Advantage	$199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.57
Rate for Payer: Cigna Commercial	$332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75
Rate for Payer: UnitedHealthcare Community & State	$16.03
Rate for Payer: Wellpoint Medicaid Managed Care	$17.62

SCREW CANN 32MM THRD 7.3x130MM

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605064
Hospital Revenue Code	278
Min. Negotiated Rate	$16.03
Max. Negotiated Rate	$332.50
Rate for Payer: Aetna Commercial	$252.70
Rate for Payer: Aetna Medicare Advantage	$199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.57
Rate for Payer: Cigna Commercial	$332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75
Rate for Payer: UnitedHealthcare Community & State	$16.03
Rate for Payer: Wellpoint Medicaid Managed Care	$17.62

SCREW CANN 32MM THRD 7.3x130MM

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605064
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$160.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.75

SCREW CANN 32MM THRD 7.3x135MM

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270605065
Hospital Revenue Code	278
Min. Negotiated Rate	$164.54
Max. Negotiated Rate	$265.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$265.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$164.54

Know your out-of-pocket cost for care.

All Charges