Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN 4.0X52MMHEADLSSCOMP

Facility

$2,132.00

Service Code	HCPCS C1713
Hospital Charge Code	270692649
Hospital Revenue Code	278
Min. Negotiated Rate	$51.38
Max. Negotiated Rate	$1,066.00
Rate for Payer: Aetna Commercial	$810.16
Rate for Payer: Aetna Medicare Advantage	$639.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$543.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$543.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$543.66
Rate for Payer: Cigna Commercial	$1,066.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$469.04
Rate for Payer: Qualcare PPO/HMO/WC	$319.80
Rate for Payer: UnitedHealthcare Community & State	$51.38
Rate for Payer: Wellpoint Medicaid Managed Care	$56.50

SCREW CANN 4.0X60MMHEADLSSCOMP

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270692642
Hospital Revenue Code	278
Min. Negotiated Rate	$45.74
Max. Negotiated Rate	$949.00
Rate for Payer: Aetna Commercial	$721.24
Rate for Payer: Aetna Medicare Advantage	$569.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$483.99
Rate for Payer: Cigna Commercial	$949.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$417.56
Rate for Payer: Qualcare PPO/HMO/WC	$284.70
Rate for Payer: UnitedHealthcare Community & State	$45.74
Rate for Payer: Wellpoint Medicaid Managed Care	$50.30

SCREW CANN 4.0X60MMHEADLSSCOMP

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270692642
Hospital Revenue Code	278
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$459.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$417.56
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

SCREW CANN 4X38MM STERILE

Facility

$931.20

Service Code	HCPCS C1713
Hospital Charge Code	270670036
Hospital Revenue Code	278
Min. Negotiated Rate	$22.44
Max. Negotiated Rate	$465.60
Rate for Payer: Aetna Commercial	$353.86
Rate for Payer: Aetna Medicare Advantage	$279.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.46
Rate for Payer: Cigna Commercial	$465.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$204.86
Rate for Payer: Qualcare PPO/HMO/WC	$139.68
Rate for Payer: UnitedHealthcare Community & State	$22.44
Rate for Payer: Wellpoint Medicaid Managed Care	$24.68

SCREW CANN 4X38MM STERILE

Facility

$931.20

Service Code	HCPCS C1713
Hospital Charge Code	270670036
Hospital Revenue Code	278
Min. Negotiated Rate	$139.68
Max. Negotiated Rate	$225.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$204.86
Rate for Payer: Qualcare PPO/HMO/WC	$139.68

SCREW CANN 4X38MM THD 13MM

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270670012
Hospital Revenue Code	278
Min. Negotiated Rate	$32.78
Max. Negotiated Rate	$680.00
Rate for Payer: Aetna Commercial	$516.80
Rate for Payer: Aetna Medicare Advantage	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$346.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$346.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$346.80
Rate for Payer: Cigna Commercial	$680.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$299.20
Rate for Payer: Qualcare PPO/HMO/WC	$204.00
Rate for Payer: UnitedHealthcare Community & State	$32.78
Rate for Payer: Wellpoint Medicaid Managed Care	$36.04

SCREW CANN 4X38MM THD 13MM

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270670012
Hospital Revenue Code	278
Min. Negotiated Rate	$204.00
Max. Negotiated Rate	$329.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$299.20
Rate for Payer: Qualcare PPO/HMO/WC	$204.00

SCREW CANN 4x40MM TL 16 SH THD

Facility

$790.00

Hospital Charge Code	270667927
Hospital Revenue Code	278
Min. Negotiated Rate	$19.04
Max. Negotiated Rate	$395.00
Rate for Payer: Aetna Commercial	$300.20
Rate for Payer: Aetna Medicare Advantage	$237.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.45
Rate for Payer: Cigna Commercial	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$173.80
Rate for Payer: Qualcare PPO/HMO/WC	$118.50
Rate for Payer: UnitedHealthcare Community & State	$19.04
Rate for Payer: Wellpoint Medicaid Managed Care	$20.93

SCREW CANN 4x40MM TL 16 SH THD

Facility

$790.00

Hospital Charge Code	270667927
Hospital Revenue Code	278
Min. Negotiated Rate	$118.50
Max. Negotiated Rate	$191.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$173.80
Rate for Payer: Qualcare PPO/HMO/WC	$118.50

SCREW CANN 4X50MM TITANIUM

Facility

$1,295.00

Service Code	HCPCS C1713
Hospital Charge Code	270669234
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

SCREW CANN 4X50MM TITANIUM

Facility

$1,295.00

Service Code	HCPCS C1713
Hospital Charge Code	270669234
Hospital Revenue Code	278
Min. Negotiated Rate	$31.21
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$492.10
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Community & State	$31.21
Rate for Payer: Wellpoint Medicaid Managed Care	$34.32

SCREW CANN 6.50X50MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693228
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW CANN 6.50X50MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693228
Hospital Revenue Code	278
Min. Negotiated Rate	$259.07
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$4,085.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50
Rate for Payer: UnitedHealthcare Community & State	$259.07
Rate for Payer: Wellpoint Medicaid Managed Care	$284.88

SCREW CANN 6.5-40MM THRD 75MM

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270680281
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$532.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$330.00

SCREW CANN 6.5-40MM THRD 75MM

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270680281
Hospital Revenue Code	278
Min. Negotiated Rate	$53.02
Max. Negotiated Rate	$1,100.00
Rate for Payer: Aetna Commercial	$836.00
Rate for Payer: Aetna Medicare Advantage	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$561.00
Rate for Payer: Cigna Commercial	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$330.00
Rate for Payer: UnitedHealthcare Community & State	$53.02
Rate for Payer: Wellpoint Medicaid Managed Care	$58.30

SCREW CANN 6.5MM THR 32MM55MM

Facility

$1,373.00

Service Code	HCPCS C1713
Hospital Charge Code	270694437
Hospital Revenue Code	278
Min. Negotiated Rate	$205.95
Max. Negotiated Rate	$332.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$274.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$302.06
Rate for Payer: Qualcare PPO/HMO/WC	$205.95

SCREW CANN 6.5MM THR 32MM55MM

Facility

$1,373.00

Service Code	HCPCS C1713
Hospital Charge Code	270694437
Hospital Revenue Code	278
Min. Negotiated Rate	$33.09
Max. Negotiated Rate	$686.50
Rate for Payer: Aetna Commercial	$521.74
Rate for Payer: Aetna Medicare Advantage	$411.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$274.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.12
Rate for Payer: Cigna Commercial	$686.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$302.06
Rate for Payer: Qualcare PPO/HMO/WC	$205.95
Rate for Payer: UnitedHealthcare Community & State	$33.09
Rate for Payer: Wellpoint Medicaid Managed Care	$36.38

SCREW CANN 6.5MM X 55MM X 16MM

Facility

$2,415.00

Service Code	HCPCS C1713
Hospital Charge Code	270704166
Hospital Revenue Code	278
Min. Negotiated Rate	$58.20
Max. Negotiated Rate	$1,207.50
Rate for Payer: Aetna Commercial	$917.70
Rate for Payer: Aetna Medicare Advantage	$724.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$615.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$615.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$483.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$615.83
Rate for Payer: Cigna Commercial	$1,207.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$584.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$531.30
Rate for Payer: Qualcare PPO/HMO/WC	$362.25
Rate for Payer: UnitedHealthcare Community & State	$58.20
Rate for Payer: Wellpoint Medicaid Managed Care	$64.00

SCREW CANN 6.5MM X 55MM X 16MM

Facility

$2,415.00

Service Code	HCPCS C1713
Hospital Charge Code	270704166
Hospital Revenue Code	278
Min. Negotiated Rate	$362.25
Max. Negotiated Rate	$584.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$483.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$584.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$531.30
Rate for Payer: Qualcare PPO/HMO/WC	$362.25

SCREW CANN 6.5X100MM

Facility

$2,258.95

Service Code	HCPCS C1713
Hospital Charge Code	270705720
Hospital Revenue Code	278
Min. Negotiated Rate	$54.44
Max. Negotiated Rate	$1,129.47
Rate for Payer: Aetna Commercial	$858.40
Rate for Payer: Aetna Medicare Advantage	$677.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$576.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$576.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$576.03
Rate for Payer: Cigna Commercial	$1,129.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$546.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.97
Rate for Payer: Qualcare PPO/HMO/WC	$338.84
Rate for Payer: UnitedHealthcare Community & State	$54.44
Rate for Payer: Wellpoint Medicaid Managed Care	$59.86

SCREW CANN 6.5X100MM

Facility

$2,258.95

Service Code	HCPCS C1713
Hospital Charge Code	270705720
Hospital Revenue Code	278
Min. Negotiated Rate	$338.84
Max. Negotiated Rate	$546.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$546.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.97
Rate for Payer: Qualcare PPO/HMO/WC	$338.84

SCREW CANN 6.5x115MM 32MM THRD

Facility

$1,103.15

Hospital Charge Code	270678285
Hospital Revenue Code	278
Min. Negotiated Rate	$165.47
Max. Negotiated Rate	$266.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.69
Rate for Payer: Qualcare PPO/HMO/WC	$165.47

SCREW CANN 6.5x115MM 32MM THRD

Facility

$1,103.15

Hospital Charge Code	270678285
Hospital Revenue Code	278
Min. Negotiated Rate	$26.59
Max. Negotiated Rate	$551.58
Rate for Payer: Aetna Commercial	$419.20
Rate for Payer: Aetna Medicare Advantage	$330.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$281.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$281.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$281.30
Rate for Payer: Cigna Commercial	$551.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.69
Rate for Payer: Qualcare PPO/HMO/WC	$165.47
Rate for Payer: UnitedHealthcare Community & State	$26.59
Rate for Payer: Wellpoint Medicaid Managed Care	$29.23

SCREW CANN 6.5x120MM

Facility

$1,071.00

Hospital Charge Code	270676292
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 6.5x120MM

Facility

$1,071.00

Hospital Charge Code	270676292
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

Know your out-of-pocket cost for care.

All Charges