Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN 6.5x75mm SHORT THRD

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270673681
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

SCREW CANN 6.5x80MM 16MM THRD

Facility

$1,136.25

Service Code	HCPCS C1713
Hospital Charge Code	270678283
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 6.5x80MM 16MM THRD

Facility

$1,136.25

Service Code	HCPCS C1713
Hospital Charge Code	270678283
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 6.5x80mm Short Thrd

Facility

$1,875.00

Hospital Charge Code	270673713
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

Screw Cann 6.5x80mm Short Thrd

Facility

$1,875.00

Hospital Charge Code	270673713
Hospital Revenue Code	278
Min. Negotiated Rate	$45.19
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$712.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$49.69

SCREW CANN 6.5x85mm SHORT THRD

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270673682
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

SCREW CANN 6.5x85mm SHORT THRD

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270673682
Hospital Revenue Code	278
Min. Negotiated Rate	$45.19
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$712.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$49.69

SCREW CANN 6.5X90MM

Facility

$2,258.95

Service Code	HCPCS 2258.95
Hospital Charge Code	270705718
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 6.5X90MM

Facility

$2,258.95

Service Code	HCPCS 2258.95
Hospital Charge Code	270705718
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 6.5x90MM 32MM THRD

Facility

$1,103.15

Service Code	HCPCS C1713
Hospital Charge Code	270678284
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 6.5x90MM 32MM THRD

Facility

$1,103.15

Service Code	HCPCS C1713
Hospital Charge Code	270678284
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 6.5X95MM

Facility

$2,258.95

Service Code	HCPCS C1713
Hospital Charge Code	270705719
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 6.5X95MM

Facility

$2,258.95

Service Code	HCPCS C1713
Hospital Charge Code	270705719
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 6.9-16mm THRD 70MM

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270680282
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 6.9-16mm THRD 70MM

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270680282
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 7.0x100mm

Facility

$1,124.75

Service Code	HCPCS C1713
Hospital Charge Code	270654625
Hospital Revenue Code	278
Min. Negotiated Rate	$168.71
Max. Negotiated Rate	$272.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.44
Rate for Payer: Qualcare PPO/HMO/WC	$168.71

SCREW CANN 7.0x100mm

Facility

$1,124.75

Service Code	HCPCS C1713
Hospital Charge Code	270654625
Hospital Revenue Code	278
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.38
Rate for Payer: Aetna Commercial	$427.40
Rate for Payer: Aetna Medicare Advantage	$337.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.81
Rate for Payer: Cigna Commercial	$562.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.44
Rate for Payer: Qualcare PPO/HMO/WC	$168.71
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

SCREW CANN 7.0X105 1146-105-32

Facility

$723.05

Hospital Charge Code	270631707
Hospital Revenue Code	278
Min. Negotiated Rate	$17.43
Max. Negotiated Rate	$361.52
Rate for Payer: Aetna Commercial	$274.76
Rate for Payer: Aetna Medicare Advantage	$216.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.38
Rate for Payer: Cigna Commercial	$361.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.07
Rate for Payer: Qualcare PPO/HMO/WC	$108.46
Rate for Payer: UnitedHealthcare Community & State	$17.43
Rate for Payer: Wellpoint Medicaid Managed Care	$19.16

SCREW CANN 7.0X105 1146-105-32

Facility

$723.05

Hospital Charge Code	270631707
Hospital Revenue Code	278
Min. Negotiated Rate	$108.46
Max. Negotiated Rate	$174.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.07
Rate for Payer: Qualcare PPO/HMO/WC	$108.46

SCREW CANN 7.0x105mm

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270604970
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 7.0x105mm

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270604970
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 7.0x110mm

Facility

$1,124.75

Service Code	HCPCS C1713
Hospital Charge Code	270654627
Hospital Revenue Code	278
Min. Negotiated Rate	$168.71
Max. Negotiated Rate	$272.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.44
Rate for Payer: Qualcare PPO/HMO/WC	$168.71

SCREW CANN 7.0x110mm

Facility

$1,124.75

Service Code	HCPCS C1713
Hospital Charge Code	270654627
Hospital Revenue Code	278
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.38
Rate for Payer: Aetna Commercial	$427.40
Rate for Payer: Aetna Medicare Advantage	$337.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.81
Rate for Payer: Cigna Commercial	$562.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.44
Rate for Payer: Qualcare PPO/HMO/WC	$168.71
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

SCREW CANN 7.0x115mm

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270604950
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 7.0x115mm

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270604950
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

Know your out-of-pocket cost for care.

All Charges