Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN 7.3x40mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605073
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 7.3x40mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605073
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 7.3x45MM 16MM THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605022
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 7.3x45MM 16MM THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605022
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 7.3x45mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605074
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 7.3x45mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605074
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 7.3x50MM 16MM THRD

Facility

$1,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270605023
Hospital Revenue Code	278
Min. Negotiated Rate	$159.75
Max. Negotiated Rate	$257.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$234.30
Rate for Payer: Qualcare PPO/HMO/WC	$159.75

SCREW CANN 7.3x50MM 16MM THRD

Facility

$1,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270605023
Hospital Revenue Code	278
Min. Negotiated Rate	$25.67
Max. Negotiated Rate	$532.50
Rate for Payer: Aetna Commercial	$404.70
Rate for Payer: Aetna Medicare Advantage	$319.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$271.57
Rate for Payer: Cigna Commercial	$532.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$234.30
Rate for Payer: Qualcare PPO/HMO/WC	$159.75
Rate for Payer: UnitedHealthcare Community & State	$25.67
Rate for Payer: Wellpoint Medicaid Managed Care	$28.22

SCREW CANN 7.3x50mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605075
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 7.3x50mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605075
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 7.3x55MM 16MM THRD

Facility

$1,129.85

Service Code	HCPCS C1713
Hospital Charge Code	270652302
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 7.3x55MM 16MM THRD

Facility

$1,129.85

Service Code	HCPCS C1713
Hospital Charge Code	270652302
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 7.3x55mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605076
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 7.3x55mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605076
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 7.3x60MM 16MM THRD

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270605025
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 7.3x60MM 16MM THRD

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270605025
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 7.3x60mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605080
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 7.3x60mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605080
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 7.3x65mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605077
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 7.3x65mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605077
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 7.3x70MM 16MM THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605027
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 7.3x70MM 16MM THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605027
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 7.3x70mm FULL THRD

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270605079
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 7.3x70mm FULL THRD

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270605079
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 7.3x75MM 16MM THRD

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270605028
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

Know your out-of-pocket cost for care.

All Charges