Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605081
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 7.3x75mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605081
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 7.3x80MM 16MM THRD

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270605029
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 7.3x80MM 16MM THRD

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270605029
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 7.3x80mm FULL THRD

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270605082
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 7.3x80mm FULL THRD

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270605082
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 7.3x85MM 16MM THRD

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270605030
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 7.3x85MM 16MM THRD

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270605030
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 7.3x85mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605083
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 7.3x85mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605083
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 7.3x90MM 16MM THRD

Facility

$1,101.35

Service Code	HCPCS C1713
Hospital Charge Code	270605031
Hospital Revenue Code	278
Min. Negotiated Rate	$165.20
Max. Negotiated Rate	$266.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.30
Rate for Payer: Qualcare PPO/HMO/WC	$165.20

SCREW CANN 7.3x90MM 16MM THRD

Facility

$1,101.35

Service Code	HCPCS C1713
Hospital Charge Code	270605031
Hospital Revenue Code	278
Min. Negotiated Rate	$26.54
Max. Negotiated Rate	$550.67
Rate for Payer: Aetna Commercial	$418.51
Rate for Payer: Aetna Medicare Advantage	$330.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.84
Rate for Payer: Cigna Commercial	$550.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.30
Rate for Payer: Qualcare PPO/HMO/WC	$165.20
Rate for Payer: UnitedHealthcare Community & State	$26.54
Rate for Payer: Wellpoint Medicaid Managed Care	$29.19

SCREW CANN 7.3x90mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605084
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 7.3x90mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605084
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 7.3x95mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605085
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 7.3x95mm FULL THRD

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270605085
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 7DX95mmZIM 11469532

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270606328
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$225.50
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

SCREW CANN 7DX95mmZIM 11469532

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270606328
Hospital Revenue Code	278
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$389.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$225.50
Rate for Payer: Qualcare PPO/HMO/WC	$153.75
Rate for Payer: UnitedHealthcare Community & State	$24.70
Rate for Payer: Wellpoint Medicaid Managed Care	$27.16

SCREW CANN ASNIS 4x36MM STER

Facility

$931.20

Hospital Charge Code	270675647
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 ASNIS 4x36MM STER

Facility

$931.20

Hospital Charge Code	270675647
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 ASNIS 4x40MM STER

Facility

$931.20

Service Code	HCPCS C1713
Hospital Charge Code	270674239
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 ASNIS 4x40MM STER

Facility

$931.20

Service Code	HCPCS C1713
Hospital Charge Code	270674239
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 ASNIS F/THD 4x40MM

Facility

$931.20

Hospital Charge Code	270675786
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 ASNIS F/THD 4x40MM

Facility

$931.20

Hospital Charge Code	270675786
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

Know your out-of-pocket cost for care.

All Charges