Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN CANC 50X20 10422550

Facility

$604.85

Hospital Charge Code	270612492
Hospital Revenue Code	278
Min. Negotiated Rate	$90.73
Max. Negotiated Rate	$146.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$133.07
Rate for Payer: Qualcare PPO/HMO/WC	$90.73

SCREW CANN COMP 6.5 HDLS 56MM

Facility

$4,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270697159
Hospital Revenue Code	278
Min. Negotiated Rate	$720.00
Max. Negotiated Rate	$1,161.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,161.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,056.00
Rate for Payer: Qualcare PPO/HMO/WC	$720.00

SCREW CANN COMP 6.5 HDLS 56MM

Facility

$4,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270697159
Hospital Revenue Code	278
Min. Negotiated Rate	$115.68
Max. Negotiated Rate	$2,400.00
Rate for Payer: Aetna Commercial	$1,824.00
Rate for Payer: Aetna Medicare Advantage	$1,440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,224.00
Rate for Payer: Cigna Commercial	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,161.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,056.00
Rate for Payer: Qualcare PPO/HMO/WC	$720.00
Rate for Payer: UnitedHealthcare Community & State	$115.68
Rate for Payer: Wellpoint Medicaid Managed Care	$127.20

SCREW CANN COMP HDLESS ST18MM

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270691912
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 COMP HDLESS ST18MM

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270691912
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 COMP HDLS 2.5X10MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700720
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,182.50
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

SCREW CANN COMP HDLS 2.5X10MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700720
Hospital Revenue Code	278
Min. Negotiated Rate	$129.54
Max. Negotiated Rate	$2,687.50
Rate for Payer: Aetna Commercial	$2,042.50
Rate for Payer: Aetna Medicare Advantage	$1,612.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.62
Rate for Payer: Cigna Commercial	$2,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,182.50
Rate for Payer: Qualcare PPO/HMO/WC	$806.25
Rate for Payer: UnitedHealthcare Community & State	$129.54
Rate for Payer: Wellpoint Medicaid Managed Care	$142.44

SCREW CANN COMP HDLS 2.5X12MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700719
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,182.50
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

SCREW CANN COMP HDLS 2.5X12MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700719
Hospital Revenue Code	278
Min. Negotiated Rate	$129.54
Max. Negotiated Rate	$2,687.50
Rate for Payer: Aetna Commercial	$2,042.50
Rate for Payer: Aetna Medicare Advantage	$1,612.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.62
Rate for Payer: Cigna Commercial	$2,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,182.50
Rate for Payer: Qualcare PPO/HMO/WC	$806.25
Rate for Payer: UnitedHealthcare Community & State	$129.54
Rate for Payer: Wellpoint Medicaid Managed Care	$142.44

SCREW CANN COMP HDLS 4.5X75MM

Facility

$2,355.00

Service Code	HCPCS C1713
Hospital Charge Code	270698818
Hospital Revenue Code	278
Min. Negotiated Rate	$56.76
Max. Negotiated Rate	$1,177.50
Rate for Payer: Aetna Commercial	$894.90
Rate for Payer: Aetna Medicare Advantage	$706.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$600.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$600.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$471.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$600.52
Rate for Payer: Cigna Commercial	$1,177.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$569.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$518.10
Rate for Payer: Qualcare PPO/HMO/WC	$353.25
Rate for Payer: UnitedHealthcare Community & State	$56.76
Rate for Payer: Wellpoint Medicaid Managed Care	$62.41

SCREW CANN COMP HDLS 4.5X75MM

Facility

$2,355.00

Service Code	HCPCS C1713
Hospital Charge Code	270698818
Hospital Revenue Code	278
Min. Negotiated Rate	$353.25
Max. Negotiated Rate	$569.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$471.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$569.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$518.10
Rate for Payer: Qualcare PPO/HMO/WC	$353.25

SCREW CANN COMP HL 4.5X38MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700248
Hospital Revenue Code	278
Min. Negotiated Rate	$129.54
Max. Negotiated Rate	$2,687.50
Rate for Payer: Aetna Commercial	$2,042.50
Rate for Payer: Aetna Medicare Advantage	$1,612.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.62
Rate for Payer: Cigna Commercial	$2,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,182.50
Rate for Payer: Qualcare PPO/HMO/WC	$806.25
Rate for Payer: UnitedHealthcare Community & State	$129.54
Rate for Payer: Wellpoint Medicaid Managed Care	$142.44

SCREW CANN COMP HL 4.5X38MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700248
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,182.50
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

SCREW CANN COMP HL 4.5X65MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700247
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,182.50
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

SCREW CANN COMP HL 4.5X65MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700247
Hospital Revenue Code	278
Min. Negotiated Rate	$129.54
Max. Negotiated Rate	$2,687.50
Rate for Payer: Aetna Commercial	$2,042.50
Rate for Payer: Aetna Medicare Advantage	$1,612.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.62
Rate for Payer: Cigna Commercial	$2,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,182.50
Rate for Payer: Qualcare PPO/HMO/WC	$806.25
Rate for Payer: UnitedHealthcare Community & State	$129.54
Rate for Payer: Wellpoint Medicaid Managed Care	$142.44

SCREW CANN COMPR 3x26MM

Facility

$2,090.00

Service Code	HCPCS C1713
Hospital Charge Code	270675273
Hospital Revenue Code	278
Min. Negotiated Rate	$313.50
Max. Negotiated Rate	$505.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$418.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$505.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$459.80
Rate for Payer: Qualcare PPO/HMO/WC	$313.50

SCREW CANN COMPR 3x26MM

Facility

$2,090.00

Service Code	HCPCS C1713
Hospital Charge Code	270675273
Hospital Revenue Code	278
Min. Negotiated Rate	$50.37
Max. Negotiated Rate	$1,045.00
Rate for Payer: Aetna Commercial	$794.20
Rate for Payer: Aetna Medicare Advantage	$627.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$532.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$532.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$418.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$532.95
Rate for Payer: Cigna Commercial	$1,045.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$505.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$459.80
Rate for Payer: Qualcare PPO/HMO/WC	$313.50
Rate for Payer: UnitedHealthcare Community & State	$50.37
Rate for Payer: Wellpoint Medicaid Managed Care	$55.38

SCREW CANN COMPR 3x40MM

Facility

$2,090.00

Service Code	HCPCS C1713
Hospital Charge Code	270675274
Hospital Revenue Code	278
Min. Negotiated Rate	$50.37
Max. Negotiated Rate	$1,045.00
Rate for Payer: Aetna Commercial	$794.20
Rate for Payer: Aetna Medicare Advantage	$627.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$532.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$532.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$418.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$532.95
Rate for Payer: Cigna Commercial	$1,045.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$505.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$459.80
Rate for Payer: Qualcare PPO/HMO/WC	$313.50
Rate for Payer: UnitedHealthcare Community & State	$50.37
Rate for Payer: Wellpoint Medicaid Managed Care	$55.38

SCREW CANN COMPR 3x40MM

Facility

$2,090.00

Service Code	HCPCS C1713
Hospital Charge Code	270675274
Hospital Revenue Code	278
Min. Negotiated Rate	$313.50
Max. Negotiated Rate	$505.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$418.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$505.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$459.80
Rate for Payer: Qualcare PPO/HMO/WC	$313.50

SCREW CANN COMPRESS 3.5X50MM

Facility

$770.00

Service Code	HCPCS C1713
Hospital Charge Code	270698547
Hospital Revenue Code	278
Min. Negotiated Rate	$18.56
Max. Negotiated Rate	$385.00
Rate for Payer: Aetna Commercial	$292.60
Rate for Payer: Aetna Medicare Advantage	$231.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.35
Rate for Payer: Cigna Commercial	$385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$115.50
Rate for Payer: UnitedHealthcare Community & State	$18.56
Rate for Payer: Wellpoint Medicaid Managed Care	$20.41

SCREW CANN COMPRESS 3.5X50MM

Facility

$770.00

Service Code	HCPCS C1713
Hospital Charge Code	270698547
Hospital Revenue Code	278
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$186.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$115.50

SCREW CANN COMP SD 2.2X20MM

Facility

$2,796.40

Service Code	HCPCS C1713
Hospital Charge Code	270699923
Hospital Revenue Code	278
Min. Negotiated Rate	$419.46
Max. Negotiated Rate	$676.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$676.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$615.21
Rate for Payer: Qualcare PPO/HMO/WC	$419.46

SCREW CANN COMP SD 2.2X20MM

Facility

$2,796.40

Service Code	HCPCS C1713
Hospital Charge Code	270699923
Hospital Revenue Code	278
Min. Negotiated Rate	$67.39
Max. Negotiated Rate	$1,398.20
Rate for Payer: Aetna Commercial	$1,062.63
Rate for Payer: Aetna Medicare Advantage	$838.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$713.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$713.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$713.08
Rate for Payer: Cigna Commercial	$1,398.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$676.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$615.21
Rate for Payer: Qualcare PPO/HMO/WC	$419.46
Rate for Payer: UnitedHealthcare Community & State	$67.39
Rate for Payer: Wellpoint Medicaid Managed Care	$74.10

SCREW CANN CONICAL 5.0X70MM

Facility

$3,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270699951
Hospital Revenue Code	278
Min. Negotiated Rate	$457.50
Max. Negotiated Rate	$738.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$610.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$738.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$671.00
Rate for Payer: Qualcare PPO/HMO/WC	$457.50

SCREW CANN CONICAL 5.0X70MM

Facility

$3,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270699951
Hospital Revenue Code	278
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$1,525.00
Rate for Payer: Aetna Commercial	$1,159.00
Rate for Payer: Aetna Medicare Advantage	$915.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$777.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$777.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$610.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$777.75
Rate for Payer: Cigna Commercial	$1,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$738.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$671.00
Rate for Payer: Qualcare PPO/HMO/WC	$457.50
Rate for Payer: UnitedHealthcare Community & State	$73.50
Rate for Payer: Wellpoint Medicaid Managed Care	$80.83

Know your out-of-pocket cost for care.

All Charges