Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN DART FIRE 2.8MM

Facility

$576.00

Service Code	HCPCS C1713
Hospital Charge Code	270699129
Hospital Revenue Code	278
Min. Negotiated Rate	$13.88
Max. Negotiated Rate	$288.00
Rate for Payer: Aetna Commercial	$218.88
Rate for Payer: Aetna Medicare Advantage	$172.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.88
Rate for Payer: Cigna Commercial	$288.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$126.72
Rate for Payer: Qualcare PPO/HMO/WC	$86.40
Rate for Payer: UnitedHealthcare Community & State	$13.88
Rate for Payer: Wellpoint Medicaid Managed Care	$15.26

SCREW CANN EXT PEDIC 7.5X40MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694869
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 EXT PEDIC 7.5X40MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694869
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

SCREWCANNEXTTABPOLYAX6.5X45MM

Facility

$7,562.50

Service Code	HCPCS C1713
Hospital Charge Code	270698060
Hospital Revenue Code	278
Min. Negotiated Rate	$1,134.38
Max. Negotiated Rate	$1,830.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,830.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,663.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,134.38

SCREWCANNEXTTABPOLYAX6.5X45MM

Facility

$7,562.50

Service Code	HCPCS C1713
Hospital Charge Code	270698060
Hospital Revenue Code	278
Min. Negotiated Rate	$182.26
Max. Negotiated Rate	$3,781.25
Rate for Payer: Aetna Commercial	$2,873.75
Rate for Payer: Aetna Medicare Advantage	$2,268.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,928.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,928.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,928.44
Rate for Payer: Cigna Commercial	$3,781.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,830.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,663.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,134.38
Rate for Payer: UnitedHealthcare Community & State	$182.26
Rate for Payer: Wellpoint Medicaid Managed Care	$200.41

SCREW CANN F/THD 4.5x40MM

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270660920
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SCREW CANN F/THD 4.5x40MM

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270660920
Hospital Revenue Code	278
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

SCREW CANN F/THD 4.5x54MM

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270604919
Hospital Revenue Code	278
Min. Negotiated Rate	$132.10
Max. Negotiated Rate	$213.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$193.74
Rate for Payer: Qualcare PPO/HMO/WC	$132.10

SCREW CANN F/THD 4.5x54MM

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270604919
Hospital Revenue Code	278
Min. Negotiated Rate	$21.22
Max. Negotiated Rate	$440.32
Rate for Payer: Aetna Commercial	$334.65
Rate for Payer: Aetna Medicare Advantage	$264.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.57
Rate for Payer: Cigna Commercial	$440.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$193.74
Rate for Payer: Qualcare PPO/HMO/WC	$132.10
Rate for Payer: UnitedHealthcare Community & State	$21.22
Rate for Payer: Wellpoint Medicaid Managed Care	$23.34

SCREW CANN F/THRD 4.5x20mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604900
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x20mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604900
Hospital Revenue Code	278
Min. Negotiated Rate	$12.17
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$191.90
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75
Rate for Payer: UnitedHealthcare Community & State	$12.17
Rate for Payer: Wellpoint Medicaid Managed Care	$13.38

SCREW CANN F/THRD 4.5x22mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604902
Hospital Revenue Code	278
Min. Negotiated Rate	$12.17
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$191.90
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75
Rate for Payer: UnitedHealthcare Community & State	$12.17
Rate for Payer: Wellpoint Medicaid Managed Care	$13.38

SCREW CANN F/THRD 4.5x22mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604902
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x24mm

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270604903
Hospital Revenue Code	278
Min. Negotiated Rate	$21.22
Max. Negotiated Rate	$440.32
Rate for Payer: Aetna Commercial	$334.65
Rate for Payer: Aetna Medicare Advantage	$264.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.57
Rate for Payer: Cigna Commercial	$440.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$193.74
Rate for Payer: Qualcare PPO/HMO/WC	$132.10
Rate for Payer: UnitedHealthcare Community & State	$21.22
Rate for Payer: Wellpoint Medicaid Managed Care	$23.34

SCREW CANN F/THRD 4.5x24mm

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270604903
Hospital Revenue Code	278
Min. Negotiated Rate	$132.10
Max. Negotiated Rate	$213.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$193.74
Rate for Payer: Qualcare PPO/HMO/WC	$132.10

SCREW CANN F/THRD 4.5x26mm

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270652283
Hospital Revenue Code	278
Min. Negotiated Rate	$132.10
Max. Negotiated Rate	$213.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$193.74
Rate for Payer: Qualcare PPO/HMO/WC	$132.10

SCREW CANN F/THRD 4.5x26mm

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270652283
Hospital Revenue Code	278
Min. Negotiated Rate	$21.22
Max. Negotiated Rate	$440.32
Rate for Payer: Aetna Commercial	$334.65
Rate for Payer: Aetna Medicare Advantage	$264.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.57
Rate for Payer: Cigna Commercial	$440.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$193.74
Rate for Payer: Qualcare PPO/HMO/WC	$132.10
Rate for Payer: UnitedHealthcare Community & State	$21.22
Rate for Payer: Wellpoint Medicaid Managed Care	$23.34

SCREW CANN F/THRD 4.5x28mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604905
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x28mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604905
Hospital Revenue Code	278
Min. Negotiated Rate	$12.17
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$191.90
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75
Rate for Payer: UnitedHealthcare Community & State	$12.17
Rate for Payer: Wellpoint Medicaid Managed Care	$13.38

SCREW CANN F/THRD 4.5x30mm

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270604906
Hospital Revenue Code	278
Min. Negotiated Rate	$132.10
Max. Negotiated Rate	$213.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$193.74
Rate for Payer: Qualcare PPO/HMO/WC	$132.10

SCREW CANN F/THRD 4.5x30mm

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270604906
Hospital Revenue Code	278
Min. Negotiated Rate	$21.22
Max. Negotiated Rate	$440.32
Rate for Payer: Aetna Commercial	$334.65
Rate for Payer: Aetna Medicare Advantage	$264.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.57
Rate for Payer: Cigna Commercial	$440.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$193.74
Rate for Payer: Qualcare PPO/HMO/WC	$132.10
Rate for Payer: UnitedHealthcare Community & State	$21.22
Rate for Payer: Wellpoint Medicaid Managed Care	$23.34

SCREW CANN F/THRD 4.5x32mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604907
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x32mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604907
Hospital Revenue Code	278
Min. Negotiated Rate	$12.17
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$191.90
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75
Rate for Payer: UnitedHealthcare Community & State	$12.17
Rate for Payer: Wellpoint Medicaid Managed Care	$13.38

SCREW CANN F/THRD 4.5x34MM

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270604908
Hospital Revenue Code	278
Min. Negotiated Rate	$132.10
Max. Negotiated Rate	$213.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$193.74
Rate for Payer: Qualcare PPO/HMO/WC	$132.10

SCREW CANN F/THRD 4.5x34MM

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270604908
Hospital Revenue Code	278
Min. Negotiated Rate	$21.22
Max. Negotiated Rate	$440.32
Rate for Payer: Aetna Commercial	$334.65
Rate for Payer: Aetna Medicare Advantage	$264.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.57
Rate for Payer: Cigna Commercial	$440.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$193.74
Rate for Payer: Qualcare PPO/HMO/WC	$132.10
Rate for Payer: UnitedHealthcare Community & State	$21.22
Rate for Payer: Wellpoint Medicaid Managed Care	$23.34

Know your out-of-pocket cost for care.

All Charges