Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN FULL THREAD 9x20MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270674089
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

SCREW CANN FULLY THD 4.5x26MM

Facility

$1,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270672275
Hospital Revenue Code	278
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.50
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

SCREW CANN FULLY THD 4.5x26MM

Facility

$1,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270672275
Hospital Revenue Code	278
Min. Negotiated Rate	$25.91
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$408.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.50
Rate for Payer: Qualcare PPO/HMO/WC	$161.25
Rate for Payer: UnitedHealthcare Community & State	$25.91
Rate for Payer: Wellpoint Medicaid Managed Care	$28.49

SCREW CANN FULLY THD 4.5x36MM

Facility

$1,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270672276
Hospital Revenue Code	278
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.50
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

SCREW CANN FULLY THD 4.5x36MM

Facility

$1,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270672276
Hospital Revenue Code	278
Min. Negotiated Rate	$25.91
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$408.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.50
Rate for Payer: Qualcare PPO/HMO/WC	$161.25
Rate for Payer: UnitedHealthcare Community & State	$25.91
Rate for Payer: Wellpoint Medicaid Managed Care	$28.49

SCREW CANN FUL THD 30MM 4.0

Facility

$918.00

Service Code	HCPCS C1713
Hospital Charge Code	270704266
Hospital Revenue Code	278
Min. Negotiated Rate	$22.12
Max. Negotiated Rate	$459.00
Rate for Payer: Aetna Commercial	$348.84
Rate for Payer: Aetna Medicare Advantage	$275.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.09
Rate for Payer: Cigna Commercial	$459.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$201.96
Rate for Payer: Qualcare PPO/HMO/WC	$137.70
Rate for Payer: UnitedHealthcare Community & State	$22.12
Rate for Payer: Wellpoint Medicaid Managed Care	$24.33

SCREW CANN FUL THD 30MM 4.0

Facility

$918.00

Service Code	HCPCS C1713
Hospital Charge Code	270704266
Hospital Revenue Code	278
Min. Negotiated Rate	$137.70
Max. Negotiated Rate	$222.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$183.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$201.96
Rate for Payer: Qualcare PPO/HMO/WC	$137.70

SCREW CANN. HD 2.7x24MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270680848
Hospital Revenue Code	278
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$271.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$246.40
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

SCREW CANN. HD 2.7x24MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270680848
Hospital Revenue Code	278
Min. Negotiated Rate	$26.99
Max. Negotiated Rate	$560.00
Rate for Payer: Aetna Commercial	$425.60
Rate for Payer: Aetna Medicare Advantage	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.60
Rate for Payer: Cigna Commercial	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$246.40
Rate for Payer: Qualcare PPO/HMO/WC	$168.00
Rate for Payer: UnitedHealthcare Community & State	$26.99
Rate for Payer: Wellpoint Medicaid Managed Care	$29.68

SCREW CANN HEADLESS 2x12MM

Facility

$1,850.00

Hospital Charge Code	270675636
Hospital Revenue Code	278
Min. Negotiated Rate	$277.50
Max. Negotiated Rate	$447.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$407.00
Rate for Payer: Qualcare PPO/HMO/WC	$277.50

SCREW CANN HEADLESS 2x12MM

Facility

$1,850.00

Hospital Charge Code	270675636
Hospital Revenue Code	278
Min. Negotiated Rate	$44.59
Max. Negotiated Rate	$925.00
Rate for Payer: Aetna Commercial	$703.00
Rate for Payer: Aetna Medicare Advantage	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.75
Rate for Payer: Cigna Commercial	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$407.00
Rate for Payer: Qualcare PPO/HMO/WC	$277.50
Rate for Payer: UnitedHealthcare Community & State	$44.59
Rate for Payer: Wellpoint Medicaid Managed Care	$49.02

SCREW CANN INTRF F/THD 7x20MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270674995
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

SCREW CANN INTRF F/THD 7x20MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270674995
Hospital Revenue Code	278
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$180.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Community & State	$11.45
Rate for Payer: Wellpoint Medicaid Managed Care	$12.59

SCREW CANN INTRF F/THD 8x20MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270656482
Hospital Revenue Code	278
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$180.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Community & State	$11.45
Rate for Payer: Wellpoint Medicaid Managed Care	$12.59

SCREW CANN INTRF F/THD 8x20MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270656482
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

SCREW CANN LAG 12.7X80MM

Facility

$4,940.00

Service Code	HCPCS C1713
Hospital Charge Code	270699446
Hospital Revenue Code	278
Min. Negotiated Rate	$741.00
Max. Negotiated Rate	$1,195.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$988.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,195.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,086.80
Rate for Payer: Qualcare PPO/HMO/WC	$741.00

SCREW CANN LAG 12.7X80MM

Facility

$4,940.00

Service Code	HCPCS C1713
Hospital Charge Code	270699446
Hospital Revenue Code	278
Min. Negotiated Rate	$119.05
Max. Negotiated Rate	$2,470.00
Rate for Payer: Aetna Commercial	$1,877.20
Rate for Payer: Aetna Medicare Advantage	$1,482.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,259.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,259.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$988.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,259.70
Rate for Payer: Cigna Commercial	$2,470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,195.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,086.80
Rate for Payer: Qualcare PPO/HMO/WC	$741.00
Rate for Payer: UnitedHealthcare Community & State	$119.05
Rate for Payer: Wellpoint Medicaid Managed Care	$130.91

SCREW CANN LAG 2.4x16MM

Facility

$975.00

Service Code	HCPCS C1713
Hospital Charge Code	270662577
Hospital Revenue Code	278
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$235.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

SCREW CANN LAG 2.4x16MM

Facility

$975.00

Service Code	HCPCS C1713
Hospital Charge Code	270662577
Hospital Revenue Code	278
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

SCREW CANN LAG 2.4x18MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270675131
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 LAG 2.4x18MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270675131
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 LAG 2x14MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270662576
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 LAG 2x14MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270662576
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 LAG 4.0 X 60 MM

Facility

$797.50

Service Code	HCPCS C1713
Hospital Charge Code	270685945
Hospital Revenue Code	278
Min. Negotiated Rate	$119.62
Max. Negotiated Rate	$193.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$119.62

SCREW CANN LAG 4.0 X 60 MM

Facility

$797.50

Service Code	HCPCS C1713
Hospital Charge Code	270685945
Hospital Revenue Code	278
Min. Negotiated Rate	$19.22
Max. Negotiated Rate	$398.75
Rate for Payer: Aetna Commercial	$303.05
Rate for Payer: Aetna Medicare Advantage	$239.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$203.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$203.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$203.36
Rate for Payer: Cigna Commercial	$398.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$119.62
Rate for Payer: UnitedHealthcare Community & State	$19.22
Rate for Payer: Wellpoint Medicaid Managed Care	$21.13

Know your out-of-pocket cost for care.

All Charges