Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN LCKG 5.0x25MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270632184
Hospital Revenue Code	278
Min. Negotiated Rate	$20.11
Max. Negotiated Rate	$417.15
Rate for Payer: Aetna Commercial	$317.03
Rate for Payer: Aetna Medicare Advantage	$250.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.75
Rate for Payer: Cigna Commercial	$417.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.55
Rate for Payer: Qualcare PPO/HMO/WC	$125.14
Rate for Payer: UnitedHealthcare Community & State	$20.11
Rate for Payer: Wellpoint Medicaid Managed Care	$22.11

SCREW CANN LCKG 5.0x25MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270632184
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$201.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.55
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW CANN LCKG 5.0x70MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270630777
Hospital Revenue Code	278
Min. Negotiated Rate	$20.11
Max. Negotiated Rate	$417.15
Rate for Payer: Aetna Commercial	$317.03
Rate for Payer: Aetna Medicare Advantage	$250.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.75
Rate for Payer: Cigna Commercial	$417.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.55
Rate for Payer: Qualcare PPO/HMO/WC	$125.14
Rate for Payer: UnitedHealthcare Community & State	$20.11
Rate for Payer: Wellpoint Medicaid Managed Care	$22.11

SCREW CANN LCKG 5.0x70MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270630777
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$201.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.55
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW CANN LCKG 5.0x75MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270630778
Hospital Revenue Code	278
Min. Negotiated Rate	$20.11
Max. Negotiated Rate	$417.15
Rate for Payer: Aetna Commercial	$317.03
Rate for Payer: Aetna Medicare Advantage	$250.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.75
Rate for Payer: Cigna Commercial	$417.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.55
Rate for Payer: Qualcare PPO/HMO/WC	$125.14
Rate for Payer: UnitedHealthcare Community & State	$20.11
Rate for Payer: Wellpoint Medicaid Managed Care	$22.11

SCREW CANN LCKG 5.0x75MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270630778
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$201.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.55
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW CANN LCKG 5.0x80MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270634361
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$201.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.55
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW CANN LCKG 5.0x80MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270634361
Hospital Revenue Code	278
Min. Negotiated Rate	$20.11
Max. Negotiated Rate	$417.15
Rate for Payer: Aetna Commercial	$317.03
Rate for Payer: Aetna Medicare Advantage	$250.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.75
Rate for Payer: Cigna Commercial	$417.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.55
Rate for Payer: Qualcare PPO/HMO/WC	$125.14
Rate for Payer: UnitedHealthcare Community & State	$20.11
Rate for Payer: Wellpoint Medicaid Managed Care	$22.11

SCREW CANN LCKG 5.0x85MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270630779
Hospital Revenue Code	278
Min. Negotiated Rate	$20.11
Max. Negotiated Rate	$417.15
Rate for Payer: Aetna Commercial	$317.03
Rate for Payer: Aetna Medicare Advantage	$250.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.75
Rate for Payer: Cigna Commercial	$417.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.55
Rate for Payer: Qualcare PPO/HMO/WC	$125.14
Rate for Payer: UnitedHealthcare Community & State	$20.11
Rate for Payer: Wellpoint Medicaid Managed Care	$22.11

SCREW CANN LCKG 5.0x85MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270630779
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$201.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.55
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW CANN LNG THD 3x24MM

Facility

$819.00

Service Code	HCPCS C1713
Hospital Charge Code	270675473
Hospital Revenue Code	278
Min. Negotiated Rate	$19.74
Max. Negotiated Rate	$409.50
Rate for Payer: Aetna Commercial	$311.22
Rate for Payer: Aetna Medicare Advantage	$245.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.84
Rate for Payer: Cigna Commercial	$409.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$180.18
Rate for Payer: Qualcare PPO/HMO/WC	$122.85
Rate for Payer: UnitedHealthcare Community & State	$19.74
Rate for Payer: Wellpoint Medicaid Managed Care	$21.70

SCREW CANN LNG THD 3x24MM

Facility

$819.00

Service Code	HCPCS C1713
Hospital Charge Code	270675473
Hospital Revenue Code	278
Min. Negotiated Rate	$122.85
Max. Negotiated Rate	$198.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$180.18
Rate for Payer: Qualcare PPO/HMO/WC	$122.85

SCREW CANN LNG THD 3x34MM

Facility

$819.00

Service Code	HCPCS C1713
Hospital Charge Code	270675472
Hospital Revenue Code	278
Min. Negotiated Rate	$19.74
Max. Negotiated Rate	$409.50
Rate for Payer: Aetna Commercial	$311.22
Rate for Payer: Aetna Medicare Advantage	$245.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.84
Rate for Payer: Cigna Commercial	$409.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$180.18
Rate for Payer: Qualcare PPO/HMO/WC	$122.85
Rate for Payer: UnitedHealthcare Community & State	$19.74
Rate for Payer: Wellpoint Medicaid Managed Care	$21.70

SCREW CANN LNG THD 3x34MM

Facility

$819.00

Service Code	HCPCS C1713
Hospital Charge Code	270675472
Hospital Revenue Code	278
Min. Negotiated Rate	$122.85
Max. Negotiated Rate	$198.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$180.18
Rate for Payer: Qualcare PPO/HMO/WC	$122.85

SCREW CANN LNG THD 4.0X16MM

Facility

$810.00

Hospital Charge Code	270670834
Hospital Revenue Code	278
Min. Negotiated Rate	$121.50
Max. Negotiated Rate	$196.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$178.20
Rate for Payer: Qualcare PPO/HMO/WC	$121.50

SCREW CANN LNG THD 4.0X16MM

Facility

$810.00

Hospital Charge Code	270670834
Hospital Revenue Code	278
Min. Negotiated Rate	$19.52
Max. Negotiated Rate	$405.00
Rate for Payer: Aetna Commercial	$307.80
Rate for Payer: Aetna Medicare Advantage	$243.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$206.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$206.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$206.55
Rate for Payer: Cigna Commercial	$405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$178.20
Rate for Payer: Qualcare PPO/HMO/WC	$121.50
Rate for Payer: UnitedHealthcare Community & State	$19.52
Rate for Payer: Wellpoint Medicaid Managed Care	$21.46

SCREW CANN LNG THD 4.0x22MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270652255
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$201.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.55
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW CANN LNG THD 4.0x22MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270652255
Hospital Revenue Code	278
Min. Negotiated Rate	$20.11
Max. Negotiated Rate	$417.15
Rate for Payer: Aetna Commercial	$317.03
Rate for Payer: Aetna Medicare Advantage	$250.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.75
Rate for Payer: Cigna Commercial	$417.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.55
Rate for Payer: Qualcare PPO/HMO/WC	$125.14
Rate for Payer: UnitedHealthcare Community & State	$20.11
Rate for Payer: Wellpoint Medicaid Managed Care	$22.11

SCREW CANN LNG THD 4.0x24MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270652289
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$201.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.55
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW CANN LNG THD 4.0x24MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270652289
Hospital Revenue Code	278
Min. Negotiated Rate	$20.11
Max. Negotiated Rate	$417.15
Rate for Payer: Aetna Commercial	$317.03
Rate for Payer: Aetna Medicare Advantage	$250.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.75
Rate for Payer: Cigna Commercial	$417.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.55
Rate for Payer: Qualcare PPO/HMO/WC	$125.14
Rate for Payer: UnitedHealthcare Community & State	$20.11
Rate for Payer: Wellpoint Medicaid Managed Care	$22.11

SCREW CANN LNG THD 4.0X28MM

Facility

$810.00

Service Code	HCPCS C1713
Hospital Charge Code	270670835
Hospital Revenue Code	278
Min. Negotiated Rate	$19.52
Max. Negotiated Rate	$405.00
Rate for Payer: Aetna Commercial	$307.80
Rate for Payer: Aetna Medicare Advantage	$243.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$206.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$206.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$206.55
Rate for Payer: Cigna Commercial	$405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$178.20
Rate for Payer: Qualcare PPO/HMO/WC	$121.50
Rate for Payer: UnitedHealthcare Community & State	$19.52
Rate for Payer: Wellpoint Medicaid Managed Care	$21.46

SCREW CANN LNG THD 4.0X28MM

Facility

$810.00

Service Code	HCPCS C1713
Hospital Charge Code	270670835
Hospital Revenue Code	278
Min. Negotiated Rate	$121.50
Max. Negotiated Rate	$196.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$178.20
Rate for Payer: Qualcare PPO/HMO/WC	$121.50

SCREW CANN LNG THD 4.0x30MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270652267
Hospital Revenue Code	278
Min. Negotiated Rate	$20.11
Max. Negotiated Rate	$417.15
Rate for Payer: Aetna Commercial	$317.03
Rate for Payer: Aetna Medicare Advantage	$250.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.75
Rate for Payer: Cigna Commercial	$417.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.55
Rate for Payer: Qualcare PPO/HMO/WC	$125.14
Rate for Payer: UnitedHealthcare Community & State	$20.11
Rate for Payer: Wellpoint Medicaid Managed Care	$22.11

SCREW CANN LNG THD 4.0x30MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270652267
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$201.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.55
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW CANN LNG THD 4.0x32MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270642841
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$201.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.55
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

Know your out-of-pocket cost for care.

All Charges