Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN LNG THD 4.0x68MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270648940
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 4.0x68MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270648940
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 4.0x72MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270648506
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 4.0x72MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270648506
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 LOCKING 5.0x105MM

Facility

$603.00

Service Code	HCPCS C1713
Hospital Charge Code	270676323
Hospital Revenue Code	278
Min. Negotiated Rate	$90.45
Max. Negotiated Rate	$145.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.66
Rate for Payer: Qualcare PPO/HMO/WC	$90.45

SCREW CANN LOCKING 5.0x105MM

Facility

$603.00

Service Code	HCPCS C1713
Hospital Charge Code	270676323
Hospital Revenue Code	278
Min. Negotiated Rate	$14.53
Max. Negotiated Rate	$301.50
Rate for Payer: Aetna Commercial	$229.14
Rate for Payer: Aetna Medicare Advantage	$180.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.76
Rate for Payer: Cigna Commercial	$301.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.66
Rate for Payer: Qualcare PPO/HMO/WC	$90.45
Rate for Payer: UnitedHealthcare Community & State	$14.53
Rate for Payer: Wellpoint Medicaid Managed Care	$15.98

SCREW CANN LOCKING 5.0 X 35MM

Facility

$810.00

Hospital Charge Code	270665860
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 LOCKING 5.0 X 35MM

Facility

$810.00

Hospital Charge Code	270665860
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 LOCKING 5.0 X 40MM

Facility

$810.00

Hospital Charge Code	270665859
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 LOCKING 5.0 X 40MM

Facility

$810.00

Hospital Charge Code	270665859
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 LOCKING 5.0 X 45MM

Facility

$810.00

Hospital Charge Code	270665858
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 LOCKING 5.0 X 45MM

Facility

$810.00

Hospital Charge Code	270665858
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 LOCKING 5x65mm

Facility

$1,150.00

Hospital Charge Code	270646084
Hospital Revenue Code	278
Min. Negotiated Rate	$27.71
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$437.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$253.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Community & State	$27.71
Rate for Payer: Wellpoint Medicaid Managed Care	$30.48

SCREW CANN LOCKING 5x65mm

Facility

$1,150.00

Hospital Charge Code	270646084
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$278.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$253.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

SCREW CANN LOCKING 7.3x50MM

Facility

$1,203.00

Hospital Charge Code	270657164
Hospital Revenue Code	278
Min. Negotiated Rate	$180.45
Max. Negotiated Rate	$291.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$264.66
Rate for Payer: Qualcare PPO/HMO/WC	$180.45

SCREW CANN LOCKING 7.3x50MM

Facility

$1,203.00

Hospital Charge Code	270657164
Hospital Revenue Code	278
Min. Negotiated Rate	$28.99
Max. Negotiated Rate	$601.50
Rate for Payer: Aetna Commercial	$457.14
Rate for Payer: Aetna Medicare Advantage	$360.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$306.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$306.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$306.76
Rate for Payer: Cigna Commercial	$601.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$264.66
Rate for Payer: Qualcare PPO/HMO/WC	$180.45
Rate for Payer: UnitedHealthcare Community & State	$28.99
Rate for Payer: Wellpoint Medicaid Managed Care	$31.88

SCREW CANN LOCKING 7.3x55MM

Facility

$1,203.00

Hospital Charge Code	270657173
Hospital Revenue Code	278
Min. Negotiated Rate	$180.45
Max. Negotiated Rate	$291.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$264.66
Rate for Payer: Qualcare PPO/HMO/WC	$180.45

SCREW CANN LOCKING 7.3x55MM

Facility

$1,203.00

Hospital Charge Code	270657173
Hospital Revenue Code	278
Min. Negotiated Rate	$28.99
Max. Negotiated Rate	$601.50
Rate for Payer: Aetna Commercial	$457.14
Rate for Payer: Aetna Medicare Advantage	$360.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$306.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$306.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$306.76
Rate for Payer: Cigna Commercial	$601.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$264.66
Rate for Payer: Qualcare PPO/HMO/WC	$180.45
Rate for Payer: UnitedHealthcare Community & State	$28.99
Rate for Payer: Wellpoint Medicaid Managed Care	$31.88

SCREW CANN LOCKING 7.3x85MM

Facility

$1,239.10

Service Code	HCPCS C1713
Hospital Charge Code	270634793
Hospital Revenue Code	278
Min. Negotiated Rate	$29.86
Max. Negotiated Rate	$619.55
Rate for Payer: Aetna Commercial	$470.86
Rate for Payer: Aetna Medicare Advantage	$371.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$315.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$315.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$247.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$315.97
Rate for Payer: Cigna Commercial	$619.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$299.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$272.60
Rate for Payer: Qualcare PPO/HMO/WC	$185.87
Rate for Payer: UnitedHealthcare Community & State	$29.86
Rate for Payer: Wellpoint Medicaid Managed Care	$32.84

SCREW CANN LOCKING 7.3x85MM

Facility

$1,239.10

Service Code	HCPCS C1713
Hospital Charge Code	270634793
Hospital Revenue Code	278
Min. Negotiated Rate	$185.87
Max. Negotiated Rate	$299.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$247.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$299.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$272.60
Rate for Payer: Qualcare PPO/HMO/WC	$185.87

SCREW CANN LOCKING 7.3x95MM

Facility

$123.00

Service Code	HCPCS C1713
Hospital Charge Code	270676322
Hospital Revenue Code	278
Min. Negotiated Rate	$18.45
Max. Negotiated Rate	$29.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.06
Rate for Payer: Qualcare PPO/HMO/WC	$18.45

SCREW CANN LOCKING 7.3x95MM

Facility

$123.00

Service Code	HCPCS C1713
Hospital Charge Code	270676322
Hospital Revenue Code	278
Min. Negotiated Rate	$2.96
Max. Negotiated Rate	$61.50
Rate for Payer: Aetna Commercial	$46.74
Rate for Payer: Aetna Medicare Advantage	$36.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.36
Rate for Payer: Cigna Commercial	$61.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.06
Rate for Payer: Qualcare PPO/HMO/WC	$18.45
Rate for Payer: UnitedHealthcare Community & State	$2.96
Rate for Payer: Wellpoint Medicaid Managed Care	$3.26

SCREW CANN LOCKING VA 5.0x45MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270677137
Hospital Revenue Code	278
Min. Negotiated Rate	$162.31
Max. Negotiated Rate	$261.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$238.06
Rate for Payer: Qualcare PPO/HMO/WC	$162.31

SCREW CANN LOCKING VA 5.0x45MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270677137
Hospital Revenue Code	278
Min. Negotiated Rate	$26.08
Max. Negotiated Rate	$541.05
Rate for Payer: Aetna Commercial	$411.20
Rate for Payer: Aetna Medicare Advantage	$324.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.94
Rate for Payer: Cigna Commercial	$541.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$238.06
Rate for Payer: Qualcare PPO/HMO/WC	$162.31
Rate for Payer: UnitedHealthcare Community & State	$26.08
Rate for Payer: Wellpoint Medicaid Managed Care	$28.68

SCREW CANN LOCKING VA 5x80MM

Facility

$1,020.00

Service Code	HCPCS C1713
Hospital Charge Code	270663326
Hospital Revenue Code	278
Min. Negotiated Rate	$24.58
Max. Negotiated Rate	$510.00
Rate for Payer: Aetna Commercial	$387.60
Rate for Payer: Aetna Medicare Advantage	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.10
Rate for Payer: Cigna Commercial	$510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$224.40
Rate for Payer: Qualcare PPO/HMO/WC	$153.00
Rate for Payer: UnitedHealthcare Community & State	$24.58
Rate for Payer: Wellpoint Medicaid Managed Care	$27.03

Know your out-of-pocket cost for care.

All Charges