Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN LO PRO L/THD 4x60MM

Facility

$825.00

Hospital Charge Code	270671989
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW CANN LO PRO L/THD 4x60MM

Facility

$825.00

Hospital Charge Code	270671989
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW CANN LO PRO S/THD 4x30MM

Facility

$825.00

Hospital Charge Code	270671976
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW CANN LO PRO S/THD 4x30MM

Facility

$825.00

Hospital Charge Code	270671976
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW CANN LO PRO S/THD 4x32MM

Facility

$825.00

Hospital Charge Code	270671977
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW CANN LO PRO S/THD 4x32MM

Facility

$825.00

Hospital Charge Code	270671977
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW CANN LO PRO S/THD 4x34MM

Facility

$825.00

Hospital Charge Code	270671978
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW CANN LO PRO S/THD 4x34MM

Facility

$825.00

Hospital Charge Code	270671978
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW CANN LO PRO S/THD 4x35MM

Facility

$1,180.00

Hospital Charge Code	270672026
Hospital Revenue Code	278
Min. Negotiated Rate	$28.44
Max. Negotiated Rate	$590.00
Rate for Payer: Aetna Commercial	$448.40
Rate for Payer: Aetna Medicare Advantage	$354.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$300.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$300.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$236.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$300.90
Rate for Payer: Cigna Commercial	$590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$285.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$259.60
Rate for Payer: Qualcare PPO/HMO/WC	$177.00
Rate for Payer: UnitedHealthcare Community & State	$28.44
Rate for Payer: Wellpoint Medicaid Managed Care	$31.27

SCREW CANN LO PRO S/THD 4x35MM

Facility

$1,180.00

Hospital Charge Code	270672026
Hospital Revenue Code	278
Min. Negotiated Rate	$177.00
Max. Negotiated Rate	$285.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$236.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$285.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$259.60
Rate for Payer: Qualcare PPO/HMO/WC	$177.00

SCREW CANN LO PRO S/THD 4x38MM

Facility

$825.00

Hospital Charge Code	270663088
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW CANN LO PRO S/THD 4x38MM

Facility

$825.00

Hospital Charge Code	270663088
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW CANN LO PRO S/THD 4x40MM

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270671980
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW CANN LO PRO S/THD 4x40MM

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270671980
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW CANN LO PRO S/THD 4x42MM

Facility

$825.00

Hospital Charge Code	270671981
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW CANN LO PRO S/THD 4x42MM

Facility

$825.00

Hospital Charge Code	270671981
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW CANN LO PRO S/THD 4x44MM

Facility

$825.00

Hospital Charge Code	270671982
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW CANN LO PRO S/THD 4x44MM

Facility

$825.00

Hospital Charge Code	270671982
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW CANN LO PRO S/THD 4x46MM

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270663090
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW CANN LO PRO S/THD 4x46MM

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270663090
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW CANN LO PRO S/THD 4x48MM

Facility

$825.00

Hospital Charge Code	270671983
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW CANN LO PRO S/THD 4x48MM

Facility

$825.00

Hospital Charge Code	270671983
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW CANN LO PRO S/THD 4x50MM

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270659328
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

SCREW CANN LO PRO S/THD 4x50MM

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270659328
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW CANN LO PRO S/THD 4x55MM

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270659327
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

Know your out-of-pocket cost for care.

All Charges