Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 4x60MM

Facility

$825.00

Hospital Charge Code	270671984
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 4x60MM

Facility

$825.00

Hospital Charge Code	270671984
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 L/THRD 3.0x24MM

Facility

$819.00

Hospital Charge Code	270676299
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 L/THRD 3.0x24MM

Facility

$819.00

Hospital Charge Code	270676299
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 L/THRD 3.0x34MM

Facility

$819.00

Hospital Charge Code	270676300
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 L/THRD 3.0x34MM

Facility

$819.00

Hospital Charge Code	270676300
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 L/THRD 3.0x36MM

Facility

$819.00

Service Code	HCPCS C1713
Hospital Charge Code	270677402
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 L/THRD 3.0x36MM

Facility

$819.00

Service Code	HCPCS C1713
Hospital Charge Code	270677402
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 L/THRD 3.0x40MM

Facility

$819.00

Service Code	HCPCS C1713
Hospital Charge Code	270677401
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 L/THRD 3.0x40MM

Facility

$819.00

Service Code	HCPCS C1713
Hospital Charge Code	270677401
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 MATRIX 6.0MM 40MM

Facility

$9,715.00

Hospital Charge Code	270656697
Hospital Revenue Code	278
Min. Negotiated Rate	$234.13
Max. Negotiated Rate	$4,857.50
Rate for Payer: Aetna Commercial	$3,691.70
Rate for Payer: Aetna Medicare Advantage	$2,914.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,477.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,477.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,943.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,477.32
Rate for Payer: Cigna Commercial	$4,857.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,351.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,137.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,457.25
Rate for Payer: UnitedHealthcare Community & State	$234.13
Rate for Payer: Wellpoint Medicaid Managed Care	$257.45

SCREW CANN MATRIX 6.0MM 40MM

Facility

$9,715.00

Hospital Charge Code	270656697
Hospital Revenue Code	278
Min. Negotiated Rate	$1,457.25
Max. Negotiated Rate	$2,351.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,943.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,351.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,137.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,457.25

SCREW CANN MEAS DEVICE 3.5/4MM

Facility

$630.00

Hospital Charge Code	270676249
Hospital Revenue Code	272
Min. Negotiated Rate	$15.18
Max. Negotiated Rate	$315.00
Rate for Payer: Aetna Commercial	$239.40
Rate for Payer: Aetna Medicare Advantage	$189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.65
Rate for Payer: Cigna Commercial	$315.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.00
Rate for Payer: Oxford Commercial	$126.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.50
Rate for Payer: UnitedHealthcare Commercial	$126.00
Rate for Payer: UnitedHealthcare Community & State	$15.18
Rate for Payer: Wellpoint Medicaid Managed Care	$16.70

SCREW CANN MEAS DEVICE 3.5/4MM

Facility

$630.00

Hospital Charge Code	270676249
Hospital Revenue Code	272
Min. Negotiated Rate	$94.50
Max. Negotiated Rate	$94.50
Rate for Payer: Qualcare PPO/HMO/WC	$94.50

SCREW CANN MICRO 12/4MM

Facility

$1,074.75

Hospital Charge Code	270677865
Hospital Revenue Code	278
Min. Negotiated Rate	$161.21
Max. Negotiated Rate	$260.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.44
Rate for Payer: Qualcare PPO/HMO/WC	$161.21

SCREW CANN MICRO 12/4MM

Facility

$1,074.75

Hospital Charge Code	270677865
Hospital Revenue Code	278
Min. Negotiated Rate	$25.90
Max. Negotiated Rate	$537.38
Rate for Payer: Aetna Commercial	$408.40
Rate for Payer: Aetna Medicare Advantage	$322.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.06
Rate for Payer: Cigna Commercial	$537.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.44
Rate for Payer: Qualcare PPO/HMO/WC	$161.21
Rate for Payer: UnitedHealthcare Community & State	$25.90
Rate for Payer: Wellpoint Medicaid Managed Care	$28.48

SCREW CANN MICRO 13/6MM

Facility

$1,074.75

Hospital Charge Code	270677866
Hospital Revenue Code	278
Min. Negotiated Rate	$25.90
Max. Negotiated Rate	$537.38
Rate for Payer: Aetna Commercial	$408.40
Rate for Payer: Aetna Medicare Advantage	$322.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.06
Rate for Payer: Cigna Commercial	$537.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.44
Rate for Payer: Qualcare PPO/HMO/WC	$161.21
Rate for Payer: UnitedHealthcare Community & State	$25.90
Rate for Payer: Wellpoint Medicaid Managed Care	$28.48

SCREW CANN MICRO 13/6MM

Facility

$1,074.75

Hospital Charge Code	270677866
Hospital Revenue Code	278
Min. Negotiated Rate	$161.21
Max. Negotiated Rate	$260.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.44
Rate for Payer: Qualcare PPO/HMO/WC	$161.21

SCREW CANN MICRO 15/4MM

Facility

$1,074.75

Service Code	HCPCS C1713
Hospital Charge Code	270677864
Hospital Revenue Code	278
Min. Negotiated Rate	$25.90
Max. Negotiated Rate	$537.38
Rate for Payer: Aetna Commercial	$408.40
Rate for Payer: Aetna Medicare Advantage	$322.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.06
Rate for Payer: Cigna Commercial	$537.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.44
Rate for Payer: Qualcare PPO/HMO/WC	$161.21
Rate for Payer: UnitedHealthcare Community & State	$25.90
Rate for Payer: Wellpoint Medicaid Managed Care	$28.48

SCREW CANN MICRO 15/4MM

Facility

$1,074.75

Service Code	HCPCS C1713
Hospital Charge Code	270677864
Hospital Revenue Code	278
Min. Negotiated Rate	$161.21
Max. Negotiated Rate	$260.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.44
Rate for Payer: Qualcare PPO/HMO/WC	$161.21

SCREW CANN MICRO 16/4MM

Facility

$1,421.80

Service Code	HCPCS C1713
Hospital Charge Code	270692083
Hospital Revenue Code	278
Min. Negotiated Rate	$34.27
Max. Negotiated Rate	$710.90
Rate for Payer: Aetna Commercial	$540.28
Rate for Payer: Aetna Medicare Advantage	$426.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$362.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$362.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$362.56
Rate for Payer: Cigna Commercial	$710.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$312.80
Rate for Payer: Qualcare PPO/HMO/WC	$213.27
Rate for Payer: UnitedHealthcare Community & State	$34.27
Rate for Payer: Wellpoint Medicaid Managed Care	$37.68

SCREW CANN MICRO 16/4MM

Facility

$1,421.80

Service Code	HCPCS C1713
Hospital Charge Code	270692083
Hospital Revenue Code	278
Min. Negotiated Rate	$213.27
Max. Negotiated Rate	$344.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$312.80
Rate for Payer: Qualcare PPO/HMO/WC	$213.27

SCREW CANN MICRO 3.0 34X7MM

Facility

$2,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270698603
Hospital Revenue Code	278
Min. Negotiated Rate	$382.50
Max. Negotiated Rate	$617.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$617.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$561.00
Rate for Payer: Qualcare PPO/HMO/WC	$382.50

SCREW CANN MICRO 3.0 34X7MM

Facility

$2,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270698603
Hospital Revenue Code	278
Min. Negotiated Rate	$61.45
Max. Negotiated Rate	$1,275.00
Rate for Payer: Aetna Commercial	$969.00
Rate for Payer: Aetna Medicare Advantage	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$650.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$650.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$650.25
Rate for Payer: Cigna Commercial	$1,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$617.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$561.00
Rate for Payer: Qualcare PPO/HMO/WC	$382.50
Rate for Payer: UnitedHealthcare Community & State	$61.45
Rate for Payer: Wellpoint Medicaid Managed Care	$67.58

Know your out-of-pocket cost for care.

All Charges