Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN MOD SHANK 6.5X40MM

Facility

$4,062.50

Service Code	HCPCS C1713
Hospital Charge Code	270698063
Hospital Revenue Code	278
Min. Negotiated Rate	$609.38
Max. Negotiated Rate	$983.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$983.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$893.75
Rate for Payer: Qualcare PPO/HMO/WC	$609.38

SCREW CANN MOD SHANK 6.5X40MM

Facility

$4,062.50

Service Code	HCPCS C1713
Hospital Charge Code	270698063
Hospital Revenue Code	278
Min. Negotiated Rate	$97.91
Max. Negotiated Rate	$2,031.25
Rate for Payer: Aetna Commercial	$1,543.75
Rate for Payer: Aetna Medicare Advantage	$1,218.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,035.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,035.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$812.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,035.94
Rate for Payer: Cigna Commercial	$2,031.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$983.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$893.75
Rate for Payer: Qualcare PPO/HMO/WC	$609.38
Rate for Payer: UnitedHealthcare Community & State	$97.91
Rate for Payer: Wellpoint Medicaid Managed Care	$107.66

SCREW CANN MOD SHANK 6.5X45MM

Facility

$4,062.50

Service Code	HCPCS C1713
Hospital Charge Code	270698062
Hospital Revenue Code	278
Min. Negotiated Rate	$97.91
Max. Negotiated Rate	$2,031.25
Rate for Payer: Aetna Commercial	$1,543.75
Rate for Payer: Aetna Medicare Advantage	$1,218.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,035.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,035.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$812.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,035.94
Rate for Payer: Cigna Commercial	$2,031.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$983.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$893.75
Rate for Payer: Qualcare PPO/HMO/WC	$609.38
Rate for Payer: UnitedHealthcare Community & State	$97.91
Rate for Payer: Wellpoint Medicaid Managed Care	$107.66

SCREW CANN MOD SHANK 6.5X45MM

Facility

$4,062.50

Service Code	HCPCS C1713
Hospital Charge Code	270698062
Hospital Revenue Code	278
Min. Negotiated Rate	$609.38
Max. Negotiated Rate	$983.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$983.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$893.75
Rate for Payer: Qualcare PPO/HMO/WC	$609.38

SCREW CANN N-FORCE 4.0 2.7MM

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270687091
Hospital Revenue Code	278
Min. Negotiated Rate	$15.24
Max. Negotiated Rate	$316.25
Rate for Payer: Aetna Commercial	$240.35
Rate for Payer: Aetna Medicare Advantage	$189.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.29
Rate for Payer: Cigna Commercial	$316.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$94.88
Rate for Payer: UnitedHealthcare Community & State	$15.24
Rate for Payer: Wellpoint Medicaid Managed Care	$16.76

SCREW CANN N-FORCE 4.0 2.7MM

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270687091
Hospital Revenue Code	278
Min. Negotiated Rate	$94.88
Max. Negotiated Rate	$153.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$94.88

SCREW CANN N-FORCE 7.3

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270687095
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW CANN N-FORCE 7.3

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270687095
Hospital Revenue Code	278
Min. Negotiated Rate	$23.20
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$365.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$144.38
Rate for Payer: UnitedHealthcare Community & State	$23.20
Rate for Payer: Wellpoint Medicaid Managed Care	$25.51

SCREW CANN PART THD 2.4X14MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270682091
Hospital Revenue Code	278
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Community & State	$17.47
Rate for Payer: Wellpoint Medicaid Managed Care	$19.21

SCREW CANN PART THD 2.4X14MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270682091
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW CANN PART THD 2.4X16MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270682092
Hospital Revenue Code	278
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Community & State	$17.47
Rate for Payer: Wellpoint Medicaid Managed Care	$19.21

SCREW CANN PART THD 2.4X16MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270682092
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW CANN PART THD 2.4X18MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270671791
Hospital Revenue Code	278
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Community & State	$17.47
Rate for Payer: Wellpoint Medicaid Managed Care	$19.21

SCREW CANN PART THD 2.4X18MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270671791
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW CANN PART THD 4x60MM

Facility

$931.20

Service Code	HCPCS C1713
Hospital Charge Code	270674954
Hospital Revenue Code	278
Min. Negotiated Rate	$22.44
Max. Negotiated Rate	$465.60
Rate for Payer: Aetna Commercial	$353.86
Rate for Payer: Aetna Medicare Advantage	$279.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.46
Rate for Payer: Cigna Commercial	$465.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$204.86
Rate for Payer: Qualcare PPO/HMO/WC	$139.68
Rate for Payer: UnitedHealthcare Community & State	$22.44
Rate for Payer: Wellpoint Medicaid Managed Care	$24.68

SCREW CANN PART THD 4x60MM

Facility

$931.20

Service Code	HCPCS C1713
Hospital Charge Code	270674954
Hospital Revenue Code	278
Min. Negotiated Rate	$139.68
Max. Negotiated Rate	$225.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$204.86
Rate for Payer: Qualcare PPO/HMO/WC	$139.68

SCREW CANN PART THD 4x65MM

Facility

$931.20

Service Code	HCPCS C1713
Hospital Charge Code	270674955
Hospital Revenue Code	278
Min. Negotiated Rate	$139.68
Max. Negotiated Rate	$225.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$204.86
Rate for Payer: Qualcare PPO/HMO/WC	$139.68

SCREW CANN PART THD 4x65MM

Facility

$931.20

Service Code	HCPCS C1713
Hospital Charge Code	270674955
Hospital Revenue Code	278
Min. Negotiated Rate	$22.44
Max. Negotiated Rate	$465.60
Rate for Payer: Aetna Commercial	$353.86
Rate for Payer: Aetna Medicare Advantage	$279.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.46
Rate for Payer: Cigna Commercial	$465.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$204.86
Rate for Payer: Qualcare PPO/HMO/WC	$139.68
Rate for Payer: UnitedHealthcare Community & State	$22.44
Rate for Payer: Wellpoint Medicaid Managed Care	$24.68

SCREW CANN PART THR 4.0MMx38MM

Facility

$542.00

Hospital Charge Code	270631982
Hospital Revenue Code	278
Min. Negotiated Rate	$13.06
Max. Negotiated Rate	$271.00
Rate for Payer: Aetna Commercial	$205.96
Rate for Payer: Aetna Medicare Advantage	$162.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.21
Rate for Payer: Cigna Commercial	$271.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.24
Rate for Payer: Qualcare PPO/HMO/WC	$81.30
Rate for Payer: UnitedHealthcare Community & State	$13.06
Rate for Payer: Wellpoint Medicaid Managed Care	$14.36

SCREW CANN PART THR 4.0MMx38MM

Facility

$542.00

Hospital Charge Code	270631982
Hospital Revenue Code	278
Min. Negotiated Rate	$81.30
Max. Negotiated Rate	$131.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.24
Rate for Payer: Qualcare PPO/HMO/WC	$81.30

SCREW CANN PART THR 7.3MMX75MM

Facility

$1,002.00

Hospital Charge Code	270634789
Hospital Revenue Code	278
Min. Negotiated Rate	$150.30
Max. Negotiated Rate	$242.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.44
Rate for Payer: Qualcare PPO/HMO/WC	$150.30

SCREW CANN PART THR 7.3MMX75MM

Facility

$1,002.00

Hospital Charge Code	270634789
Hospital Revenue Code	278
Min. Negotiated Rate	$24.15
Max. Negotiated Rate	$501.00
Rate for Payer: Aetna Commercial	$380.76
Rate for Payer: Aetna Medicare Advantage	$300.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.51
Rate for Payer: Cigna Commercial	$501.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.44
Rate for Payer: Qualcare PPO/HMO/WC	$150.30
Rate for Payer: UnitedHealthcare Community & State	$24.15
Rate for Payer: Wellpoint Medicaid Managed Care	$26.55

SCREW CANN PART THRD 3.0X36MM

Facility

$942.50

Service Code	HCPCS C1713
Hospital Charge Code	270694750
Hospital Revenue Code	278
Min. Negotiated Rate	$141.38
Max. Negotiated Rate	$228.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$188.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$207.35
Rate for Payer: Qualcare PPO/HMO/WC	$141.38

SCREW CANN PART THRD 3.0X36MM

Facility

$942.50

Service Code	HCPCS C1713
Hospital Charge Code	270694750
Hospital Revenue Code	278
Min. Negotiated Rate	$22.71
Max. Negotiated Rate	$471.25
Rate for Payer: Aetna Commercial	$358.15
Rate for Payer: Aetna Medicare Advantage	$282.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$188.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.34
Rate for Payer: Cigna Commercial	$471.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$207.35
Rate for Payer: Qualcare PPO/HMO/WC	$141.38
Rate for Payer: UnitedHealthcare Community & State	$22.71
Rate for Payer: Wellpoint Medicaid Managed Care	$24.98

SCREW CANN. PART THRD 3.5X18MM

Facility

$780.00

Hospital Charge Code	270667997
Hospital Revenue Code	278
Min. Negotiated Rate	$18.80
Max. Negotiated Rate	$390.00
Rate for Payer: Aetna Commercial	$296.40
Rate for Payer: Aetna Medicare Advantage	$234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.90
Rate for Payer: Cigna Commercial	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$171.60
Rate for Payer: Qualcare PPO/HMO/WC	$117.00
Rate for Payer: UnitedHealthcare Community & State	$18.80
Rate for Payer: Wellpoint Medicaid Managed Care	$20.67

Know your out-of-pocket cost for care.

All Charges