Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN. PART THRD 3.5X18MM

Facility

$780.00

Hospital Charge Code	270667997
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$188.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
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

SCREW CANN PART/THREAD 4.5/64

Facility

$881.65

Service Code	HCPCS C1713
Hospital Charge Code	270604898
Hospital Revenue Code	278
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$440.82
Rate for Payer: Aetna Commercial	$335.03
Rate for Payer: Aetna Medicare Advantage	$264.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.82
Rate for Payer: Cigna Commercial	$440.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$193.96
Rate for Payer: Qualcare PPO/HMO/WC	$132.25
Rate for Payer: UnitedHealthcare Community & State	$21.25
Rate for Payer: Wellpoint Medicaid Managed Care	$23.36

SCREW CANN PART/THREAD 4.5/64

Facility

$881.65

Service Code	HCPCS C1713
Hospital Charge Code	270604898
Hospital Revenue Code	278
Min. Negotiated Rate	$132.25
Max. Negotiated Rate	$213.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$193.96
Rate for Payer: Qualcare PPO/HMO/WC	$132.25

SCREW CANN POLYAXIAL 2.5X30

Facility

$745.00

Service Code	HCPCS C1713
Hospital Charge Code	270664430
Hospital Revenue Code	278
Min. Negotiated Rate	$17.95
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$163.90
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$17.95
Rate for Payer: Wellpoint Medicaid Managed Care	$19.74

SCREW CANN POLYAXIAL 2.5X30

Facility

$745.00

Service Code	HCPCS C1713
Hospital Charge Code	270664430
Hospital Revenue Code	278
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$163.90
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

SCREW CANN PT 4.3X16MM

Facility

$3,125.00

Hospital Charge Code	270702505
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

SCREW CANN PT 4.3X16MM

Facility

$3,125.00

Hospital Charge Code	270702505
Hospital Revenue Code	278
Min. Negotiated Rate	$75.31
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$75.31
Rate for Payer: Wellpoint Medicaid Managed Care	$82.81

SCREW CANN P/THD 4.5X48MM

Facility

$881.65

Service Code	HCPCS C1713
Hospital Charge Code	270604892
Hospital Revenue Code	278
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$440.82
Rate for Payer: Aetna Commercial	$335.03
Rate for Payer: Aetna Medicare Advantage	$264.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.82
Rate for Payer: Cigna Commercial	$440.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$193.96
Rate for Payer: Qualcare PPO/HMO/WC	$132.25
Rate for Payer: UnitedHealthcare Community & State	$21.25
Rate for Payer: Wellpoint Medicaid Managed Care	$23.36

SCREW CANN P/THD 4.5X48MM

Facility

$881.65

Service Code	HCPCS C1713
Hospital Charge Code	270604892
Hospital Revenue Code	278
Min. Negotiated Rate	$132.25
Max. Negotiated Rate	$213.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$193.96
Rate for Payer: Qualcare PPO/HMO/WC	$132.25

SCREW CANN P/THD 4x32MM

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270673666
Hospital Revenue Code	278
Min. Negotiated Rate	$32.78
Max. Negotiated Rate	$680.00
Rate for Payer: Aetna Commercial	$516.80
Rate for Payer: Aetna Medicare Advantage	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$346.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$346.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$346.80
Rate for Payer: Cigna Commercial	$680.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$299.20
Rate for Payer: Qualcare PPO/HMO/WC	$204.00
Rate for Payer: UnitedHealthcare Community & State	$32.78
Rate for Payer: Wellpoint Medicaid Managed Care	$36.04

SCREW CANN P/THD 4x32MM

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270673666
Hospital Revenue Code	278
Min. Negotiated Rate	$204.00
Max. Negotiated Rate	$329.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$299.20
Rate for Payer: Qualcare PPO/HMO/WC	$204.00

SCREW CANN P/THD 5.0x48mm

Facility

$505.00

Hospital Charge Code	270624916
Hospital Revenue Code	278
Min. Negotiated Rate	$12.17
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$191.90
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75
Rate for Payer: UnitedHealthcare Community & State	$12.17
Rate for Payer: Wellpoint Medicaid Managed Care	$13.38

SCREW CANN P/THD 5.0x48mm

Facility

$505.00

Hospital Charge Code	270624916
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN P/THRD 3.5x30MM

Facility

$827.50

Service Code	HCPCS C1713
Hospital Charge Code	270622122
Hospital Revenue Code	278
Min. Negotiated Rate	$124.12
Max. Negotiated Rate	$200.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$182.05
Rate for Payer: Qualcare PPO/HMO/WC	$124.12

SCREW CANN P/THRD 3.5x30MM

Facility

$827.50

Service Code	HCPCS C1713
Hospital Charge Code	270622122
Hospital Revenue Code	278
Min. Negotiated Rate	$19.94
Max. Negotiated Rate	$413.75
Rate for Payer: Aetna Commercial	$314.45
Rate for Payer: Aetna Medicare Advantage	$248.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.01
Rate for Payer: Cigna Commercial	$413.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$182.05
Rate for Payer: Qualcare PPO/HMO/WC	$124.12
Rate for Payer: UnitedHealthcare Community & State	$19.94
Rate for Payer: Wellpoint Medicaid Managed Care	$21.93

SCREW CANN P/THRD 3.5x32MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270608217
Hospital Revenue Code	278
Min. Negotiated Rate	$19.36
Max. Negotiated Rate	$401.70
Rate for Payer: Aetna Commercial	$305.29
Rate for Payer: Aetna Medicare Advantage	$241.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.87
Rate for Payer: Cigna Commercial	$401.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.51
Rate for Payer: UnitedHealthcare Community & State	$19.36
Rate for Payer: Wellpoint Medicaid Managed Care	$21.29

SCREW CANN P/THRD 3.5x32MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270608217
Hospital Revenue Code	278
Min. Negotiated Rate	$120.51
Max. Negotiated Rate	$194.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.51

SCREW CANN P/THRD 3.5x34MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270632481
Hospital Revenue Code	278
Min. Negotiated Rate	$120.51
Max. Negotiated Rate	$194.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.51

SCREW CANN P/THRD 3.5x34MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270632481
Hospital Revenue Code	278
Min. Negotiated Rate	$19.36
Max. Negotiated Rate	$401.70
Rate for Payer: Aetna Commercial	$305.29
Rate for Payer: Aetna Medicare Advantage	$241.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.87
Rate for Payer: Cigna Commercial	$401.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$176.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.51
Rate for Payer: UnitedHealthcare Community & State	$19.36
Rate for Payer: Wellpoint Medicaid Managed Care	$21.29

SCREW CANN P/THRD 4.5x20MM

Facility

$855.95

Service Code	HCPCS C1713
Hospital Charge Code	270604876
Hospital Revenue Code	278
Min. Negotiated Rate	$128.39
Max. Negotiated Rate	$207.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$188.31
Rate for Payer: Qualcare PPO/HMO/WC	$128.39

SCREW CANN P/THRD 4.5x20MM

Facility

$855.95

Service Code	HCPCS C1713
Hospital Charge Code	270604876
Hospital Revenue Code	278
Min. Negotiated Rate	$20.63
Max. Negotiated Rate	$427.98
Rate for Payer: Aetna Commercial	$325.26
Rate for Payer: Aetna Medicare Advantage	$256.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.27
Rate for Payer: Cigna Commercial	$427.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$188.31
Rate for Payer: Qualcare PPO/HMO/WC	$128.39
Rate for Payer: UnitedHealthcare Community & State	$20.63
Rate for Payer: Wellpoint Medicaid Managed Care	$22.68

SCREW CANN P/THRD 4.5x22mm

Facility

$855.95

Hospital Charge Code	270604877
Hospital Revenue Code	278
Min. Negotiated Rate	$20.63
Max. Negotiated Rate	$427.98
Rate for Payer: Aetna Commercial	$325.26
Rate for Payer: Aetna Medicare Advantage	$256.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.27
Rate for Payer: Cigna Commercial	$427.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$188.31
Rate for Payer: Qualcare PPO/HMO/WC	$128.39
Rate for Payer: UnitedHealthcare Community & State	$20.63
Rate for Payer: Wellpoint Medicaid Managed Care	$22.68

SCREW CANN P/THRD 4.5x22mm

Facility

$855.95

Hospital Charge Code	270604877
Hospital Revenue Code	278
Min. Negotiated Rate	$128.39
Max. Negotiated Rate	$207.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$188.31
Rate for Payer: Qualcare PPO/HMO/WC	$128.39

SCREW CANN P/THRD 4.5x26mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604879
Hospital Revenue Code	278
Min. Negotiated Rate	$12.17
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$191.90
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75
Rate for Payer: UnitedHealthcare Community & State	$12.17
Rate for Payer: Wellpoint Medicaid Managed Care	$13.38

SCREW CANN P/THRD 4.5x26mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604879
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

Know your out-of-pocket cost for care.

All Charges