Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN P/THRD 4.5x56mm

Facility

$855.95

Service Code	HCPCS C1713
Hospital Charge Code	270604896
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 4.5x60mm

Facility

$855.95

Service Code	HCPCS C1713
Hospital Charge Code	270604897
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 4.5x60mm

Facility

$855.95

Service Code	HCPCS C1713
Hospital Charge Code	270604897
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 4.5x68mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604891
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 4.5x68mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604891
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 4.5x72mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604899
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 4.5x72mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604899
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/THREADED 4x28MM

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270667258
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/THREADED 4x28MM

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270667258
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/THREADED 4x30MM

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270667259
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/THREADED 4x30MM

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270667259
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 SH THD 4.0X16MM

Facility

$810.00

Service Code	HCPCS C1713
Hospital Charge Code	270670833
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 SH THD 4.0X16MM

Facility

$810.00

Service Code	HCPCS C1713
Hospital Charge Code	270670833
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 SH/THRD 4.0x10MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270648924
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 SH/THRD 4.0x10MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270648924
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 SH/THRD 4.0x12MM

Facility

$833.40

Service Code	HCPCS C1713
Hospital Charge Code	270652249
Hospital Revenue Code	278
Min. Negotiated Rate	$125.01
Max. Negotiated Rate	$201.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.35
Rate for Payer: Qualcare PPO/HMO/WC	$125.01

SCREW CANN SH/THRD 4.0x12MM

Facility

$833.40

Service Code	HCPCS C1713
Hospital Charge Code	270652249
Hospital Revenue Code	278
Min. Negotiated Rate	$20.08
Max. Negotiated Rate	$416.70
Rate for Payer: Aetna Commercial	$316.69
Rate for Payer: Aetna Medicare Advantage	$250.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.52
Rate for Payer: Cigna Commercial	$416.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.35
Rate for Payer: Qualcare PPO/HMO/WC	$125.01
Rate for Payer: UnitedHealthcare Community & State	$20.08
Rate for Payer: Wellpoint Medicaid Managed Care	$22.09

SCREW CANN SH/THRD 4.0x14MM

Facility

$810.00

Hospital Charge Code	270676296
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 SH/THRD 4.0x14MM

Facility

$810.00

Hospital Charge Code	270676296
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 SH/THRD 4.0x18MM

Facility

$810.00

Hospital Charge Code	270676298
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 SH/THRD 4.0x18MM

Facility

$810.00

Hospital Charge Code	270676298
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 SH/THRD 4.0x20mm

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270652251
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 SH/THRD 4.0x20mm

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270652251
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 SH/THRD 4.0x22mm

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270652253
Hospital Revenue Code	278
Min. Negotiated Rate	$128.90
Max. Negotiated Rate	$207.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$189.06
Rate for Payer: Qualcare PPO/HMO/WC	$128.90

SCREW CANN SH/THRD 4.0x22mm

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270652253
Hospital Revenue Code	278
Min. Negotiated Rate	$20.71
Max. Negotiated Rate	$429.68
Rate for Payer: Aetna Commercial	$326.55
Rate for Payer: Aetna Medicare Advantage	$257.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.13
Rate for Payer: Cigna Commercial	$429.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$189.06
Rate for Payer: Qualcare PPO/HMO/WC	$128.90
Rate for Payer: UnitedHealthcare Community & State	$20.71
Rate for Payer: Wellpoint Medicaid Managed Care	$22.77

Know your out-of-pocket cost for care.

All Charges