Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN TI 4.0X44MM LT

Facility

$3,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270700093
Hospital Revenue Code	278
Min. Negotiated Rate	$75.55
Max. Negotiated Rate	$1,567.50
Rate for Payer: Aetna Commercial	$1,191.30
Rate for Payer: Aetna Medicare Advantage	$940.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$799.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$799.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$799.42
Rate for Payer: Cigna Commercial	$1,567.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$758.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$689.70
Rate for Payer: Qualcare PPO/HMO/WC	$470.25
Rate for Payer: UnitedHealthcare Community & State	$75.55
Rate for Payer: Wellpoint Medicaid Managed Care	$83.08

SCREW CANN TI 4.0X44MM LT

Facility

$3,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270700093
Hospital Revenue Code	278
Min. Negotiated Rate	$470.25
Max. Negotiated Rate	$758.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$758.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$689.70
Rate for Payer: Qualcare PPO/HMO/WC	$470.25

SCREW CANN TI 4.0X46MM LT

Facility

$3,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270700094
Hospital Revenue Code	278
Min. Negotiated Rate	$75.55
Max. Negotiated Rate	$1,567.50
Rate for Payer: Aetna Commercial	$1,191.30
Rate for Payer: Aetna Medicare Advantage	$940.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$799.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$799.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$799.42
Rate for Payer: Cigna Commercial	$1,567.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$758.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$689.70
Rate for Payer: Qualcare PPO/HMO/WC	$470.25
Rate for Payer: UnitedHealthcare Community & State	$75.55
Rate for Payer: Wellpoint Medicaid Managed Care	$83.08

SCREW CANN TI 4.0X46MM LT

Facility

$3,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270700094
Hospital Revenue Code	278
Min. Negotiated Rate	$470.25
Max. Negotiated Rate	$758.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$758.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$689.70
Rate for Payer: Qualcare PPO/HMO/WC	$470.25

SCREW CANN TI 4.0X50MM LT

Facility

$3,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270700092
Hospital Revenue Code	278
Min. Negotiated Rate	$75.55
Max. Negotiated Rate	$1,567.50
Rate for Payer: Aetna Commercial	$1,191.30
Rate for Payer: Aetna Medicare Advantage	$940.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$799.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$799.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$799.42
Rate for Payer: Cigna Commercial	$1,567.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$758.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$689.70
Rate for Payer: Qualcare PPO/HMO/WC	$470.25
Rate for Payer: UnitedHealthcare Community & State	$75.55
Rate for Payer: Wellpoint Medicaid Managed Care	$83.08

SCREW CANN TI 4.0X50MM LT

Facility

$3,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270700092
Hospital Revenue Code	278
Min. Negotiated Rate	$470.25
Max. Negotiated Rate	$758.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$758.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$689.70
Rate for Payer: Qualcare PPO/HMO/WC	$470.25

SCREW CANN TI 4.0X70MM

Facility

$1,363.50

Service Code	HCPCS C1713
Hospital Charge Code	270699448
Hospital Revenue Code	278
Min. Negotiated Rate	$32.86
Max. Negotiated Rate	$681.75
Rate for Payer: Aetna Commercial	$518.13
Rate for Payer: Aetna Medicare Advantage	$409.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$347.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$347.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$347.69
Rate for Payer: Cigna Commercial	$681.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$299.97
Rate for Payer: Qualcare PPO/HMO/WC	$204.53
Rate for Payer: UnitedHealthcare Community & State	$32.86
Rate for Payer: Wellpoint Medicaid Managed Care	$36.13

SCREW CANN TI 4.0X70MM

Facility

$1,363.50

Service Code	HCPCS C1713
Hospital Charge Code	270699448
Hospital Revenue Code	278
Min. Negotiated Rate	$204.53
Max. Negotiated Rate	$329.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$299.97
Rate for Payer: Qualcare PPO/HMO/WC	$204.53

SCREW CANN TI FT 4X60MM

Facility

$272.70

Service Code	HCPCS C1713
Hospital Charge Code	270699117
Hospital Revenue Code	278
Min. Negotiated Rate	$40.91
Max. Negotiated Rate	$65.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$59.99
Rate for Payer: Qualcare PPO/HMO/WC	$40.91

SCREW CANN TI FT 4X60MM

Facility

$272.70

Service Code	HCPCS C1713
Hospital Charge Code	270699117
Hospital Revenue Code	278
Min. Negotiated Rate	$6.57
Max. Negotiated Rate	$136.35
Rate for Payer: Aetna Commercial	$103.63
Rate for Payer: Aetna Medicare Advantage	$81.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.54
Rate for Payer: Cigna Commercial	$136.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$59.99
Rate for Payer: Qualcare PPO/HMO/WC	$40.91
Rate for Payer: UnitedHealthcare Community & State	$6.57
Rate for Payer: Wellpoint Medicaid Managed Care	$7.23

SCREW CANN TI HEDLESS 2.5X24MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700728
Hospital Revenue Code	278
Min. Negotiated Rate	$129.54
Max. Negotiated Rate	$2,687.50
Rate for Payer: Aetna Commercial	$2,042.50
Rate for Payer: Aetna Medicare Advantage	$1,612.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.62
Rate for Payer: Cigna Commercial	$2,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,182.50
Rate for Payer: Qualcare PPO/HMO/WC	$806.25
Rate for Payer: UnitedHealthcare Community & State	$129.54
Rate for Payer: Wellpoint Medicaid Managed Care	$142.44

SCREW CANN TI HEDLESS 2.5X24MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700728
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,182.50
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

SCREW CANN TI MODULAR 7.5X35MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270695890
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$1,631.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,482.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

SCREW CANN TI MODULAR 7.5X35MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270695890
Hospital Revenue Code	278
Min. Negotiated Rate	$162.43
Max. Negotiated Rate	$3,370.00
Rate for Payer: Aetna Commercial	$2,561.20
Rate for Payer: Aetna Medicare Advantage	$2,022.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,718.70
Rate for Payer: Cigna Commercial	$3,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,482.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00
Rate for Payer: UnitedHealthcare Community & State	$162.43
Rate for Payer: Wellpoint Medicaid Managed Care	$178.61

SCREW CANN TI PT 4X40MM

Facility

$595.00

Service Code	HCPCS C1713
Hospital Charge Code	270700149
Hospital Revenue Code	278
Min. Negotiated Rate	$14.34
Max. Negotiated Rate	$297.50
Rate for Payer: Aetna Commercial	$226.10
Rate for Payer: Aetna Medicare Advantage	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.72
Rate for Payer: Cigna Commercial	$297.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$130.90
Rate for Payer: Qualcare PPO/HMO/WC	$89.25
Rate for Payer: UnitedHealthcare Community & State	$14.34
Rate for Payer: Wellpoint Medicaid Managed Care	$15.77

SCREW CANN TI PT 4X40MM

Facility

$595.00

Service Code	HCPCS C1713
Hospital Charge Code	270700149
Hospital Revenue Code	278
Min. Negotiated Rate	$89.25
Max. Negotiated Rate	$143.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$130.90
Rate for Payer: Qualcare PPO/HMO/WC	$89.25

SCREW CANN TI SHORT 6.5X55MM

Facility

$1,809.50

Service Code	HCPCS C1713
Hospital Charge Code	270697387
Hospital Revenue Code	278
Min. Negotiated Rate	$271.43
Max. Negotiated Rate	$437.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$361.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$437.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$398.09
Rate for Payer: Qualcare PPO/HMO/WC	$271.43

SCREW CANN TI SHORT 6.5X55MM

Facility

$1,809.50

Service Code	HCPCS C1713
Hospital Charge Code	270697387
Hospital Revenue Code	278
Min. Negotiated Rate	$43.61
Max. Negotiated Rate	$904.75
Rate for Payer: Aetna Commercial	$687.61
Rate for Payer: Aetna Medicare Advantage	$542.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$361.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.42
Rate for Payer: Cigna Commercial	$904.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$437.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$398.09
Rate for Payer: Qualcare PPO/HMO/WC	$271.43
Rate for Payer: UnitedHealthcare Community & State	$43.61
Rate for Payer: Wellpoint Medicaid Managed Care	$47.95

SCREW CANN TI ST 4.0X30MM

Facility

$1,296.50

Service Code	HCPCS C1713
Hospital Charge Code	270697383
Hospital Revenue Code	278
Min. Negotiated Rate	$31.25
Max. Negotiated Rate	$648.25
Rate for Payer: Aetna Commercial	$492.67
Rate for Payer: Aetna Medicare Advantage	$388.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.61
Rate for Payer: Cigna Commercial	$648.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$285.23
Rate for Payer: Qualcare PPO/HMO/WC	$194.47
Rate for Payer: UnitedHealthcare Community & State	$31.25
Rate for Payer: Wellpoint Medicaid Managed Care	$34.36

SCREW CANN TI ST 4.0X30MM

Facility

$1,296.50

Service Code	HCPCS C1713
Hospital Charge Code	270697383
Hospital Revenue Code	278
Min. Negotiated Rate	$194.47
Max. Negotiated Rate	$313.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$285.23
Rate for Payer: Qualcare PPO/HMO/WC	$194.47

SCREW CANN TI ST 4.0X32MM

Facility

$1,296.50

Service Code	HCPCS C1713
Hospital Charge Code	270697384
Hospital Revenue Code	278
Min. Negotiated Rate	$194.47
Max. Negotiated Rate	$313.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$285.23
Rate for Payer: Qualcare PPO/HMO/WC	$194.47

SCREW CANN TI ST 4.0X32MM

Facility

$1,296.50

Service Code	HCPCS C1713
Hospital Charge Code	270697384
Hospital Revenue Code	278
Min. Negotiated Rate	$31.25
Max. Negotiated Rate	$648.25
Rate for Payer: Aetna Commercial	$492.67
Rate for Payer: Aetna Medicare Advantage	$388.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.61
Rate for Payer: Cigna Commercial	$648.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$285.23
Rate for Payer: Qualcare PPO/HMO/WC	$194.47
Rate for Payer: UnitedHealthcare Community & State	$31.25
Rate for Payer: Wellpoint Medicaid Managed Care	$34.36

SCREW CANN TI ST 4.0X42MM

Facility

$1,296.50

Service Code	HCPCS C1713
Hospital Charge Code	270697385
Hospital Revenue Code	278
Min. Negotiated Rate	$31.25
Max. Negotiated Rate	$648.25
Rate for Payer: Aetna Commercial	$492.67
Rate for Payer: Aetna Medicare Advantage	$388.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.61
Rate for Payer: Cigna Commercial	$648.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$285.23
Rate for Payer: Qualcare PPO/HMO/WC	$194.47
Rate for Payer: UnitedHealthcare Community & State	$31.25
Rate for Payer: Wellpoint Medicaid Managed Care	$34.36

SCREW CANN TI ST 4.0X42MM

Facility

$1,296.50

Service Code	HCPCS C1713
Hospital Charge Code	270697385
Hospital Revenue Code	278
Min. Negotiated Rate	$194.47
Max. Negotiated Rate	$313.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$285.23
Rate for Payer: Qualcare PPO/HMO/WC	$194.47

SCREW CANN TI ST 5.5X75MM

Facility

$1,809.50

Service Code	HCPCS C1713
Hospital Charge Code	270697381
Hospital Revenue Code	278
Min. Negotiated Rate	$43.61
Max. Negotiated Rate	$904.75
Rate for Payer: Aetna Commercial	$687.61
Rate for Payer: Aetna Medicare Advantage	$542.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$361.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.42
Rate for Payer: Cigna Commercial	$904.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$437.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$398.09
Rate for Payer: Qualcare PPO/HMO/WC	$271.43
Rate for Payer: UnitedHealthcare Community & State	$43.61
Rate for Payer: Wellpoint Medicaid Managed Care	$47.95

Know your out-of-pocket cost for care.

All Charges