Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 ST 7.5X65MM

Facility

$4,195.00

Service Code	HCPCS C1713
Hospital Charge Code	270700705
Hospital Revenue Code	278
Min. Negotiated Rate	$629.25
Max. Negotiated Rate	$1,015.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$839.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,015.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$922.90
Rate for Payer: Qualcare PPO/HMO/WC	$629.25

SCREW CANN TI ST 7.5X65MM

Facility

$4,195.00

Service Code	HCPCS C1713
Hospital Charge Code	270700705
Hospital Revenue Code	278
Min. Negotiated Rate	$101.10
Max. Negotiated Rate	$2,097.50
Rate for Payer: Aetna Commercial	$1,594.10
Rate for Payer: Aetna Medicare Advantage	$1,258.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,069.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,069.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$839.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,069.72
Rate for Payer: Cigna Commercial	$2,097.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,015.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$922.90
Rate for Payer: Qualcare PPO/HMO/WC	$629.25
Rate for Payer: UnitedHealthcare Community & State	$101.10
Rate for Payer: Wellpoint Medicaid Managed Care	$111.17

SCREW CANN TI ST 7.5X70MM

Facility

$4,195.00

Service Code	HCPCS C1713
Hospital Charge Code	270700706
Hospital Revenue Code	278
Min. Negotiated Rate	$629.25
Max. Negotiated Rate	$1,015.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$839.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,015.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$922.90
Rate for Payer: Qualcare PPO/HMO/WC	$629.25

SCREW CANN TI ST 7.5X70MM

Facility

$4,195.00

Service Code	HCPCS C1713
Hospital Charge Code	270700706
Hospital Revenue Code	278
Min. Negotiated Rate	$101.10
Max. Negotiated Rate	$2,097.50
Rate for Payer: Aetna Commercial	$1,594.10
Rate for Payer: Aetna Medicare Advantage	$1,258.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,069.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,069.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$839.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,069.72
Rate for Payer: Cigna Commercial	$2,097.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,015.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$922.90
Rate for Payer: Qualcare PPO/HMO/WC	$629.25
Rate for Payer: UnitedHealthcare Community & State	$101.10
Rate for Payer: Wellpoint Medicaid Managed Care	$111.17

SCREW CANN TI ST 7.5X75MM

Facility

$4,195.00

Service Code	HCPCS C1713
Hospital Charge Code	270700707
Hospital Revenue Code	278
Min. Negotiated Rate	$629.25
Max. Negotiated Rate	$1,015.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$839.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,015.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$922.90
Rate for Payer: Qualcare PPO/HMO/WC	$629.25

SCREW CANN TI ST 7.5X75MM

Facility

$4,195.00

Service Code	HCPCS C1713
Hospital Charge Code	270700707
Hospital Revenue Code	278
Min. Negotiated Rate	$101.10
Max. Negotiated Rate	$2,097.50
Rate for Payer: Aetna Commercial	$1,594.10
Rate for Payer: Aetna Medicare Advantage	$1,258.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,069.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,069.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$839.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,069.72
Rate for Payer: Cigna Commercial	$2,097.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,015.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$922.90
Rate for Payer: Qualcare PPO/HMO/WC	$629.25
Rate for Payer: UnitedHealthcare Community & State	$101.10
Rate for Payer: Wellpoint Medicaid Managed Care	$111.17

SCREW CANN TYB 2.0 HD 12 MM

Facility

$1,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270691399
Hospital Revenue Code	278
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$387.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$352.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

SCREW CANN TYB 2.0 HD 12 MM

Facility

$1,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270691399
Hospital Revenue Code	278
Min. Negotiated Rate	$38.56
Max. Negotiated Rate	$800.00
Rate for Payer: Aetna Commercial	$608.00
Rate for Payer: Aetna Medicare Advantage	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$408.00
Rate for Payer: Cigna Commercial	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$352.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00
Rate for Payer: UnitedHealthcare Community & State	$38.56
Rate for Payer: Wellpoint Medicaid Managed Care	$42.40

SCREW CANNUALTED 2.4X12MM LONG

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270684720
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

SCREW CANNUALTED 2.4X12MM LONG

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270684720
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 CANNULATD 4.0 X 42MM

Facility

$1,295.00

Service Code	HCPCS C1713
Hospital Charge Code	270663660
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

SCREW CANNULATD 4.0 X 42MM

Facility

$1,295.00

Service Code	HCPCS C1713
Hospital Charge Code	270663660
Hospital Revenue Code	278
Min. Negotiated Rate	$31.21
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$492.10
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Community & State	$31.21
Rate for Payer: Wellpoint Medicaid Managed Care	$34.32

SCREW CANNULATD 4.0 x 46mm

Facility

$1,448.00

Service Code	HCPCS C1713
Hospital Charge Code	270663659
Hospital Revenue Code	278
Min. Negotiated Rate	$217.20
Max. Negotiated Rate	$350.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$318.56
Rate for Payer: Qualcare PPO/HMO/WC	$217.20

SCREW CANNULATD 4.0 x 46mm

Facility

$1,448.00

Service Code	HCPCS C1713
Hospital Charge Code	270663659
Hospital Revenue Code	278
Min. Negotiated Rate	$34.90
Max. Negotiated Rate	$724.00
Rate for Payer: Aetna Commercial	$550.24
Rate for Payer: Aetna Medicare Advantage	$434.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$369.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$369.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$369.24
Rate for Payer: Cigna Commercial	$724.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$318.56
Rate for Payer: Qualcare PPO/HMO/WC	$217.20
Rate for Payer: UnitedHealthcare Community & State	$34.90
Rate for Payer: Wellpoint Medicaid Managed Care	$38.37

SCREWCANNULATEASNIS6.5MMX80MM

Facility

$2,020.00

Hospital Charge Code	270661506
Hospital Revenue Code	278
Min. Negotiated Rate	$48.68
Max. Negotiated Rate	$1,010.00
Rate for Payer: Aetna Commercial	$767.60
Rate for Payer: Aetna Medicare Advantage	$606.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$515.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$515.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$404.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$515.10
Rate for Payer: Cigna Commercial	$1,010.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$488.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$444.40
Rate for Payer: Qualcare PPO/HMO/WC	$303.00
Rate for Payer: UnitedHealthcare Community & State	$48.68
Rate for Payer: Wellpoint Medicaid Managed Care	$53.53

SCREWCANNULATEASNIS6.5MMX80MM

Facility

$2,020.00

Hospital Charge Code	270661506
Hospital Revenue Code	278
Min. Negotiated Rate	$303.00
Max. Negotiated Rate	$488.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$404.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$488.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$444.40
Rate for Payer: Qualcare PPO/HMO/WC	$303.00

SCREWCANNULATEASNIS6.5MMX85MM

Facility

$2,020.00

Hospital Charge Code	270664546
Hospital Revenue Code	278
Min. Negotiated Rate	$48.68
Max. Negotiated Rate	$1,010.00
Rate for Payer: Aetna Commercial	$767.60
Rate for Payer: Aetna Medicare Advantage	$606.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$515.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$515.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$404.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$515.10
Rate for Payer: Cigna Commercial	$1,010.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$488.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$444.40
Rate for Payer: Qualcare PPO/HMO/WC	$303.00
Rate for Payer: UnitedHealthcare Community & State	$48.68
Rate for Payer: Wellpoint Medicaid Managed Care	$53.53

SCREWCANNULATEASNIS6.5MMX85MM

Facility

$2,020.00

Hospital Charge Code	270664546
Hospital Revenue Code	278
Min. Negotiated Rate	$303.00
Max. Negotiated Rate	$488.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$404.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$488.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$444.40
Rate for Payer: Qualcare PPO/HMO/WC	$303.00

SCREW CANNULATED 2.0MM X10 MM

Facility

$1,074.75

Service Code	HCPCS C1713
Hospital Charge Code	270681790
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 CANNULATED 2.0MM X10 MM

Facility

$1,074.75

Service Code	HCPCS C1713
Hospital Charge Code	270681790
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 CANNULATED 2.0 X 16MM

Facility

$860.00

Service Code	HCPCS C1713
Hospital Charge Code	270662156
Hospital Revenue Code	278
Min. Negotiated Rate	$20.73
Max. Negotiated Rate	$430.00
Rate for Payer: Aetna Commercial	$326.80
Rate for Payer: Aetna Medicare Advantage	$258.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.30
Rate for Payer: Cigna Commercial	$430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$189.20
Rate for Payer: Qualcare PPO/HMO/WC	$129.00
Rate for Payer: UnitedHealthcare Community & State	$20.73
Rate for Payer: Wellpoint Medicaid Managed Care	$22.79

SCREW CANNULATED 2.0 X 16MM

Facility

$860.00

Service Code	HCPCS C1713
Hospital Charge Code	270662156
Hospital Revenue Code	278
Min. Negotiated Rate	$129.00
Max. Negotiated Rate	$208.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$189.20
Rate for Payer: Qualcare PPO/HMO/WC	$129.00

SCREW CANNULATED 2.0 X 18MM

Facility

$860.00

Hospital Charge Code	27062155
Hospital Revenue Code	278
Min. Negotiated Rate	$20.73
Max. Negotiated Rate	$430.00
Rate for Payer: Aetna Commercial	$326.80
Rate for Payer: Aetna Medicare Advantage	$258.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.30
Rate for Payer: Cigna Commercial	$430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$189.20
Rate for Payer: Qualcare PPO/HMO/WC	$129.00
Rate for Payer: UnitedHealthcare Community & State	$20.73
Rate for Payer: Wellpoint Medicaid Managed Care	$22.79

SCREW CANNULATED 2.0 X 18MM

Facility

$860.00

Hospital Charge Code	27062155
Hospital Revenue Code	278
Min. Negotiated Rate	$129.00
Max. Negotiated Rate	$208.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$189.20
Rate for Payer: Qualcare PPO/HMO/WC	$129.00

Know your out-of-pocket cost for care.

All Charges