Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANNULATED 2.4 X 12MM

Facility

$895.00

Hospital Charge Code	270662157
Hospital Revenue Code	278
Min. Negotiated Rate	$134.25
Max. Negotiated Rate	$216.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$196.90
Rate for Payer: Qualcare PPO/HMO/WC	$134.25

SCREW CANNULATED 2.4 X 12MM

Facility

$895.00

Hospital Charge Code	270662157
Hospital Revenue Code	278
Min. Negotiated Rate	$21.57
Max. Negotiated Rate	$447.50
Rate for Payer: Aetna Commercial	$340.10
Rate for Payer: Aetna Medicare Advantage	$268.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$228.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$228.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$228.22
Rate for Payer: Cigna Commercial	$447.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$196.90
Rate for Payer: Qualcare PPO/HMO/WC	$134.25
Rate for Payer: UnitedHealthcare Community & State	$21.57
Rate for Payer: Wellpoint Medicaid Managed Care	$23.72

SCREW CANNULATED 2.4x12MM

Facility

$950.00

Hospital Charge Code	270674378
Hospital Revenue Code	278
Min. Negotiated Rate	$22.89
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$361.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.00
Rate for Payer: Qualcare PPO/HMO/WC	$142.50
Rate for Payer: UnitedHealthcare Community & State	$22.89
Rate for Payer: Wellpoint Medicaid Managed Care	$25.18

SCREW CANNULATED 2.4x12MM

Facility

$950.00

Hospital Charge Code	270674378
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$229.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.00
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

SCREW CANNULATED 2.5MM X 18MM

Facility

$2,935.00

Service Code	HCPCS C1713
Hospital Charge Code	270678563
Hospital Revenue Code	278
Min. Negotiated Rate	$440.25
Max. Negotiated Rate	$710.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$587.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$710.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$645.70
Rate for Payer: Qualcare PPO/HMO/WC	$440.25

SCREW CANNULATED 2.5MM X 18MM

Facility

$2,935.00

Service Code	HCPCS C1713
Hospital Charge Code	270678563
Hospital Revenue Code	278
Min. Negotiated Rate	$70.73
Max. Negotiated Rate	$1,467.50
Rate for Payer: Aetna Commercial	$1,115.30
Rate for Payer: Aetna Medicare Advantage	$880.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$748.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$748.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$587.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$748.42
Rate for Payer: Cigna Commercial	$1,467.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$710.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$645.70
Rate for Payer: Qualcare PPO/HMO/WC	$440.25
Rate for Payer: UnitedHealthcare Community & State	$70.73
Rate for Payer: Wellpoint Medicaid Managed Care	$77.78

SCREW CANNULATED 2.5 X 14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270688590
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW CANNULATED 2.5 X 14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270688590
Hospital Revenue Code	278
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

SCREW CANNULATED 2.5 X 20MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701485
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 CANNULATED 2.5 X 20MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701485
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 CANNULATED 2.7X10 P22710

Facility

$434.00

Hospital Charge Code	270634412
Hospital Revenue Code	278
Min. Negotiated Rate	$65.10
Max. Negotiated Rate	$105.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$95.48
Rate for Payer: Qualcare PPO/HMO/WC	$65.10

SCREW CANNULATED 2.7X10 P22710

Facility

$434.00

Hospital Charge Code	270634412
Hospital Revenue Code	278
Min. Negotiated Rate	$10.46
Max. Negotiated Rate	$217.00
Rate for Payer: Aetna Commercial	$164.92
Rate for Payer: Aetna Medicare Advantage	$130.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.67
Rate for Payer: Cigna Commercial	$217.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$95.48
Rate for Payer: Qualcare PPO/HMO/WC	$65.10
Rate for Payer: UnitedHealthcare Community & State	$10.46
Rate for Payer: Wellpoint Medicaid Managed Care	$11.50

SCREW CANNULATED 3.0 X 22MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270682559
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW CANNULATED 3.0 X 22MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270682559
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

SCREW CANNULATED 3.0X26MM

Facility

$950.00

Hospital Charge Code	270669671
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$229.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.00
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

SCREW CANNULATED 3.0X26MM

Facility

$950.00

Hospital Charge Code	270669671
Hospital Revenue Code	278
Min. Negotiated Rate	$22.89
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$361.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.00
Rate for Payer: Qualcare PPO/HMO/WC	$142.50
Rate for Payer: UnitedHealthcare Community & State	$22.89
Rate for Payer: Wellpoint Medicaid Managed Care	$25.18

SCREW CANNULATED 3.0X28MM

Facility

$950.00

Hospital Charge Code	270669672
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$229.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.00
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

SCREW CANNULATED 3.0X28MM

Facility

$950.00

Hospital Charge Code	270669672
Hospital Revenue Code	278
Min. Negotiated Rate	$22.89
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$361.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.00
Rate for Payer: Qualcare PPO/HMO/WC	$142.50
Rate for Payer: UnitedHealthcare Community & State	$22.89
Rate for Payer: Wellpoint Medicaid Managed Care	$25.18

SCREW CANNULATED 3.2X26MM

Facility

$2,600.00

Hospital Charge Code	270669225
Hospital Revenue Code	278
Min. Negotiated Rate	$62.66
Max. Negotiated Rate	$1,300.00
Rate for Payer: Aetna Commercial	$988.00
Rate for Payer: Aetna Medicare Advantage	$780.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$663.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$663.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$520.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$663.00
Rate for Payer: Cigna Commercial	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$629.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$572.00
Rate for Payer: Qualcare PPO/HMO/WC	$390.00
Rate for Payer: UnitedHealthcare Community & State	$62.66
Rate for Payer: Wellpoint Medicaid Managed Care	$68.90

SCREW CANNULATED 3.2X26MM

Facility

$2,600.00

Hospital Charge Code	270669225
Hospital Revenue Code	278
Min. Negotiated Rate	$390.00
Max. Negotiated Rate	$629.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$520.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$629.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$572.00
Rate for Payer: Qualcare PPO/HMO/WC	$390.00

SCREW CANNULATED 3.5x46mm

Facility

$1,162.30

Service Code	HCPCS C1713
Hospital Charge Code	270652245
Hospital Revenue Code	278
Min. Negotiated Rate	$28.01
Max. Negotiated Rate	$581.15
Rate for Payer: Aetna Commercial	$441.67
Rate for Payer: Aetna Medicare Advantage	$348.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$296.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$296.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$232.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$296.39
Rate for Payer: Cigna Commercial	$581.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$281.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$255.71
Rate for Payer: Qualcare PPO/HMO/WC	$174.34
Rate for Payer: UnitedHealthcare Community & State	$28.01
Rate for Payer: Wellpoint Medicaid Managed Care	$30.80

SCREW CANNULATED 3.5x46mm

Facility

$1,162.30

Service Code	HCPCS C1713
Hospital Charge Code	270652245
Hospital Revenue Code	278
Min. Negotiated Rate	$174.34
Max. Negotiated Rate	$281.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$232.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$281.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$255.71
Rate for Payer: Qualcare PPO/HMO/WC	$174.34

SCREW CANNULATED 3x14MM

Facility

$950.00

Hospital Charge Code	270674379
Hospital Revenue Code	278
Min. Negotiated Rate	$22.89
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$361.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.00
Rate for Payer: Qualcare PPO/HMO/WC	$142.50
Rate for Payer: UnitedHealthcare Community & State	$22.89
Rate for Payer: Wellpoint Medicaid Managed Care	$25.18

SCREW CANNULATED 3x14MM

Facility

$950.00

Hospital Charge Code	270674379
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$229.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.00
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

SCREW CANNULATED 3x16MM

Facility

$950.00

Service Code	HCPCS C1713
Hospital Charge Code	270674376
Hospital Revenue Code	278
Min. Negotiated Rate	$22.89
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$361.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.00
Rate for Payer: Qualcare PPO/HMO/WC	$142.50
Rate for Payer: UnitedHealthcare Community & State	$22.89
Rate for Payer: Wellpoint Medicaid Managed Care	$25.18

Know your out-of-pocket cost for care.

All Charges