Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANNULATED ASNIS 4X14MM

Facility

$1,360.00

Hospital Charge Code	270670578
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 CANNULATED ASNIS 4X40MM

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270670576
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 CANNULATED ASNIS 4X40MM

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270670576
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 CANNULATED ASNIS 4X55MM

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270670577
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 CANNULATED ASNIS 4X55MM

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270670577
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 CANNULATED LG 7.0D/16MMT

Facility

$1,092.00

Hospital Charge Code	270654622
Hospital Revenue Code	278
Min. Negotiated Rate	$163.80
Max. Negotiated Rate	$264.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$218.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$264.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$240.24
Rate for Payer: Qualcare PPO/HMO/WC	$163.80

SCREW CANNULATED LG 7.0D/16MMT

Facility

$1,092.00

Hospital Charge Code	270654622
Hospital Revenue Code	278
Min. Negotiated Rate	$26.32
Max. Negotiated Rate	$546.00
Rate for Payer: Aetna Commercial	$414.96
Rate for Payer: Aetna Medicare Advantage	$327.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$278.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$278.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$218.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$278.46
Rate for Payer: Cigna Commercial	$546.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$264.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$240.24
Rate for Payer: Qualcare PPO/HMO/WC	$163.80
Rate for Payer: UnitedHealthcare Community & State	$26.32
Rate for Payer: Wellpoint Medicaid Managed Care	$28.94

SCREW CANNULATED MIS 6.5X35

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694771
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW CANNULATED MIS 6.5X35

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694771
Hospital Revenue Code	278
Min. Negotiated Rate	$259.07
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$4,085.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50
Rate for Payer: UnitedHealthcare Community & State	$259.07
Rate for Payer: Wellpoint Medicaid Managed Care	$284.88

SCREW CANNULATED MIS 6.5X45

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694770
Hospital Revenue Code	278
Min. Negotiated Rate	$259.07
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$4,085.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50
Rate for Payer: UnitedHealthcare Community & State	$259.07
Rate for Payer: Wellpoint Medicaid Managed Care	$284.88

SCREW CANNULATED MIS 6.5X45

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694770
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW CANNULATED PT/THD 3x32MM

Facility

$860.00

Hospital Charge Code	270672899
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 PT/THD 3x32MM

Facility

$860.00

Hospital Charge Code	270672899
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 PT/THD 3x36MM

Facility

$860.00

Hospital Charge Code	270672898
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 PT/THD 3x36MM

Facility

$860.00

Hospital Charge Code	270672898
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 STAINLESS

Facility

$2,020.00

Hospital Charge Code	270663875
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

SCREW CANNULATED STAINLESS

Facility

$2,020.00

Hospital Charge Code	270663875
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 TI 4.0X36MM

Facility

$1,490.00

Service Code	HCPCS C1713
Hospital Charge Code	270696026
Hospital Revenue Code	278
Min. Negotiated Rate	$35.91
Max. Negotiated Rate	$745.00
Rate for Payer: Aetna Commercial	$566.20
Rate for Payer: Aetna Medicare Advantage	$447.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$379.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$379.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$379.95
Rate for Payer: Cigna Commercial	$745.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$327.80
Rate for Payer: Qualcare PPO/HMO/WC	$223.50
Rate for Payer: UnitedHealthcare Community & State	$35.91
Rate for Payer: Wellpoint Medicaid Managed Care	$39.48

SCREW CANNULATED TI 4.0X36MM

Facility

$1,490.00

Service Code	HCPCS C1713
Hospital Charge Code	270696026
Hospital Revenue Code	278
Min. Negotiated Rate	$223.50
Max. Negotiated Rate	$360.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$327.80
Rate for Payer: Qualcare PPO/HMO/WC	$223.50

SCREW CANNUL MARINER 6.50X45MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694848
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW CANNUL MARINER 6.50X45MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694848
Hospital Revenue Code	278
Min. Negotiated Rate	$259.07
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$4,085.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50
Rate for Payer: UnitedHealthcare Community & State	$259.07
Rate for Payer: Wellpoint Medicaid Managed Care	$284.88

SCREW CANNUL MARINER 7.50X40MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694849
Hospital Revenue Code	278
Min. Negotiated Rate	$259.07
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$4,085.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50
Rate for Payer: UnitedHealthcare Community & State	$259.07
Rate for Payer: Wellpoint Medicaid Managed Care	$284.88

SCREW CANNUL MARINER 7.50X40MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694849
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW CANNUL PED EXT 7.5X30MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694888
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW CANNUL PED EXT 7.5X30MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694888
Hospital Revenue Code	278
Min. Negotiated Rate	$259.07
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$4,085.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50
Rate for Payer: UnitedHealthcare Community & State	$259.07
Rate for Payer: Wellpoint Medicaid Managed Care	$284.88

Know your out-of-pocket cost for care.

All Charges