Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING CANNUL 5.0MMX55

Facility

$834.25

Service Code	HCPCS C1713
Hospital Charge Code	270689700
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$201.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.53
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW LOCKING CANNUL 5.0MMX55

Facility

$834.25

Service Code	HCPCS C1713
Hospital Charge Code	270689700
Hospital Revenue Code	278
Min. Negotiated Rate	$20.11
Max. Negotiated Rate	$417.12
Rate for Payer: Aetna Commercial	$317.01
Rate for Payer: Aetna Medicare Advantage	$250.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.73
Rate for Payer: Cigna Commercial	$417.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.53
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 LOCKING CANNUL 5.0MMX60

Facility

$834.25

Service Code	HCPCS C1713
Hospital Charge Code	270689701
Hospital Revenue Code	278
Min. Negotiated Rate	$20.11
Max. Negotiated Rate	$417.12
Rate for Payer: Aetna Commercial	$317.01
Rate for Payer: Aetna Medicare Advantage	$250.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.73
Rate for Payer: Cigna Commercial	$417.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.53
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 LOCKING CANNUL 5.0MMX60

Facility

$834.25

Service Code	HCPCS C1713
Hospital Charge Code	270689701
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$201.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.53
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW LOCKING CANNULATED 40

Facility

$1,203.00

Hospital Charge Code	270661929
Hospital Revenue Code	278
Min. Negotiated Rate	$180.45
Max. Negotiated Rate	$291.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$264.66
Rate for Payer: Qualcare PPO/HMO/WC	$180.45

SCREW LOCKING CANNULATED 40

Facility

$1,203.00

Hospital Charge Code	270661929
Hospital Revenue Code	278
Min. Negotiated Rate	$28.99
Max. Negotiated Rate	$601.50
Rate for Payer: Aetna Commercial	$457.14
Rate for Payer: Aetna Medicare Advantage	$360.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$306.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$306.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$306.76
Rate for Payer: Cigna Commercial	$601.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$264.66
Rate for Payer: Qualcare PPO/HMO/WC	$180.45
Rate for Payer: UnitedHealthcare Community & State	$28.99
Rate for Payer: Wellpoint Medicaid Managed Care	$31.88

SCREW LOCKING CANN VA 5x60MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270663324
Hospital Revenue Code	278
Min. Negotiated Rate	$162.31
Max. Negotiated Rate	$261.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$238.06
Rate for Payer: Qualcare PPO/HMO/WC	$162.31

SCREW LOCKING CANN VA 5x60MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270663324
Hospital Revenue Code	278
Min. Negotiated Rate	$26.08
Max. Negotiated Rate	$541.05
Rate for Payer: Aetna Commercial	$411.20
Rate for Payer: Aetna Medicare Advantage	$324.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.94
Rate for Payer: Cigna Commercial	$541.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$238.06
Rate for Payer: Qualcare PPO/HMO/WC	$162.31
Rate for Payer: UnitedHealthcare Community & State	$26.08
Rate for Payer: Wellpoint Medicaid Managed Care	$28.68

SCREW LOCKING CANN VA 5x70MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270663325
Hospital Revenue Code	278
Min. Negotiated Rate	$162.31
Max. Negotiated Rate	$261.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$238.06
Rate for Payer: Qualcare PPO/HMO/WC	$162.31

SCREW LOCKING CANN VA 5x70MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270663325
Hospital Revenue Code	278
Min. Negotiated Rate	$26.08
Max. Negotiated Rate	$541.05
Rate for Payer: Aetna Commercial	$411.20
Rate for Payer: Aetna Medicare Advantage	$324.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.94
Rate for Payer: Cigna Commercial	$541.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$238.06
Rate for Payer: Qualcare PPO/HMO/WC	$162.31
Rate for Payer: UnitedHealthcare Community & State	$26.08
Rate for Payer: Wellpoint Medicaid Managed Care	$28.68

SCREW LOCKING CANN VA 5x85MM

Facility

$1,020.00

Service Code	HCPCS C1713
Hospital Charge Code	270663327
Hospital Revenue Code	278
Min. Negotiated Rate	$24.58
Max. Negotiated Rate	$510.00
Rate for Payer: Aetna Commercial	$387.60
Rate for Payer: Aetna Medicare Advantage	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.10
Rate for Payer: Cigna Commercial	$510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$224.40
Rate for Payer: Qualcare PPO/HMO/WC	$153.00
Rate for Payer: UnitedHealthcare Community & State	$24.58
Rate for Payer: Wellpoint Medicaid Managed Care	$27.03

SCREW LOCKING CANN VA 5x85MM

Facility

$1,020.00

Service Code	HCPCS C1713
Hospital Charge Code	270663327
Hospital Revenue Code	278
Min. Negotiated Rate	$153.00
Max. Negotiated Rate	$246.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$224.40
Rate for Payer: Qualcare PPO/HMO/WC	$153.00

SCREW LOCKING CAP KIT 38MM GRN

Facility

$1,175.00

Hospital Charge Code	270670956
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$284.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$258.50
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

SCREW LOCKING CAP KIT 38MM GRN

Facility

$1,175.00

Hospital Charge Code	270670956
Hospital Revenue Code	278
Min. Negotiated Rate	$28.32
Max. Negotiated Rate	$587.50
Rate for Payer: Aetna Commercial	$446.50
Rate for Payer: Aetna Medicare Advantage	$352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.62
Rate for Payer: Cigna Commercial	$587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$258.50
Rate for Payer: Qualcare PPO/HMO/WC	$176.25
Rate for Payer: UnitedHealthcare Community & State	$28.32
Rate for Payer: Wellpoint Medicaid Managed Care	$31.14

SCREW LOCKING CAP T30

Facility

$770.00

Service Code	HCPCS C1713
Hospital Charge Code	270695295
Hospital Revenue Code	278
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$186.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$115.50

SCREW LOCKING CAP T30

Facility

$770.00

Service Code	HCPCS C1713
Hospital Charge Code	270695295
Hospital Revenue Code	278
Min. Negotiated Rate	$18.56
Max. Negotiated Rate	$385.00
Rate for Payer: Aetna Commercial	$292.60
Rate for Payer: Aetna Medicare Advantage	$231.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.35
Rate for Payer: Cigna Commercial	$385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$115.50
Rate for Payer: UnitedHealthcare Community & State	$18.56
Rate for Payer: Wellpoint Medicaid Managed Care	$20.41

SCREW LOCKING CORT 3.5x12MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270672105
Hospital Revenue Code	278
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$271.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$246.40
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

SCREW LOCKING CORT 3.5x12MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270672105
Hospital Revenue Code	278
Min. Negotiated Rate	$26.99
Max. Negotiated Rate	$560.00
Rate for Payer: Aetna Commercial	$425.60
Rate for Payer: Aetna Medicare Advantage	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.60
Rate for Payer: Cigna Commercial	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$246.40
Rate for Payer: Qualcare PPO/HMO/WC	$168.00
Rate for Payer: UnitedHealthcare Community & State	$26.99
Rate for Payer: Wellpoint Medicaid Managed Care	$29.68

SCREW LOCKING CORT 3.5x16MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270672104
Hospital Revenue Code	278
Min. Negotiated Rate	$26.99
Max. Negotiated Rate	$560.00
Rate for Payer: Aetna Commercial	$425.60
Rate for Payer: Aetna Medicare Advantage	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.60
Rate for Payer: Cigna Commercial	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$246.40
Rate for Payer: Qualcare PPO/HMO/WC	$168.00
Rate for Payer: UnitedHealthcare Community & State	$26.99
Rate for Payer: Wellpoint Medicaid Managed Care	$29.68

SCREW LOCKING CORT 3.5x16MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270672104
Hospital Revenue Code	278
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$271.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$246.40
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

SCREW LOCKING CORT 3.5x18MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270672100
Hospital Revenue Code	278
Min. Negotiated Rate	$26.99
Max. Negotiated Rate	$560.00
Rate for Payer: Aetna Commercial	$425.60
Rate for Payer: Aetna Medicare Advantage	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.60
Rate for Payer: Cigna Commercial	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$246.40
Rate for Payer: Qualcare PPO/HMO/WC	$168.00
Rate for Payer: UnitedHealthcare Community & State	$26.99
Rate for Payer: Wellpoint Medicaid Managed Care	$29.68

SCREW LOCKING CORT 3.5x18MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270672100
Hospital Revenue Code	278
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$271.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$246.40
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

SCREW LOCKING CORT 3.5x20MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270665919
Hospital Revenue Code	278
Min. Negotiated Rate	$26.99
Max. Negotiated Rate	$560.00
Rate for Payer: Aetna Commercial	$425.60
Rate for Payer: Aetna Medicare Advantage	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.60
Rate for Payer: Cigna Commercial	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$246.40
Rate for Payer: Qualcare PPO/HMO/WC	$168.00
Rate for Payer: UnitedHealthcare Community & State	$26.99
Rate for Payer: Wellpoint Medicaid Managed Care	$29.68

SCREW LOCKING CORT 3.5x20MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270665919
Hospital Revenue Code	278
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$271.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$246.40
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

SCREW LOCKING CORT 3.5x22MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270671026
Hospital Revenue Code	278
Min. Negotiated Rate	$26.99
Max. Negotiated Rate	$560.00
Rate for Payer: Aetna Commercial	$425.60
Rate for Payer: Aetna Medicare Advantage	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.60
Rate for Payer: Cigna Commercial	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$246.40
Rate for Payer: Qualcare PPO/HMO/WC	$168.00
Rate for Payer: UnitedHealthcare Community & State	$26.99
Rate for Payer: Wellpoint Medicaid Managed Care	$29.68

Know your out-of-pocket cost for care.

All Charges