Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW TFNA 105MM STERILE

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270676514
Hospital Revenue Code	278
Min. Negotiated Rate	$470.45
Max. Negotiated Rate	$759.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$690.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45

SCREW TFNA 105MM STERILE

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270676514
Hospital Revenue Code	278
Min. Negotiated Rate	$75.59
Max. Negotiated Rate	$1,568.17
Rate for Payer: Aetna Commercial	$1,191.81
Rate for Payer: Aetna Medicare Advantage	$940.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$799.77
Rate for Payer: Cigna Commercial	$1,568.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$690.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45
Rate for Payer: UnitedHealthcare Community & State	$75.59
Rate for Payer: Wellpoint Medicaid Managed Care	$83.11

SCREW TFNA 75MM

Facility

$3,559.30

Service Code	HCPCS C1713
Hospital Charge Code	270694884
Hospital Revenue Code	278
Min. Negotiated Rate	$533.89
Max. Negotiated Rate	$861.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$711.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$861.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$783.05
Rate for Payer: Qualcare PPO/HMO/WC	$533.89

SCREW TFNA 75MM

Facility

$3,559.30

Service Code	HCPCS C1713
Hospital Charge Code	270694884
Hospital Revenue Code	278
Min. Negotiated Rate	$85.78
Max. Negotiated Rate	$1,779.65
Rate for Payer: Aetna Commercial	$1,352.53
Rate for Payer: Aetna Medicare Advantage	$1,067.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$907.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$907.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$711.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$907.62
Rate for Payer: Cigna Commercial	$1,779.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$861.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$783.05
Rate for Payer: Qualcare PPO/HMO/WC	$533.89
Rate for Payer: UnitedHealthcare Community & State	$85.78
Rate for Payer: Wellpoint Medicaid Managed Care	$94.32

SCREW TFNA 80MM

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270676286
Hospital Revenue Code	278
Min. Negotiated Rate	$75.59
Max. Negotiated Rate	$1,568.17
Rate for Payer: Aetna Commercial	$1,191.81
Rate for Payer: Aetna Medicare Advantage	$940.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$799.77
Rate for Payer: Cigna Commercial	$1,568.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$690.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45
Rate for Payer: UnitedHealthcare Community & State	$75.59
Rate for Payer: Wellpoint Medicaid Managed Care	$83.11

SCREW TFNA 80MM

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270676286
Hospital Revenue Code	278
Min. Negotiated Rate	$470.45
Max. Negotiated Rate	$759.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$690.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45

SCREW TFNA 85MM STERILE

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270676276
Hospital Revenue Code	278
Min. Negotiated Rate	$470.45
Max. Negotiated Rate	$759.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$690.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45

SCREW TFNA 85MM STERILE

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270676276
Hospital Revenue Code	278
Min. Negotiated Rate	$75.59
Max. Negotiated Rate	$1,568.17
Rate for Payer: Aetna Commercial	$1,191.81
Rate for Payer: Aetna Medicare Advantage	$940.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$799.77
Rate for Payer: Cigna Commercial	$1,568.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$690.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45
Rate for Payer: UnitedHealthcare Community & State	$75.59
Rate for Payer: Wellpoint Medicaid Managed Care	$83.11

SCREW TFNA 90MM STERILE

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270675685
Hospital Revenue Code	278
Min. Negotiated Rate	$470.45
Max. Negotiated Rate	$759.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$690.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45

SCREW TFNA 90MM STERILE

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270675685
Hospital Revenue Code	278
Min. Negotiated Rate	$75.59
Max. Negotiated Rate	$1,568.17
Rate for Payer: Aetna Commercial	$1,191.81
Rate for Payer: Aetna Medicare Advantage	$940.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$799.77
Rate for Payer: Cigna Commercial	$1,568.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$690.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45
Rate for Payer: UnitedHealthcare Community & State	$75.59
Rate for Payer: Wellpoint Medicaid Managed Care	$83.11

SCREW THD 4.0 MM X 34 MM

Facility

$935.00

Hospital Charge Code	270702806
Hospital Revenue Code	278
Min. Negotiated Rate	$140.25
Max. Negotiated Rate	$226.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$140.25

SCREW THD 4.0 MM X 34 MM

Facility

$935.00

Hospital Charge Code	270702805
Hospital Revenue Code	278
Min. Negotiated Rate	$22.53
Max. Negotiated Rate	$467.50
Rate for Payer: Aetna Commercial	$355.30
Rate for Payer: Aetna Medicare Advantage	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.43
Rate for Payer: Cigna Commercial	$467.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$140.25
Rate for Payer: UnitedHealthcare Community & State	$22.53
Rate for Payer: Wellpoint Medicaid Managed Care	$24.78

SCREW THD 4.0 MM X 34 MM

Facility

$935.00

Hospital Charge Code	270702806
Hospital Revenue Code	278
Min. Negotiated Rate	$22.53
Max. Negotiated Rate	$467.50
Rate for Payer: Aetna Commercial	$355.30
Rate for Payer: Aetna Medicare Advantage	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.43
Rate for Payer: Cigna Commercial	$467.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$140.25
Rate for Payer: UnitedHealthcare Community & State	$22.53
Rate for Payer: Wellpoint Medicaid Managed Care	$24.78

SCREW THD 4.0 MM X 34 MM

Facility

$935.00

Hospital Charge Code	270702805
Hospital Revenue Code	278
Min. Negotiated Rate	$140.25
Max. Negotiated Rate	$226.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$140.25

SCREW THD 4.0 MM X 44 MM

Facility

$935.00

Hospital Charge Code	270702807
Hospital Revenue Code	278
Min. Negotiated Rate	$22.53
Max. Negotiated Rate	$467.50
Rate for Payer: Aetna Commercial	$355.30
Rate for Payer: Aetna Medicare Advantage	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.43
Rate for Payer: Cigna Commercial	$467.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$140.25
Rate for Payer: UnitedHealthcare Community & State	$22.53
Rate for Payer: Wellpoint Medicaid Managed Care	$24.78

SCREW THD 4.0 MM X 44 MM

Facility

$935.00

Hospital Charge Code	270702807
Hospital Revenue Code	278
Min. Negotiated Rate	$140.25
Max. Negotiated Rate	$226.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$140.25

SCREW THD 4.0 MM X 48 MM

Facility

$935.00

Hospital Charge Code	270702808
Hospital Revenue Code	278
Min. Negotiated Rate	$140.25
Max. Negotiated Rate	$226.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$140.25

SCREW THD 4.0 MM X 48 MM

Facility

$935.00

Hospital Charge Code	270702808
Hospital Revenue Code	278
Min. Negotiated Rate	$22.53
Max. Negotiated Rate	$467.50
Rate for Payer: Aetna Commercial	$355.30
Rate for Payer: Aetna Medicare Advantage	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.43
Rate for Payer: Cigna Commercial	$467.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$140.25
Rate for Payer: UnitedHealthcare Community & State	$22.53
Rate for Payer: Wellpoint Medicaid Managed Care	$24.78

SCREW THD 4.0 MM X 50 MM

Facility

$935.00

Hospital Charge Code	270702810
Hospital Revenue Code	278
Min. Negotiated Rate	$140.25
Max. Negotiated Rate	$226.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$140.25

SCREW THD 4.0 MM X 50 MM

Facility

$935.00

Hospital Charge Code	270702810
Hospital Revenue Code	278
Min. Negotiated Rate	$22.53
Max. Negotiated Rate	$467.50
Rate for Payer: Aetna Commercial	$355.30
Rate for Payer: Aetna Medicare Advantage	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.43
Rate for Payer: Cigna Commercial	$467.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$140.25
Rate for Payer: UnitedHealthcare Community & State	$22.53
Rate for Payer: Wellpoint Medicaid Managed Care	$24.78

SCREW THD 4.0 MM X 60 MM

Facility

$935.00

Hospital Charge Code	270702811
Hospital Revenue Code	278
Min. Negotiated Rate	$22.53
Max. Negotiated Rate	$467.50
Rate for Payer: Aetna Commercial	$355.30
Rate for Payer: Aetna Medicare Advantage	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.43
Rate for Payer: Cigna Commercial	$467.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$140.25
Rate for Payer: UnitedHealthcare Community & State	$22.53
Rate for Payer: Wellpoint Medicaid Managed Care	$24.78

SCREW THD 4.0 MM X 60 MM

Facility

$935.00

Hospital Charge Code	270702811
Hospital Revenue Code	278
Min. Negotiated Rate	$140.25
Max. Negotiated Rate	$226.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$140.25

SCREW THD CAN HDLS 4X28MM

Facility

$1,251.25

Service Code	HCPCS C1713
Hospital Charge Code	270700277
Hospital Revenue Code	278
Min. Negotiated Rate	$30.16
Max. Negotiated Rate	$625.62
Rate for Payer: Aetna Commercial	$475.48
Rate for Payer: Aetna Medicare Advantage	$375.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$319.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$319.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$319.07
Rate for Payer: Cigna Commercial	$625.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.27
Rate for Payer: Qualcare PPO/HMO/WC	$187.69
Rate for Payer: UnitedHealthcare Community & State	$30.16
Rate for Payer: Wellpoint Medicaid Managed Care	$33.16

SCREW THD CAN HDLS 4X28MM

Facility

$1,251.25

Service Code	HCPCS C1713
Hospital Charge Code	270700277
Hospital Revenue Code	278
Min. Negotiated Rate	$187.69
Max. Negotiated Rate	$302.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.27
Rate for Payer: Qualcare PPO/HMO/WC	$187.69

SCREW THD CAN HDLS 4X32MM

Facility

$1,251.25

Service Code	HCPCS C1713
Hospital Charge Code	270700276
Hospital Revenue Code	278
Min. Negotiated Rate	$187.69
Max. Negotiated Rate	$302.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.27
Rate for Payer: Qualcare PPO/HMO/WC	$187.69

Know your out-of-pocket cost for care.

All Charges