Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW VAL TI 1.6 MM X 10 MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270689949
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SCREW VAL TI 1.6 MM X 8 MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270689948
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SCREW VAL TI 1.6 MM X 8 MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270689948
Hospital Revenue Code	278
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

SCREW VAL TI 1.6X6MM

Facility

$760.50

Service Code	HCPCS C1713
Hospital Charge Code	270699304
Hospital Revenue Code	278
Min. Negotiated Rate	$114.08
Max. Negotiated Rate	$184.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$152.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$167.31
Rate for Payer: Qualcare PPO/HMO/WC	$114.08

SCREW VAL TI 1.6X6MM

Facility

$760.50

Service Code	HCPCS C1713
Hospital Charge Code	270699304
Hospital Revenue Code	278
Min. Negotiated Rate	$18.33
Max. Negotiated Rate	$380.25
Rate for Payer: Aetna Commercial	$288.99
Rate for Payer: Aetna Medicare Advantage	$228.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$193.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$193.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$152.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$193.93
Rate for Payer: Cigna Commercial	$380.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$167.31
Rate for Payer: Qualcare PPO/HMO/WC	$114.08
Rate for Payer: UnitedHealthcare Community & State	$18.33
Rate for Payer: Wellpoint Medicaid Managed Care	$20.15

SCREW VAL TI 2.0 MMX 16 MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270689952
Hospital Revenue Code	278
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

SCREW VAL TI 2.0 MMX 16 MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270689952
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SCREW VAL TI 2.0 X 10 MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270689808
Hospital Revenue Code	278
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

SCREW VAL TI 2.0 X 10 MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270689808
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SCREW VAL TI 2.0 X 12 MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270689807
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SCREW VAL TI 2.0 X 12 MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270689807
Hospital Revenue Code	278
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

SCREW VAL TI 2.0 X 14 MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270689951
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SCREW VAL TI 2.0 X 14 MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270689951
Hospital Revenue Code	278
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

SCREW VAL TI 2.0X6MM

Facility

$760.50

Service Code	HCPCS C1713
Hospital Charge Code	270699865
Hospital Revenue Code	278
Min. Negotiated Rate	$114.08
Max. Negotiated Rate	$184.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$152.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$167.31
Rate for Payer: Qualcare PPO/HMO/WC	$114.08

SCREW VAL TI 2.0X6MM

Facility

$760.50

Service Code	HCPCS C1713
Hospital Charge Code	270699865
Hospital Revenue Code	278
Min. Negotiated Rate	$18.33
Max. Negotiated Rate	$380.25
Rate for Payer: Aetna Commercial	$288.99
Rate for Payer: Aetna Medicare Advantage	$228.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$193.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$193.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$152.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$193.93
Rate for Payer: Cigna Commercial	$380.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$167.31
Rate for Payer: Qualcare PPO/HMO/WC	$114.08
Rate for Payer: UnitedHealthcare Community & State	$18.33
Rate for Payer: Wellpoint Medicaid Managed Care	$20.15

SCREW VAL TI 2.0X7MM

Facility

$760.50

Service Code	HCPCS C1713
Hospital Charge Code	270699866
Hospital Revenue Code	278
Min. Negotiated Rate	$114.08
Max. Negotiated Rate	$184.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$152.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$167.31
Rate for Payer: Qualcare PPO/HMO/WC	$114.08

SCREW VAL TI 2.0X7MM

Facility

$760.50

Service Code	HCPCS C1713
Hospital Charge Code	270699866
Hospital Revenue Code	278
Min. Negotiated Rate	$18.33
Max. Negotiated Rate	$380.25
Rate for Payer: Aetna Commercial	$288.99
Rate for Payer: Aetna Medicare Advantage	$228.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$193.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$193.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$152.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$193.93
Rate for Payer: Cigna Commercial	$380.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$167.31
Rate for Payer: Qualcare PPO/HMO/WC	$114.08
Rate for Payer: UnitedHealthcare Community & State	$18.33
Rate for Payer: Wellpoint Medicaid Managed Care	$20.15

SCREW VAL TI 2.0 X 8 MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270689806
Hospital Revenue Code	278
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

SCREW VAL TI 2.0 X 8 MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270689806
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SCREW VALTI 2.4 X 14MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270687864
Hospital Revenue Code	278
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

SCREW VALTI 2.4 X 14MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270687864
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SCREW VAL TI 2.4X16MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270690223
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

SCREW VAL TI 2.4X16MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270690223
Hospital Revenue Code	278
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

SCREW VAL TI 2X24MM

Facility

$721.00

Service Code	HCPCS C1713
Hospital Charge Code	270702063
Hospital Revenue Code	278
Min. Negotiated Rate	$17.38
Max. Negotiated Rate	$360.50
Rate for Payer: Aetna Commercial	$273.98
Rate for Payer: Aetna Medicare Advantage	$216.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.85
Rate for Payer: Cigna Commercial	$360.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.62
Rate for Payer: Qualcare PPO/HMO/WC	$108.15
Rate for Payer: UnitedHealthcare Community & State	$17.38
Rate for Payer: Wellpoint Medicaid Managed Care	$19.11

SCREW VAL TI 2X24MM

Facility

$721.00

Service Code	HCPCS C1713
Hospital Charge Code	270702063
Hospital Revenue Code	278
Min. Negotiated Rate	$108.15
Max. Negotiated Rate	$174.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.62
Rate for Payer: Qualcare PPO/HMO/WC	$108.15

Know your out-of-pocket cost for care.

All Charges