Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LAG SCREW CANN CANC 4x36MM

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270673657
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

LAG SCREW CANN CANC 4x38MM

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270673658
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

LAG SCREW CANN CANC 4x38MM

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270673658
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

LAG SCREW CANN CANC 4x42MM

Facility

$797.50

Service Code	HCPCS C1713
Hospital Charge Code	270673659
Hospital Revenue Code	278
Min. Negotiated Rate	$119.62
Max. Negotiated Rate	$193.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$119.62

LAG SCREW CANN CANC 4x42MM

Facility

$797.50

Service Code	HCPCS C1713
Hospital Charge Code	270673659
Hospital Revenue Code	278
Min. Negotiated Rate	$19.22
Max. Negotiated Rate	$398.75
Rate for Payer: Aetna Commercial	$303.05
Rate for Payer: Aetna Medicare Advantage	$239.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$203.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$203.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$203.36
Rate for Payer: Cigna Commercial	$398.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$119.62
Rate for Payer: UnitedHealthcare Community & State	$19.22
Rate for Payer: Wellpoint Medicaid Managed Care	$21.13

LAG SCREW CANN CANC 4x42MM

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270663214
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

LAG SCREW CANN CANC 4x42MM

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270663214
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

LAG SCREW CANN CANC 4x46MM

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270673660
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

LAG SCREW CANN CANC 4x46MM

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270673660
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

LAG SCREW SOLID FIXED 85mm

Facility

$2,725.00

Hospital Charge Code	270644154
Hospital Revenue Code	278
Min. Negotiated Rate	$65.67
Max. Negotiated Rate	$1,362.50
Rate for Payer: Aetna Commercial	$1,035.50
Rate for Payer: Aetna Medicare Advantage	$817.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$694.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$694.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$545.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$694.88
Rate for Payer: Cigna Commercial	$1,362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$599.50
Rate for Payer: Qualcare PPO/HMO/WC	$408.75
Rate for Payer: UnitedHealthcare Community & State	$65.67
Rate for Payer: Wellpoint Medicaid Managed Care	$72.21

LAG SCREW SOLID FIXED 85mm

Facility

$2,725.00

Hospital Charge Code	270644154
Hospital Revenue Code	278
Min. Negotiated Rate	$408.75
Max. Negotiated Rate	$659.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$545.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$599.50
Rate for Payer: Qualcare PPO/HMO/WC	$408.75

LAG SCREW SOLID SLIDING 115 MM

Facility

$2,230.00

Service Code	HCPCS C1713
Hospital Charge Code	270681679
Hospital Revenue Code	278
Min. Negotiated Rate	$53.74
Max. Negotiated Rate	$1,115.00
Rate for Payer: Aetna Commercial	$847.40
Rate for Payer: Aetna Medicare Advantage	$669.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$568.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$568.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$446.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$568.65
Rate for Payer: Cigna Commercial	$1,115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$539.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$490.60
Rate for Payer: Qualcare PPO/HMO/WC	$334.50
Rate for Payer: UnitedHealthcare Community & State	$53.74
Rate for Payer: Wellpoint Medicaid Managed Care	$59.09

LAG SCREW SOLID SLIDING 115 MM

Facility

$2,230.00

Service Code	HCPCS C1713
Hospital Charge Code	270681679
Hospital Revenue Code	278
Min. Negotiated Rate	$334.50
Max. Negotiated Rate	$539.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$446.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$539.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$490.60
Rate for Payer: Qualcare PPO/HMO/WC	$334.50

LAG SCREW SOLID SLIDING 75MM

Facility

$2,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270685415
Hospital Revenue Code	278
Min. Negotiated Rate	$348.75
Max. Negotiated Rate	$562.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$511.50
Rate for Payer: Qualcare PPO/HMO/WC	$348.75

LAG SCREW SOLID SLIDING 75MM

Facility

$2,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270685415
Hospital Revenue Code	278
Min. Negotiated Rate	$56.03
Max. Negotiated Rate	$1,162.50
Rate for Payer: Aetna Commercial	$883.50
Rate for Payer: Aetna Medicare Advantage	$697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.88
Rate for Payer: Cigna Commercial	$1,162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$511.50
Rate for Payer: Qualcare PPO/HMO/WC	$348.75
Rate for Payer: UnitedHealthcare Community & State	$56.03
Rate for Payer: Wellpoint Medicaid Managed Care	$61.61

LAG SCREW TI 10.5MMX95MM

Facility

$3,685.00

Service Code	HCPCS C1713
Hospital Charge Code	270656522
Hospital Revenue Code	278
Min. Negotiated Rate	$88.81
Max. Negotiated Rate	$1,842.50
Rate for Payer: Aetna Commercial	$1,400.30
Rate for Payer: Aetna Medicare Advantage	$1,105.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$939.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$939.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$737.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$939.67
Rate for Payer: Cigna Commercial	$1,842.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$891.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$810.70
Rate for Payer: Qualcare PPO/HMO/WC	$552.75
Rate for Payer: UnitedHealthcare Community & State	$88.81
Rate for Payer: Wellpoint Medicaid Managed Care	$97.65

LAG SCREW TI 10.5MMX95MM

Facility

$3,685.00

Service Code	HCPCS C1713
Hospital Charge Code	270656522
Hospital Revenue Code	278
Min. Negotiated Rate	$552.75
Max. Negotiated Rate	$891.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$737.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$891.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$810.70
Rate for Payer: Qualcare PPO/HMO/WC	$552.75

LAG SCREW TI 10.5x80MM

Facility

$3,077.10

Hospital Charge Code	270663318
Hospital Revenue Code	278
Min. Negotiated Rate	$461.56
Max. Negotiated Rate	$744.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$615.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$744.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$676.96
Rate for Payer: Qualcare PPO/HMO/WC	$461.56

LAG SCREW TI 10.5x80MM

Facility

$3,077.10

Hospital Charge Code	270663318
Hospital Revenue Code	278
Min. Negotiated Rate	$74.16
Max. Negotiated Rate	$1,538.55
Rate for Payer: Aetna Commercial	$1,169.30
Rate for Payer: Aetna Medicare Advantage	$923.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$784.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$784.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$615.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$784.66
Rate for Payer: Cigna Commercial	$1,538.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$744.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$676.96
Rate for Payer: Qualcare PPO/HMO/WC	$461.56
Rate for Payer: UnitedHealthcare Community & State	$74.16
Rate for Payer: Wellpoint Medicaid Managed Care	$81.54

LAMELLAR BLADE

Facility

$190.00

Hospital Charge Code	270332568
Hospital Revenue Code	272
Min. Negotiated Rate	$28.50
Max. Negotiated Rate	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.50

LAMELLAR BLADE

Facility

$190.00

Hospital Charge Code	270332568
Hospital Revenue Code	272
Min. Negotiated Rate	$4.58
Max. Negotiated Rate	$95.00
Rate for Payer: Aetna Commercial	$72.20
Rate for Payer: Aetna Medicare Advantage	$57.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.45
Rate for Payer: Cigna Commercial	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.00
Rate for Payer: Oxford Commercial	$38.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.50
Rate for Payer: UnitedHealthcare Commercial	$38.00
Rate for Payer: UnitedHealthcare Community & State	$4.58
Rate for Payer: Wellpoint Medicaid Managed Care	$5.04

LAM FACETC/FRMT ARTHRD LUM 1

Facility

$1,133.60

Service Code	HCPCS 63052
Hospital Charge Code	16001022
Hospital Revenue Code	360
Min. Negotiated Rate	$170.04
Max. Negotiated Rate	$170.04
Rate for Payer: Qualcare PPO/HMO/WC	$170.04

LAM FACETC/FRMT ARTHRD LUM 1

Facility

$1,133.60

Service Code	HCPCS 63052
Hospital Charge Code	16001022
Hospital Revenue Code	360
Min. Negotiated Rate	$27.32
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$430.77
Rate for Payer: Aetna Medicare Advantage	$340.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$289.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$289.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$289.07
Rate for Payer: Cigna Commercial	$566.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$340.08
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$170.04
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$27.32
Rate for Payer: Wellpoint Medicaid Managed Care	$30.04

LAM FACTC/FRMT ARTHRD LUM EA

Facility

$848.24

Service Code	HCPCS 63053
Hospital Charge Code	16001023
Hospital Revenue Code	360
Min. Negotiated Rate	$127.24
Max. Negotiated Rate	$127.24
Rate for Payer: Qualcare PPO/HMO/WC	$127.24

LAM FACTC/FRMT ARTHRD LUM EA

Facility

$848.24

Service Code	HCPCS 63053
Hospital Charge Code	16001023
Hospital Revenue Code	360
Min. Negotiated Rate	$20.44
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$322.33
Rate for Payer: Aetna Medicare Advantage	$254.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.30
Rate for Payer: Cigna Commercial	$424.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.47
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.24
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$20.44
Rate for Payer: Wellpoint Medicaid Managed Care	$22.48

Know your out-of-pocket cost for care.

All Charges