Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LOCK SCREW 1.5X16MM

Facility

$687.50

Hospital Charge Code	270702798
Hospital Revenue Code	278
Min. Negotiated Rate	$103.12
Max. Negotiated Rate	$166.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$103.12

LOCK SCREW 1.5X16MM

Facility

$687.50

Hospital Charge Code	270702798
Hospital Revenue Code	278
Min. Negotiated Rate	$16.57
Max. Negotiated Rate	$343.75
Rate for Payer: Aetna Commercial	$261.25
Rate for Payer: Aetna Medicare Advantage	$206.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.31
Rate for Payer: Cigna Commercial	$343.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$103.12
Rate for Payer: UnitedHealthcare Community & State	$16.57
Rate for Payer: Wellpoint Medicaid Managed Care	$18.22

LOCK SCREW 3.5 X 12MM

Facility

$522.40

Service Code	HCPCS C1713
Hospital Charge Code	270657756
Hospital Revenue Code	278
Min. Negotiated Rate	$12.59
Max. Negotiated Rate	$261.20
Rate for Payer: Aetna Commercial	$198.51
Rate for Payer: Aetna Medicare Advantage	$156.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.21
Rate for Payer: Cigna Commercial	$261.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.93
Rate for Payer: Qualcare PPO/HMO/WC	$78.36
Rate for Payer: UnitedHealthcare Community & State	$12.59
Rate for Payer: Wellpoint Medicaid Managed Care	$13.84

LOCK SCREW 3.5 X 12MM

Facility

$522.40

Service Code	HCPCS C1713
Hospital Charge Code	270657756
Hospital Revenue Code	278
Min. Negotiated Rate	$78.36
Max. Negotiated Rate	$126.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.93
Rate for Payer: Qualcare PPO/HMO/WC	$78.36

LOCK SCREW 3.5 X 14MM

Facility

$522.40

Service Code	HCPCS C1713
Hospital Charge Code	270657758
Hospital Revenue Code	278
Min. Negotiated Rate	$12.59
Max. Negotiated Rate	$261.20
Rate for Payer: Aetna Commercial	$198.51
Rate for Payer: Aetna Medicare Advantage	$156.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.21
Rate for Payer: Cigna Commercial	$261.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.93
Rate for Payer: Qualcare PPO/HMO/WC	$78.36
Rate for Payer: UnitedHealthcare Community & State	$12.59
Rate for Payer: Wellpoint Medicaid Managed Care	$13.84

LOCK SCREW 3.5 X 14MM

Facility

$522.40

Service Code	HCPCS C1713
Hospital Charge Code	270657758
Hospital Revenue Code	278
Min. Negotiated Rate	$78.36
Max. Negotiated Rate	$126.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.93
Rate for Payer: Qualcare PPO/HMO/WC	$78.36

LOCK SCREW DRIVER

Facility

$2,595.00

Hospital Charge Code	270656530
Hospital Revenue Code	278
Min. Negotiated Rate	$62.54
Max. Negotiated Rate	$1,297.50
Rate for Payer: Aetna Commercial	$986.10
Rate for Payer: Aetna Medicare Advantage	$778.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$661.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$661.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$519.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$661.73
Rate for Payer: Cigna Commercial	$1,297.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$627.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$570.90
Rate for Payer: Qualcare PPO/HMO/WC	$389.25
Rate for Payer: UnitedHealthcare Community & State	$62.54
Rate for Payer: Wellpoint Medicaid Managed Care	$68.77

LOCK SCREW DRIVER

Facility

$2,595.00

Hospital Charge Code	270656530
Hospital Revenue Code	278
Min. Negotiated Rate	$389.25
Max. Negotiated Rate	$627.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$519.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$627.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$570.90
Rate for Payer: Qualcare PPO/HMO/WC	$389.25

LOCK SCREW SQUARE 2.7 MM X 12M

Facility

$650.00

Hospital Charge Code	270663852
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

LOCK SCREW SQUARE 2.7 MM X 12M

Facility

$650.00

Hospital Charge Code	270663852
Hospital Revenue Code	278
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

LOCK SCREW SQUARE 2.7MM X 16MM

Facility

$522.50

Service Code	HCPCS C1713
Hospital Charge Code	270688184
Hospital Revenue Code	278
Min. Negotiated Rate	$12.59
Max. Negotiated Rate	$261.25
Rate for Payer: Aetna Commercial	$198.55
Rate for Payer: Aetna Medicare Advantage	$156.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.24
Rate for Payer: Cigna Commercial	$261.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$78.38
Rate for Payer: UnitedHealthcare Community & State	$12.59
Rate for Payer: Wellpoint Medicaid Managed Care	$13.85

LOCK SCREW SQUARE 2.7MM X 16MM

Facility

$522.50

Service Code	HCPCS C1713
Hospital Charge Code	270688184
Hospital Revenue Code	278
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$126.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

LOCK SCREW SQUARE 2.7MM X 18MM

Facility

$980.00

Service Code	HCPCS C1713
Hospital Charge Code	270688185
Hospital Revenue Code	278
Min. Negotiated Rate	$23.62
Max. Negotiated Rate	$490.00
Rate for Payer: Aetna Commercial	$372.40
Rate for Payer: Aetna Medicare Advantage	$294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.90
Rate for Payer: Cigna Commercial	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$215.60
Rate for Payer: Qualcare PPO/HMO/WC	$147.00
Rate for Payer: UnitedHealthcare Community & State	$23.62
Rate for Payer: Wellpoint Medicaid Managed Care	$25.97

LOCK SCREW SQUARE 2.7MM X 18MM

Facility

$980.00

Service Code	HCPCS C1713
Hospital Charge Code	270688185
Hospital Revenue Code	278
Min. Negotiated Rate	$147.00
Max. Negotiated Rate	$237.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$215.60
Rate for Payer: Qualcare PPO/HMO/WC	$147.00

LOCK SCREW SQUARE 2.7MM X 24MM

Facility

$650.00

Service Code	HCPCS C1776
Hospital Charge Code	270663849
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

LOCK SCREW SQUARE 2.7MM X 24MM

Facility

$650.00

Service Code	HCPCS C1776
Hospital Charge Code	270663849
Hospital Revenue Code	278
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

LOCM IODINE VISIPA PER ML

Facility

$8.00

Hospital Charge Code	7411325
Hospital Revenue Code	255
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$3.04
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.40
Rate for Payer: Oxford Commercial	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$1.60
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

LOCM IODINE VISIPA PER ML

Facility

$8.00

Hospital Charge Code	7411327
Hospital Revenue Code	255
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

LOCM IODINE VISIPA PER ML

Facility

$8.00

Hospital Charge Code	7411325
Hospital Revenue Code	255
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

LOCM IODINE VISIPA PER ML

Facility

$8.00

Hospital Charge Code	7411327
Hospital Revenue Code	255
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$3.04
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.40
Rate for Payer: Oxford Commercial	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$1.60
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

LOCOSAMIDE UNIT 50MG/5ML

Facility

$291.12

Service Code	NDC 904746466
Hospital Charge Code	606390602
Hospital Revenue Code	250
Min. Negotiated Rate	$7.02
Max. Negotiated Rate	$145.56
Rate for Payer: Aetna Commercial	$110.63
Rate for Payer: Aetna Medicare Advantage	$87.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.24
Rate for Payer: Cigna Commercial	$145.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.34
Rate for Payer: Oxford Commercial	$58.22
Rate for Payer: Qualcare PPO/HMO/WC	$43.67
Rate for Payer: UnitedHealthcare Commercial	$58.22
Rate for Payer: UnitedHealthcare Community & State	$7.02
Rate for Payer: Wellpoint Medicaid Managed Care	$7.71

LOCOSAMIDE UNIT 50MG/5ML

Facility

$291.12

Service Code	NDC 904746466
Hospital Charge Code	606390602
Hospital Revenue Code	250
Min. Negotiated Rate	$43.67
Max. Negotiated Rate	$43.67
Rate for Payer: Qualcare PPO/HMO/WC	$43.67

LODA UNIT TA 30 4.8 015713

Facility

$263.50

Hospital Charge Code	270600053
Hospital Revenue Code	270
Min. Negotiated Rate	$39.52
Max. Negotiated Rate	$39.52
Rate for Payer: Qualcare PPO/HMO/WC	$39.52

LODA UNIT TA 30 4.8 015713

Facility

$263.50

Hospital Charge Code	270600053
Hospital Revenue Code	270
Min. Negotiated Rate	$6.35
Max. Negotiated Rate	$131.75
Rate for Payer: Aetna Commercial	$100.13
Rate for Payer: Aetna Medicare Advantage	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.19
Rate for Payer: Cigna Commercial	$131.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.05
Rate for Payer: Oxford Commercial	$52.70
Rate for Payer: Qualcare PPO/HMO/WC	$39.52
Rate for Payer: UnitedHealthcare Commercial	$52.70
Rate for Payer: UnitedHealthcare Community & State	$6.35
Rate for Payer: Wellpoint Medicaid Managed Care	$6.98

LOGOL'S SOLN/15ML

Facility

$56.00

Hospital Charge Code	60634571
Hospital Revenue Code	250
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

Know your out-of-pocket cost for care.

All Charges