Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW FREE LOCK LAG STD 13TH.

Facility

$623.15

Service Code	HCPCS C1713
Hospital Charge Code	270656363
Hospital Revenue Code	278
Min. Negotiated Rate	$93.47
Max. Negotiated Rate	$150.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.09
Rate for Payer: Qualcare PPO/HMO/WC	$93.47

SCREW FREE LOCK LAG STD 13TH.

Facility

$623.15

Hospital Charge Code	270656348
Hospital Revenue Code	278
Min. Negotiated Rate	$93.47
Max. Negotiated Rate	$150.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.09
Rate for Payer: Qualcare PPO/HMO/WC	$93.47

SCREW FREE LOCK LAG STD 13TH.

Facility

$623.15

Service Code	HCPCS C1713
Hospital Charge Code	270656363
Hospital Revenue Code	278
Min. Negotiated Rate	$15.02
Max. Negotiated Rate	$311.57
Rate for Payer: Aetna Commercial	$236.80
Rate for Payer: Aetna Medicare Advantage	$186.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.90
Rate for Payer: Cigna Commercial	$311.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.09
Rate for Payer: Qualcare PPO/HMO/WC	$93.47
Rate for Payer: UnitedHealthcare Community & State	$15.02
Rate for Payer: Wellpoint Medicaid Managed Care	$16.51

SCREW FREE LOCK LAG STD 13THD

Facility

$756.00

Service Code	HCPCS C1713
Hospital Charge Code	270650797
Hospital Revenue Code	278
Min. Negotiated Rate	$113.40
Max. Negotiated Rate	$182.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$151.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$166.32
Rate for Payer: Qualcare PPO/HMO/WC	$113.40

SCREW FREE LOCK LAG STD 13THD

Facility

$756.00

Service Code	HCPCS C1713
Hospital Charge Code	270650797
Hospital Revenue Code	278
Min. Negotiated Rate	$18.22
Max. Negotiated Rate	$378.00
Rate for Payer: Aetna Commercial	$287.28
Rate for Payer: Aetna Medicare Advantage	$226.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$151.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.78
Rate for Payer: Cigna Commercial	$378.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$166.32
Rate for Payer: Qualcare PPO/HMO/WC	$113.40
Rate for Payer: UnitedHealthcare Community & State	$18.22
Rate for Payer: Wellpoint Medicaid Managed Care	$20.03

SCREW FREELOCK LAG STD 13THD.

Facility

$623.15

Hospital Charge Code	270656350
Hospital Revenue Code	278
Min. Negotiated Rate	$15.02
Max. Negotiated Rate	$311.57
Rate for Payer: Aetna Commercial	$236.80
Rate for Payer: Aetna Medicare Advantage	$186.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.90
Rate for Payer: Cigna Commercial	$311.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.09
Rate for Payer: Qualcare PPO/HMO/WC	$93.47
Rate for Payer: UnitedHealthcare Community & State	$15.02
Rate for Payer: Wellpoint Medicaid Managed Care	$16.51

SCREW FREELOCK LAG STD 13THD.

Facility

$623.15

Hospital Charge Code	270656350
Hospital Revenue Code	278
Min. Negotiated Rate	$93.47
Max. Negotiated Rate	$150.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.09
Rate for Payer: Qualcare PPO/HMO/WC	$93.47

SCREW FRLK 12.7T 55mm 11810520

Facility

$855.25

Hospital Charge Code	270625764
Hospital Revenue Code	278
Min. Negotiated Rate	$128.29
Max. Negotiated Rate	$206.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$188.16
Rate for Payer: Qualcare PPO/HMO/WC	$128.29

SCREW FRLK 12.7T 55mm 11810520

Facility

$855.25

Hospital Charge Code	270625764
Hospital Revenue Code	278
Min. Negotiated Rate	$20.61
Max. Negotiated Rate	$427.62
Rate for Payer: Aetna Commercial	$325.00
Rate for Payer: Aetna Medicare Advantage	$256.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.09
Rate for Payer: Cigna Commercial	$427.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$188.16
Rate for Payer: Qualcare PPO/HMO/WC	$128.29
Rate for Payer: UnitedHealthcare Community & State	$20.61
Rate for Payer: Wellpoint Medicaid Managed Care	$22.66

SCREW FRLOK COMP LAG 115MM

Facility

$602.00

Hospital Charge Code	1605211
Hospital Revenue Code	274
Min. Negotiated Rate	$14.51
Max. Negotiated Rate	$301.00
Rate for Payer: Aetna Commercial	$228.76
Rate for Payer: Aetna Medicare Advantage	$180.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.51
Rate for Payer: Cigna Commercial	$301.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.44
Rate for Payer: Qualcare PPO/HMO/WC	$90.30
Rate for Payer: UnitedHealthcare Community & State	$14.51
Rate for Payer: Wellpoint Medicaid Managed Care	$15.95

SCREW FRLOK COMP LAG 115MM

Facility

$602.00

Hospital Charge Code	1605211
Hospital Revenue Code	274
Min. Negotiated Rate	$90.30
Max. Negotiated Rate	$145.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.44
Rate for Payer: Qualcare PPO/HMO/WC	$90.30

SCREW FRLOK COMP LAG 120MM

Facility

$602.00

Hospital Charge Code	1605245
Hospital Revenue Code	274
Min. Negotiated Rate	$90.30
Max. Negotiated Rate	$145.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.44
Rate for Payer: Qualcare PPO/HMO/WC	$90.30

SCREW FRLOK COMP LAG 120MM

Facility

$602.00

Hospital Charge Code	1605245
Hospital Revenue Code	274
Min. Negotiated Rate	$14.51
Max. Negotiated Rate	$301.00
Rate for Payer: Aetna Commercial	$228.76
Rate for Payer: Aetna Medicare Advantage	$180.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.51
Rate for Payer: Cigna Commercial	$301.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.44
Rate for Payer: Qualcare PPO/HMO/WC	$90.30
Rate for Payer: UnitedHealthcare Community & State	$14.51
Rate for Payer: Wellpoint Medicaid Managed Care	$15.95

SCREW FRLOK COMP LAG 125MM

Facility

$602.00

Hospital Charge Code	1605237
Hospital Revenue Code	274
Min. Negotiated Rate	$14.51
Max. Negotiated Rate	$301.00
Rate for Payer: Aetna Commercial	$228.76
Rate for Payer: Aetna Medicare Advantage	$180.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.51
Rate for Payer: Cigna Commercial	$301.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.44
Rate for Payer: Qualcare PPO/HMO/WC	$90.30
Rate for Payer: UnitedHealthcare Community & State	$14.51
Rate for Payer: Wellpoint Medicaid Managed Care	$15.95

SCREW FRLOK COMP LAG 125MM

Facility

$602.00

Hospital Charge Code	1605237
Hospital Revenue Code	274
Min. Negotiated Rate	$90.30
Max. Negotiated Rate	$145.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.44
Rate for Payer: Qualcare PPO/HMO/WC	$90.30

SCREW FRLOK COMP LAG 130MM

Facility

$602.00

Hospital Charge Code	1605229
Hospital Revenue Code	274
Min. Negotiated Rate	$90.30
Max. Negotiated Rate	$145.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.44
Rate for Payer: Qualcare PPO/HMO/WC	$90.30

SCREW FRLOK COMP LAG 130MM

Facility

$602.00

Hospital Charge Code	1605229
Hospital Revenue Code	274
Min. Negotiated Rate	$14.51
Max. Negotiated Rate	$301.00
Rate for Payer: Aetna Commercial	$228.76
Rate for Payer: Aetna Medicare Advantage	$180.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.51
Rate for Payer: Cigna Commercial	$301.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.44
Rate for Payer: Qualcare PPO/HMO/WC	$90.30
Rate for Payer: UnitedHealthcare Community & State	$14.51
Rate for Payer: Wellpoint Medicaid Managed Care	$15.95

SCREW FRLOK COMP LAG 60MM

Facility

$602.00

Hospital Charge Code	1605195
Hospital Revenue Code	274
Min. Negotiated Rate	$90.30
Max. Negotiated Rate	$145.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.44
Rate for Payer: Qualcare PPO/HMO/WC	$90.30

SCREW FRLOK COMP LAG 60MM

Facility

$602.00

Hospital Charge Code	1605195
Hospital Revenue Code	274
Min. Negotiated Rate	$14.51
Max. Negotiated Rate	$301.00
Rate for Payer: Aetna Commercial	$228.76
Rate for Payer: Aetna Medicare Advantage	$180.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.51
Rate for Payer: Cigna Commercial	$301.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.44
Rate for Payer: Qualcare PPO/HMO/WC	$90.30
Rate for Payer: UnitedHealthcare Community & State	$14.51
Rate for Payer: Wellpoint Medicaid Managed Care	$15.95

SCREW FRLOK COMP LAG 65MM

Facility

$602.00

Hospital Charge Code	1605203
Hospital Revenue Code	274
Min. Negotiated Rate	$14.51
Max. Negotiated Rate	$301.00
Rate for Payer: Aetna Commercial	$228.76
Rate for Payer: Aetna Medicare Advantage	$180.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.51
Rate for Payer: Cigna Commercial	$301.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.44
Rate for Payer: Qualcare PPO/HMO/WC	$90.30
Rate for Payer: UnitedHealthcare Community & State	$14.51
Rate for Payer: Wellpoint Medicaid Managed Care	$15.95

SCREW FRLOK COMP LAG 65MM

Facility

$602.00

Hospital Charge Code	1605203
Hospital Revenue Code	274
Min. Negotiated Rate	$90.30
Max. Negotiated Rate	$145.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.44
Rate for Payer: Qualcare PPO/HMO/WC	$90.30

SCREW FRLOK COMP LAG 90MM

Facility

$951.25

Hospital Charge Code	270606022
Hospital Revenue Code	278
Min. Negotiated Rate	$22.93
Max. Negotiated Rate	$475.62
Rate for Payer: Aetna Commercial	$361.48
Rate for Payer: Aetna Medicare Advantage	$285.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.57
Rate for Payer: Cigna Commercial	$475.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.28
Rate for Payer: Qualcare PPO/HMO/WC	$142.69
Rate for Payer: UnitedHealthcare Community & State	$22.93
Rate for Payer: Wellpoint Medicaid Managed Care	$25.21

SCREW FRLOK COMP LAG 90MM

Facility

$951.25

Hospital Charge Code	270606022
Hospital Revenue Code	278
Min. Negotiated Rate	$142.69
Max. Negotiated Rate	$230.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$209.28
Rate for Payer: Qualcare PPO/HMO/WC	$142.69

SCREW FRLOK SHORT LAG 65MM

Facility

$708.00

Hospital Charge Code	1605153
Hospital Revenue Code	274
Min. Negotiated Rate	$17.06
Max. Negotiated Rate	$354.00
Rate for Payer: Aetna Commercial	$269.04
Rate for Payer: Aetna Medicare Advantage	$212.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$180.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$180.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$180.54
Rate for Payer: Cigna Commercial	$354.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$155.76
Rate for Payer: Qualcare PPO/HMO/WC	$106.20
Rate for Payer: UnitedHealthcare Community & State	$17.06
Rate for Payer: Wellpoint Medicaid Managed Care	$18.76

SCREW FRLOK SHORT LAG 65MM

Facility

$708.00

Hospital Charge Code	1605153
Hospital Revenue Code	274
Min. Negotiated Rate	$106.20
Max. Negotiated Rate	$171.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$155.76
Rate for Payer: Qualcare PPO/HMO/WC	$106.20

Know your out-of-pocket cost for care.

All Charges