Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW FRLOK SHORT LAG 70MM

Facility

$708.00

Hospital Charge Code	1605146
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 70MM

Facility

$708.00

Hospital Charge Code	1605146
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

SCREW FRLOK SHORT LAG 80MM

Facility

$708.00

Hospital Charge Code	1605161
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 80MM

Facility

$708.00

Hospital Charge Code	1605161
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

SCREW FRLOK SHORT LAG 85MM

Facility

$708.00

Hospital Charge Code	1605179
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

SCREW FRLOK SHORT LAG 85MM

Facility

$708.00

Hospital Charge Code	1605179
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 90MM

Facility

$708.00

Hospital Charge Code	1605187
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

SCREW FRLOK SHORT LAG 90MM

Facility

$708.00

Hospital Charge Code	1605187
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 STD LAG 55-140MM**

Facility

$733.00

Hospital Charge Code	1605708
Hospital Revenue Code	274
Min. Negotiated Rate	$109.95
Max. Negotiated Rate	$177.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$161.26
Rate for Payer: Qualcare PPO/HMO/WC	$109.95

SCREW FRLOK STD LAG 55-140MM**

Facility

$733.00

Hospital Charge Code	1605708
Hospital Revenue Code	274
Min. Negotiated Rate	$17.67
Max. Negotiated Rate	$366.50
Rate for Payer: Aetna Commercial	$278.54
Rate for Payer: Aetna Medicare Advantage	$219.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.91
Rate for Payer: Cigna Commercial	$366.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$161.26
Rate for Payer: Qualcare PPO/HMO/WC	$109.95
Rate for Payer: UnitedHealthcare Community & State	$17.67
Rate for Payer: Wellpoint Medicaid Managed Care	$19.42

SCREW FSD 4.0X10MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695488
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW FSD 4.0X10MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695488
Hospital Revenue Code	278
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

SCREW FT COMP 4.0X42MM

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270698524
Hospital Revenue Code	278
Min. Negotiated Rate	$45.74
Max. Negotiated Rate	$949.00
Rate for Payer: Aetna Commercial	$721.24
Rate for Payer: Aetna Medicare Advantage	$569.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$483.99
Rate for Payer: Cigna Commercial	$949.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$417.56
Rate for Payer: Qualcare PPO/HMO/WC	$284.70
Rate for Payer: UnitedHealthcare Community & State	$45.74
Rate for Payer: Wellpoint Medicaid Managed Care	$50.30

SCREW FT COMP 4.0X42MM

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270698524
Hospital Revenue Code	278
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$459.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$417.56
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

SCREW FT PANTA2 5.0X26MM

Facility

$3,260.00

Service Code	HCPCS C1713
Hospital Charge Code	270699959
Hospital Revenue Code	278
Min. Negotiated Rate	$78.57
Max. Negotiated Rate	$1,630.00
Rate for Payer: Aetna Commercial	$1,238.80
Rate for Payer: Aetna Medicare Advantage	$978.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$831.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$831.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$652.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$831.30
Rate for Payer: Cigna Commercial	$1,630.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$788.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$717.20
Rate for Payer: Qualcare PPO/HMO/WC	$489.00
Rate for Payer: UnitedHealthcare Community & State	$78.57
Rate for Payer: Wellpoint Medicaid Managed Care	$86.39

SCREW FT PANTA2 5.0X26MM

Facility

$3,260.00

Service Code	HCPCS C1713
Hospital Charge Code	270699959
Hospital Revenue Code	278
Min. Negotiated Rate	$489.00
Max. Negotiated Rate	$788.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$652.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$788.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$717.20
Rate for Payer: Qualcare PPO/HMO/WC	$489.00

SCREWFT SACROILIAC 9.5X50MM

Facility

$18,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270699022
Hospital Revenue Code	278
Min. Negotiated Rate	$2,737.50
Max. Negotiated Rate	$4,416.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,416.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,015.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,737.50

SCREWFT SACROILIAC 9.5X50MM

Facility

$18,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270699022
Hospital Revenue Code	278
Min. Negotiated Rate	$439.82
Max. Negotiated Rate	$9,125.00
Rate for Payer: Aetna Commercial	$6,935.00
Rate for Payer: Aetna Medicare Advantage	$5,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,653.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,653.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,653.75
Rate for Payer: Cigna Commercial	$9,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,416.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,015.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,737.50
Rate for Payer: UnitedHealthcare Community & State	$439.82
Rate for Payer: Wellpoint Medicaid Managed Care	$483.62

SCREW FT T8 2.4X14MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270700504
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW FT T8 2.4X14MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270700504
Hospital Revenue Code	278
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Community & State	$17.47
Rate for Payer: Wellpoint Medicaid Managed Care	$19.21

SCREW FT T8 2.4X18MM

Facility

$727.20

Service Code	HCPCS C1713
Hospital Charge Code	270700505
Hospital Revenue Code	278
Min. Negotiated Rate	$109.08
Max. Negotiated Rate	$175.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.98
Rate for Payer: Qualcare PPO/HMO/WC	$109.08

SCREW FT T8 2.4X18MM

Facility

$727.20

Service Code	HCPCS C1713
Hospital Charge Code	270700505
Hospital Revenue Code	278
Min. Negotiated Rate	$17.53
Max. Negotiated Rate	$363.60
Rate for Payer: Aetna Commercial	$276.34
Rate for Payer: Aetna Medicare Advantage	$218.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.44
Rate for Payer: Cigna Commercial	$363.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.98
Rate for Payer: Qualcare PPO/HMO/WC	$109.08
Rate for Payer: UnitedHealthcare Community & State	$17.53
Rate for Payer: Wellpoint Medicaid Managed Care	$19.27

SCREW FULL CAN 2 X 12 MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701235
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW FULL CAN 2 X 12 MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701235
Hospital Revenue Code	278
Min. Negotiated Rate	$23.20
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$365.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$144.38
Rate for Payer: UnitedHealthcare Community & State	$23.20
Rate for Payer: Wellpoint Medicaid Managed Care	$25.51

SCREW FULL CORTICAL 3.5 X 14 M

Facility

$535.00

Service Code	HCPCS C1713
Hospital Charge Code	270701109
Hospital Revenue Code	278
Min. Negotiated Rate	$80.25
Max. Negotiated Rate	$129.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.70
Rate for Payer: Qualcare PPO/HMO/WC	$80.25

Know your out-of-pocket cost for care.

All Charges