Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE 3.5MM LCP PROX HUMERUS

Facility

$6,498.00

Hospital Charge Code	270656205
Hospital Revenue Code	278
Min. Negotiated Rate	$974.70
Max. Negotiated Rate	$1,572.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,299.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,572.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,429.56
Rate for Payer: Qualcare PPO/HMO/WC	$974.70

PLATE3.5MMLCPPROXTIB8HR145MM

Facility

$8,399.40

Service Code	HCPCS C1713
Hospital Charge Code	270696100
Hospital Revenue Code	278
Min. Negotiated Rate	$1,259.91
Max. Negotiated Rate	$2,032.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,679.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,032.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,847.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,259.91

PLATE3.5MMLCPPROXTIB8HR145MM

Facility

$8,399.40

Service Code	HCPCS C1713
Hospital Charge Code	270696100
Hospital Revenue Code	278
Min. Negotiated Rate	$202.43
Max. Negotiated Rate	$4,199.70
Rate for Payer: Aetna Commercial	$3,191.77
Rate for Payer: Aetna Medicare Advantage	$2,519.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,141.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,141.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,679.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,141.85
Rate for Payer: Cigna Commercial	$4,199.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,032.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,847.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,259.91
Rate for Payer: UnitedHealthcare Community & State	$202.43
Rate for Payer: Wellpoint Medicaid Managed Care	$222.58

PLATE 3.5mm LOCK 5-HOL 2110409

Facility

$4,495.00

Hospital Charge Code	270643386
Hospital Revenue Code	278
Min. Negotiated Rate	$674.25
Max. Negotiated Rate	$1,087.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$899.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,087.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$988.90
Rate for Payer: Qualcare PPO/HMO/WC	$674.25

PLATE 3.5mm LOCK 5-HOL 2110409

Facility

$4,495.00

Hospital Charge Code	270643386
Hospital Revenue Code	278
Min. Negotiated Rate	$108.33
Max. Negotiated Rate	$2,247.50
Rate for Payer: Aetna Commercial	$1,708.10
Rate for Payer: Aetna Medicare Advantage	$1,348.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,146.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,146.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$899.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,146.22
Rate for Payer: Cigna Commercial	$2,247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,087.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$988.90
Rate for Payer: Qualcare PPO/HMO/WC	$674.25
Rate for Payer: UnitedHealthcare Community & State	$108.33
Rate for Payer: Wellpoint Medicaid Managed Care	$119.12

PLATE 3.5 MM POW LOCK

Facility

$6,395.00

Service Code	HCPCS C1713
Hospital Charge Code	270684000
Hospital Revenue Code	278
Min. Negotiated Rate	$959.25
Max. Negotiated Rate	$1,547.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,279.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,547.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,406.90
Rate for Payer: Qualcare PPO/HMO/WC	$959.25

PLATE 3.5 MM POW LOCK

Facility

$6,395.00

Service Code	HCPCS C1713
Hospital Charge Code	270684000
Hospital Revenue Code	278
Min. Negotiated Rate	$154.12
Max. Negotiated Rate	$3,197.50
Rate for Payer: Aetna Commercial	$2,430.10
Rate for Payer: Aetna Medicare Advantage	$1,918.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,630.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,630.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,630.72
Rate for Payer: Cigna Commercial	$3,197.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,547.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,406.90
Rate for Payer: Qualcare PPO/HMO/WC	$959.25
Rate for Payer: UnitedHealthcare Community & State	$154.12
Rate for Payer: Wellpoint Medicaid Managed Care	$169.47

PLATE 3.5MM RECON 6HOLE/70MM

Facility

$1,928.15

Service Code	HCPCS C1713
Hospital Charge Code	270603390
Hospital Revenue Code	278
Min. Negotiated Rate	$46.47
Max. Negotiated Rate	$964.08
Rate for Payer: Aetna Commercial	$732.70
Rate for Payer: Aetna Medicare Advantage	$578.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$491.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$491.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$385.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$491.68
Rate for Payer: Cigna Commercial	$964.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$466.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$424.19
Rate for Payer: Qualcare PPO/HMO/WC	$289.22
Rate for Payer: UnitedHealthcare Community & State	$46.47
Rate for Payer: Wellpoint Medicaid Managed Care	$51.10

PLATE 3.5MM RECON 6HOLE/70MM

Facility

$1,928.15

Service Code	HCPCS C1713
Hospital Charge Code	270603390
Hospital Revenue Code	278
Min. Negotiated Rate	$289.22
Max. Negotiated Rate	$466.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$385.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$466.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$424.19
Rate for Payer: Qualcare PPO/HMO/WC	$289.22

PLATE 3.5MM RECON 7HOLE/82MM

Facility

$1,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270603391
Hospital Revenue Code	278
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.50
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

PLATE 3.5MM RECON 7HOLE/82MM

Facility

$1,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270603391
Hospital Revenue Code	278
Min. Negotiated Rate	$25.91
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$408.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.50
Rate for Payer: Qualcare PPO/HMO/WC	$161.25
Rate for Payer: UnitedHealthcare Community & State	$25.91
Rate for Payer: Wellpoint Medicaid Managed Care	$28.49

PLATE 3.5MM RECON 9HOLES/106MM

Facility

$2,163.00

Service Code	HCPCS C1713
Hospital Charge Code	270655716
Hospital Revenue Code	278
Min. Negotiated Rate	$324.45
Max. Negotiated Rate	$523.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$432.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$523.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$475.86
Rate for Payer: Qualcare PPO/HMO/WC	$324.45

PLATE 3.5MM RECON 9HOLES/106MM

Facility

$2,163.00

Service Code	HCPCS C1713
Hospital Charge Code	270655716
Hospital Revenue Code	278
Min. Negotiated Rate	$52.13
Max. Negotiated Rate	$1,081.50
Rate for Payer: Aetna Commercial	$821.94
Rate for Payer: Aetna Medicare Advantage	$648.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$551.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$551.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$432.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$551.57
Rate for Payer: Cigna Commercial	$1,081.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$523.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$475.86
Rate for Payer: Qualcare PPO/HMO/WC	$324.45
Rate for Payer: UnitedHealthcare Community & State	$52.13
Rate for Payer: Wellpoint Medicaid Managed Care	$57.32

PLATE 3.5MM RECONS

Facility

$2,246.45

Service Code	HCPCS C1713
Hospital Charge Code	270655710
Hospital Revenue Code	278
Min. Negotiated Rate	$54.14
Max. Negotiated Rate	$1,123.22
Rate for Payer: Aetna Commercial	$853.65
Rate for Payer: Aetna Medicare Advantage	$673.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$572.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$572.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$449.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$572.84
Rate for Payer: Cigna Commercial	$1,123.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$543.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$494.22
Rate for Payer: Qualcare PPO/HMO/WC	$336.97
Rate for Payer: UnitedHealthcare Community & State	$54.14
Rate for Payer: Wellpoint Medicaid Managed Care	$59.53

PLATE 3.5MM RECONS

Facility

$2,246.45

Service Code	HCPCS C1713
Hospital Charge Code	270655710
Hospital Revenue Code	278
Min. Negotiated Rate	$336.97
Max. Negotiated Rate	$543.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$449.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$543.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$494.22
Rate for Payer: Qualcare PPO/HMO/WC	$336.97

PLATE 3.5MM RECONST 5

Facility

$1,671.70

Service Code	HCPCS C1713
Hospital Charge Code	270603389
Hospital Revenue Code	278
Min. Negotiated Rate	$40.29
Max. Negotiated Rate	$835.85
Rate for Payer: Aetna Commercial	$635.25
Rate for Payer: Aetna Medicare Advantage	$501.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$334.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$426.28
Rate for Payer: Cigna Commercial	$835.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$404.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$367.77
Rate for Payer: Qualcare PPO/HMO/WC	$250.75
Rate for Payer: UnitedHealthcare Community & State	$40.29
Rate for Payer: Wellpoint Medicaid Managed Care	$44.30

PLATE 3.5MM RECONST 5

Facility

$1,671.70

Service Code	HCPCS C1713
Hospital Charge Code	270603389
Hospital Revenue Code	278
Min. Negotiated Rate	$250.75
Max. Negotiated Rate	$404.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$334.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$404.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$367.77
Rate for Payer: Qualcare PPO/HMO/WC	$250.75

PLATE 3.5MM T3 HOLES OBLIQUE

Facility

$988.80

Service Code	HCPCS C1713
Hospital Charge Code	270655670
Hospital Revenue Code	278
Min. Negotiated Rate	$23.83
Max. Negotiated Rate	$494.40
Rate for Payer: Aetna Commercial	$375.74
Rate for Payer: Aetna Medicare Advantage	$296.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$197.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.14
Rate for Payer: Cigna Commercial	$494.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$217.54
Rate for Payer: Qualcare PPO/HMO/WC	$148.32
Rate for Payer: UnitedHealthcare Community & State	$23.83
Rate for Payer: Wellpoint Medicaid Managed Care	$26.20

PLATE 3.5MM T3 HOLES OBLIQUE

Facility

$988.80

Service Code	HCPCS C1713
Hospital Charge Code	270655670
Hospital Revenue Code	278
Min. Negotiated Rate	$148.32
Max. Negotiated Rate	$239.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$197.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$217.54
Rate for Payer: Qualcare PPO/HMO/WC	$148.32

PLATE 3.5MM T3 HOLES RT ANGLE

Facility

$543.85

Service Code	HCPCS C1713
Hospital Charge Code	270655659
Hospital Revenue Code	278
Min. Negotiated Rate	$13.11
Max. Negotiated Rate	$271.93
Rate for Payer: Aetna Commercial	$206.66
Rate for Payer: Aetna Medicare Advantage	$163.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.68
Rate for Payer: Cigna Commercial	$271.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.65
Rate for Payer: Qualcare PPO/HMO/WC	$81.58
Rate for Payer: UnitedHealthcare Community & State	$13.11
Rate for Payer: Wellpoint Medicaid Managed Care	$14.41

PLATE 3.5MM T3 HOLES RT ANGLE

Facility

$543.85

Service Code	HCPCS C1713
Hospital Charge Code	270655659
Hospital Revenue Code	278
Min. Negotiated Rate	$81.58
Max. Negotiated Rate	$131.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.65
Rate for Payer: Qualcare PPO/HMO/WC	$81.58

PLATE 3.5MM T5 HOLES OBLIQUE

Facility

$1,016.60

Service Code	HCPCS C1713
Hospital Charge Code	270655671
Hospital Revenue Code	278
Min. Negotiated Rate	$152.49
Max. Negotiated Rate	$246.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$223.65
Rate for Payer: Qualcare PPO/HMO/WC	$152.49

PLATE 3.5MM T5 HOLES OBLIQUE

Facility

$1,016.60

Service Code	HCPCS C1713
Hospital Charge Code	270655671
Hospital Revenue Code	278
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$508.30
Rate for Payer: Aetna Commercial	$386.31
Rate for Payer: Aetna Medicare Advantage	$304.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$259.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$259.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$259.23
Rate for Payer: Cigna Commercial	$508.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$223.65
Rate for Payer: Qualcare PPO/HMO/WC	$152.49
Rate for Payer: UnitedHealthcare Community & State	$24.50
Rate for Payer: Wellpoint Medicaid Managed Care	$26.94

PLATE 3.5MM T5 HOLES RT ANGLE

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270603400
Hospital Revenue Code	278
Min. Negotiated Rate	$14.97
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$14.97
Rate for Payer: Wellpoint Medicaid Managed Care	$16.46

PLATE 3.5MM T5 HOLES RT ANGLE

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270603400
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

Know your out-of-pocket cost for care.

All Charges