Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE 4HOLE 64mm MEDIAL LEFT

Facility

$4,116.00

Hospital Charge Code	270643697
Hospital Revenue Code	278
Min. Negotiated Rate	$617.40
Max. Negotiated Rate	$996.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$823.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$996.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$905.52
Rate for Payer: Qualcare PPO/HMO/WC	$617.40

PLATE 4-HOLE REG STR 017040

Facility

$362.15

Hospital Charge Code	270630555
Hospital Revenue Code	278
Min. Negotiated Rate	$54.32
Max. Negotiated Rate	$87.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$79.67
Rate for Payer: Qualcare PPO/HMO/WC	$54.32

PLATE 4-HOLE REG STR 017040

Facility

$362.15

Hospital Charge Code	270630555
Hospital Revenue Code	278
Min. Negotiated Rate	$8.73
Max. Negotiated Rate	$181.07
Rate for Payer: Aetna Commercial	$137.62
Rate for Payer: Aetna Medicare Advantage	$108.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.35
Rate for Payer: Cigna Commercial	$181.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$79.67
Rate for Payer: Qualcare PPO/HMO/WC	$54.32
Rate for Payer: UnitedHealthcare Community & State	$8.73
Rate for Payer: Wellpoint Medicaid Managed Care	$9.60

PLATE 4 HOLES TUBULAR 31MM

Facility

$345.00

Service Code	HCPCS C1713
Hospital Charge Code	270656908
Hospital Revenue Code	278
Min. Negotiated Rate	$8.31
Max. Negotiated Rate	$172.50
Rate for Payer: Aetna Commercial	$131.10
Rate for Payer: Aetna Medicare Advantage	$103.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.97
Rate for Payer: Cigna Commercial	$172.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$75.90
Rate for Payer: Qualcare PPO/HMO/WC	$51.75
Rate for Payer: UnitedHealthcare Community & State	$8.31
Rate for Payer: Wellpoint Medicaid Managed Care	$9.14

PLATE 4 HOLES TUBULAR 31MM

Facility

$345.00

Service Code	HCPCS C1713
Hospital Charge Code	270656908
Hospital Revenue Code	278
Min. Negotiated Rate	$51.75
Max. Negotiated Rate	$83.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$75.90
Rate for Payer: Qualcare PPO/HMO/WC	$51.75

PLATE 4-HOLE X-LONG STR 017048

Facility

$362.15

Hospital Charge Code	270630554
Hospital Revenue Code	278
Min. Negotiated Rate	$54.32
Max. Negotiated Rate	$87.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$79.67
Rate for Payer: Qualcare PPO/HMO/WC	$54.32

PLATE 4-HOLE X-LONG STR 017048

Facility

$362.15

Hospital Charge Code	270630554
Hospital Revenue Code	278
Min. Negotiated Rate	$8.73
Max. Negotiated Rate	$181.07
Rate for Payer: Aetna Commercial	$137.62
Rate for Payer: Aetna Medicare Advantage	$108.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.35
Rate for Payer: Cigna Commercial	$181.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$79.67
Rate for Payer: Qualcare PPO/HMO/WC	$54.32
Rate for Payer: UnitedHealthcare Community & State	$8.73
Rate for Payer: Wellpoint Medicaid Managed Care	$9.60

PLATE 4H ULNA PROXDR 234800904

Facility

$3,156.00

Hospital Charge Code	270632812
Hospital Revenue Code	278
Min. Negotiated Rate	$473.40
Max. Negotiated Rate	$763.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$631.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$763.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$694.32
Rate for Payer: Qualcare PPO/HMO/WC	$473.40

PLATE 4H ULNA PROXDR 234800904

Facility

$3,156.00

Hospital Charge Code	270632812
Hospital Revenue Code	278
Min. Negotiated Rate	$76.06
Max. Negotiated Rate	$1,578.00
Rate for Payer: Aetna Commercial	$1,199.28
Rate for Payer: Aetna Medicare Advantage	$946.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$804.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$804.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$631.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$804.78
Rate for Payer: Cigna Commercial	$1,578.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$763.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$694.32
Rate for Payer: Qualcare PPO/HMO/WC	$473.40
Rate for Payer: UnitedHealthcare Community & State	$76.06
Rate for Payer: Wellpoint Medicaid Managed Care	$83.63

PLATE 51MM 3-LEVEL

Facility

$13,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270688528
Hospital Revenue Code	278
Min. Negotiated Rate	$2,070.00
Max. Negotiated Rate	$3,339.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,760.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,339.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,036.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,070.00

PLATE 51MM 3-LEVEL

Facility

$13,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270688528
Hospital Revenue Code	278
Min. Negotiated Rate	$332.58
Max. Negotiated Rate	$6,900.00
Rate for Payer: Aetna Commercial	$5,244.00
Rate for Payer: Aetna Medicare Advantage	$4,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,519.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,519.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,760.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,519.00
Rate for Payer: Cigna Commercial	$6,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,339.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,036.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,070.00
Rate for Payer: UnitedHealthcare Community & State	$332.58
Rate for Payer: Wellpoint Medicaid Managed Care	$365.70

PLATE 51MM 3LVL REF#011.305

Facility

$7,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270703950
Hospital Revenue Code	278
Min. Negotiated Rate	$1,132.50
Max. Negotiated Rate	$1,827.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,827.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,661.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,132.50

PLATE 51MM 3LVL REF#011.305

Facility

$7,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270703950
Hospital Revenue Code	278
Min. Negotiated Rate	$181.96
Max. Negotiated Rate	$3,775.00
Rate for Payer: Aetna Commercial	$2,869.00
Rate for Payer: Aetna Medicare Advantage	$2,265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,925.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,925.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,925.25
Rate for Payer: Cigna Commercial	$3,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,827.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,661.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,132.50
Rate for Payer: UnitedHealthcare Community & State	$181.96
Rate for Payer: Wellpoint Medicaid Managed Care	$200.07

PLATE 51MM 3LVL REF#011.305

Facility

$7,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270704950
Hospital Revenue Code	278
Min. Negotiated Rate	$181.96
Max. Negotiated Rate	$3,775.00
Rate for Payer: Aetna Commercial	$2,869.00
Rate for Payer: Aetna Medicare Advantage	$2,265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,925.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,925.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,925.25
Rate for Payer: Cigna Commercial	$3,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,827.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,661.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,132.50
Rate for Payer: UnitedHealthcare Community & State	$181.96
Rate for Payer: Wellpoint Medicaid Managed Care	$200.07

PLATE 51MM 3LVL REF#011.305

Facility

$7,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270704950
Hospital Revenue Code	278
Min. Negotiated Rate	$1,132.50
Max. Negotiated Rate	$1,827.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,827.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,661.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,132.50

PLATE 5H LEFT

Facility

$4,378.55

Hospital Charge Code	270662179
Hospital Revenue Code	278
Min. Negotiated Rate	$656.78
Max. Negotiated Rate	$1,059.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,059.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$963.28
Rate for Payer: Qualcare PPO/HMO/WC	$656.78

PLATE 5H LEFT

Facility

$4,378.55

Hospital Charge Code	270662179
Hospital Revenue Code	278
Min. Negotiated Rate	$105.52
Max. Negotiated Rate	$2,189.28
Rate for Payer: Aetna Commercial	$1,663.85
Rate for Payer: Aetna Medicare Advantage	$1,313.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,116.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,116.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,116.53
Rate for Payer: Cigna Commercial	$2,189.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,059.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$963.28
Rate for Payer: Qualcare PPO/HMO/WC	$656.78
Rate for Payer: UnitedHealthcare Community & State	$105.52
Rate for Payer: Wellpoint Medicaid Managed Care	$116.03

PLATE 5 HOLE 1/3 TUBULAR

Facility

$460.00

Hospital Charge Code	270669257
Hospital Revenue Code	278
Min. Negotiated Rate	$69.00
Max. Negotiated Rate	$111.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$101.20
Rate for Payer: Qualcare PPO/HMO/WC	$69.00

PLATE 5 HOLE 1/3 TUBULAR

Facility

$460.00

Hospital Charge Code	270669257
Hospital Revenue Code	278
Min. Negotiated Rate	$11.09
Max. Negotiated Rate	$230.00
Rate for Payer: Aetna Commercial	$174.80
Rate for Payer: Aetna Medicare Advantage	$138.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.30
Rate for Payer: Cigna Commercial	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$101.20
Rate for Payer: Qualcare PPO/HMO/WC	$69.00
Rate for Payer: UnitedHealthcare Community & State	$11.09
Rate for Payer: Wellpoint Medicaid Managed Care	$12.19

PLATE 5 HOLE 140DEG 107MM

Facility

$1,241.25

Hospital Charge Code	270654992
Hospital Revenue Code	278
Min. Negotiated Rate	$186.19
Max. Negotiated Rate	$300.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.07
Rate for Payer: Qualcare PPO/HMO/WC	$186.19

PLATE 5 HOLE 140DEG 107MM

Facility

$1,241.25

Hospital Charge Code	270654992
Hospital Revenue Code	278
Min. Negotiated Rate	$29.91
Max. Negotiated Rate	$620.62
Rate for Payer: Aetna Commercial	$471.68
Rate for Payer: Aetna Medicare Advantage	$372.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.52
Rate for Payer: Cigna Commercial	$620.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.07
Rate for Payer: Qualcare PPO/HMO/WC	$186.19
Rate for Payer: UnitedHealthcare Community & State	$29.91
Rate for Payer: Wellpoint Medicaid Managed Care	$32.89

PLATE 5 HOLE CONNECTING

Facility

$551.85

Hospital Charge Code	270691900
Hospital Revenue Code	272
Min. Negotiated Rate	$13.30
Max. Negotiated Rate	$275.93
Rate for Payer: Aetna Commercial	$209.70
Rate for Payer: Aetna Medicare Advantage	$165.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.72
Rate for Payer: Cigna Commercial	$275.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.56
Rate for Payer: Oxford Commercial	$110.37
Rate for Payer: Qualcare PPO/HMO/WC	$82.78
Rate for Payer: UnitedHealthcare Commercial	$110.37
Rate for Payer: UnitedHealthcare Community & State	$13.30
Rate for Payer: Wellpoint Medicaid Managed Care	$14.62

PLATE 5 HOLE CONNECTING

Facility

$551.85

Hospital Charge Code	270691900
Hospital Revenue Code	272
Min. Negotiated Rate	$82.78
Max. Negotiated Rate	$82.78
Rate for Payer: Qualcare PPO/HMO/WC	$82.78

PLATE 5 HOLE LOCKING MEDIAL

Facility

$4,970.00

Hospital Charge Code	270702837
Hospital Revenue Code	278
Min. Negotiated Rate	$745.50
Max. Negotiated Rate	$1,202.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$994.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,202.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,093.40
Rate for Payer: Qualcare PPO/HMO/WC	$745.50

PLATE 5 HOLE LOCKING MEDIAL

Facility

$4,970.00

Hospital Charge Code	270702837
Hospital Revenue Code	278
Min. Negotiated Rate	$119.78
Max. Negotiated Rate	$2,485.00
Rate for Payer: Aetna Commercial	$1,888.60
Rate for Payer: Aetna Medicare Advantage	$1,491.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,267.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,267.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$994.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,267.35
Rate for Payer: Cigna Commercial	$2,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,202.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,093.40
Rate for Payer: Qualcare PPO/HMO/WC	$745.50
Rate for Payer: UnitedHealthcare Community & State	$119.78
Rate for Payer: Wellpoint Medicaid Managed Care	$131.71

Know your out-of-pocket cost for care.

All Charges