Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE 5-HOLE META SM 814117005

Facility

$1,140.85

Hospital Charge Code	270632798
Hospital Revenue Code	278
Min. Negotiated Rate	$171.13
Max. Negotiated Rate	$276.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$250.99
Rate for Payer: Qualcare PPO/HMO/WC	$171.13

PLATE 5-HOLE META SM 814117005

Facility

$1,140.85

Hospital Charge Code	270632798
Hospital Revenue Code	278
Min. Negotiated Rate	$27.49
Max. Negotiated Rate	$570.42
Rate for Payer: Aetna Commercial	$433.52
Rate for Payer: Aetna Medicare Advantage	$342.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.92
Rate for Payer: Cigna Commercial	$570.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$250.99
Rate for Payer: Qualcare PPO/HMO/WC	$171.13
Rate for Payer: UnitedHealthcare Community & State	$27.49
Rate for Payer: Wellpoint Medicaid Managed Care	$30.23

PLATE 5 HOLE RIGHT

Facility

$5,500.00

Hospital Charge Code	270654891
Hospital Revenue Code	278
Min. Negotiated Rate	$132.55
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$132.55
Rate for Payer: Wellpoint Medicaid Managed Care	$145.75

PLATE 5 HOLE RIGHT

Facility

$5,500.00

Hospital Charge Code	270654891
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

PLATE 5 HOLES TUBULAR 39MM

Facility

$366.00

Hospital Charge Code	270656909
Hospital Revenue Code	278
Min. Negotiated Rate	$54.90
Max. Negotiated Rate	$88.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$80.52
Rate for Payer: Qualcare PPO/HMO/WC	$54.90

PLATE 5 HOLES TUBULAR 39MM

Facility

$366.00

Hospital Charge Code	270656909
Hospital Revenue Code	278
Min. Negotiated Rate	$8.82
Max. Negotiated Rate	$183.00
Rate for Payer: Aetna Commercial	$139.08
Rate for Payer: Aetna Medicare Advantage	$109.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.33
Rate for Payer: Cigna Commercial	$183.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$80.52
Rate for Payer: Qualcare PPO/HMO/WC	$54.90
Rate for Payer: UnitedHealthcare Community & State	$8.82
Rate for Payer: Wellpoint Medicaid Managed Care	$9.70

PLATE 5 HOLE TIBIAL LG RT

Facility

$8,100.00

Hospital Charge Code	270648292
Hospital Revenue Code	278
Min. Negotiated Rate	$1,215.00
Max. Negotiated Rate	$1,960.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,620.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,960.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,782.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,215.00

PLATE 5 HOLE TIBIAL LG RT

Facility

$8,100.00

Hospital Charge Code	270648292
Hospital Revenue Code	278
Min. Negotiated Rate	$195.21
Max. Negotiated Rate	$4,050.00
Rate for Payer: Aetna Commercial	$3,078.00
Rate for Payer: Aetna Medicare Advantage	$2,430.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,065.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,065.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,065.50
Rate for Payer: Cigna Commercial	$4,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,960.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,782.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,215.00
Rate for Payer: UnitedHealthcare Community & State	$195.21
Rate for Payer: Wellpoint Medicaid Managed Care	$214.65

PLATE 5 HOLE Utility pole

Facility

$8,100.00

Hospital Charge Code	270669406
Hospital Revenue Code	278
Min. Negotiated Rate	$195.21
Max. Negotiated Rate	$4,050.00
Rate for Payer: Aetna Commercial	$3,078.00
Rate for Payer: Aetna Medicare Advantage	$2,430.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,065.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,065.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,065.50
Rate for Payer: Cigna Commercial	$4,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,960.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,782.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,215.00
Rate for Payer: UnitedHealthcare Community & State	$195.21
Rate for Payer: Wellpoint Medicaid Managed Care	$214.65

PLATE 5 HOLE Utility pole

Facility

$8,100.00

Hospital Charge Code	270669406
Hospital Revenue Code	278
Min. Negotiated Rate	$1,215.00
Max. Negotiated Rate	$1,960.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,620.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,960.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,782.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,215.00

PLATE 5TH HOOK MET

Facility

$5,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270680981
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$1,306.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,188.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

PLATE 5TH HOOK MET

Facility

$5,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270680981
Hospital Revenue Code	278
Min. Negotiated Rate	$130.14
Max. Negotiated Rate	$2,700.00
Rate for Payer: Aetna Commercial	$2,052.00
Rate for Payer: Aetna Medicare Advantage	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.00
Rate for Payer: Cigna Commercial	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,188.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Community & State	$130.14
Rate for Payer: Wellpoint Medicaid Managed Care	$143.10

PLATE 60 MM

Facility

$5,500.00

Hospital Charge Code	270703447
Hospital Revenue Code	278
Min. Negotiated Rate	$132.55
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$132.55
Rate for Payer: Wellpoint Medicaid Managed Care	$145.75

PLATE 60 MM

Facility

$5,500.00

Hospital Charge Code	270703447
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

PLATE 63MM

Facility

$5,150.00

Hospital Charge Code	270703362
Hospital Revenue Code	278
Min. Negotiated Rate	$772.50
Max. Negotiated Rate	$1,246.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,030.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,246.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,133.00
Rate for Payer: Qualcare PPO/HMO/WC	$772.50

PLATE 63MM

Facility

$5,150.00

Hospital Charge Code	270703362
Hospital Revenue Code	278
Min. Negotiated Rate	$124.11
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,957.00
Rate for Payer: Aetna Medicare Advantage	$1,545.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,313.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,313.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,030.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,313.25
Rate for Payer: Cigna Commercial	$2,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,246.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,133.00
Rate for Payer: Qualcare PPO/HMO/WC	$772.50
Rate for Payer: UnitedHealthcare Community & State	$124.11
Rate for Payer: Wellpoint Medicaid Managed Care	$136.47

PLATE 64MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704427
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

PLATE 64MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704427
Hospital Revenue Code	278
Min. Negotiated Rate	$132.55
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$132.55
Rate for Payer: Wellpoint Medicaid Managed Care	$145.75

PLATE 65MM 4 LEVEL CURE

Facility

$16,747.50

Service Code	HCPCS C1713
Hospital Charge Code	270698845
Hospital Revenue Code	278
Min. Negotiated Rate	$2,512.12
Max. Negotiated Rate	$4,052.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,349.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,052.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,684.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,512.12

PLATE 65MM 4 LEVEL CURE

Facility

$16,747.50

Service Code	HCPCS C1713
Hospital Charge Code	270698845
Hospital Revenue Code	278
Min. Negotiated Rate	$403.61
Max. Negotiated Rate	$8,373.75
Rate for Payer: Aetna Commercial	$6,364.05
Rate for Payer: Aetna Medicare Advantage	$5,024.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,270.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,270.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,349.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,270.61
Rate for Payer: Cigna Commercial	$8,373.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,052.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,684.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,512.12
Rate for Payer: UnitedHealthcare Community & State	$403.61
Rate for Payer: Wellpoint Medicaid Managed Care	$443.81

PLATE 6.5MMX30MM

Facility

$6,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695936
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

PLATE 6.5MMX30MM

Facility

$6,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695936
Hospital Revenue Code	278
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

PLATE 6H 76MM

Facility

$4,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270699982
Hospital Revenue Code	278
Min. Negotiated Rate	$112.06
Max. Negotiated Rate	$2,325.00
Rate for Payer: Aetna Commercial	$1,767.00
Rate for Payer: Aetna Medicare Advantage	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,185.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,185.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$930.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,185.75
Rate for Payer: Cigna Commercial	$2,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,125.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,023.00
Rate for Payer: Qualcare PPO/HMO/WC	$697.50
Rate for Payer: UnitedHealthcare Community & State	$112.06
Rate for Payer: Wellpoint Medicaid Managed Care	$123.22

PLATE 6H 76MM

Facility

$4,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270699982
Hospital Revenue Code	278
Min. Negotiated Rate	$697.50
Max. Negotiated Rate	$1,125.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$930.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,125.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,023.00
Rate for Payer: Qualcare PPO/HMO/WC	$697.50

PLATE 6H LT ULNADORL 234801006

Facility

$3,085.75

Hospital Charge Code	270633304
Hospital Revenue Code	278
Min. Negotiated Rate	$462.86
Max. Negotiated Rate	$746.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$617.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$746.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$678.87
Rate for Payer: Qualcare PPO/HMO/WC	$462.86

Know your out-of-pocket cost for care.

All Charges