Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE 6H RT LCP CONDYLR 222656

Facility

$5,862.75

Hospital Charge Code	270633659
Hospital Revenue Code	278
Min. Negotiated Rate	$141.29
Max. Negotiated Rate	$2,931.38
Rate for Payer: Aetna Commercial	$2,227.84
Rate for Payer: Aetna Medicare Advantage	$1,758.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,495.00
Rate for Payer: Cigna Commercial	$2,931.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,289.81
Rate for Payer: Qualcare PPO/HMO/WC	$879.41
Rate for Payer: UnitedHealthcare Community & State	$141.29
Rate for Payer: Wellpoint Medicaid Managed Care	$155.36

PLATE 6H RT LCP CONDYLR 222656

Facility

$5,862.75

Hospital Charge Code	270633659
Hospital Revenue Code	278
Min. Negotiated Rate	$879.41
Max. Negotiated Rate	$1,418.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,289.81
Rate for Payer: Qualcare PPO/HMO/WC	$879.41

PLATE 72MM 4 LEVEL

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270705762
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

PLATE 72MM 4 LEVEL

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270705762
Hospital Revenue Code	278
Min. Negotiated Rate	$210.88
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$210.88
Rate for Payer: Wellpoint Medicaid Managed Care	$231.88

PLATE 7 HOLE

Facility

$1,275.00

Service Code	HCPCS C1713
Hospital Charge Code	270685167
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$308.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$280.50
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

PLATE 7 HOLE

Facility

$1,275.00

Service Code	HCPCS C1713
Hospital Charge Code	270685167
Hospital Revenue Code	278
Min. Negotiated Rate	$30.73
Max. Negotiated Rate	$637.50
Rate for Payer: Aetna Commercial	$484.50
Rate for Payer: Aetna Medicare Advantage	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.12
Rate for Payer: Cigna Commercial	$637.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$280.50
Rate for Payer: Qualcare PPO/HMO/WC	$191.25
Rate for Payer: UnitedHealthcare Community & State	$30.73
Rate for Payer: Wellpoint Medicaid Managed Care	$33.79

PLATE 7HOLE CABLE PLATE 350817

Facility

$3,820.00

Hospital Charge Code	270640545
Hospital Revenue Code	278
Min. Negotiated Rate	$573.00
Max. Negotiated Rate	$924.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$764.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$924.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$840.40
Rate for Payer: Qualcare PPO/HMO/WC	$573.00

PLATE 7HOLE CABLE PLATE 350817

Facility

$3,820.00

Hospital Charge Code	270640545
Hospital Revenue Code	278
Min. Negotiated Rate	$92.06
Max. Negotiated Rate	$1,910.00
Rate for Payer: Aetna Commercial	$1,451.60
Rate for Payer: Aetna Medicare Advantage	$1,146.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$974.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$974.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$764.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$974.10
Rate for Payer: Cigna Commercial	$1,910.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$924.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$840.40
Rate for Payer: Qualcare PPO/HMO/WC	$573.00
Rate for Payer: UnitedHealthcare Community & State	$92.06
Rate for Payer: Wellpoint Medicaid Managed Care	$101.23

PLATE 7 HOLES VDF 125MM

Facility

$5,565.00

Service Code	HCPCS C1713
Hospital Charge Code	270671145
Hospital Revenue Code	278
Min. Negotiated Rate	$834.75
Max. Negotiated Rate	$1,346.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,113.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,346.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,224.30
Rate for Payer: Qualcare PPO/HMO/WC	$834.75

PLATE 7 HOLES VDF 125MM

Facility

$5,565.00

Service Code	HCPCS C1713
Hospital Charge Code	270671145
Hospital Revenue Code	278
Min. Negotiated Rate	$134.12
Max. Negotiated Rate	$2,782.50
Rate for Payer: Aetna Commercial	$2,114.70
Rate for Payer: Aetna Medicare Advantage	$1,669.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,419.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,419.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,113.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,419.08
Rate for Payer: Cigna Commercial	$2,782.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,346.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,224.30
Rate for Payer: Qualcare PPO/HMO/WC	$834.75
Rate for Payer: UnitedHealthcare Community & State	$134.12
Rate for Payer: Wellpoint Medicaid Managed Care	$147.47

PLATE 7 MM 4 HOLE

Facility

$9,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270693118
Hospital Revenue Code	278
Min. Negotiated Rate	$227.75
Max. Negotiated Rate	$4,725.00
Rate for Payer: Aetna Commercial	$3,591.00
Rate for Payer: Aetna Medicare Advantage	$2,835.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,409.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,409.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,890.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,409.75
Rate for Payer: Cigna Commercial	$4,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,286.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,079.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.50
Rate for Payer: UnitedHealthcare Community & State	$227.75
Rate for Payer: Wellpoint Medicaid Managed Care	$250.43

PLATE 7 MM 4 HOLE

Facility

$9,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270693118
Hospital Revenue Code	278
Min. Negotiated Rate	$1,417.50
Max. Negotiated Rate	$2,286.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,890.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,286.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,079.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.50

PLATE 80 HOLE THIRD TUBE

Facility

$1,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270682857
Hospital Revenue Code	278
Min. Negotiated Rate	$31.93
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$31.93
Rate for Payer: Wellpoint Medicaid Managed Care	$35.11

PLATE 80 HOLE THIRD TUBE

Facility

$1,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270682857
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

PLATE 80MM LORDOTIC PRE-BENT.

Facility

$1,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270703622
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

PLATE 80MM LORDOTIC PRE-BENT.

Facility

$1,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270703622
Hospital Revenue Code	278
Min. Negotiated Rate	$31.93
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$31.93
Rate for Payer: Wellpoint Medicaid Managed Care	$35.11

PLATE 8H DYNAC COMPRESS PLDCP8

Facility

$830.00

Hospital Charge Code	270638176
Hospital Revenue Code	278
Min. Negotiated Rate	$124.50
Max. Negotiated Rate	$200.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$182.60
Rate for Payer: Qualcare PPO/HMO/WC	$124.50

PLATE 8H DYNAC COMPRESS PLDCP8

Facility

$830.00

Hospital Charge Code	270638176
Hospital Revenue Code	278
Min. Negotiated Rate	$20.00
Max. Negotiated Rate	$415.00
Rate for Payer: Aetna Commercial	$315.40
Rate for Payer: Aetna Medicare Advantage	$249.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.65
Rate for Payer: Cigna Commercial	$415.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$182.60
Rate for Payer: Qualcare PPO/HMO/WC	$124.50
Rate for Payer: UnitedHealthcare Community & State	$20.00
Rate for Payer: Wellpoint Medicaid Managed Care	$22.00

PLATE 8-HOLE CLAVICLE LEFT

Facility

$5,610.00

Hospital Charge Code	270648046
Hospital Revenue Code	278
Min. Negotiated Rate	$841.50
Max. Negotiated Rate	$1,357.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,122.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,357.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,234.20
Rate for Payer: Qualcare PPO/HMO/WC	$841.50

PLATE 8-HOLE CLAVICLE LEFT

Facility

$5,610.00

Hospital Charge Code	270648046
Hospital Revenue Code	278
Min. Negotiated Rate	$135.20
Max. Negotiated Rate	$2,805.00
Rate for Payer: Aetna Commercial	$2,131.80
Rate for Payer: Aetna Medicare Advantage	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,430.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,430.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,430.55
Rate for Payer: Cigna Commercial	$2,805.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,357.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,234.20
Rate for Payer: Qualcare PPO/HMO/WC	$841.50
Rate for Payer: UnitedHealthcare Community & State	$135.20
Rate for Payer: Wellpoint Medicaid Managed Care	$148.66

PLATE 8-HOLE DISTAL MED 437208

Facility

$9,835.00

Hospital Charge Code	270648064
Hospital Revenue Code	278
Min. Negotiated Rate	$1,475.25
Max. Negotiated Rate	$2,380.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,967.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,380.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,163.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,475.25

PLATE 8-HOLE DISTAL MED 437208

Facility

$9,835.00

Hospital Charge Code	270648064
Hospital Revenue Code	278
Min. Negotiated Rate	$237.02
Max. Negotiated Rate	$4,917.50
Rate for Payer: Aetna Commercial	$3,737.30
Rate for Payer: Aetna Medicare Advantage	$2,950.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,507.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,507.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,967.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,507.93
Rate for Payer: Cigna Commercial	$4,917.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,380.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,163.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,475.25
Rate for Payer: UnitedHealthcare Community & State	$237.02
Rate for Payer: Wellpoint Medicaid Managed Care	$260.63

PLATE 8HOLE LATERAL 27134

Facility

$5,640.00

Hospital Charge Code	270639622
Hospital Revenue Code	278
Min. Negotiated Rate	$846.00
Max. Negotiated Rate	$1,364.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,128.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,364.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,240.80
Rate for Payer: Qualcare PPO/HMO/WC	$846.00

PLATE 8HOLE LATERAL 27134

Facility

$5,640.00

Hospital Charge Code	270639622
Hospital Revenue Code	278
Min. Negotiated Rate	$135.92
Max. Negotiated Rate	$2,820.00
Rate for Payer: Aetna Commercial	$2,143.20
Rate for Payer: Aetna Medicare Advantage	$1,692.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,438.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,438.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,128.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,438.20
Rate for Payer: Cigna Commercial	$2,820.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,364.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,240.80
Rate for Payer: Qualcare PPO/HMO/WC	$846.00
Rate for Payer: UnitedHealthcare Community & State	$135.92
Rate for Payer: Wellpoint Medicaid Managed Care	$149.46

PLATE 8 HOLES 2.0 MM X 48MM

Facility

$1,308.00

Service Code	HCPCS C1713
Hospital Charge Code	270667562
Hospital Revenue Code	278
Min. Negotiated Rate	$31.52
Max. Negotiated Rate	$654.00
Rate for Payer: Aetna Commercial	$497.04
Rate for Payer: Aetna Medicare Advantage	$392.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$333.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$333.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$261.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$333.54
Rate for Payer: Cigna Commercial	$654.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$316.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$287.76
Rate for Payer: Qualcare PPO/HMO/WC	$196.20
Rate for Payer: UnitedHealthcare Community & State	$31.52
Rate for Payer: Wellpoint Medicaid Managed Care	$34.66

Know your out-of-pocket cost for care.

All Charges