Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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	$196.20
Max. Negotiated Rate	$316.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$261.60
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

PLATE 8 HOLES 88MM RIGHT

Facility

$8,350.00

Hospital Charge Code	270670805
Hospital Revenue Code	278
Min. Negotiated Rate	$201.24
Max. Negotiated Rate	$4,175.00
Rate for Payer: Aetna Commercial	$3,173.00
Rate for Payer: Aetna Medicare Advantage	$2,505.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,129.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,129.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,670.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,129.25
Rate for Payer: Cigna Commercial	$4,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,020.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,837.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,252.50
Rate for Payer: UnitedHealthcare Community & State	$201.24
Rate for Payer: Wellpoint Medicaid Managed Care	$221.28

PLATE 8 HOLES 88MM RIGHT

Facility

$8,350.00

Hospital Charge Code	270670805
Hospital Revenue Code	278
Min. Negotiated Rate	$1,252.50
Max. Negotiated Rate	$2,020.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,670.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,020.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,837.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,252.50

PLATE 8 HOLE TUBULAR

Facility

$1,325.00

Hospital Charge Code	270664487
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 8 HOLE TUBULAR

Facility

$1,325.00

Hospital Charge Code	270664487
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 8MM 4 HOLE PLATE MONET

Facility

$9,450.00

Service Code	HCPCS C1889
Hospital Charge Code	270693272
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 8MM 4 HOLE PLATE MONET

Facility

$9,450.00

Service Code	HCPCS C1889
Hospital Charge Code	270693272
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 8MM CERES-C

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692581
Hospital Revenue Code	278
Min. Negotiated Rate	$241.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$241.00
Rate for Payer: Wellpoint Medicaid Managed Care	$265.00

PLATE 8MM CERES-C

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692581
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

PLATE 9H 3.5CM LCP METAPHYSEAL

Facility

$3,867.00

Service Code	HCPCS C1713
Hospital Charge Code	270656671
Hospital Revenue Code	278
Min. Negotiated Rate	$93.19
Max. Negotiated Rate	$1,933.50
Rate for Payer: Aetna Commercial	$1,469.46
Rate for Payer: Aetna Medicare Advantage	$1,160.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$986.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$986.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$773.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$986.09
Rate for Payer: Cigna Commercial	$1,933.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$935.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.74
Rate for Payer: Qualcare PPO/HMO/WC	$580.05
Rate for Payer: UnitedHealthcare Community & State	$93.19
Rate for Payer: Wellpoint Medicaid Managed Care	$102.48

PLATE 9H 3.5CM LCP METAPHYSEAL

Facility

$3,867.00

Service Code	HCPCS C1713
Hospital Charge Code	270656671
Hospital Revenue Code	278
Min. Negotiated Rate	$580.05
Max. Negotiated Rate	$935.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$773.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$935.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.74
Rate for Payer: Qualcare PPO/HMO/WC	$580.05

PLATE 9MM 4 HOLE

Facility

$10,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705745
Hospital Revenue Code	278
Min. Negotiated Rate	$253.05
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,990.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00
Rate for Payer: UnitedHealthcare Community & State	$253.05
Rate for Payer: Wellpoint Medicaid Managed Care	$278.25

PLATE 9MM 4 HOLE

Facility

$10,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705745
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

PLATE ACDF VAULT C 16X14X6MM

Facility

$17,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695547
Hospital Revenue Code	278
Min. Negotiated Rate	$415.73
Max. Negotiated Rate	$8,625.00
Rate for Payer: Aetna Commercial	$6,555.00
Rate for Payer: Aetna Medicare Advantage	$5,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,398.75
Rate for Payer: Cigna Commercial	$8,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50
Rate for Payer: UnitedHealthcare Community & State	$415.73
Rate for Payer: Wellpoint Medicaid Managed Care	$457.12

PLATE ACDF VAULT C 16X14X6MM

Facility

$17,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695547
Hospital Revenue Code	278
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$4,174.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

PLATE ACP 14MM 1LEVEL

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695532
Hospital Revenue Code	278
Min. Negotiated Rate	$2,887.50
Max. Negotiated Rate	$4,658.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50

PLATE ACP 14MM 1LEVEL

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695532
Hospital Revenue Code	278
Min. Negotiated Rate	$463.93
Max. Negotiated Rate	$9,625.00
Rate for Payer: Aetna Commercial	$7,315.00
Rate for Payer: Aetna Medicare Advantage	$5,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,908.75
Rate for Payer: Cigna Commercial	$9,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50
Rate for Payer: UnitedHealthcare Community & State	$463.93
Rate for Payer: Wellpoint Medicaid Managed Care	$510.12

PLATE ACP 1.6V 18MM 1LEVEL

Facility

$11,203.50

Service Code	HCPCS C1713
Hospital Charge Code	270694182
Hospital Revenue Code	278
Min. Negotiated Rate	$1,680.53
Max. Negotiated Rate	$2,711.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,240.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,464.77
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.53

PLATE ACP 1.6V 18MM 1LEVEL

Facility

$11,203.50

Service Code	HCPCS C1713
Hospital Charge Code	270694182
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$5,601.75
Rate for Payer: Aetna Commercial	$4,257.33
Rate for Payer: Aetna Medicare Advantage	$3,361.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,856.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,856.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,240.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,856.89
Rate for Payer: Cigna Commercial	$5,601.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,464.77
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.53
Rate for Payer: UnitedHealthcare Community & State	$270.00
Rate for Payer: Wellpoint Medicaid Managed Care	$296.89

PLATE ACP 1.6V 1LEV 20MM

Facility

$11,203.50

Service Code	HCPCS C1713
Hospital Charge Code	270696632
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$5,601.75
Rate for Payer: Aetna Commercial	$4,257.33
Rate for Payer: Aetna Medicare Advantage	$3,361.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,856.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,856.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,240.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,856.89
Rate for Payer: Cigna Commercial	$5,601.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,464.77
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.53
Rate for Payer: UnitedHealthcare Community & State	$270.00
Rate for Payer: Wellpoint Medicaid Managed Care	$296.89

PLATE ACP 1.6V 1LEV 20MM

Facility

$11,203.50

Service Code	HCPCS C1713
Hospital Charge Code	270696632
Hospital Revenue Code	278
Min. Negotiated Rate	$1,680.53
Max. Negotiated Rate	$2,711.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,240.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,464.77
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.53

PLATE ACP 1.6V 22MM 1LEVEL

Facility

$11,203.50

Service Code	HCPCS C1713
Hospital Charge Code	270695533
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$5,601.75
Rate for Payer: Aetna Commercial	$4,257.33
Rate for Payer: Aetna Medicare Advantage	$3,361.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,856.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,856.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,240.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,856.89
Rate for Payer: Cigna Commercial	$5,601.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,464.77
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.53
Rate for Payer: UnitedHealthcare Community & State	$270.00
Rate for Payer: Wellpoint Medicaid Managed Care	$296.89

PLATE ACP 1.6V 22MM 1LEVEL

Facility

$11,203.50

Service Code	HCPCS C1713
Hospital Charge Code	270695533
Hospital Revenue Code	278
Min. Negotiated Rate	$1,680.53
Max. Negotiated Rate	$2,711.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,240.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,464.77
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.53

PLATE ACP 1.6V 24MM 1LEV

Facility

$11,203.50

Service Code	HCPCS C1713
Hospital Charge Code	270694491
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$5,601.75
Rate for Payer: Aetna Commercial	$4,257.33
Rate for Payer: Aetna Medicare Advantage	$3,361.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,856.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,856.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,240.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,856.89
Rate for Payer: Cigna Commercial	$5,601.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,464.77
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.53
Rate for Payer: UnitedHealthcare Community & State	$270.00
Rate for Payer: Wellpoint Medicaid Managed Care	$296.89

PLATE ACP 1.6V 24MM 1LEV

Facility

$11,203.50

Service Code	HCPCS C1713
Hospital Charge Code	270694491
Hospital Revenue Code	278
Min. Negotiated Rate	$1,680.53
Max. Negotiated Rate	$2,711.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,240.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,464.77
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.53

Know your out-of-pocket cost for care.

All Charges