Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE BMT TIBIAL 67MM 141212

Facility

$3,871.25

Hospital Charge Code	270606312
Hospital Revenue Code	278
Min. Negotiated Rate	$580.69
Max. Negotiated Rate	$936.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$774.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$936.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$851.67
Rate for Payer: Qualcare PPO/HMO/WC	$580.69

PLATE BMT TIBIAL 67MM 141212

Facility

$3,871.25

Hospital Charge Code	270606312
Hospital Revenue Code	278
Min. Negotiated Rate	$93.30
Max. Negotiated Rate	$1,935.62
Rate for Payer: Aetna Commercial	$1,471.08
Rate for Payer: Aetna Medicare Advantage	$1,161.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$987.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$987.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$774.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$987.17
Rate for Payer: Cigna Commercial	$1,935.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$936.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$851.67
Rate for Payer: Qualcare PPO/HMO/WC	$580.69
Rate for Payer: UnitedHealthcare Community & State	$93.30
Rate for Payer: Wellpoint Medicaid Managed Care	$102.59

PLATE BMT TIBIAL 67MM 141222

Facility

$7,890.00

Hospital Charge Code	270629063
Hospital Revenue Code	278
Min. Negotiated Rate	$1,183.50
Max. Negotiated Rate	$1,909.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,578.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,909.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,735.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,183.50

PLATE BMT TIBIAL 67MM 141222

Facility

$7,890.00

Hospital Charge Code	270629063
Hospital Revenue Code	278
Min. Negotiated Rate	$190.15
Max. Negotiated Rate	$3,945.00
Rate for Payer: Aetna Commercial	$2,998.20
Rate for Payer: Aetna Medicare Advantage	$2,367.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,011.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,011.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,578.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,011.95
Rate for Payer: Cigna Commercial	$3,945.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,909.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,735.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,183.50
Rate for Payer: UnitedHealthcare Community & State	$190.15
Rate for Payer: Wellpoint Medicaid Managed Care	$209.09

PLATE BMT TIBIAL 71MM 141213

Facility

$3,871.25

Hospital Charge Code	270609003
Hospital Revenue Code	278
Min. Negotiated Rate	$93.30
Max. Negotiated Rate	$1,935.62
Rate for Payer: Aetna Commercial	$1,471.08
Rate for Payer: Aetna Medicare Advantage	$1,161.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$987.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$987.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$774.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$987.17
Rate for Payer: Cigna Commercial	$1,935.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$936.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$851.67
Rate for Payer: Qualcare PPO/HMO/WC	$580.69
Rate for Payer: UnitedHealthcare Community & State	$93.30
Rate for Payer: Wellpoint Medicaid Managed Care	$102.59

PLATE BMT TIBIAL 71MM 141213

Facility

$3,871.25

Hospital Charge Code	270609003
Hospital Revenue Code	278
Min. Negotiated Rate	$580.69
Max. Negotiated Rate	$936.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$774.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$936.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$851.67
Rate for Payer: Qualcare PPO/HMO/WC	$580.69

PLATE BMT TIBIAL 71MM 141223

Facility

$7,826.95

Hospital Charge Code	270617362
Hospital Revenue Code	278
Min. Negotiated Rate	$1,174.04
Max. Negotiated Rate	$1,894.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,565.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,894.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,721.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,174.04

PLATE BMT TIBIAL 71MM 141223

Facility

$7,826.95

Hospital Charge Code	270617362
Hospital Revenue Code	278
Min. Negotiated Rate	$188.63
Max. Negotiated Rate	$3,913.47
Rate for Payer: Aetna Commercial	$2,974.24
Rate for Payer: Aetna Medicare Advantage	$2,348.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,995.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,995.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,565.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,995.87
Rate for Payer: Cigna Commercial	$3,913.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,894.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,721.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,174.04
Rate for Payer: UnitedHealthcare Community & State	$188.63
Rate for Payer: Wellpoint Medicaid Managed Care	$207.41

PLATE BMT TIBIAL 75MM 141214

Facility

$4,028.85

Hospital Charge Code	270606913
Hospital Revenue Code	278
Min. Negotiated Rate	$97.10
Max. Negotiated Rate	$2,014.42
Rate for Payer: Aetna Commercial	$1,530.96
Rate for Payer: Aetna Medicare Advantage	$1,208.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,027.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,027.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$805.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,027.36
Rate for Payer: Cigna Commercial	$2,014.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$974.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$886.35
Rate for Payer: Qualcare PPO/HMO/WC	$604.33
Rate for Payer: UnitedHealthcare Community & State	$97.10
Rate for Payer: Wellpoint Medicaid Managed Care	$106.76

PLATE BMT TIBIAL 75MM 141214

Facility

$4,028.85

Hospital Charge Code	270606913
Hospital Revenue Code	278
Min. Negotiated Rate	$604.33
Max. Negotiated Rate	$974.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$805.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$974.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$886.35
Rate for Payer: Qualcare PPO/HMO/WC	$604.33

PLATE BMT TIBIAL 75MM 141224

Facility

$7,890.00

Hospital Charge Code	270619032
Hospital Revenue Code	278
Min. Negotiated Rate	$1,183.50
Max. Negotiated Rate	$1,909.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,578.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,909.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,735.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,183.50

PLATE BMT TIBIAL 75MM 141224

Facility

$7,890.00

Hospital Charge Code	270619032
Hospital Revenue Code	278
Min. Negotiated Rate	$190.15
Max. Negotiated Rate	$3,945.00
Rate for Payer: Aetna Commercial	$2,998.20
Rate for Payer: Aetna Medicare Advantage	$2,367.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,011.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,011.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,578.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,011.95
Rate for Payer: Cigna Commercial	$3,945.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,909.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,735.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,183.50
Rate for Payer: UnitedHealthcare Community & State	$190.15
Rate for Payer: Wellpoint Medicaid Managed Care	$209.09

PLATE BMT TIBIAL 79MM 141225

Facility

$7,826.95

Hospital Charge Code	270618618
Hospital Revenue Code	278
Min. Negotiated Rate	$188.63
Max. Negotiated Rate	$3,913.47
Rate for Payer: Aetna Commercial	$2,974.24
Rate for Payer: Aetna Medicare Advantage	$2,348.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,995.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,995.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,565.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,995.87
Rate for Payer: Cigna Commercial	$3,913.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,894.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,721.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,174.04
Rate for Payer: UnitedHealthcare Community & State	$188.63
Rate for Payer: Wellpoint Medicaid Managed Care	$207.41

PLATE BMT TIBIAL 79MM 141225

Facility

$7,826.95

Hospital Charge Code	270618618
Hospital Revenue Code	278
Min. Negotiated Rate	$1,174.04
Max. Negotiated Rate	$1,894.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,565.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,894.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,721.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,174.04

PLATE BMT TIBIAL 87MM 141217

Facility

$3,871.25

Hospital Charge Code	270606323
Hospital Revenue Code	278
Min. Negotiated Rate	$580.69
Max. Negotiated Rate	$936.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$774.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$936.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$851.67
Rate for Payer: Qualcare PPO/HMO/WC	$580.69

PLATE BMT TIBIAL 87MM 141217

Facility

$3,871.25

Hospital Charge Code	270606323
Hospital Revenue Code	278
Min. Negotiated Rate	$93.30
Max. Negotiated Rate	$1,935.62
Rate for Payer: Aetna Commercial	$1,471.08
Rate for Payer: Aetna Medicare Advantage	$1,161.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$987.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$987.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$774.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$987.17
Rate for Payer: Cigna Commercial	$1,935.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$936.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$851.67
Rate for Payer: Qualcare PPO/HMO/WC	$580.69
Rate for Payer: UnitedHealthcare Community & State	$93.30
Rate for Payer: Wellpoint Medicaid Managed Care	$102.59

PLATE BMT VHS 12H 200112

Facility

$3,113.65

Hospital Charge Code	270623040
Hospital Revenue Code	278
Min. Negotiated Rate	$75.04
Max. Negotiated Rate	$1,556.83
Rate for Payer: Aetna Commercial	$1,183.19
Rate for Payer: Aetna Medicare Advantage	$934.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$793.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$793.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$622.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$793.98
Rate for Payer: Cigna Commercial	$1,556.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$753.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$685.00
Rate for Payer: Qualcare PPO/HMO/WC	$467.05
Rate for Payer: UnitedHealthcare Community & State	$75.04
Rate for Payer: Wellpoint Medicaid Managed Care	$82.51

PLATE BMT VHS 12H 200112

Facility

$3,113.65

Hospital Charge Code	270623040
Hospital Revenue Code	278
Min. Negotiated Rate	$467.05
Max. Negotiated Rate	$753.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$622.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$753.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$685.00
Rate for Payer: Qualcare PPO/HMO/WC	$467.05

PLATE BMT VHS 4H 88MM 200104

Facility

$2,323.25

Hospital Charge Code	270612178
Hospital Revenue Code	278
Min. Negotiated Rate	$55.99
Max. Negotiated Rate	$1,161.62
Rate for Payer: Aetna Commercial	$882.84
Rate for Payer: Aetna Medicare Advantage	$696.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$464.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.43
Rate for Payer: Cigna Commercial	$1,161.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$511.12
Rate for Payer: Qualcare PPO/HMO/WC	$348.49
Rate for Payer: UnitedHealthcare Community & State	$55.99
Rate for Payer: Wellpoint Medicaid Managed Care	$61.57

PLATE BMT VHS 4H 88MM 200104

Facility

$2,323.25

Hospital Charge Code	270612178
Hospital Revenue Code	278
Min. Negotiated Rate	$348.49
Max. Negotiated Rate	$562.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$464.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$511.12
Rate for Payer: Qualcare PPO/HMO/WC	$348.49

PLATE BMT VHS 4H 88MM 200304

Facility

$2,323.25

Hospital Charge Code	270617475
Hospital Revenue Code	278
Min. Negotiated Rate	$55.99
Max. Negotiated Rate	$1,161.62
Rate for Payer: Aetna Commercial	$882.84
Rate for Payer: Aetna Medicare Advantage	$696.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$464.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.43
Rate for Payer: Cigna Commercial	$1,161.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$511.12
Rate for Payer: Qualcare PPO/HMO/WC	$348.49
Rate for Payer: UnitedHealthcare Community & State	$55.99
Rate for Payer: Wellpoint Medicaid Managed Care	$61.57

PLATE BMT VHS 4H 88MM 200304

Facility

$2,323.25

Hospital Charge Code	270617475
Hospital Revenue Code	278
Min. Negotiated Rate	$348.49
Max. Negotiated Rate	$562.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$464.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$511.12
Rate for Payer: Qualcare PPO/HMO/WC	$348.49

PLATE BMT VHS 6H 120MM 200106

Facility

$2,323.25

Hospital Charge Code	270616950
Hospital Revenue Code	278
Min. Negotiated Rate	$55.99
Max. Negotiated Rate	$1,161.62
Rate for Payer: Aetna Commercial	$882.84
Rate for Payer: Aetna Medicare Advantage	$696.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$464.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.43
Rate for Payer: Cigna Commercial	$1,161.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$511.12
Rate for Payer: Qualcare PPO/HMO/WC	$348.49
Rate for Payer: UnitedHealthcare Community & State	$55.99
Rate for Payer: Wellpoint Medicaid Managed Care	$61.57

PLATE BMT VHS 6H 120MM 200106

Facility

$2,323.25

Hospital Charge Code	270616950
Hospital Revenue Code	278
Min. Negotiated Rate	$348.49
Max. Negotiated Rate	$562.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$464.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$511.12
Rate for Payer: Qualcare PPO/HMO/WC	$348.49

PLATE BOLSTER 7x1 TAWT7

Facility

$225.00

Hospital Charge Code	270647557
Hospital Revenue Code	278
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

Know your out-of-pocket cost for care.

All Charges