Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE BOLSTER 7x1 TAWT7

Facility

$225.00

Hospital Charge Code	270647557
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
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

PLATE BOLSTER 9x1 TAWT9

Facility

$225.00

Hospital Charge Code	270647558
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

PLATE BOLSTER 9x1 TAWT9

Facility

$225.00

Hospital Charge Code	270647558
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
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

PLATE BROAD 14H 4.5x260MM

Facility

$3,279.00

Hospital Charge Code	270675501
Hospital Revenue Code	278
Min. Negotiated Rate	$79.02
Max. Negotiated Rate	$1,639.50
Rate for Payer: Aetna Commercial	$1,246.02
Rate for Payer: Aetna Medicare Advantage	$983.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$836.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$836.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$655.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$836.14
Rate for Payer: Cigna Commercial	$1,639.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$793.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$721.38
Rate for Payer: Qualcare PPO/HMO/WC	$491.85
Rate for Payer: UnitedHealthcare Community & State	$79.02
Rate for Payer: Wellpoint Medicaid Managed Care	$86.89

PLATE BROAD 14H 4.5x260MM

Facility

$3,279.00

Hospital Charge Code	270675501
Hospital Revenue Code	278
Min. Negotiated Rate	$491.85
Max. Negotiated Rate	$793.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$655.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$793.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$721.38
Rate for Payer: Qualcare PPO/HMO/WC	$491.85

PLATE BROAD 4 HOLE ALTA

Facility

$610.00

Hospital Charge Code	270335169
Hospital Revenue Code	278
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$305.00
Rate for Payer: Aetna Commercial	$231.80
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.20
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Community & State	$14.70
Rate for Payer: Wellpoint Medicaid Managed Care	$16.16

PLATE BROAD 4 HOLE ALTA

Facility

$610.00

Hospital Charge Code	270335169
Hospital Revenue Code	278
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$147.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.20
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

PLATE BROAD 6 HOLE ALTA

Facility

$713.00

Hospital Charge Code	270335170
Hospital Revenue Code	278
Min. Negotiated Rate	$17.18
Max. Negotiated Rate	$356.50
Rate for Payer: Aetna Commercial	$270.94
Rate for Payer: Aetna Medicare Advantage	$213.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.81
Rate for Payer: Cigna Commercial	$356.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$156.86
Rate for Payer: Qualcare PPO/HMO/WC	$106.95
Rate for Payer: UnitedHealthcare Community & State	$17.18
Rate for Payer: Wellpoint Medicaid Managed Care	$18.89

PLATE BROAD 6 HOLE ALTA

Facility

$713.00

Hospital Charge Code	270335170
Hospital Revenue Code	278
Min. Negotiated Rate	$106.95
Max. Negotiated Rate	$172.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$156.86
Rate for Payer: Qualcare PPO/HMO/WC	$106.95

PLATE BROAD 8 HOLE ALTA

Facility

$911.00

Hospital Charge Code	270335171
Hospital Revenue Code	278
Min. Negotiated Rate	$136.65
Max. Negotiated Rate	$220.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.42
Rate for Payer: Qualcare PPO/HMO/WC	$136.65

PLATE BROAD 8 HOLE ALTA

Facility

$911.00

Hospital Charge Code	270335171
Hospital Revenue Code	278
Min. Negotiated Rate	$21.96
Max. Negotiated Rate	$455.50
Rate for Payer: Aetna Commercial	$346.18
Rate for Payer: Aetna Medicare Advantage	$273.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.31
Rate for Payer: Cigna Commercial	$455.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.42
Rate for Payer: Qualcare PPO/HMO/WC	$136.65
Rate for Payer: UnitedHealthcare Community & State	$21.96
Rate for Payer: Wellpoint Medicaid Managed Care	$24.14

PLATE BROAD DCP 14H 4.5x286MM

Facility

$1,581.00

Hospital Charge Code	270675502
Hospital Revenue Code	278
Min. Negotiated Rate	$237.15
Max. Negotiated Rate	$382.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$316.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$382.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$347.82
Rate for Payer: Qualcare PPO/HMO/WC	$237.15

PLATE BROAD DCP 14H 4.5x286MM

Facility

$1,581.00

Hospital Charge Code	270675502
Hospital Revenue Code	278
Min. Negotiated Rate	$38.10
Max. Negotiated Rate	$790.50
Rate for Payer: Aetna Commercial	$600.78
Rate for Payer: Aetna Medicare Advantage	$474.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$403.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$403.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$316.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$403.15
Rate for Payer: Cigna Commercial	$790.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$382.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$347.82
Rate for Payer: Qualcare PPO/HMO/WC	$237.15
Rate for Payer: UnitedHealthcare Community & State	$38.10
Rate for Payer: Wellpoint Medicaid Managed Care	$41.90

PLATE BROAD LKG 4H 39MM

Facility

$6,115.55

Service Code	HCPCS C1713
Hospital Charge Code	270699827
Hospital Revenue Code	278
Min. Negotiated Rate	$147.38
Max. Negotiated Rate	$3,057.78
Rate for Payer: Aetna Commercial	$2,323.91
Rate for Payer: Aetna Medicare Advantage	$1,834.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,559.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,559.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,223.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,559.47
Rate for Payer: Cigna Commercial	$3,057.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,479.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,345.42
Rate for Payer: Qualcare PPO/HMO/WC	$917.33
Rate for Payer: UnitedHealthcare Community & State	$147.38
Rate for Payer: Wellpoint Medicaid Managed Care	$162.06

PLATE BROAD LKG 4H 39MM

Facility

$6,115.55

Service Code	HCPCS C1713
Hospital Charge Code	270699827
Hospital Revenue Code	278
Min. Negotiated Rate	$917.33
Max. Negotiated Rate	$1,479.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,223.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,479.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,345.42
Rate for Payer: Qualcare PPO/HMO/WC	$917.33

PLATE BUT L 4HOLE LT 244908514

Facility

$715.00

Hospital Charge Code	270610439
Hospital Revenue Code	278
Min. Negotiated Rate	$107.25
Max. Negotiated Rate	$173.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$107.25

PLATE BUT L 4HOLE LT 244908514

Facility

$715.00

Hospital Charge Code	270610439
Hospital Revenue Code	278
Min. Negotiated Rate	$17.23
Max. Negotiated Rate	$357.50
Rate for Payer: Aetna Commercial	$271.70
Rate for Payer: Aetna Medicare Advantage	$214.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.32
Rate for Payer: Cigna Commercial	$357.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$107.25
Rate for Payer: UnitedHealthcare Community & State	$17.23
Rate for Payer: Wellpoint Medicaid Managed Care	$18.95

PLATE BUTRES T 4-HOL 244908404

Facility

$790.00

Hospital Charge Code	270610436
Hospital Revenue Code	278
Min. Negotiated Rate	$118.50
Max. Negotiated Rate	$191.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$173.80
Rate for Payer: Qualcare PPO/HMO/WC	$118.50

PLATE BUTRES T 4-HOL 244908404

Facility

$790.00

Hospital Charge Code	270610436
Hospital Revenue Code	278
Min. Negotiated Rate	$19.04
Max. Negotiated Rate	$395.00
Rate for Payer: Aetna Commercial	$300.20
Rate for Payer: Aetna Medicare Advantage	$237.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.45
Rate for Payer: Cigna Commercial	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$173.80
Rate for Payer: Qualcare PPO/HMO/WC	$118.50
Rate for Payer: UnitedHealthcare Community & State	$19.04
Rate for Payer: Wellpoint Medicaid Managed Care	$20.93

PLATE BUTTON DISTAL CLAVICLE

Facility

$4,925.00

Service Code	HCPCS C1713
Hospital Charge Code	270687594
Hospital Revenue Code	278
Min. Negotiated Rate	$118.69
Max. Negotiated Rate	$2,462.50
Rate for Payer: Aetna Commercial	$1,871.50
Rate for Payer: Aetna Medicare Advantage	$1,477.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,255.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,255.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$985.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,255.88
Rate for Payer: Cigna Commercial	$2,462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,191.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,083.50
Rate for Payer: Qualcare PPO/HMO/WC	$738.75
Rate for Payer: UnitedHealthcare Community & State	$118.69
Rate for Payer: Wellpoint Medicaid Managed Care	$130.51

PLATE BUTTON DISTAL CLAVICLE

Facility

$4,925.00

Service Code	HCPCS C1713
Hospital Charge Code	270687594
Hospital Revenue Code	278
Min. Negotiated Rate	$738.75
Max. Negotiated Rate	$1,191.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$985.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,191.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,083.50
Rate for Payer: Qualcare PPO/HMO/WC	$738.75

PLATE BUTTRESS 4 HOLES RIGHT

Facility

$1,710.00

Hospital Charge Code	270656207
Hospital Revenue Code	278
Min. Negotiated Rate	$256.50
Max. Negotiated Rate	$413.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$342.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$376.20
Rate for Payer: Qualcare PPO/HMO/WC	$256.50

PLATE BUTTRESS 4 HOLES RIGHT

Facility

$1,710.00

Hospital Charge Code	270656207
Hospital Revenue Code	278
Min. Negotiated Rate	$41.21
Max. Negotiated Rate	$855.00
Rate for Payer: Aetna Commercial	$649.80
Rate for Payer: Aetna Medicare Advantage	$513.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$436.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$436.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$342.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$436.05
Rate for Payer: Cigna Commercial	$855.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$376.20
Rate for Payer: Qualcare PPO/HMO/WC	$256.50
Rate for Payer: UnitedHealthcare Community & State	$41.21
Rate for Payer: Wellpoint Medicaid Managed Care	$45.31

PLATE CALCANEAL

Facility

$5,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270690198
Hospital Revenue Code	278
Min. Negotiated Rate	$131.95
Max. Negotiated Rate	$2,737.50
Rate for Payer: Aetna Commercial	$2,080.50
Rate for Payer: Aetna Medicare Advantage	$1,642.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,396.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,396.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,095.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,396.12
Rate for Payer: Cigna Commercial	$2,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,204.50
Rate for Payer: Qualcare PPO/HMO/WC	$821.25
Rate for Payer: UnitedHealthcare Community & State	$131.95
Rate for Payer: Wellpoint Medicaid Managed Care	$145.09

PLATE CALCANEAL

Facility

$5,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270690198
Hospital Revenue Code	278
Min. Negotiated Rate	$821.25
Max. Negotiated Rate	$1,324.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,095.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,204.50
Rate for Payer: Qualcare PPO/HMO/WC	$821.25

Know your out-of-pocket cost for care.

All Charges