Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE CERV TERRACE 2LEVEL 40MM

Facility

$19,990.00

Service Code	HCPCS C1713
Hospital Charge Code	270696967
Hospital Revenue Code	278
Min. Negotiated Rate	$481.76
Max. Negotiated Rate	$9,995.00
Rate for Payer: Aetna Commercial	$7,596.20
Rate for Payer: Aetna Medicare Advantage	$5,997.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,097.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,097.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,097.45
Rate for Payer: Cigna Commercial	$9,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,837.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,397.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,998.50
Rate for Payer: UnitedHealthcare Community & State	$481.76
Rate for Payer: Wellpoint Medicaid Managed Care	$529.74

PLATE CERV TERRACE 2LEVEL 40MM

Facility

$19,990.00

Service Code	HCPCS C1713
Hospital Charge Code	270696967
Hospital Revenue Code	278
Min. Negotiated Rate	$2,998.50
Max. Negotiated Rate	$4,837.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,998.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,837.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,397.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,998.50

PLATE CERV ZEVO TI 2L 1.9X37MM

Facility

$11,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270697848
Hospital Revenue Code	278
Min. Negotiated Rate	$271.12
Max. Negotiated Rate	$5,625.00
Rate for Payer: Aetna Commercial	$4,275.00
Rate for Payer: Aetna Medicare Advantage	$3,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,868.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,868.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,868.75
Rate for Payer: Cigna Commercial	$5,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,722.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,475.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,687.50
Rate for Payer: UnitedHealthcare Community & State	$271.12
Rate for Payer: Wellpoint Medicaid Managed Care	$298.12

PLATE CERV ZEVO TI 2L 1.9X37MM

Facility

$11,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270697848
Hospital Revenue Code	278
Min. Negotiated Rate	$1,687.50
Max. Negotiated Rate	$2,722.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,722.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,475.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,687.50

PLATE CLAVICAL

Facility

$4,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270687718
Hospital Revenue Code	278
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$1,028.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$935.00
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

PLATE CLAVICAL

Facility

$4,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270687718
Hospital Revenue Code	278
Min. Negotiated Rate	$102.42
Max. Negotiated Rate	$2,125.00
Rate for Payer: Aetna Commercial	$1,615.00
Rate for Payer: Aetna Medicare Advantage	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,083.75
Rate for Payer: Cigna Commercial	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$935.00
Rate for Payer: Qualcare PPO/HMO/WC	$637.50
Rate for Payer: UnitedHealthcare Community & State	$102.42
Rate for Payer: Wellpoint Medicaid Managed Care	$112.62

PLATE CLAVICAL 3.5MM 8 HOLE

Facility

$4,379.40

Service Code	HCPCS C1713
Hospital Charge Code	270685590
Hospital Revenue Code	278
Min. Negotiated Rate	$656.91
Max. Negotiated Rate	$1,059.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,059.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$963.47
Rate for Payer: Qualcare PPO/HMO/WC	$656.91

PLATE CLAVICAL 3.5MM 8 HOLE

Facility

$4,379.40

Service Code	HCPCS C1713
Hospital Charge Code	270685590
Hospital Revenue Code	278
Min. Negotiated Rate	$105.54
Max. Negotiated Rate	$2,189.70
Rate for Payer: Aetna Commercial	$1,664.17
Rate for Payer: Aetna Medicare Advantage	$1,313.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,116.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,116.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,116.75
Rate for Payer: Cigna Commercial	$2,189.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,059.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$963.47
Rate for Payer: Qualcare PPO/HMO/WC	$656.91
Rate for Payer: UnitedHealthcare Community & State	$105.54
Rate for Payer: Wellpoint Medicaid Managed Care	$116.05

PLATE CLAVICAL ANTERIOR 10 HO

Facility

$5,830.00

Hospital Charge Code	270669425
Hospital Revenue Code	278
Min. Negotiated Rate	$140.50
Max. Negotiated Rate	$2,915.00
Rate for Payer: Aetna Commercial	$2,215.40
Rate for Payer: Aetna Medicare Advantage	$1,749.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,486.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,486.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,166.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,486.65
Rate for Payer: Cigna Commercial	$2,915.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,410.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,282.60
Rate for Payer: Qualcare PPO/HMO/WC	$874.50
Rate for Payer: UnitedHealthcare Community & State	$140.50
Rate for Payer: Wellpoint Medicaid Managed Care	$154.50

PLATE CLAVICAL ANTERIOR 10 HO

Facility

$5,830.00

Hospital Charge Code	270669425
Hospital Revenue Code	278
Min. Negotiated Rate	$874.50
Max. Negotiated Rate	$1,410.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,166.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,410.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,282.60
Rate for Payer: Qualcare PPO/HMO/WC	$874.50

PLATE CLAVICAL LEFT 8 HOLE

Facility

$2,750.00

Hospital Charge Code	270668043
Hospital Revenue Code	278
Min. Negotiated Rate	$66.28
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Community & State	$66.28
Rate for Payer: Wellpoint Medicaid Managed Care	$72.88

PLATE CLAVICAL LEFT 8 HOLE

Facility

$2,750.00

Hospital Charge Code	270668043
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

PLATE CLAVICAL SYSTEM

Facility

$11,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270687868
Hospital Revenue Code	278
Min. Negotiated Rate	$271.12
Max. Negotiated Rate	$5,625.00
Rate for Payer: Aetna Commercial	$4,275.00
Rate for Payer: Aetna Medicare Advantage	$3,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,868.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,868.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,868.75
Rate for Payer: Cigna Commercial	$5,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,722.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,475.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,687.50
Rate for Payer: UnitedHealthcare Community & State	$271.12
Rate for Payer: Wellpoint Medicaid Managed Care	$298.12

PLATE CLAVICAL SYSTEM

Facility

$11,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270687868
Hospital Revenue Code	278
Min. Negotiated Rate	$1,687.50
Max. Negotiated Rate	$2,722.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,722.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,475.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,687.50

PLATE CLAVICLA ANT 7 HOLE

Facility

$4,274.35

Service Code	HCPCS C1713
Hospital Charge Code	270685591
Hospital Revenue Code	278
Min. Negotiated Rate	$103.01
Max. Negotiated Rate	$2,137.18
Rate for Payer: Aetna Commercial	$1,624.25
Rate for Payer: Aetna Medicare Advantage	$1,282.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,089.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,089.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$854.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,089.96
Rate for Payer: Cigna Commercial	$2,137.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,034.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$940.36
Rate for Payer: Qualcare PPO/HMO/WC	$641.15
Rate for Payer: UnitedHealthcare Community & State	$103.01
Rate for Payer: Wellpoint Medicaid Managed Care	$113.27

PLATE CLAVICLA ANT 7 HOLE

Facility

$4,274.35

Service Code	HCPCS C1713
Hospital Charge Code	270685591
Hospital Revenue Code	278
Min. Negotiated Rate	$641.15
Max. Negotiated Rate	$1,034.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$854.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,034.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$940.36
Rate for Payer: Qualcare PPO/HMO/WC	$641.15

PLATE CLAVICLE 2.7MM LT CS2

Facility

$4,919.20

Service Code	HCPCS C1713
Hospital Charge Code	270693039
Hospital Revenue Code	278
Min. Negotiated Rate	$118.55
Max. Negotiated Rate	$2,459.60
Rate for Payer: Aetna Commercial	$1,869.30
Rate for Payer: Aetna Medicare Advantage	$1,475.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,254.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,254.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$983.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,254.40
Rate for Payer: Cigna Commercial	$2,459.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,190.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,082.22
Rate for Payer: Qualcare PPO/HMO/WC	$737.88
Rate for Payer: UnitedHealthcare Community & State	$118.55
Rate for Payer: Wellpoint Medicaid Managed Care	$130.36

PLATE CLAVICLE 2.7MM LT CS2

Facility

$4,919.20

Service Code	HCPCS C1713
Hospital Charge Code	270693039
Hospital Revenue Code	278
Min. Negotiated Rate	$737.88
Max. Negotiated Rate	$1,190.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$983.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,190.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,082.22
Rate for Payer: Qualcare PPO/HMO/WC	$737.88

PLATECLAVICLE3.5MMLCP5HRT94MM

Facility

$5,721.15

Service Code	HCPCS C1713
Hospital Charge Code	270697376
Hospital Revenue Code	278
Min. Negotiated Rate	$137.88
Max. Negotiated Rate	$2,860.57
Rate for Payer: Aetna Commercial	$2,174.04
Rate for Payer: Aetna Medicare Advantage	$1,716.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,458.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,458.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,144.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,458.89
Rate for Payer: Cigna Commercial	$2,860.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,384.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,258.65
Rate for Payer: Qualcare PPO/HMO/WC	$858.17
Rate for Payer: UnitedHealthcare Community & State	$137.88
Rate for Payer: Wellpoint Medicaid Managed Care	$151.61

PLATECLAVICLE3.5MMLCP5HRT94MM

Facility

$5,721.15

Service Code	HCPCS C1713
Hospital Charge Code	270697376
Hospital Revenue Code	278
Min. Negotiated Rate	$858.17
Max. Negotiated Rate	$1,384.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,144.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,384.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,258.65
Rate for Payer: Qualcare PPO/HMO/WC	$858.17

PLATE CLAVICLE 6 HOLE

Facility

$9,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270672584
Hospital Revenue Code	278
Min. Negotiated Rate	$1,377.00
Max. Negotiated Rate	$2,221.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,836.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,221.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,019.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,377.00

PLATE CLAVICLE 6 HOLE

Facility

$9,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270672584
Hospital Revenue Code	278
Min. Negotiated Rate	$221.24
Max. Negotiated Rate	$4,590.00
Rate for Payer: Aetna Commercial	$3,488.40
Rate for Payer: Aetna Medicare Advantage	$2,754.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,340.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,340.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,836.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,340.90
Rate for Payer: Cigna Commercial	$4,590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,221.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,019.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,377.00
Rate for Payer: UnitedHealthcare Community & State	$221.24
Rate for Payer: Wellpoint Medicaid Managed Care	$243.27

PLATE CLAVICLE SUPER 3.5MM 8 H

Facility

$4,460.30

Service Code	HCPCS C1776
Hospital Charge Code	270689730
Hospital Revenue Code	278
Min. Negotiated Rate	$669.04
Max. Negotiated Rate	$1,079.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$892.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,079.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$981.27
Rate for Payer: Qualcare PPO/HMO/WC	$669.04

PLATE CLAVICLE SUPER 3.5MM 8 H

Facility

$4,460.30

Service Code	HCPCS C1776
Hospital Charge Code	270689730
Hospital Revenue Code	278
Min. Negotiated Rate	$107.49
Max. Negotiated Rate	$2,230.15
Rate for Payer: Aetna Commercial	$1,694.91
Rate for Payer: Aetna Medicare Advantage	$1,338.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,137.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,137.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$892.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,137.38
Rate for Payer: Cigna Commercial	$2,230.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,079.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$981.27
Rate for Payer: Qualcare PPO/HMO/WC	$669.04
Rate for Payer: UnitedHealthcare Community & State	$107.49
Rate for Payer: Wellpoint Medicaid Managed Care	$118.20

PLATE CLAVICLE WITH LAT EXT

Facility

$4,904.45

Service Code	HCPCS C1713
Hospital Charge Code	270688478
Hospital Revenue Code	278
Min. Negotiated Rate	$118.20
Max. Negotiated Rate	$2,452.22
Rate for Payer: Aetna Commercial	$1,863.69
Rate for Payer: Aetna Medicare Advantage	$1,471.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,250.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,250.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$980.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,250.63
Rate for Payer: Cigna Commercial	$2,452.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,186.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,078.98
Rate for Payer: Qualcare PPO/HMO/WC	$735.67
Rate for Payer: UnitedHealthcare Community & State	$118.20
Rate for Payer: Wellpoint Medicaid Managed Care	$129.97

Know your out-of-pocket cost for care.

All Charges