Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE CLAVICLE WITH LAT EXT

Facility

$4,904.45

Service Code	HCPCS C1713
Hospital Charge Code	270688478
Hospital Revenue Code	278
Min. Negotiated Rate	$735.67
Max. Negotiated Rate	$1,186.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$980.89
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

PLATE CLAV LT MED LOCK PLCL8ML

Facility

$3,475.00

Hospital Charge Code	270638666
Hospital Revenue Code	278
Min. Negotiated Rate	$521.25
Max. Negotiated Rate	$840.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$764.50
Rate for Payer: Qualcare PPO/HMO/WC	$521.25

PLATE CLAV LT MED LOCK PLCL8ML

Facility

$3,475.00

Hospital Charge Code	270638666
Hospital Revenue Code	278
Min. Negotiated Rate	$83.75
Max. Negotiated Rate	$1,737.50
Rate for Payer: Aetna Commercial	$1,320.50
Rate for Payer: Aetna Medicare Advantage	$1,042.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$886.12
Rate for Payer: Cigna Commercial	$1,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$764.50
Rate for Payer: Qualcare PPO/HMO/WC	$521.25
Rate for Payer: UnitedHealthcare Community & State	$83.75
Rate for Payer: Wellpoint Medicaid Managed Care	$92.09

PLATE CLAW II 2HOLE 20MM

Facility

$10,675.00

Service Code	HCPCS C1713
Hospital Charge Code	270676415
Hospital Revenue Code	278
Min. Negotiated Rate	$1,601.25
Max. Negotiated Rate	$2,583.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,583.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,348.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,601.25

PLATE CLAW II 2HOLE 20MM

Facility

$10,675.00

Service Code	HCPCS C1713
Hospital Charge Code	270676415
Hospital Revenue Code	278
Min. Negotiated Rate	$257.27
Max. Negotiated Rate	$5,337.50
Rate for Payer: Aetna Commercial	$4,056.50
Rate for Payer: Aetna Medicare Advantage	$3,202.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,722.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,722.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,722.12
Rate for Payer: Cigna Commercial	$5,337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,583.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,348.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,601.25
Rate for Payer: UnitedHealthcare Community & State	$257.27
Rate for Payer: Wellpoint Medicaid Managed Care	$282.89

PLATE CLC FRAC PERIMETER SM

Facility

$6,620.00

Service Code	HCPCS C1713
Hospital Charge Code	270667699
Hospital Revenue Code	278
Min. Negotiated Rate	$159.54
Max. Negotiated Rate	$3,310.00
Rate for Payer: Aetna Commercial	$2,515.60
Rate for Payer: Aetna Medicare Advantage	$1,986.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,688.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,688.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,688.10
Rate for Payer: Cigna Commercial	$3,310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,602.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,456.40
Rate for Payer: Qualcare PPO/HMO/WC	$993.00
Rate for Payer: UnitedHealthcare Community & State	$159.54
Rate for Payer: Wellpoint Medicaid Managed Care	$175.43

PLATE CLC FRAC PERIMETER SM

Facility

$6,620.00

Service Code	HCPCS C1713
Hospital Charge Code	270667699
Hospital Revenue Code	278
Min. Negotiated Rate	$993.00
Max. Negotiated Rate	$1,602.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,324.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,602.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,456.40
Rate for Payer: Qualcare PPO/HMO/WC	$993.00

PLATE CLC FRAC STD X-SM/SM

Facility

$6,620.00

Hospital Charge Code	270656830
Hospital Revenue Code	278
Min. Negotiated Rate	$159.54
Max. Negotiated Rate	$3,310.00
Rate for Payer: Aetna Commercial	$2,515.60
Rate for Payer: Aetna Medicare Advantage	$1,986.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,688.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,688.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,688.10
Rate for Payer: Cigna Commercial	$3,310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,602.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,456.40
Rate for Payer: Qualcare PPO/HMO/WC	$993.00
Rate for Payer: UnitedHealthcare Community & State	$159.54
Rate for Payer: Wellpoint Medicaid Managed Care	$175.43

PLATE CLC FRAC STD X-SM/SM

Facility

$6,620.00

Hospital Charge Code	270656830
Hospital Revenue Code	278
Min. Negotiated Rate	$993.00
Max. Negotiated Rate	$1,602.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,324.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,602.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,456.40
Rate for Payer: Qualcare PPO/HMO/WC	$993.00

PLATE CLOVERLEAF

Facility

$1,792.20

Service Code	HCPCS C1713
Hospital Charge Code	270655699
Hospital Revenue Code	278
Min. Negotiated Rate	$43.19
Max. Negotiated Rate	$896.10
Rate for Payer: Aetna Commercial	$681.04
Rate for Payer: Aetna Medicare Advantage	$537.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$457.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$457.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$358.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$457.01
Rate for Payer: Cigna Commercial	$896.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$394.28
Rate for Payer: Qualcare PPO/HMO/WC	$268.83
Rate for Payer: UnitedHealthcare Community & State	$43.19
Rate for Payer: Wellpoint Medicaid Managed Care	$47.49

PLATE CLOVERLEAF

Facility

$1,792.20

Service Code	HCPCS C1713
Hospital Charge Code	270655699
Hospital Revenue Code	278
Min. Negotiated Rate	$268.83
Max. Negotiated Rate	$433.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$358.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$394.28
Rate for Payer: Qualcare PPO/HMO/WC	$268.83

PLATE CLOVERLEAF 3H 88MM

Facility

$1,291.60

Service Code	HCPCS C1713
Hospital Charge Code	270604061
Hospital Revenue Code	278
Min. Negotiated Rate	$193.74
Max. Negotiated Rate	$312.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$258.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.15
Rate for Payer: Qualcare PPO/HMO/WC	$193.74

PLATE CLOVERLEAF 3H 88MM

Facility

$1,291.60

Service Code	HCPCS C1713
Hospital Charge Code	270604061
Hospital Revenue Code	278
Min. Negotiated Rate	$31.13
Max. Negotiated Rate	$645.80
Rate for Payer: Aetna Commercial	$490.81
Rate for Payer: Aetna Medicare Advantage	$387.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$329.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$329.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$258.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$329.36
Rate for Payer: Cigna Commercial	$645.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.15
Rate for Payer: Qualcare PPO/HMO/WC	$193.74
Rate for Payer: UnitedHealthcare Community & State	$31.13
Rate for Payer: Wellpoint Medicaid Managed Care	$34.23

PLATE CLOVERLEAF 8 HOLES

Facility

$2,224.80

Service Code	HCPCS C1713
Hospital Charge Code	270655707
Hospital Revenue Code	278
Min. Negotiated Rate	$53.62
Max. Negotiated Rate	$1,112.40
Rate for Payer: Aetna Commercial	$845.42
Rate for Payer: Aetna Medicare Advantage	$667.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$567.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$567.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$444.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$567.32
Rate for Payer: Cigna Commercial	$1,112.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$538.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$489.46
Rate for Payer: Qualcare PPO/HMO/WC	$333.72
Rate for Payer: UnitedHealthcare Community & State	$53.62
Rate for Payer: Wellpoint Medicaid Managed Care	$58.96

PLATE CLOVERLEAF 8 HOLES

Facility

$2,224.80

Service Code	HCPCS C1713
Hospital Charge Code	270655707
Hospital Revenue Code	278
Min. Negotiated Rate	$333.72
Max. Negotiated Rate	$538.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$444.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$538.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$489.46
Rate for Payer: Qualcare PPO/HMO/WC	$333.72

PLATE CLOVERLEAF THIN

Facility

$1,424.50

Service Code	HCPCS C1713
Hospital Charge Code	270655698
Hospital Revenue Code	278
Min. Negotiated Rate	$213.68
Max. Negotiated Rate	$344.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$213.68

PLATE CLOVERLEAF THIN

Facility

$2,034.00

Service Code	HCPCS C1713
Hospital Charge Code	270655705
Hospital Revenue Code	278
Min. Negotiated Rate	$49.02
Max. Negotiated Rate	$1,017.00
Rate for Payer: Aetna Commercial	$772.92
Rate for Payer: Aetna Medicare Advantage	$610.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$518.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$518.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$406.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$518.67
Rate for Payer: Cigna Commercial	$1,017.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$492.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$447.48
Rate for Payer: Qualcare PPO/HMO/WC	$305.10
Rate for Payer: UnitedHealthcare Community & State	$49.02
Rate for Payer: Wellpoint Medicaid Managed Care	$53.90

PLATE CLOVERLEAF THIN

Facility

$1,424.50

Service Code	HCPCS C1713
Hospital Charge Code	270655698
Hospital Revenue Code	278
Min. Negotiated Rate	$34.33
Max. Negotiated Rate	$712.25
Rate for Payer: Aetna Commercial	$541.31
Rate for Payer: Aetna Medicare Advantage	$427.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.25
Rate for Payer: Cigna Commercial	$712.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$213.68
Rate for Payer: UnitedHealthcare Community & State	$34.33
Rate for Payer: Wellpoint Medicaid Managed Care	$37.75

PLATE CLOVERLEAF THIN

Facility

$1,331.80

Service Code	HCPCS C1713
Hospital Charge Code	270655695
Hospital Revenue Code	278
Min. Negotiated Rate	$199.77
Max. Negotiated Rate	$322.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$266.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$322.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$293.00
Rate for Payer: Qualcare PPO/HMO/WC	$199.77

PLATE CLOVERLEAF THIN

Facility

$1,331.80

Service Code	HCPCS C1713
Hospital Charge Code	270655695
Hospital Revenue Code	278
Min. Negotiated Rate	$32.10
Max. Negotiated Rate	$665.90
Rate for Payer: Aetna Commercial	$506.08
Rate for Payer: Aetna Medicare Advantage	$399.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$339.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$339.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$266.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$339.61
Rate for Payer: Cigna Commercial	$665.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$322.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$293.00
Rate for Payer: Qualcare PPO/HMO/WC	$199.77
Rate for Payer: UnitedHealthcare Community & State	$32.10
Rate for Payer: Wellpoint Medicaid Managed Care	$35.29

PLATE CLOVERLEAF THIN

Facility

$2,034.00

Service Code	HCPCS C1713
Hospital Charge Code	270655705
Hospital Revenue Code	278
Min. Negotiated Rate	$305.10
Max. Negotiated Rate	$492.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$406.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$492.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$447.48
Rate for Payer: Qualcare PPO/HMO/WC	$305.10

PLATE CLOVERLEAF THIN 10HOLES

Facility

$2,334.00

Service Code	HCPCS C1713
Hospital Charge Code	270655708
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$1,167.00
Rate for Payer: Aetna Commercial	$886.92
Rate for Payer: Aetna Medicare Advantage	$700.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$595.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$595.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$466.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$595.17
Rate for Payer: Cigna Commercial	$1,167.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$564.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$513.48
Rate for Payer: Qualcare PPO/HMO/WC	$350.10
Rate for Payer: UnitedHealthcare Community & State	$56.25
Rate for Payer: Wellpoint Medicaid Managed Care	$61.85

PLATE CLOVERLEAF THIN 10HOLES

Facility

$2,334.00

Service Code	HCPCS C1713
Hospital Charge Code	270655708
Hospital Revenue Code	278
Min. Negotiated Rate	$350.10
Max. Negotiated Rate	$564.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$466.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$564.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$513.48
Rate for Payer: Qualcare PPO/HMO/WC	$350.10

PLATE CLOVERLEAF THIN 6 HOLES

Facility

$1,946.70

Service Code	HCPCS C1713
Hospital Charge Code	270655702
Hospital Revenue Code	278
Min. Negotiated Rate	$46.92
Max. Negotiated Rate	$973.35
Rate for Payer: Aetna Commercial	$739.75
Rate for Payer: Aetna Medicare Advantage	$584.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$496.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$496.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$389.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$496.41
Rate for Payer: Cigna Commercial	$973.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$428.27
Rate for Payer: Qualcare PPO/HMO/WC	$292.00
Rate for Payer: UnitedHealthcare Community & State	$46.92
Rate for Payer: Wellpoint Medicaid Managed Care	$51.59

PLATE CLOVERLEAF THIN 6 HOLES

Facility

$1,946.70

Service Code	HCPCS C1713
Hospital Charge Code	270655702
Hospital Revenue Code	278
Min. Negotiated Rate	$292.00
Max. Negotiated Rate	$471.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$389.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$428.27
Rate for Payer: Qualcare PPO/HMO/WC	$292.00

Know your out-of-pocket cost for care.

All Charges